Bell, Michael Subject: Canceled: Call w! Rep. Renacci Location: Start: Sun 3/12f2017 5:00 PM End: Sun 3(123?2017 5:30 PM Show Time As: Free Recurrence: (none) Meeting Status: Not yet responded Organizer: (W6) Required Attendees: Harrison, Jeseica Kristin Twomey, John Ara manda, Alec McGuffee. Tyler Ann Leggitt, Lance (HHSXIOS) Scheduler number? 2017--000001 Confidential Pre?decisional Draft (W5) 2017--000002 Confidential Pre?decisional Draft 2017--000003 Bell, Michael Subject: Location: Start: End: Recurrence: Meeting Status: Organizer: Required Attendees: Optional Attendees: Staff: Carla and Demetrios Attendees: Marshall Roe Buschon Babin Ferguson DesJarIais Abraham Gosar Black Wenstrup Carter Dunn Murphy Brugess Topic: Mtg. w! Doctors Cacus Secretary's Large Conference Room Fri 31?17/2017 7:30 AM Fri 8:15 AM (none) Accepted ?33(5) (osrlosi DiBlasio, Carla Kouzoukas, Demetrios Leggitt, Lance Harrison, Jessica Kristin Twomey, John K. Aramandai Alec McGuffee, Tyler Ann Morse, Sara (HHSIASL) The discussion will be about the regulatory efforts that HHS plans to undertake, as well as how the Docs Caucus can be helpful in messaging the ACA replacement. They just want the opportunity to connect with Dr. Price in a less formal setting than some of these Conference meetings. 2017--000004 Confidential Pre?decisional Draft (W5) 2017--000005 Confidential Pre?decisional Draft (MG) 2017--000006 Confidential Pre?decisional Draft 2017--000007 Confidential Pre?decisional Draft (110(5) 2017--000008 Confidential Pre?decisional Draft 2017--000009 Confidential Pre?decisional Draft 2017--000010 Confidential Pre?decisional Draft (133(5) 2017--000011 Bell, Michael Subject: Mtg. w! Senator Orrin Hatch and GOP Members of the Senate Finance Committee Location: 5?124; US. Capitol Start: Wed 3/15/2017 10:30 AM End: Wed 3/15/2017 11:30 AM Recurrence: (none) Meeting Status: Accepted Organizer: (mus) (OSHOS) Required Attendees: Harrison, Jessica Kristin Twomey, John Leggitt, Lance (H Aramanda, Alec McGu??ee, Tyler Ann Tepic: Healthcare Bill The Republican senators attending are: Senators Hatch, Grassley, Crapo, Roberts, Enzi, Cornyn, Thune, Burr, Portman, Toomey, Heller, Scott, and Cassidy. 2017--000012 Confidential Pre?decisional Draft (E05) 2017--000013 Confidential Pre?decisional Draft (W5) 2017--000014 Confidential Pre?decisional Draft (W5) 2017--000015 Confidential Pre?decisional Draft (W5) 2017--000016 Confidential Pre?decisional Draft (W5) 2017--000017 Confidential Pre?decisional Draft (W5) 2017--000018 Confidential Pre?decisional Draft (13125) 2017--000019 Confidential Pre?decisional Draft (W5) 2017--000020 Confidential Pre?decisional Draft 2017--000021 Confidential Pre?decisional Draft (W5) 2017--000022 Confidential Pre?decisional Draft (W5) 2017--000023 Bell, Michael Subject: Location: Start: End: Show Time As: Recurrence: Meeting Status: Organizer: Required Attendees: Secretary Price House LHHS Appropriations Subcommittee Hearing Prep Session - Hearing Overview 81 Strategy Large conference room- 610-F Wed 3/22f2017 4:00 PM Wed 3I22f2017 4:30 PM Tentative (none) Tentatively accepted Klimczak, Kate (HHSXASFR) Moughalian, Jen Brooks, John Wynne, Maggie Stannard, Paula Flick, Heather Schaefer, Nina Horn, Wade Kristin Leggitt, Lance Lapinski, Mary-Sumpter Street, Amanda Cochran, Norris Coughlin, Janis Pollock, Rachel Harrison, Jessica Brennan, Patrick Murphy, Ryan (OSKASPA) The meeting has been moved to 4pm; a meeting agenda is attached. Also included below are the hearing prep materials that went to the Secretary last night. He received a hearing memo, draft written testimonyr for review, briefing papers, and Member profiles. ii ?Pill? I ii iE: l: 1an iiur mirr 2017--000024 Secretary Price House LHHS Appropriations Subcommittee Hearing Prep Session Hearing Overview Strategy Session March 4pm 4:30pm Agenda: I. Hearing logistics 0 Hearing Structure Staf?ng needs Press De?nition of success Other Budget hearings 0000 II. Member Call Time Testimony 0 Written testimony 0 Oral testimony IV. Guidance on hearing prep Brie?ng papers 0 sessions 0 AHCA Prep 0 Member Polling V. Hearing Strategy (W5) 2017--000025 . Fe ?1 if: A DEPARTMENT OF HEALTH 3; HUMAN SERVICES Of?ce of the Secretary 2% Washington, DC. 20201 DATE: March 21, 2017 TO: Thomas E. Price, M.D., Secretary FROM: Jen Moughalian, Acting Assistant Secretary for Financial ResourcesuniM CC: John Brooks Heather Flick Wade Horn Mary-Sumpter Lapinski Lance Leggitt Nina Schaefer Kristin Paula Stannard Amanda Street Maggie Wynne SUBJECT: Appropriations Hearing Preparation INFORMATION Details Hoose Laborp?HHS Subcommittee Appropriations Hearing Date: Wednesday, March 29 Time: 10:00 am. Attendees: Jen Moughalian, Norris Cochran Overview On Wednesday, March 29m you are scheduled to testify before the House Appropriations Subcommittee for Labor, Health and Human Services, Education, and Related Agencies on the President?s FY 2018 Budget Blueprint. We have prepared brie?ng materials for you based on key themes in the HHS chapter of the Budget Blueprint and current hot topics in health and human services policy, as well as issues of Speci?c interest to Committee Members based on incoming letters and staff interaction. In this brie?ng book you will ?nd: - Draft written testimony for your review; a Brie?ng papers on select policy issue areas; and I House LaborfI-IHS Appropriations Subcommittee Member Pro?les. Your brie?ng papers are organized by issue area (HHS cross-cutting issues, public health, and human services). Prior to the hearing, ASF will engage with subcommittee staff on potential topics and questions that may come up at the hearing (we refer to this as ?member polling"). Based on those conversations, ASFR will provide additional papers or talking points as needed. 2017-?000026 We currently have four brie?ngs scheduled to help you prepare for this hearing: Wednesday, March 22, 11:30am 12:00pm to discuss overaii hearing strategy; Friday, March 24, 3 :30?4z3 0pm to answer any questions you have from the brie?ng book and conduct practice I Monday, March 27, 3:30-4:30pm to conduct practice and 0 Tuesday, March 28, 3:30-4:00pm to review member polling and address any ?nal concerns. We also have set aside time on your calendar on Monday, March 27th for you to make calls to all the members of the subcommittee. Reaching out to Members of Congress before your hearing allows you the opportunity to check in before the hearing and take the temperature of members. These calls are informal and may be placed personally or arranged through your scheduler. Committee Activity in the 115''1 Congress Last week, the House LaboerHS Appropriations Subcommittee held a hearing entitled ?Investing in the Future?Early Childhood Education Programs at the Department of Health and Human Services.? There were no government witnesses. During that hearing, members expressed concern over the possibility of deep cuts to Head Start and the impacts those cuts would have to the current waitlist for Head Start programs. Members were also concerned that cuts to Early Head Start and Head Start would undermine the results experts hoped to see in those programs. Members also asked questions about Federal funding for Head Start and the Child Care Block Grant. Enclosures A. Draft written testimony B. Brie?ng Papers C. MemberPro?les 2017??000027 Page 028 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000028 Page 029 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000029 Page 030 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000030 Page 031 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000031 Page 032 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000032 Page 033 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000033 Page 034 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000034 Page 035 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000035 Page 035 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000036 Page 03? 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000037 Page 038 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000038 Page 039 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000039 Page 040 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000040 Page 041 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000041 Page 042 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000042 Page 043 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000043 Page 044 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000044 Page 045 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000045 Page 045 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000046 Page 04? 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000047 Page 048 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000048 Page 049 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000049 Page 050 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000050 Page 051 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000051 Page 052 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000052 Page 053 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000053 Page 054 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000054 Page 055 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000055 Page 055 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000056 Page 05? 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000057 Page 058 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000058 Page 059 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000059 Page 060 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000060 Page 061 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000061 Page 062 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000062 Page 063 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000063 House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies Jurisdiction: The panel oversees all of the Departments of Education and Labor and a large portion of the Health and Human Services Department (except for the FDA, IHS, National Institute of Environmental Sciences, and the Agency for Toxic Substances and Disease Registry). In addition, the subcommittee oversees the Social Security Administration, Medicaid and Payment and Access Commission, Medicare Payment Advisory Commissions, and several other related, smaller agencies. Members in the 115?1 Congress Maioritv {8 Republicans) Tom Cole, OK Chairman Mike Simpson, Steve Womack, AK, Vice Chair Chuck TN Andy Harris, MD Martha Roby, AL Jamie Herrera Bcutlcr, WA John Moolenaar, Ml Rodney Frelinghuysen, NJ (ex of?cio) Minority (5 Democrats) Rosa DeLauro, CT Ranking Member Lucille Roybal-Allard, CA Barbara Lee, CA Mark Pecan, WI Katherine Clark, MA Nita Lowey, NY (ex of?cio} 2017--000064 Maiorig; REP. TOM COLE (R), CHAIRMAN District of Oklahoma South central Norman, Lawton, part of Oklahoma City Residence: Moore Born: April 28; 1949; Shreveport, Louisiana Religion: Methodist Family: Wife; Ellen Cole; one child Education: Grinnell College, BA. 1971 (history); Yale MA. 19?4 (British history); U. of Oklahoma, 1984 (19th Century British history) Military Service: None Career: Political consultant; party of?cial; congressional district director; professor First Elected: 2002 (8th term) Latest Election: 2016 General (69.63%) Political Highlights: Okla. Republican Party chairman, 1985-89; Okla. Senate, 1989-91; Okla. secretary of state, l995-99 Committees: Appropriations (LHHS Chairman, Defense; Interior); Budget; and Ru] (W5) 2017--000065 {bll{5l 2017--000066 REP. MIKE SIMPSON (R) 2nd District of Idaho East -- Pocatello, Idaho Falls, part of Boise Residence: Idaho Falls Born: Sept. 8, 1950; Barley, Idaho Religion: Mormon Family: Wife, Kathy Simpson Education: Utah State U., attended 1968-72 (pro-dentistry); Washington U. D.M.D. 1977; Utah State U., 3.8. 2002 (pro-dentistry] Military Service: None Career: Dentist First Elected: 1998 (10th term) Latest Election: 20l6 General (62.93%) Political Highlights: Blackfoot City Council, l980-84, Idaho House, 1984-98 (speaker, 1992- 98) Committees: Appropriations (Energy-Water chairman; Interior-Environment; Labor-HHS- Education) (bll5l 2017--000067 REP. STEVE WOMACK (R), 3rd District of Arkansas Northwest Fort Smith, Fayetteville Residence: Rogers Born: Feb. 18; 1957; Russellville, Arkansas Religion: Southern Baptist Family: Wife, Terri Womack; three children Education: Arkansas Tech, BA. 1979 (speech) Military Service: Ark. National Guard 1979-2009 Career: Securities broker; college ROTC program director; radio station manager; National Guard First Elected: 2010 (41" term) Latest Election: 2016 General (77.32 Political Highlights: Rogers City Council, 1983-84, 1997-98; mayor of Rogers, 1999-2010 Committees: Appropriations Defense; Financial Services); Budget {131(5) 2017--000068 REP. CHUCK FLEISCHMANN (R) 3rd District of Tennessee East Chattanooga, Oak Ridge Residence: Ooltewah Born: Oct. 1 l, 1962; Manhattan, New York City, New York Religion: Roman Catholic Family: Wife, Brenda Fleischmann; three children Education: U. of Illinois, B.A.L.A.S. 1983 (political science); U. of Tennessee, JD. I986 Military Service: None Career: Attorney First Elected: 2010 (44lh term) Latest Election: 2016 General (66.39%) Political Highlights: No previous of?ce Committees: Appropriations Energy Water; Homeland Security) (bli5l 2017--000069 REP. ANDY HARRIS (R) District of Maryland Northeast and Eastern Shore Residence: Cockeysville Born: Jan. 25, 1957; Brooklyn, New York Religion: Roman Catholic Family: Widowed; ?ve children Education: U. of attended 1973-75; Johns Hopkins U., BA. 1977' (human biology), MD. 1980, M.H.S. 1995 (health ?nance 8; management) Military Service: Navy Reserve 1988-2005 Career: Physician (Anesthesiologist) First Elected: 2010 (3rd term) Latest Election: 2016 General (66.99%) Political Highlights: MD Senate, 1999-2010 (Republican whip, 2003-06); Republican nominee for US. House, 2008 Committees: Appropriations (LHHS, Commerce, Justice, and Related Agencies) (131(5) 2017--000070 2017--000071 REP. MARTHA ROBY (R) 2nd District of Alabama Southeast part of Montgomery, Dothan Residence: Montgomery Born: July 26, 1976; Montgomery, AL Religion: Presbyterian Family: Husband, Riley Roby; two children Education: New York U., BM. 1998 (music, business and technology); Samford U., JD. 200] Military Service: None . Career: Lawyer First Elected: 2010 (3rd term) Latest Election: 2016 General (48.77%) Political Highlights: Montgomery City Council, 2004-l 1 Committees: Appropriations (LHHS, Legislative Branch, Military Constructiom?VA); Benghazi Attack (131(5) 2017--000072 REP. JAMIE HERRERA BEUTLER (R) 3rd District of Washington, Southwest Washington Residence: Battle Ground Born: November 3, 1978; Glendale, CA Religion: Christian Family: Husband, Daniel Beutler; two children Education: University of Washington, BA. 2004 (Communications) Military Service: None Career: Congressional aide First Elected: 2010 (4th term) Latest Election: 2016 General Political Highlights: Congressional aide for Congresswomcn Cathy MeMorris Rodgers (R- WA), State Representative (R-WA, District 18) Committees: Appropriations Energy and Water; Financial Services) {131(5) 2017--000073 REP. JOHN MOOLENAAR (R) 4th District of Michigan, Midland, Mt. Pleasant Residence: Midland Born: May IS, 196]; Midland, MI Religion: Christian Family: Wife, Amy Moolenaar; six children Education: Hope College, BS. 1983 (Chemistry); Harvard University, MPA I989 Military Service: None. Career: Chemist, worked at Dow Chemical Company First Elected: 2014 (2rd term) Latest Election: 2016 General Political Highlights: State Representative (R-MI, District 98), Michigan House of Representatives; State Senator (R-MI, District 36), Michigan Senate Committees: Appropriations Financial Services; Legislative Branch) {bli5l 2017--000074 REP. RODNEY FRELINGHUYSEN (R) 11th District of New Jersey, North Central?eastern Morris Country, Wayne Residence: Harding Born: April 29, 1946; Manhattan, NY Religion: Episcopalian Family: Wife, Virginia; two children Education: Hobart College, BA. 1969 (American History) Military Service: Army, 1969 1971 Career: County board aide First Elected: 1994 (12?1?term) Latest Election: 2016 General Political Highlights: Morris County Board of reeholders (1974 1983]; New Jersey Assembly, 1983 1994 Committees: Appropriations, Chairman (131(5) 2017--000075 Minority REP. ROSA DELAURO (D) 3rd District of Connecticut South -- New Haven, Milford Residence: New Haven Born: March 2, 1943; New Haven, Conn. Religion: Roman Catholic Family: Husband, Stanley Greenberg; three children Education: London School of Economics, attended 1962-63; Marymount College (N.Y.), BA. 1964; Columbia U., MA. 1966 (international politics) Military Service: None Career: Political activist; congressional and mayoral aide First Elected: 1990 (14'1? term) Latest Election: 2016 General Political Highlights: No previous of?ce Committees: Appropriations (LHHS - ranking member; Agriculture) (W5) 2017--000076 East Los Angeles; Downey Residence: Downey Born: June 12, 1941; Boyle Heights, Calif. Religion: Roman Catholic Family: Husband, Edward Allard; four children Military Service: None Career: Nonpro?t worker First Elected: 1992 (13?1 term) Latest Election: 2016 General Political Highlights: Calif. Assembly: 1937-92 Committees: Appropriations Homeland Security - ranking member) REP. LUCILLE ROYBAL-ALLARD (D) 40th District of California Education: California State U., Los Angeles, BA. 1965 (speech therapy) (W5) 2017--000077 REP. BARBARA LEE (D) 13th District of California Northwest Alameda County -- Oakland, Berkeley Residence: Oakland Born: July 16, 1946; El Paso, Texas Religion: Baptist Family: Divorced; two children Education: Mills College, BA. 1973 U. of California, Berkeley, M.S.W. 197'5 Military Service: None Career: Congressional aide First Elected: 1998 (9th full term) Latest Election: 2014 General (88.48%) Political Highlights: Calif. Assembly, 1990-96; Calif. Senate, 1996-98 Committees: Appropriations Military Construction-VA; State-Foreign Operations); Budget {bli5l 2017--000078 REP. MARK POCAN (D) District of Wisconsin, Sou Residence: Madison Born: August 14, 1964; Kenosha, WI Religion: Unspeci?ed Family: Husband, Philip Frank Education: University of Wisconsin, BA. 1986 (journalism) Military Service: None Career: Sign manufacturing company owner First Elected: 2012 (31"Cl full term) Latest Election: 2014 General th?Madison Political Highlights: Dane County Board ofSupervisors, 1991-96; Wis. Assembly, 1999-2013 Committees: Appropriations Agriculture) {131(5) 2017--000079 REP. KATHERINE CLARK (D) 5th District of Massachusetts, North and west Boston suburbs; Framingham Residence: Melrose Born: July 17, 1963; New Haven, Connecticut Religion: Protestant Family: Husband, Rodney Dowell; three children - - Education: St. Lawrence University BA. 1985 (history); Cornell University JD. 1989; Harvard University, M.P.A. 1997 Military Service: None Career: Attorney; state assistant attorney general First Elected: 2013 (2?'21 full term) Latest Election: 2016 General Political Highlights: Mass. House, 2008-1 1; Mass. Senate, 2011-13 Committees: Appropriations Transportation-HUD) (W5) 2017--000080 REP. NITA LOWEY (D) 18th District of New York Rockland and part of Westchester counties White Plains, Peekskill Residence: Born: July 5, 193?; Bronx, New York Religion: Jewish Family: Husband, Stephen Lowe-y; three children Education: Mount Holyoke College, BA, 1955-59 (political science) Military Service: None Career: State government aide; homemaker First Elected: 1988 (15th term) Latest Election: 2016 General Political Highlights: NY. Assistant Secretary of State, 1985?87 Committees: Appropriations Ranking Member (State Foreign Ops - Ranking Member) (bit5l 2017--000081 Bell, Michael Subject: Start: End: Recurrence: Organizer: Strategic health care reform meeting Fri 9:30 AM Fri 2217/2017 10:00 AM (none) (W53 (05/105) Note: Lance will advise which senior staff needs to attend 2017--000082 Bell, Michael Subject: Location: Start: End: Recurrence: Meeting Status: Organizer: Required Attendees: Contact: Kendall Kelley Call w! Rep. Matt Gaetz Sun 3/12f2017 1:00 PM Sun 3f12j2017 1:30 PM (none) Accepted 05/105) Harrison, Jessica Kristin Twemey, John Leggitt. Lance (H Aramanda, Alec McGuffee, Tyler Ann (HHSXIOS) 2017--000083 Confidential Pre?decisional Draft (W5) 2017--000084 Confidential Pre?decisional Draft (W5) 2017--000085 Bell, Michael Subject: Call w/ Rep. McClintock Location: Start: Sun 3/12f2017 12:30 PM End: Sun 3/l2f2017 1:00 PM Recurrence: (none) Meeting Status: Accepted Organizer: (We) Required Attendees: Harrison, Jessica Kristin Twomey, John Leggitt. Lance (H Aramanda, Alec McGuffee, Tyler Ann Back lit-i: Ii. 2017--000086 Confidential Pre?decisional Draft (W5) 2017--000087 Bell, Michael Subject: Call w! Rep Dave Brat Location: Start: Sun 3/12f2017 6:00 PM End: Sun 3f12j2017 6:30 PM Recurrence: (none) Meeting Status: Accepted Organizer: (OSXIOS) Required Attendees: Harrison, Jessica Kristin Twomey. John Ara manda. Alec McGuffee, Tyler Ann Leggitt, Lance Contact: Zoe O?Herin 2017--000088 Confidential Pre?decisional Draft (13125) 2017--000089 Confidential Pre?decisional Draft (MG) 2017--000090 Bell, Michael Subject: Call w! Senator Murkowski Location: Start: Thu 3f16/2017 2:15 PM End: Thu 3/16/2017 2:45 PM Recurrence: (none) Meeting Status: Accepted Organizer: Required Attendees: Harrison, Jessica Kristin Tworney, John K.: Leggitt. Lance Aramanda, Alec McGu??ee, Tyler Ann Contactzl?omi The senator will call John and he will patch her through to Dr. Price Senators numberjust in case-) (We) 2017--000091 Confidential Pre?decisional Draft (W15) 2017--000092 Confidential Pre?decisional Draft (Mi) 2017--000093 Confidential Pre?decisional Draft (W5) 2017--000094 Bell, Michael Subject: Location: Start: End: Recurrence: Meeting Status: Organizer: Required Attendees: Call w! Senator Sullivan (W5) Tue 3121/2017 11:30 AM Tue 3f21f2017 12:00 PM (none) Accepted (osnos; Harrison, Jessica Kristin Twomey. John K. Leggitt, Lance Arbes, Sarah Morse, Sara Schedulers direct and scheduler will patch TEP into the Senator Suggested Messages: ll - 31: II 'ilize?illili ll F's} 2017--000095 {Ll 5l i iltl-?Hk? Sen. Dan Sullivan (R?Alaska) Junior Senator from Alaska ResidencezAnchorage BermNov. 13. 1964; Fairview Park, Ohio Religion:Roman Catholic Family:Wife, Julie Fate Sullivan; three children Education?larvard U., AB. 1987 (economics); U. ot?Birmingham (England), MA. 1988; Georgetown U., M.S.F.S. 1993, JD. 1993 Military Service:Marine Corps 1993-1997; Marine Corps Reserve l997-present (awarded Defense Meritorious Service Medal} Career:White House aide; lawyer; author First Elected?OM {1 st term); Defeated Sen. Mark Begieh, Latest Election:2[ll4 General (47.96%) Political Highlights:U.S. State Department assistant secretary for economic and business affairs, 2006?09; Alaska attorney general, 2009?] OAlaska Department of Natural Resources commissioner, 2010?13 Committees: 0 Armed Services (Airland; Seapower; Strategic Forces} 0 Commerce, Science Transportation (Aviation Operations, Safety Sc Security: Communications, Technology, Innovation the Internet; Oceans, Atmosphere, Fisheries Coast Guard - chairman; Space, Science Sc Competitiveness) 0 Environment 8: Public Works (Fisheries, Wildlife Water: Superfund, Waste Management Regulatory Oversight; Transportation 85 Infrastructure) 0 Veterans' Affairs Phone:202-224-3DO4 Faxz202?224?6501 702 Hart Bldg. Washington, DC 20510 CQ Politics in America Profile (Updated: June 17, 2015) Energy policy and other natural resource issues will likely be the driving force in Sullivan?s tenure, as it has been for his Alaska colleague, senior Sen. Lisa Murkowski, who chairs the Energy and Natural Resources Committee. Sullivan has foreign policy credentials and was Alaska?s attorney general, but he also directed the state?s Department of Natural Resources and in the George W. Bush administration?s State Department, he worked on 2017--000096 international energy policy, Alaska?s natural gas pipeline, and oil and gas pipeline projects in other regions of the world. He now has a seat on the Senate Environment and Public Works Committee. Alaska?s oil and gas industry have particular importance to the state, which bene?ts from the payrolls and the royalties. Sullivan weighed in on the Keystone XL pipeline just a month after being sworn into of?ce. He voted to approve construction of the energy project, cosponsored the legislation and highlighted the issue in his maiden speech. The pipeline would transport hundreds of thousands barrels of tar sands oil from Alberta, Canada, along with some US. oil, to southern Nebraska, where it would connect with an existing pipeline network that would carry it to Gulf Coast re?neries. The administration didn?t decide whether to approve the project in light of environmental concerns and related court proceedings. ?In supporting Keystone," Sullivan said in his first floor speech, ?I?m also standing for a larger, more important principle: the idea that the federal government should be a partner in opportunity, a partner in progress, not an obstacle." Sullivan wanted to put his own stamp on the bill to approve the Keystone project with an amendment that would have prohibited Environmental Protection Agency personnel from carrying firearms, saying he was ?not for a country with an armed bureaucracy." He characterized his provision as limiting the scope of the federal government as opposed to restricting gun rights. But the amendment was not adopted. The underlying Keystone measure passed the Senate, cleared the House but was vetoed by President Barack Obama. The EPA and environmental regulations are particular targets for Sullivan, who promotes his record of challenging the Obama administration?s regulatory policy ?every step of the way.? Sullivan had an immediate opportunity to showcase his position after the White House announced in January 2015 it would recommend designating 12.3 million acres of the Arctic National Wildlife Refuge (ANWR) as wilderness, making the region totallyr off-limits to oil and gas exploration and drilling. ?This outrageous proposal from the Obama Administration will undermine Alaska?s future and America?s energy security. It will never see the light of day in Congress,? Sullivan said in a statement. ?President Obama?s goal of starving the Trans-Alaska Pipeline of oil and turnng our state into a giant national park will not stand.? Sullivan teamed up with Murkowski on legislation that would permit limited oil and natural gas activity in the non-wilderness coastal plain of ANWR, which Alaska lawmakers have been trying to pry open for development since the mid-1970s. A 1980 conservation law made most ofthe refuge off-limits to drilling, but it included an option for future congresses to allow energy development on a 1.5?million?acre section of the coastal plain. Sullivan also hopes that an ongoing state lawsuit against the federal government to try to compel the Interior Department to accept a state?written exploration plan for ANWR could provide another opening for Frontier State priorities. pledge to do everything in my power to protect the economic growth and prosperity of our state, and defend the promises made to Alaskans under" the conservation law, Sullivan said at a news conference. There could be some room for compromise in Sullivan?s legislative agenda. His first hearing as chairman of the Environment and Public Works Subcommittee on Fisheries, Water, and Wildlife was on his bipartisan sportsmen?s bill to case some regulations for recreational hunting and ?shing, among other things. ?This legislation represents years of hard work by the sporting community, and I am appreciative of the cf forts that have gone into crafting what is a collection of bills that have demonstrated broad bipartisan support over the years, including some that enjoy the support of the Obama Administration,? he said at the hearing. am hopeful that in this Congress, we will be able to take this effort across the ?nish line.? 2017--000097 Sullivan took the reins on the measure, which was previously championed by Democratic Sen. Kay Hagan of North Carolina, who lost her seat to Republican Thom Tillis in 2014. That version picked up some steam in the last Congress, but stalled in the Democratic-controlled Senate. Sullivan also takes on the White House on national security and foreign policy. He is on the Armed Services Committee, which in?uences national security defense. In an appearance at a local chamber of commerce in September 2014, he said: ?We have gotten to the point where our friends no longer trust us and our adversaries no longer fear us in the international world. We have been a country that?s been exhibiting weakness, and weakness in my view is provocative.? So far on the committee, he has pressed administration witnesses for information on risk assessments of Guantanamo Bay detainees and criticized them for not notifying Congress before exchanging ?ve Taliban prisoners for Sgt. Bowe Bergdahl last year. ?This was a clear directive frotn the Congress in the law that this administration violated,? he said at the Gitmo hearing. ?And, as far as I can tell, there?s been no good explanation.? Sullivan was one of 46 Republican senators who signed a letter written by fellow GOP freshman Tom Cotton of Arkansas warning Iran?s leaders that any nuclear deal signed with President Obama would be subject to change by Congress or by the next president. Cotton and Sullivan are two of five GOP freshman on Armed Services. His assignment to the Veterans? Affairs Committee suits his portfolio well. He joined the Marine Corps after earning graduate and law degrees from Georgetown University, and entered the Marine Corps Reserves after four years of active duty. Although he told the Alaska Public Radio Network that he planned to remain in the military, the Marine Corps removed Sullivan from his post as a reserve commander in March 2015, citing a provision in the Constitution that bars members of Congress from holding of?ce in the executive branch. Sullivan was sent overseas three times while in the reserves, including deployments to provide strategic analysis for commanders and on an anti-terror task force. agree with comments about this being the most important committee in the United States Senate,? he said at the VA panel?s ?rst hearing in 2015. ?I?m very honored to be here and to start to rebuild the sacred trust and responsibility that we have in the Congress and the federal government to our veterans.? Alaska?s military bases are home to tens of thousands of service members. Sullivan said Alaska ?has the highest number of veterans per capita of any state." His ?promises delivered? pledge addresses VA backlogs, preventative care, access to health care for veterans living in remote areas, re?cvaluations of combat zone designations and programs to provide incentives for hiring veterans. Sullivan didn?t move to Alaska until after leaving active duty, and despite his time in Alaska government, opponents have called him an outsider. Sullivan met his wife, an Alaska Native, when they were both in Washington, DC. he was at Georgetown, she was working for Republican Sen. Ted Stevens. After his stints in federal and state government, Sullivan jumped into the US. Senate race. He narrowly defeated incumbent Democratic Sen. Mark Begich with 48 percent ofthe vote. Sullivan?s win declared after weeks ofcounting absentee ballots helped Republicans ultimately capture control of the Senate. 2017--000098 Confidential Pre?decisional Draft (W5) 2017--000099 Dan Sullivan United States Senator - Alaska Graghs Highlighting Alaska?s Health Care Challenges: Legislative Priorities American Health Care Act Premium Tax Credits Would Fall Sharply Under House Republican Plan Difference in 2020 between average cred il fer marketplace consumers under Affordable Care Act and Republican plan 510243 $5.350 $4.542 $4.293 54.224 -$4.133 $4.133 $3.830 $3.548 $3.461" $2.850 527.114 $2.549 $2.512 $2.320 $2.312 $2.294 $2.214 $2.188 $2.031 51.91"? $1.455 $1.361 $1.230 $1.123 $1.043 $950 $79? $622 3569 $519 5429 ?$110 $41 Nan-11" exit:- ?lew Hen eel me- A :?lRl?fr'l C1152 '1a Oddl'U'Wd r'l Nebraska Wee! 'u'nglr' rl W-f'r 3-1" r11; lennessee 501111 Dakum Nornar?a 301111 Ce'uli'm M1 '19 lU'n'U'rl 5130111 .1 11? 251:2 pr; Fla-'Icld Kansas A r'I?lH llama-1 Tuner. Dnlu'lb-I (7-9an Nevada. Uld'] 0'110 Ir?rl ms: $9 $5415 2017--000100 Page101 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000101 Page102 240 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--000102 Bell, Michael Subject: HOLD: Mtg, w/ Senator Orrin Hatch and GOP Members of the Senate Finance Committee Location: 5-124; U.S. Capitol Start: Wed 31532017 10:30 AM End: Wed 11:30 AM Show Time As: Tentative Recurrence: (none) Meeting Status: Not yet responded Organizer: (W) (osxtosi Required Attendees: Harrison, Jessica Kristin Twomey, John Leggitt, Lance (H Aramanda, Alec McGu??ee, Tyler Ann Topic: Healthcare Bill The Republican senators attending are: Senators Hatch, Grassley, Crapo, Roberts, Enzi, Cornyn, Thune, Burr, Portrnan, Toomey, Heller, Scott, and Cassidy. 2017--000103 Confidential Pre?decisional Draft 2017--000104 Confidential Pre?decisional Draft (W5) 2017--000105 Confidential Pre?decisional Draft (130(5) 2017--000106 Confidential Pre?decisional Draft (W5) 2017--000107 Confidential Pre?decisional Draft 2017--000108 Confidential Pre?decisional Draft 2017--000109 Confidential Pre?decisional Draft 2017--000110 Confidential Pre?decisional Draft (W5) 2017--000111 Confidential Pre?decisional Draft (W5) 2017--000112 Confidential Pre?decisional Draft (W5) 2017--000113 Confidential Pre?decisional Draft (W5) 2017--000114 Bell, Michael Subject: HOLD: Mtg, w/ Senator Orrin Hatch and GOP Members of the Senate Finance Committee Location: 5-124; U.S. Capitol Start: Wed 31532017 10:30 AM End: Wed 11:30 AM Show Time As: Tentative Recurrence: (none) Meeting Status: Not yet responded Organizer: (W) (osxtosi Required Attendees: Harrison, Jessica Kristin Twomey, John Leggitt, Lance (H Aramanda, Alec McGu??ee, Tyler Ann Topic: Healthcare Bill The Republican senators attending are: Senators Hatch, Grassley, Crapo, Roberts, Enzi, Cornyn, Thune, Burr, Portrnan, Toomey, Heller, Scott, and Cassidy. 2017--000115 Confidential Pre?decisional Draft I II If? I I ?nd-I I II IU duly LU I I IU Confidential Pre?decisional Draft (W5) 2017--000117 Confidential Pre?decisional Draft (W5) 2017--000118 Confidential Pre?decisional Draft (W5) 2017--000119 Confidential Pre?decisional Draft 2017--000120 Confidential Pre?decisional Draft (W5) 2017--000121 Confidential Pre?decisional Draft 2017--000122 Confidential Pre?decisional Draft (W5) 2017--000123 Confidential Pre?decisional Draft 2017--000124 Confidential Pre?decisional Draft (W5) 2017--000125 Confidential Pre?decisional Draft (W5) 2017--000126 Bell, Michael Subject: Location: Start: End: Recurrence: Meeting Status: Organizer: Required Attendees: Optional Attendees: Staff: Carla and Demetrios Attendees: Marshall Roe Buschon Babin Ferguson DesJarIais Abraham Gosar Black Wenstrup Carter Dunn Murphy Brugess Topic: Mtg. w! Doctors Cacus Secretary's Large Conference Room Fri 31?17/2017 7:30 AM Fri 8:15 AM (none) Accepted ?33(5) (osrlosi DiBlasio, Carla Kouzoukas, Demetrios Leggitt, Lance Harrison, Jessica Kristin Twomey, John K. Aramandai Alec McGuffee, Tyler Ann Morse, Sara (HHSIASL) The discussion will be about the regulatory efforts that HHS plans to undertake, as well as how the Docs Caucus can be helpful in messaging the ACA replacement. They just want the opportunity to connect with Dr. Price in a less formal setting than some of these Conference meetings. 2017--000127 Confidential Pre?decisional Draft (W5) 2017--000128 Confidential Pre?decisional Draft (W5) 2017--000129 Confidential Pre?decisional Draft (W5) 2017--000130 Confidential Pre?decisional Draft (W5) 2017--000131 Confidential Pre?decisional Draft 2017--000132 Confidential Pre?decisional Draft 2017--000133 Confidential Pre?decisional Draft 2017--000134 Bell, Michael Subject: Mtg. w/ Tuesday Group Location: Start: Tue 3f7f201? 4:00 PM End: Tue 3/7/2017 5:00 PM Show Time As: Tentative Recurrence: (none) Meeting Status: Not yet responded Organizer: (?Hal Required Attendees: Tworneyr John K. Aramanda: Alec Clark, Barbara Leggitt, Lance Tom MacArthur? staff: Ryan Carmen,f (C05) Charlie Dent? staff: Drew Kent John Katko-staff: Brad Gentile Leonard Lance?staff: Robert Butora II Mile-ill 2017--000135 Confidential Pre?decisional Draft (W5) 2017--000136 Confidential Pre?decisional Draft (W5) 2017--000137 Bell, Michael Subject: Canceled: Call w! Rep. Renacci Location: Start: Sun 3/12f2017 5:00 PM End: Sun 3(123?2017 5:30 PM Show Time As: Free Recurrence: (none) Meeting Status: Not yet responded Organizer: (W6) Required Attendees: Harrison, Jeseica Kristin Twomey, John Ara manda, Alec McGuffee. Tyler Ann Leggitt, Lance (HHSXIOS) Scheduler number? 2017--000138 Confidential Pre?decisional Draft (W5) 2017--000139 Confidential Pre?decisional Draft (W5) 2017--000140 Bell, Michael Subject: Call w! Senator Murkowski Location: Start: Thu 3f16/2017 2:15 PM End: Thu 3/16/2017 2:45 PM Recurrence: (none) Meeting Status: Accepted Organizer: Required Attendees: Harrison, Jessica Kristin Tworney, John K.: Leggitt. Lance Aramanda, Alec McGu??ee, Tyler Ann Contactzl?omi The senator will call John and he will patch her through to Dr. Price Senators numberjust in case-) (We) 2017--000141 Confidential Pre?decisional Draft II Ily 901 Confidential Pre?decisional Draft (W5) 2017--000143 Confidential Pre?decisional Draft 2017--000144 Bell, Michael Subject: Call w! Senator Murkowski Location: Start: Thu 3f16/2017 2:15 PM End: Thu 3/16/2017 2:45 PM Recurrence: (none) Meeting Status: Accepted Organizer: Required Attendees: Harrison, Jessica Kristin Tworney, John K.: Leggitt. Lance Aramanda, Alec McGu??ee, Tyler Ann Contactzl?omi The senator will call John and he will patch her through to Dr. Price Senators numberjust in case-) (We) 2017--000145 Confidential Pre?decisional Draft 2017--000146 Confidential Pre?decisional Draft (W5) 2017--000147 Confidential Pre?decisional Draft (W5) 2017--000148 Bell, Michael Subject: Location: Start: End: Recurrence: Meeting Status: Organizer: Required Attendees: Call w! Senator Sullivan (W5) Tue 3121/2017 11:30 AM Tue 3f21f2017 12:00 PM (none) Accepted (osnos; Harrison, Jessica Kristin Twomey. John K. Leggitt, Lance Arbes, Sarah Morse, Sara Schedulers direct and scheduler will patch TEP into the Senator Suggested Messages: ll - 31: II 'ilize?illili ll F's} 2017--000149 {Ll 5l i iltl-?Hk? Sen. Dan Sullivan (R?Alaska) Junior Senator from Alaska ResidencezAnchorage BermNov. 13. 1964; Fairview Park, Ohio Religion:Roman Catholic Family:Wife, Julie Fate Sullivan; three children Education?larvard U., AB. 1987 (economics); U. ot?Birmingham (England), MA. 1988; Georgetown U., M.S.F.S. 1993, JD. 1993 Military Service:Marine Corps 1993-1997; Marine Corps Reserve l997-present (awarded Defense Meritorious Service Medal} Career:White House aide; lawyer; author First Elected?OM {1 st term); Defeated Sen. Mark Begieh, Latest Election:2[ll4 General (47.96%) Political Highlights:U.S. State Department assistant secretary for economic and business affairs, 2006?09; Alaska attorney general, 2009?] OAlaska Department of Natural Resources commissioner, 2010?13 Committees: 0 Armed Services (Airland; Seapower; Strategic Forces} 0 Commerce, Science Transportation (Aviation Operations, Safety Sc Security: Communications, Technology, Innovation the Internet; Oceans, Atmosphere, Fisheries Coast Guard - chairman; Space, Science Sc Competitiveness) 0 Environment 8: Public Works (Fisheries, Wildlife Water: Superfund, Waste Management Regulatory Oversight; Transportation 85 Infrastructure) 0 Veterans' Affairs Phone:202-224-3DO4 Faxz202?224?6501 702 Hart Bldg. Washington, DC 20510 CQ Politics in America Profile (Updated: June 17, 2015) Energy policy and other natural resource issues will likely be the driving force in Sullivan?s tenure, as it has been for his Alaska colleague, senior Sen. Lisa Murkowski, who chairs the Energy and Natural Resources Committee. Sullivan has foreign policy credentials and was Alaska?s attorney general, but he also directed the state?s Department of Natural Resources and in the George W. Bush administration?s State Department, he worked on 2017--000150 international energy policy, Alaska?s natural gas pipeline, and oil and gas pipeline projects in other regions of the world. He now has a seat on the Senate Environment and Public Works Committee. Alaska?s oil and gas industry have particular importance to the state, which bene?ts from the payrolls and the royalties. Sullivan weighed in on the Keystone XL pipeline just a month after being sworn into of?ce. He voted to approve construction of the energy project, cosponsored the legislation and highlighted the issue in his maiden speech. The pipeline would transport hundreds of thousands barrels of tar sands oil from Alberta, Canada, along with some US. oil, to southern Nebraska, where it would connect with an existing pipeline network that would carry it to Gulf Coast re?neries. The administration didn?t decide whether to approve the project in light of environmental concerns and related court proceedings. ?In supporting Keystone," Sullivan said in his first floor speech, ?I?m also standing for a larger, more important principle: the idea that the federal government should be a partner in opportunity, a partner in progress, not an obstacle." Sullivan wanted to put his own stamp on the bill to approve the Keystone project with an amendment that would have prohibited Environmental Protection Agency personnel from carrying firearms, saying he was ?not for a country with an armed bureaucracy." He characterized his provision as limiting the scope of the federal government as opposed to restricting gun rights. But the amendment was not adopted. The underlying Keystone measure passed the Senate, cleared the House but was vetoed by President Barack Obama. The EPA and environmental regulations are particular targets for Sullivan, who promotes his record of challenging the Obama administration?s regulatory policy ?every step of the way.? Sullivan had an immediate opportunity to showcase his position after the White House announced in January 2015 it would recommend designating 12.3 million acres of the Arctic National Wildlife Refuge (ANWR) as wilderness, making the region totallyr off-limits to oil and gas exploration and drilling. ?This outrageous proposal from the Obama Administration will undermine Alaska?s future and America?s energy security. It will never see the light of day in Congress,? Sullivan said in a statement. ?President Obama?s goal of starving the Trans-Alaska Pipeline of oil and turnng our state into a giant national park will not stand.? Sullivan teamed up with Murkowski on legislation that would permit limited oil and natural gas activity in the non-wilderness coastal plain of ANWR, which Alaska lawmakers have been trying to pry open for development since the mid-1970s. A 1980 conservation law made most ofthe refuge off-limits to drilling, but it included an option for future congresses to allow energy development on a 1.5?million?acre section of the coastal plain. Sullivan also hopes that an ongoing state lawsuit against the federal government to try to compel the Interior Department to accept a state?written exploration plan for ANWR could provide another opening for Frontier State priorities. pledge to do everything in my power to protect the economic growth and prosperity of our state, and defend the promises made to Alaskans under" the conservation law, Sullivan said at a news conference. There could be some room for compromise in Sullivan?s legislative agenda. His first hearing as chairman of the Environment and Public Works Subcommittee on Fisheries, Water, and Wildlife was on his bipartisan sportsmen?s bill to case some regulations for recreational hunting and ?shing, among other things. ?This legislation represents years of hard work by the sporting community, and I am appreciative of the cf forts that have gone into crafting what is a collection of bills that have demonstrated broad bipartisan support over the years, including some that enjoy the support of the Obama Administration,? he said at the hearing. am hopeful that in this Congress, we will be able to take this effort across the ?nish line.? 2017--000151 Sullivan took the reins on the measure, which was previously championed by Democratic Sen. Kay Hagan of North Carolina, who lost her seat to Republican Thom Tillis in 2014. That version picked up some steam in the last Congress, but stalled in the Democratic-controlled Senate. Sullivan also takes on the White House on national security and foreign policy. He is on the Armed Services Committee, which in?uences national security defense. In an appearance at a local chamber of commerce in September 2014, he said: ?We have gotten to the point where our friends no longer trust us and our adversaries no longer fear us in the international world. We have been a country that?s been exhibiting weakness, and weakness in my view is provocative.? So far on the committee, he has pressed administration witnesses for information on risk assessments of Guantanamo Bay detainees and criticized them for not notifying Congress before exchanging ?ve Taliban prisoners for Sgt. Bowe Bergdahl last year. ?This was a clear directive frotn the Congress in the law that this administration violated,? he said at the Gitmo hearing. ?And, as far as I can tell, there?s been no good explanation.? Sullivan was one of 46 Republican senators who signed a letter written by fellow GOP freshman Tom Cotton of Arkansas warning Iran?s leaders that any nuclear deal signed with President Obama would be subject to change by Congress or by the next president. Cotton and Sullivan are two of five GOP freshman on Armed Services. His assignment to the Veterans? Affairs Committee suits his portfolio well. He joined the Marine Corps after earning graduate and law degrees from Georgetown University, and entered the Marine Corps Reserves after four years of active duty. Although he told the Alaska Public Radio Network that he planned to remain in the military, the Marine Corps removed Sullivan from his post as a reserve commander in March 2015, citing a provision in the Constitution that bars members of Congress from holding of?ce in the executive branch. Sullivan was sent overseas three times while in the reserves, including deployments to provide strategic analysis for commanders and on an anti-terror task force. agree with comments about this being the most important committee in the United States Senate,? he said at the VA panel?s ?rst hearing in 2015. ?I?m very honored to be here and to start to rebuild the sacred trust and responsibility that we have in the Congress and the federal government to our veterans.? Alaska?s military bases are home to tens of thousands of service members. Sullivan said Alaska ?has the highest number of veterans per capita of any state." His ?promises delivered? pledge addresses VA backlogs, preventative care, access to health care for veterans living in remote areas, re?cvaluations of combat zone designations and programs to provide incentives for hiring veterans. Sullivan didn?t move to Alaska until after leaving active duty, and despite his time in Alaska government, opponents have called him an outsider. Sullivan met his wife, an Alaska Native, when they were both in Washington, DC. he was at Georgetown, she was working for Republican Sen. Ted Stevens. After his stints in federal and state government, Sullivan jumped into the US. Senate race. He narrowly defeated incumbent Democratic Sen. Mark Begich with 48 percent ofthe vote. Sullivan?s win declared after weeks ofcounting absentee ballots helped Republicans ultimately capture control of the Senate. 2017--000152 Confidential Pre?decisional Draft 2017--000153 Bell, Michael Subject: Call w/ Rep. McClintock Location: Start: Sun 3/12f2017 12:30 PM End: Sun 3/l2f2017 1:00 PM Recurrence: (none) Meeting Status: Accepted Organizer: (We) Required Attendees: Harrison, Jessica Kristin Twomey, John Leggitt. Lance (H Aramanda, Alec McGuffee, Tyler Ann Back lit-i: Ii. 2017--000154 Confidential Pre?decisional Draft (W5) 2017--000155 Bell, Michael Subject: Call w! Rep Dave Brat Location: Start: Sun 3/12f2017 6:00 PM End: Sun 3f12j2017 6:30 PM Recurrence: (none) Meeting Status: Accepted Organizer: (OSXIOS) Required Attendees: Harrison, Jessica Kristin Twomey. John Ara manda. Alec McGuffee, Tyler Ann Leggitt, Lance Contact: Zoe O?Herin 2017--000156 Confidential Pre?decisional Draft 2017--000157 Confidential Pre?decisional Draft 2017--000158 Bell, Michael Subject: Call w! Senator Murkowski Location: Start: Thu 3f16/2017 2:15 PM End: Thu 3/16/2017 2:45 PM Recurrence: (none) Meeting Status: Accepted Organizer: Required Attendees: Harrison, Jessica Kristin Tworney, John K.: Leggitt. Lance Aramanda, Alec McGu??ee, Tyler Ann Contactzl?omi The senator will call John and he will patch her through to Dr. Price Senators numberjust in case-) (We) 2017--000159 Confidential Pre?decisional Draft (W5) 2017--000160 Confidential Pre?decisional Draft (W5) 2017--000161 Confidential Pre?decisional Draft 2017--000162 Bell, Michael Subject: Location: Start: End: Recurrence: Meeting Status: Organizer: Required Attendees: Call w! Senator Sullivan (W5) Tue 3121/2017 11:30 AM Tue 3f21f2017 12:00 PM (none) Accepted (osnos; Harrison, Jessica Kristin Twomey. John K. Leggitt, Lance Arbes, Sarah Morse, Sara Schedulers direct and scheduler will patch TEP into the Senator Suggested Messages: ll - 31: II 'ilize?illili ll F's} 2017--000163 {Ll 5l i iltl-?Hk? Sen. Dan Sullivan (R?Alaska) Junior Senator from Alaska ResidencezAnchorage BermNov. 13. 1964; Fairview Park, Ohio Religion:Roman Catholic Family:Wife, Julie Fate Sullivan; three children Education?larvard U., AB. 1987 (economics); U. ot?Birmingham (England), MA. 1988; Georgetown U., M.S.F.S. 1993, JD. 1993 Military Service:Marine Corps 1993-1997; Marine Corps Reserve l997-present (awarded Defense Meritorious Service Medal} Career:White House aide; lawyer; author First Elected?OM {1 st term); Defeated Sen. Mark Begieh, Latest Election:2[ll4 General (47.96%) Political Highlights:U.S. State Department assistant secretary for economic and business affairs, 2006?09; Alaska attorney general, 2009?] OAlaska Department of Natural Resources commissioner, 2010?13 Committees: 0 Armed Services (Airland; Seapower; Strategic Forces} 0 Commerce, Science Transportation (Aviation Operations, Safety Sc Security: Communications, Technology, Innovation the Internet; Oceans, Atmosphere, Fisheries Coast Guard - chairman; Space, Science Sc Competitiveness) 0 Environment 8: Public Works (Fisheries, Wildlife Water: Superfund, Waste Management Regulatory Oversight; Transportation 85 Infrastructure) 0 Veterans' Affairs Phone:202-224-3DO4 Faxz202?224?6501 702 Hart Bldg. Washington, DC 20510 CQ Politics in America Profile (Updated: June 17, 2015) Energy policy and other natural resource issues will likely be the driving force in Sullivan?s tenure, as it has been for his Alaska colleague, senior Sen. Lisa Murkowski, who chairs the Energy and Natural Resources Committee. Sullivan has foreign policy credentials and was Alaska?s attorney general, but he also directed the state?s Department of Natural Resources and in the George W. Bush administration?s State Department, he worked on 2017--000164 international energy policy, Alaska?s natural gas pipeline, and oil and gas pipeline projects in other regions of the world. He now has a seat on the Senate Environment and Public Works Committee. Alaska?s oil and gas industry have particular importance to the state, which bene?ts from the payrolls and the royalties. Sullivan weighed in on the Keystone XL pipeline just a month after being sworn into of?ce. He voted to approve construction of the energy project, cosponsored the legislation and highlighted the issue in his maiden speech. The pipeline would transport hundreds of thousands barrels of tar sands oil from Alberta, Canada, along with some US. oil, to southern Nebraska, where it would connect with an existing pipeline network that would carry it to Gulf Coast re?neries. The administration didn?t decide whether to approve the project in light of environmental concerns and related court proceedings. ?In supporting Keystone," Sullivan said in his first floor speech, ?I?m also standing for a larger, more important principle: the idea that the federal government should be a partner in opportunity, a partner in progress, not an obstacle." Sullivan wanted to put his own stamp on the bill to approve the Keystone project with an amendment that would have prohibited Environmental Protection Agency personnel from carrying firearms, saying he was ?not for a country with an armed bureaucracy." He characterized his provision as limiting the scope of the federal government as opposed to restricting gun rights. But the amendment was not adopted. The underlying Keystone measure passed the Senate, cleared the House but was vetoed by President Barack Obama. The EPA and environmental regulations are particular targets for Sullivan, who promotes his record of challenging the Obama administration?s regulatory policy ?every step of the way.? Sullivan had an immediate opportunity to showcase his position after the White House announced in January 2015 it would recommend designating 12.3 million acres of the Arctic National Wildlife Refuge (ANWR) as wilderness, making the region totallyr off-limits to oil and gas exploration and drilling. ?This outrageous proposal from the Obama Administration will undermine Alaska?s future and America?s energy security. It will never see the light of day in Congress,? Sullivan said in a statement. ?President Obama?s goal of starving the Trans-Alaska Pipeline of oil and turnng our state into a giant national park will not stand.? Sullivan teamed up with Murkowski on legislation that would permit limited oil and natural gas activity in the non-wilderness coastal plain of ANWR, which Alaska lawmakers have been trying to pry open for development since the mid-1970s. A 1980 conservation law made most ofthe refuge off-limits to drilling, but it included an option for future congresses to allow energy development on a 1.5?million?acre section of the coastal plain. Sullivan also hopes that an ongoing state lawsuit against the federal government to try to compel the Interior Department to accept a state?written exploration plan for ANWR could provide another opening for Frontier State priorities. pledge to do everything in my power to protect the economic growth and prosperity of our state, and defend the promises made to Alaskans under" the conservation law, Sullivan said at a news conference. There could be some room for compromise in Sullivan?s legislative agenda. His first hearing as chairman of the Environment and Public Works Subcommittee on Fisheries, Water, and Wildlife was on his bipartisan sportsmen?s bill to case some regulations for recreational hunting and ?shing, among other things. ?This legislation represents years of hard work by the sporting community, and I am appreciative of the cf forts that have gone into crafting what is a collection of bills that have demonstrated broad bipartisan support over the years, including some that enjoy the support of the Obama Administration,? he said at the hearing. am hopeful that in this Congress, we will be able to take this effort across the ?nish line.? 2017--000165 Sullivan took the reins on the measure, which was previously championed by Democratic Sen. Kay Hagan of North Carolina, who lost her seat to Republican Thom Tillis in 2014. That version picked up some steam in the last Congress, but stalled in the Democratic-controlled Senate. Sullivan also takes on the White House on national security and foreign policy. He is on the Armed Services Committee, which in?uences national security defense. In an appearance at a local chamber of commerce in September 2014, he said: ?We have gotten to the point where our friends no longer trust us and our adversaries no longer fear us in the international world. We have been a country that?s been exhibiting weakness, and weakness in my view is provocative.? So far on the committee, he has pressed administration witnesses for information on risk assessments of Guantanamo Bay detainees and criticized them for not notifying Congress before exchanging ?ve Taliban prisoners for Sgt. Bowe Bergdahl last year. ?This was a clear directive frotn the Congress in the law that this administration violated,? he said at the Gitmo hearing. ?And, as far as I can tell, there?s been no good explanation.? Sullivan was one of 46 Republican senators who signed a letter written by fellow GOP freshman Tom Cotton of Arkansas warning Iran?s leaders that any nuclear deal signed with President Obama would be subject to change by Congress or by the next president. Cotton and Sullivan are two of five GOP freshman on Armed Services. His assignment to the Veterans? Affairs Committee suits his portfolio well. He joined the Marine Corps after earning graduate and law degrees from Georgetown University, and entered the Marine Corps Reserves after four years of active duty. Although he told the Alaska Public Radio Network that he planned to remain in the military, the Marine Corps removed Sullivan from his post as a reserve commander in March 2015, citing a provision in the Constitution that bars members of Congress from holding of?ce in the executive branch. Sullivan was sent overseas three times while in the reserves, including deployments to provide strategic analysis for commanders and on an anti-terror task force. agree with comments about this being the most important committee in the United States Senate,? he said at the VA panel?s ?rst hearing in 2015. ?I?m very honored to be here and to start to rebuild the sacred trust and responsibility that we have in the Congress and the federal government to our veterans.? Alaska?s military bases are home to tens of thousands of service members. Sullivan said Alaska ?has the highest number of veterans per capita of any state." His ?promises delivered? pledge addresses VA backlogs, preventative care, access to health care for veterans living in remote areas, re?cvaluations of combat zone designations and programs to provide incentives for hiring veterans. Sullivan didn?t move to Alaska until after leaving active duty, and despite his time in Alaska government, opponents have called him an outsider. Sullivan met his wife, an Alaska Native, when they were both in Washington, DC. he was at Georgetown, she was working for Republican Sen. Ted Stevens. After his stints in federal and state government, Sullivan jumped into the US. Senate race. He narrowly defeated incumbent Democratic Sen. Mark Begich with 48 percent ofthe vote. Sullivan?s win declared after weeks ofcounting absentee ballots helped Republicans ultimately capture control of the Senate. 2017--000166 Confidential Pre?decisional Draft (W5) 2017--000167 Dan Sullivan United States Senator - Alaska Graghs Highlighting Alaska?s Health Care Challenges: Legislative Priorities American Health Care Act Premium Tax Credits Would Fall Sharply Under House Republican Plan Difference in 2020 between average cred il fer marketplace consumers under Affordable Care Act and Republican plan 510243 $5.350 $4.542 $4.293 54.224 -$4.133 $4.133 $3.830 $3.548 $3.461" $2.850 527.114 $2.549 $2.512 $2.320 $2.312 $2.294 $2.214 $2.188 $2.031 51.91"? $1.455 $1.361 $1.230 $1.123 $1.043 $950 $79? $622 3569 $519 5429 ?$110 $41 Nan-11" exit:- ?lew Hen eel me- A :?lRl?fr'l C1152 '1a Oddl'U'Wd r'l Nebraska Wee! 'u'nglr' rl W-f'r 3-1" r11; lennessee 501111 Dakum Nornar?a 301111 Ce'uli'm M1 '19 lU'n'U'rl 5130111 .1 11? 251:2 pr; Fla-'Icld Kansas A r'I?lH llama-1 Tuner. Dnlu'lb-I (7-9an Nevada. Uld'] 0'110 Ir?rl ms: $9 $5415 2017--000168 Bell, Michael Subject: Location: Start: End: Show Time As: Recurrence: Meeting Status: Organizer: Required Attendees: Canceled: Call w/ Lance Leggitt re: Health Care Reform Lance will Call TPMD Fri 3f3f2017 4:00 PM Fri 3/3/2017 4:30 PM Free (none) Tentatively accepted Harrison, Jessica Leggitt, Lance Twomey, John K. Kristin 2017--000169 Bell, Michael Subject: Canceled: Call w! Rep. Renacci Location: Start: Sun 3/12f2017 5:00 PM End: Sun 3(123?2017 5:30 PM Show Time As: Free Recurrence: (none) Meeting Status: Not yet responded Organizer: (W6) Required Attendees: Harrison, Jeseica Kristin Twomey, John Ara manda, Alec McGuffee. Tyler Ann Leggitt, Lance (HHSXIOS) Scheduler number? 2017--000170 Confidential Pre?decisional Draft (W5) 2017--000171 Confidential Pre?decisional Draft (W5) 2017--000172 From: Kristin Sent: 7 Mar 201? 12:53:56 +0000 To: Cc: Leggitt, Lance Subject: Daily War Room Good morning, Barrett. I understand that there is a daily war roorn at 3:15 AM re: health care reform being run out of the Majority Leader?s Office. I would like to represent Dr. Price at these if possible. Please let me know and happy to discuss more. Thanks. Kris 2017--000173 Bell, Michael Subject: Location: Start: End: Recurrence: Meeting Status: Organizer: Required Attendees: Optional Attendees: Staff: Carla and Demetrios Attendees: Marshall Roe Buschon Babin Ferguson DesJarIais Abraham Gosar Black Wenstrup Carter Dunn Murphy Brugess Topic: Mtg. w! Doctors Cacus Secretary's Large Conference Room Fri 31?17/2017 7:30 AM Fri 8:15 AM (none) Accepted ?33(5) (osrlosi DiBlasio, Carla Kouzoukas, Demetrios Leggitt, Lance Harrison, Jessica Kristin Twomey, John K. Aramandai Alec McGuffee, Tyler Ann Morse, Sara (HHSIASL) The discussion will be about the regulatory efforts that HHS plans to undertake, as well as how the Docs Caucus can be helpful in messaging the ACA replacement. They just want the opportunity to connect with Dr. Price in a less formal setting than some of these Conference meetings. 2017--000174 Confidential Pre?decisional Draft (W5) 2017--000175 Confidential Pre?decisional Draft (W5) 2017--000176 Confidential Pre?decisional Draft 2017--000177 Confidential Pre?decisional Draft 2017--000178 Confidential Pre?decisional Draft (W5) 2017--000179 Confidential Pre?decisional Draft (W5) 2017--000180 Confidential Pre?decisional Draft 2017--000181 Bell, Michael Subject: Mtg. w! Senator Orrin Hatch and GOP Members of the Senate Finance Committee Location: 5?124; US. Capitol Start: Wed 3/15/2017 10:30 AM End: Wed 3/15/2017 11:30 AM Recurrence: (none) Meeting Status: Accepted Organizer: (mus) (OSHOS) Required Attendees: Harrison, Jessica Kristin Twomey, John Leggitt, Lance (H Aramanda, Alec McGu??ee, Tyler Ann Tepic: Healthcare Bill The Republican senators attending are: Senators Hatch, Grassley, Crapo, Roberts, Enzi, Cornyn, Thune, Burr, Portman, Toomey, Heller, Scott, and Cassidy. 2017--000182 Confidential Pre?decisional Draft (W5) 2017--000183 Confidential Pre?decisional Draft 2017--000184 Confidential Pre?decisional Draft (W5) 2017--000185 Confidential Pre?decisional Draft (W5) 2017--000186 Confidential Pre?decisional Draft 2017--000187 Confidential Pre?decisional Draft 2017--000188 Confidential Pre?decisional Draft (W5) 2017--000189 Confidential Pre?decisional Draft (W5) 2017--000190 Confidential Pre?decisional Draft (W5) 2017--000191 Confidential Pre?decisional Draft (W5) 2017--000192 Confidential Pre?decisional Draft 2017--000193 Bell, Michael Subject: Mtg. w/ Tuesday Group Location: Start: Tue 3f7f201? 4:00 PM End: Tue 3/7/2017 5:00 PM Show Time As: Tentative Recurrence: (none) Meeting Status: Not yet responded Organizer: (?Hal Required Attendees: Tworneyr John K. Aramanda: Alec Clark, Barbara Leggitt, Lance Tom MacArthur? staff: Ryan Carmen,f (C05) Charlie Dent? staff: Drew Kent John Katko-staff: Brad Gentile Leonard Lance?staff: Robert Butora II Mile-ill 2017--000194 Confidential Pre?decisional Draft (W5) 2017--000195 Confidential Pre?decisional Draft 2017--000196 From: Kristin Sent: 7 Mar 201? 14:23:43 +0000 Tu; We} Cc: Burks, Jonathan;Hoffmann, Matt;l 2017--000204 From: Stewart, David Sent: 7 Mar 2017 14:46:01 +0000 To: Burks, Kristin Ray Cc: Hoffmann, Matt;Karr, Barrett;Horton, Brett;Leggitt, Lance Matt Ryan Subject: Re: Price - HHS - Letter of Support Yes, many thanks Kris. From: Jonathan' 'Burks 14%) I Date: Tuesday, March 7, 2017 at 9:32 AM To: Kristin 4333(6) Fay David Stewart {bl{53 Cc: "Hoffmann, Matt? HD1031 Barrett Karr (bi{6i Brett Horton "Leggitt, Lance Lloyd, "Murphy, Ryan Subject: RE: Price - HHS - Letter of Support Thank you. From: Kristin [mailto {bl{51 Sent: Tuesday, March 07, 2017 9:24 AM To: Baum, Ray {{blt?i 1; Stewart, Dayid {{blt?i I Cc: Burks, Jonathan I(bl{5i Hoffmann, Matt {b1(6i HKarr, Barrett Horton, Brett eggitt, Lance Lloyd, Matt IMurphy, Ryan Subject: Price - HHS - Letter of Support Dr. Price, Secretary of HHS, has issued a letter of support for the reconciliation bills regarding health care reform. Your attention to this is appreciated. Kris 2017--000205 From: Karr, Barrett Sent: 7 Mar 2017 14:44:45 +0000 To: Kristin Cc: Burks, Jonathan;Hoffrnann, Matt;Horton, Brett;Leggitt, Lance Matt Ryan Katie;Baum, Ray;5tewart, David Subject: RE: Price - HHS - Letter of Support Super, super helpful. Thank you, thank you. From: Kristin I Sent: Tuesday, March 07, 2017 9:24 AM To: Baum, RavlleBi Stewart, David I Cc: Burks, Jonathan (bl(6l I: Hoffmann, Matt Karr, Barrett (WES) IHorton, Brett (bl(6l Leggitt, Lance [(me lLloyd, Matt (HHsnos) IMurphy, Ryan Subject: Price - HHS - Letter of Support Dr. Price, Secretary of HHS, has issued a letter of support for the reconciliation bills regarding health care reform. Your attention to this is appreciated. Kris 2017--000206 From: Burks,Jonathan Sent: 7 Mar 2017 14:32:42 +0000 To: Kristin Ray;5tewart, David Cc: Hoffmann, Barrett;Horton, Brett;Leggitt, Lance Matt Ryan (HHSIIOS) Subject: RE: Price - HHS - Letter of Support Thank you. From: Kristin [mailtcl??ltBl Sent: Tuesday, March 07, 2017 9:24 AM To: Baum, RavlleB) Stewart, David IthBl I Cc: Burks, l? Hoffmann, Matt (mas) l; Karr, Horton, Brett M6) Leggitt, Lance (124(6) Lloyd, Matt {04(6) lMurphy, Ryan (hrs) Subject: Price - HHS - Letter of Support Dr. Price, Secretary of HHS, has issued a letter of support for the reconciliation bills regarding health care reform. Your attention to this is appreciated. Kris 2017--000207 From: Burks,Jonathan Sent: 7 Mar 2017 14:31:25 +0000 To: Kristin Lance Cc: Hoffmann, Matt Subject: RE: Price - HHS Letter of Support Never mind. Just arrived. From: Kristin [mailtdmusl Sent: Tuesday, March 07, 2017 91:24l AM To: Baum, Rav {003(6) Stewart, David (bi{6l I Cc: Burks, Jonathan 400(6) I Hoffmann, Matt 9, Kerr, Barrett (bi(6i Horton, Brett 1mm: eggitt, Lance 4M6) Llovd, Matt llbiisl Murphy, Rvan Subject: Price - HHS - Letter of Support Dr. Price, Secretary of HHS, has issued a letter of support for the reconciliation bills regarding health care reform. Your attention to this is appreciated. Kris 2017--000208 From: Karr, Barrett Sent: 7 Mar 2017 23:05:45 +0000 To: Kristin Cc: Burks, Jonathan;Hoffrnann, Matt;Horton, Brett;Leggitt, Lance Matt Ryan Katie;Baum, Ray;5tewart, David Subject: RE: Price - HHS - Letter of Support We?ll sing the praises from the capitol balcony. From: Kristin Sent: Tuesday, March 07, 2017 6:00 PM To: Karr, I Cc: Burks, Jonathan Hoffmann, Matt I Horton, Brett (W6) Leggitt, Lance _ond, Matt (-iHs/Ios] qrbxe) Murphy, Ryan Ilbllel Meyer, Katie (W5) Sun 3/12f2017 5:00 PM Sun 3f12j2017 5:30 PM (none) Meeting organizer -(osr1051 Harrison, Jessica Kristin Twomey. John Ara manda. Alec McGurfee, Tyler Ann Leggitt, Lance (W5) Scheduler number? 2017--000341 Confidential Pre?decisional Draft 2017--000342 Confidential Pre?decisional Draft 2017--000343 Bell, Michael Subject: HOLD: Mtg, w/ Senator Orrin Hatch and GOP Members of the Senate Finance Committee Location: 5-124; U.S. Capitol Start: Wed 31532017 10:30 AM End: Wed 11:30 AM Recurrence: (none) Meeting Status: Meeting organizer Organizer: (W (05/105) Required Attendees: Harrison, Jessica Kristin Twomey, John Leggitt, Lance Aramanda, Alec McGuffee, Tyler Ann (HHSXIOS) Topic: Healthcare Bill The Republican senators attending are: Senators Hatch, Grassley, Crapo, Roberts, Enzi, Cornyn, Thune, Burr, Portman, Toomey, Heller Scott, and Cassidy. 2017--000344 Confidential Pre?decisional Draft (W5) 2017--000345 Confidential Pre?decisional Draft (W5) lulu on47 . .v vul] hv . . IV Confidential Pre?decisional Draft (W5) 2017--000347 Confidential Pre?decisional Draft (W5) 2017--000348 Confidential Pre?decisional Draft 2017--000349 Confidential Pre?decisional Draft 2017--000350 Confidential Pre?decisional Draft (W5) 2017--000351 Confidential Pre?decisional Draft (W5) 2017--000352 Confidential Pre?decisional Draft (W5) 2017--000353 Confidential Pre?decisional Draft (W5) 2017--000354 Confidential Pre?decisional Draft (W5) 2017--000355 Bell, Michael Subject: Meeting with Rep. Walker Location: Start: Wed 3/1/2017 1:45 PM End: Wed 3/1/2017 2:15 PM Recurrence: (none) Organizer: Staff: Kris Tyler Ann Attendees: Chairman Walker Scott Parkinson Executive Director Brittarl Specht? Policy Director 2017--000356 Confidential Pre?decisional Draft (W5) 2017--000357 Confidential Pre?decisional Draft 2017--000358 Confidential Pre?decisional Draft (W5) 2017--000359 Bell. Michael Subject: Location: Start: End: Recurrence: Meeting Status: Organizer: Required Attendees: Optional Attendees: Staff: Carla and Demetrios Attendees: Marshall Roe Buschon Babin Ferguson DesJarlais Abraham Gosar Black Wenstrup Carter Dunn Murphy Brugess Mtg. w! Doctors Cacus Secretary's Large Conference Room Fri 3/17/2017 7:30 AM Fri 3/17/2017 8:15 AM (none) Meeting organizer oerosi DiBlasio. Carla Kouzoukas, Demetrios Leggitt, Lance Harrison, Jessica Kristin Twomey, John K. Aramanda. Alec McGuffee. Tyler Ann Morse. Sara (HHSIASL) They just want the opportunity to connect with Dr. Price in a less formal setting than some of these Conference meetings. 2017--000360 Confidential Pre?decisional Draft (W5) 2017--000361 Confidential Pre?decisional Draft (W5) 2017--000362 Confidential Pre?decisional Draft (W5) 2017--000363 Confidential Pre?decisional Draft (W5) 2017--000364 Confidential Pre?decisional Draft (W5) 2017--000365 Confidential Pre?decisional Draft (W5) 2017--000366 Confidential Pre?decisional Draft (W5) 2017--000367 Bell. Michael Subject: At Senate Republican Policy Committee Lunch Location: 520?; Masnfield Room Start: Tue 12:30 PM End: Tue 3f14/2017 12:50 PM Recurrence: (none) Organizer: 2017--000368 Confidential Pre?decisional Draft (W5) 2017--000369 Confidential Pre?decisional Draft 2017--000370 Confidential Pre?decisional Draft 2017--000371 Confidential Pre?decisional Draft (W5) 2017--000372 Confidential Pre?decisional Draft (W5) 2017--000373 Confidential Pre?decisional Draft 2017--000374 Confidential Pre?decisional Draft (W5) 2017--000375 Confidential Pre?decisional Draft 2017--000376 Confidential Pre?decisional Draft 2017--000377 Confidential Pre?decisional Draft (W5) 2017--000378 Confidential Pre?decisional Draft 2017--000379 Bell, Michael Subject: Call w! Senator Murkowski Location: Start: Thu 3f16/2017 2:15 PM End: Thu 3/16/2017 2:45 PM Recurrence: (none) Meeting Status: Meeting organizer Organizer: Required Attendees: Harrison, Jessica Kristin Tworney, John K.: Leggitt. Lance Aramanda, Alec McGu??ee, Tyler Ann Contactzl?jmI The senator will call John and he will patch her through to Dr. Price Senators numberjust in case-) (We) 2017--000380 Confidential Pre?decisional Draft (W5) 2017--000381 Confidential Pre?decisional Draft (W5) 2017--000382 Confidential Pre?decisional Draft 2017--000383 Bell, Michael Subject: Call w! Senator Sullivan Location: (W53 Start: Tue 3/21/2017 11:30 AM End: Tue 3f21f2017 12:00 PM Recurrence: (none) Meeting Status: Meeting organizer Organizer: {bro (OSXIOS) Required Attendees: Harrison, Jessica Kristin Twomey. John K. Leggitt, Lance Arbes, Sarah Morse, Sara (HHSXASL) Schedulers direct and scheduler will patch TEP into the Senator Messages: {bi{5i *3 3'4" - 134 bill 2017--000384 {Ll 5l i iltl-?Hk? Sen. Dan Sullivan (R?Alaska) Junior Senator from Alaska ResidencezAnchorage BermNov. 13. 1964; Fairview Park, Ohio Religion:Roman Catholic Family:Wife, Julie Fate Sullivan; three children Education?larvard U., AB. 1987 (economics); U. ot?Birmingham (England), MA. 1988; Georgetown U., M.S.F.S. 1993, JD. 1993 Military Service:Marine Corps 1993-1997; Marine Corps Reserve l997-present (awarded Defense Meritorious Service Medal} Career:White House aide; lawyer; author First Elected?OM {1 st term); Defeated Sen. Mark Begieh, Latest Election:2[ll4 General (47.96%) Political Highlights:U.S. State Department assistant secretary for economic and business affairs, 2006?09; Alaska attorney general, 2009?] OAlaska Department of Natural Resources commissioner, 2010?13 Committees: 0 Armed Services (Airland; Seapower; Strategic Forces} 0 Commerce, Science Transportation (Aviation Operations, Safety Sc Security: Communications, Technology, Innovation the Internet; Oceans, Atmosphere, Fisheries Coast Guard - chairman; Space, Science Sc Competitiveness) 0 Environment 8: Public Works (Fisheries, Wildlife Water: Superfund, Waste Management Regulatory Oversight; Transportation 85 Infrastructure) 0 Veterans' Affairs Phone:202-224-3DO4 Faxz202?224?6501 702 Hart Bldg. Washington, DC 20510 CQ Politics in America Profile (Updated: June 17, 2015) Energy policy and other natural resource issues will likely be the driving force in Sullivan?s tenure, as it has been for his Alaska colleague, senior Sen. Lisa Murkowski, who chairs the Energy and Natural Resources Committee. Sullivan has foreign policy credentials and was Alaska?s attorney general, but he also directed the state?s Department of Natural Resources and in the George W. Bush administration?s State Department, he worked on 2017--000385 international energy policy, Alaska?s natural gas pipeline, and oil and gas pipeline projects in other regions of the world. He now has a seat on the Senate Environment and Public Works Committee. Alaska?s oil and gas industry have particular importance to the state, which bene?ts from the payrolls and the royalties. Sullivan weighed in on the Keystone XL pipeline just a month after being sworn into of?ce. He voted to approve construction of the energy project, cosponsored the legislation and highlighted the issue in his maiden speech. The pipeline would transport hundreds of thousands barrels of tar sands oil from Alberta, Canada, along with some US. oil, to southern Nebraska, where it would connect with an existing pipeline network that would carry it to Gulf Coast re?neries. The administration didn?t decide whether to approve the project in light of environmental concerns and related court proceedings. ?In supporting Keystone," Sullivan said in his first floor speech, ?I?m also standing for a larger, more important principle: the idea that the federal government should be a partner in opportunity, a partner in progress, not an obstacle." Sullivan wanted to put his own stamp on the bill to approve the Keystone project with an amendment that would have prohibited Environmental Protection Agency personnel from carrying firearms, saying he was ?not for a country with an armed bureaucracy." He characterized his provision as limiting the scope of the federal government as opposed to restricting gun rights. But the amendment was not adopted. The underlying Keystone measure passed the Senate, cleared the House but was vetoed by President Barack Obama. The EPA and environmental regulations are particular targets for Sullivan, who promotes his record of challenging the Obama administration?s regulatory policy ?every step of the way.? Sullivan had an immediate opportunity to showcase his position after the White House announced in January 2015 it would recommend designating 12.3 million acres of the Arctic National Wildlife Refuge (ANWR) as wilderness, making the region totallyr off-limits to oil and gas exploration and drilling. ?This outrageous proposal from the Obama Administration will undermine Alaska?s future and America?s energy security. It will never see the light of day in Congress,? Sullivan said in a statement. ?President Obama?s goal of starving the Trans-Alaska Pipeline of oil and turnng our state into a giant national park will not stand.? Sullivan teamed up with Murkowski on legislation that would permit limited oil and natural gas activity in the non-wilderness coastal plain of ANWR, which Alaska lawmakers have been trying to pry open for development since the mid-1970s. A 1980 conservation law made most ofthe refuge off-limits to drilling, but it included an option for future congresses to allow energy development on a 1.5?million?acre section of the coastal plain. Sullivan also hopes that an ongoing state lawsuit against the federal government to try to compel the Interior Department to accept a state?written exploration plan for ANWR could provide another opening for Frontier State priorities. pledge to do everything in my power to protect the economic growth and prosperity of our state, and defend the promises made to Alaskans under" the conservation law, Sullivan said at a news conference. There could be some room for compromise in Sullivan?s legislative agenda. His first hearing as chairman of the Environment and Public Works Subcommittee on Fisheries, Water, and Wildlife was on his bipartisan sportsmen?s bill to case some regulations for recreational hunting and ?shing, among other things. ?This legislation represents years of hard work by the sporting community, and I am appreciative of the cf forts that have gone into crafting what is a collection of bills that have demonstrated broad bipartisan support over the years, including some that enjoy the support of the Obama Administration,? he said at the hearing. am hopeful that in this Congress, we will be able to take this effort across the ?nish line.? 2017--000386 Sullivan took the reins on the measure, which was previously championed by Democratic Sen. Kay Hagan of North Carolina, who lost her seat to Republican Thom Tillis in 2014. That version picked up some steam in the last Congress, but stalled in the Democratic-controlled Senate. Sullivan also takes on the White House on national security and foreign policy. He is on the Armed Services Committee, which in?uences national security defense. In an appearance at a local chamber of commerce in September 2014, he said: ?We have gotten to the point where our friends no longer trust us and our adversaries no longer fear us in the international world. We have been a country that?s been exhibiting weakness, and weakness in my view is provocative.? So far on the committee, he has pressed administration witnesses for information on risk assessments of Guantanamo Bay detainees and criticized them for not notifying Congress before exchanging ?ve Taliban prisoners for Sgt. Bowe Bergdahl last year. ?This was a clear directive frotn the Congress in the law that this administration violated,? he said at the Gitmo hearing. ?And, as far as I can tell, there?s been no good explanation.? Sullivan was one of 46 Republican senators who signed a letter written by fellow GOP freshman Tom Cotton of Arkansas warning Iran?s leaders that any nuclear deal signed with President Obama would be subject to change by Congress or by the next president. Cotton and Sullivan are two of five GOP freshman on Armed Services. His assignment to the Veterans? Affairs Committee suits his portfolio well. He joined the Marine Corps after earning graduate and law degrees from Georgetown University, and entered the Marine Corps Reserves after four years of active duty. Although he told the Alaska Public Radio Network that he planned to remain in the military, the Marine Corps removed Sullivan from his post as a reserve commander in March 2015, citing a provision in the Constitution that bars members of Congress from holding of?ce in the executive branch. Sullivan was sent overseas three times while in the reserves, including deployments to provide strategic analysis for commanders and on an anti-terror task force. agree with comments about this being the most important committee in the United States Senate,? he said at the VA panel?s ?rst hearing in 2015. ?I?m very honored to be here and to start to rebuild the sacred trust and responsibility that we have in the Congress and the federal government to our veterans.? Alaska?s military bases are home to tens of thousands of service members. Sullivan said Alaska ?has the highest number of veterans per capita of any state." His ?promises delivered? pledge addresses VA backlogs, preventative care, access to health care for veterans living in remote areas, re?cvaluations of combat zone designations and programs to provide incentives for hiring veterans. Sullivan didn?t move to Alaska until after leaving active duty, and despite his time in Alaska government, opponents have called him an outsider. Sullivan met his wife, an Alaska Native, when they were both in Washington, DC. he was at Georgetown, she was working for Republican Sen. Ted Stevens. After his stints in federal and state government, Sullivan jumped into the US. Senate race. He narrowly defeated incumbent Democratic Sen. Mark Begich with 48 percent ofthe vote. Sullivan?s win declared after weeks ofcounting absentee ballots helped Republicans ultimately capture control of the Senate. 2017--000387 Confidential Pre?decisional Draft 2017--000388 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Mon 3X27f2017 4:30 PM End: Mon 3(27/201? 5:30 PM Recurrence: Daily Recurrence Pattern: every weekday from 4:30 PM to 5:30 PM Meeting Status: Meeting organizer Organizer: (W6) Required Attendees: Agnew, Ann Anderson, Jeffrey Arbes, Sarah Barcus, Lea Bardis, John Brookes, Brady Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Marre. Alleigh (OSXASPAE Murphy. Ryan Neale. Brian Oakley, Caitlin B. Pate, Randy Perez?Rivera, Diana Schaefer, Nina Seema Verma; Kristin Stannard, Paula Street, Amanda Twomey, John K. (OSIIOS) 2017--000389 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Mon 5:00 PM End: Mon 3/13/2017" 5:30 PM Recurrence: (none) Meeting Status: Meeting organizer Organizer: (W3) Required Attendees: Agnew, Ann Brooks, John DlBlasio, Carla Harrison, Jessica Horn, Wade Keith; Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakleyr Caitlin B, Pate, Randy Schaefer, Nina (H Kristin Street, Amanda Twomey, John K. 2017--000390 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Fri 3/10/2017 5:00 PM End: Fri 3/10/2017 5:30 PM Recurrence: (none) Meeting Status: Meeting organizer Organizer: (W5) Required Attendees: Agnew, Ann Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Keith; Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakleyr Caitlin B, Pate, Randy Schaefer, Nina Kristin Street, Amanda Twomey, John K. NOTE: Participants to include staff from Legislative Affairs and Public Affairs, and appropriate policy personnel. Lance Leggitt determines the appropriate staff for inclusion. 2017--000391 Bell, Michael Subject: Daily Health Care Reform Meeting Start: Fri BXSIZUIT 5:30 PM End: Fri 3f3I2017 6:00 PM Recurrence: (none) Organizer: (05/105) NOTE: Participants to include staff from Legislative Affairs and Public Affairs. and appropriate policy personnel. Lance Leggitt determines the appropriate staff for inclusion. 2017--000392 Bell, Michael Subject: Start: End: Recurrence: Organizer: Daily Health Care Reform Meeting Thu 2f23f2017 5:30 PM Thu 22'23/2017 6:00 PM (none) ?33(5) (05/105) NOTE: Participants to include staff from Legislative Affairs and Public Affairs. and appropriate policy personnel. 2017--000393 Bell, Michael Subject: Location: Start: End: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Daily Health Care Reform Meeting 610F Mon 3127f2017 4:30 PM Mon 337/201? 5:30 PM Daily every weekday from 4:30 PM to 5:30 PM Meeting organizer Agnew, Ann Anderson, Jeffrey Arbes, Sarah Bardis, John Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Schaefer, Nina Seema Verma; Kristin Stannard, Paula Street, Amanda Twomey, John K. Barcus, Lea (PSCXOD) 2017--000394 Bell, Michael Subject: Location: Start: End: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Daily Health Care Reform Meeting 610F Mon 3127f2017 4:30 PM Mon 337/201? 5:30 PM Daily every weekday from 4:30 PM to 5:30 PM Meeting organizer Agnew, Ann Anderson, Jeffrey Arbes, Sarah Bardis, John Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Schaefer, Nina Seema Verma; Kristin Stannard, Paula Street, Amanda Twomey, John K. 2017--000395 Bell, Michael Subject: Location: Start: End: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Daily Health Care Reform Meeting 610F Mon 3127f2017 4:30 PM Mon 337/201? 5:30 PM Daily every weekday from 4:30 PM to 5:30 PM Meeting organizer (W Agnew, Ann Anderson, Jeffrey Arbes, Sarah Bardis, John Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Schaefer, Nina Seema Verma; Kristin Stannard, Paula Street, Amanda Twomey, John K. Barcus, Lea (PSCXOD) 2017--000396 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Mon 3127x2017 4:30 PM End: Mon 3(27/201? 5:30 PM Recurrence: Daily Recurrence Pattern: every weekday from 4:30 PM to 5:30 PM Meeting Status: Meeting organizer Organizer: (W6) Required Attendees: Agnew, Ann Anderson, Jeffrey Arbes, Sarah Bardis, John Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Schaefer, Nina Seema Verma; Kristin Stannard, Paula Street, Amanda Twomey, John K. 2017--000397 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Mon 3X20I2017 5:00 PM End: Mon 3(20/201? 5:30 PM Recurrence: Daily Recurrence Pattern: every weekday from 5:00 PM to 5:30 PM Meeting Status: Meeting organizer Organizer: (W5) Required Attendees: gnew, Ann Anderson, Jeffrey Arbes, Sarah Bardis, John Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Schaefer, Nina Seema Verma; Kristin Stannard, Paula Street, Amanda Twomey, John K. 2017--000398 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Tue 3/14/2017 5:00 PM End: Tue 5:30 PM Recurrence: (none) Meeting Status: Meeting organizer Organizer: Required Attendees: Agnew, Ann Brooks, John DlBlasio, Carla Harrison, Jessica Horn, Wade Keith; Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakleyr Caitlin B, Pate, Randy Schaefer, Nina (H Kristin Street, Amanda Twomey, John K. 2017--000399 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Mon 3X20f2017 5:00 PM End: Mon 3(20/201? 5:30 PM Recurrence: Daily Recurrence Pattern: every weekday from 5:00 PM to 5:30 PM Meeting Status: Meeting organizer Organizer: (W5) Required Attendees: Agnew, Ann Anderson, Jeffrey Arbes, Sarah Bardis, John Brookes, Brady Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios Leggitt, Lance (H Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. (OSXASPA): Pate, Randy (H Perez?Rivera, Diana Schaefer, Nina Seema Verma; Kristin Stannard, Paula Street, Amanda Twomey, John K, Barcus, Lea 2017--000400 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Fri 4:30 PM End: Fri 3/17/2017 5:30 PM Recurrence: (none) Meeting Status: Meeting organizer Organizer: {mm} Required Attendees: Agnew, Ann Anderson, Jeffrey Arbes. Sarah Bardis, John Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Schaefer, Nina Seema Verma; Kristin Stannard, Paula Street, Amanda Twomey, John K. 2017--000401 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Thu 4:00 PM End: Thu 3/16/2017 5:00 PM Recurrence: (none) Meeting Status: Meeting organizer Organizer: (W6) Required Attendees: (W5) Agnew, Ann Bardls. John Brooks. John DiBlasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Schaefer, Nina Kristin Stannard, Paula Street. Amanda Twomey. John K. Optional Attendees: Anderson: Jeffrey Meszaros. Marie (HHSZIOS) 2017--000402 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Wed 12:15 PM End: Wed 3/15/2017 1:00 PM Recurrence: (none) Meeting Status: Meeting organizer Organizer: Required Attendees: Agnew, Ann Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Keith; Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakleyr Caitlin B, Pate, Randy Schaefer, Nina Kristin Stannard, Paula Street, Amanda Twomey, John K. 2017--000403 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Thu 3f9x2017 5:10 PM End: Thu 3/9201? 5:30 PM Recurrence: (none) Meeting Status: Meeting organizer (W5) Organlzer: Required Attendees: Agnew, Ann Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Keith; Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakleyr Caitlin B, Pate, Randy Schaefer, Nina (H Kristin Street, Amanda Twomey, John Stannard, Paula NOTE: Participants to include staff from Legislative Affairs and Public Affairs, and appropriate policy personnel. Lance Leggitt determines the appropriate staff for inclusion. 2017--000404 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Wed 5:00 PM End: Wed 5:30 PM Recurrence: (none) Meeting Status: Meeting organizer Organizer: (W5) Required Attendees: Agnew, Ann Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Keith; Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakleyr Caitlin B, Pate, Randy Schaefer, Nina (H Kristin Street, Amanda Twomey, John K. NOTE: Participants to include staff from Legislative Affairs and Public Affairs, and appropriate policy personnel. Lance Leggitt determines the appropriate staff for inclusion. 2017--000405 Bell, Michael Subject: Daily Health Care Reform Meeting Location: Secretary's Large Conf Room Start: Mon 316/2017 4:30 PM End: Mon 5:30 PM Recurrence: (none) Meeting Status: Meeting organizer Organizer: (W6) Required Attendees: Agnew, Ann Brooks, John DlBlasio, Carla Horn, Wade (H HSXIOS) Kouzoukas, Demetrios Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Schaefer, Nina Kristin Stannard, Paula Street, Amanda Harrison, Jessica Neale, Brian (CMSICMCS) 2017--000406 Bell, Michael Subject: Daily Health Care Reform Meeting Location: Start: Wed 3/1/2017?' 4:30 PM End: Wed 5:30 PM Recurrence: (none) Organizer: 2017--000407 Bell, Michael Subject: Daily Health Care Reform Meeting Start: Mon 23772017 5:30 PM End: Mon 6:00 PM Recurrence: (none) Organizer: ?33(6) NOTE: Participants to include staff from Legislative Affairs and Public Affairs. and appropriate policy personnel. Lance Leggitt determines the appropriate staff for inclusion. 2017--000408 Bell, Michael Subject: 4:15pm Daily Health Care Reform Meeting Location: Secretary,r Large Conference Room 610F Start: Fri 2f24/201? 4:15 PM End: Fri 224/2017 4:45 PM Recurrence: (none) Organizer: (W53 NOTE: Participants to include staff from Legislative Affairs and Public Affairs, and appropriate policy personnel. Lance Leggitt determines the appropriate staff for inclusion. 2017--000409 Bell, Michael Subject: Location: Start: End: Recurrence: Organizer: Daily Health Care Reform Meeting Secretary's Large Conf Room Tue 2/28/2017 3:30 PM Tue 3282017 4:30 PM (none) (W53 2017--000410 Bell, Michael Subject: Meeting Forward Notification: Daily Health Care Reform Meeting Location: 610F Start: Tue 3/21/2017 6:00 PM End: Tue 3/21/2017 7:00 PM Recurrence: (none) Organizer: DiBlasio, Carla Your meeting was forwarded DiBlaslo. Carla has forwarded your meeting request to additional recipients. Meeting Daily Health Care Reform Meeting Meeting Time Tuesday, March 21, 2017 6:00 PM. Recipients Kouzoukas, Demetrios All times listed are in the following time zone: Eastern Time (US Canada) Sent by ?-.-liorosoit Fxohango Bower 2017--000411 Bell, Michael Subject: Meeting Forward Notification: Daily Health Care Reform Meeting Location: 610F Start: Mon 5:30 PM End: Mon 33/20/2017 6:30 PM Recurrence: (none) Organizer: Duncan. Leyi (OSXOHCR) Your meeting was forwarded Duncan. Levi (OSIOHCRZI has forwarded your meeting request to additional recipients. Meeting Daily Health Care Reform Meeting Meeting Time Monday, March 20, 2017 5:30 PM. Recipients Anderson, le?rey (HHSIIDS) All times listed are in the following time zone: Eastern Time (US Canada) Soot by ?-.-liorcsoit Fxohango Bower 2017--000412 Bell, Michael Subject: Meeting Forward Notification: Daily Health Care Reform Meeting Location: 610F Start: Fri 4:30 PM End: Fri 3/17/2201? 5:30 PM Recurrence: (none) Organizer: Brooks, John Your meeting was forwarded Brooks. lohn has forwarded your meeting request to additional recipients. Meeting Daily Health Care Reform Meeting Meeting Time Friday, March 17, 2017 4:30 Phil-5:30 PM. Recipients Anderson, le?rey (HHSIIDS) All times listed are in the following time zone: Eastern Time (US Canada) Soot by ?-.-liorcsoit erhango Bower 2017--000413 Bell, Michael Subject: Meeting Forward Notification: Daily Health Care Reform Meeting Location: 610F Start: Thu 3X16f2017 4:00 PM End: Thu 3/16/2017 5:00 PM Recurrence: (none) Organizer: Duncan. Leyi (OSXOHCR) Your meeting was forwarded Duncan. Levi (OSIOHCRZI has forwarded your meeting request to additional recipients. Meeting Daily Health Care Reform Meeting Meeting Time Thursday, March 16, 2017 4:00 Phil-5:00 PM. Recipients Meszaros, Marie (H HSIIOS) All times listed are in the following time zone: Eastern Time (US Canada) Soot by ?-.-liorcsoit Fxohango Bower 2017--000414 Bell, Michael Subject: Meeting Forward Notification: Daily Health Care Reform Meeting Location: 610F Start: Thu 3f16f2017 4:00 PM End: Thu 3/16/2017 5:00 PM Recurrence: (0009) Organizer: Brooks, John (HHSXIOS) Your meeting was forwarded Brooks. lohn has forwarded your meeting request to additional recipients. Meeting Daily Health Care Reform Meeting Meeting Time Thursday, March 16, 2017 4:00 Phil-5:00 PM. Recipients Anderson, le?rey (HHSIIDS) All times listed are in the following time zone: Eastern Time (US Canada) Soot by ?Microsoft Fxohango Bower 2017--000415 Bell. Michael Subject: Regulatory Huddle Location: Dep Sec Conference Room Start: Thu 3X9X2017 11:00 AM End: Thu 3/9201? 12:00 PM Recurrence: (none) Meeting Status: Accepted Organizer: Pate. Randy (HHSHOS) Required Attendees: Schaefer. Nina Meszaros. Marie Horn. Wade (HHSXIOS) Stannard. Paula Agnew, Ann Brooks. John Street. Amanda #3313. 13?3- All, (W53 Thanks and looking forward to it. Randy 2017--000416 Page 0002 M1518 Withheld pursuant to exemption (110(5) CIT thE CIT Information AC1 2017--000417 Page 0003 M1518 Withheld pursuant to exemption (110(5) CIT thE CIT Information AC1 2017--000418 Page 0004 M1518 Withheld pursuant to exemption (110(5) CIT thE CIT Information AC1 2017--000419 Page 0005 M1518 Withheld pursuant to exemption (110(5) CIT thE CIT Information AC1 2017--000420 Page 0006 M1518 Withheld pursuant to exemption (htt?t CIT thE CIT Information AC1 2017--000421 Page 000? M1518 Withheld pursuant to exemption (htt?t CIT thE CIT Information AC1 2017--000422 Page 0008 M1518 Withheld pursuant to exemption (htt?t CIT thE CIT Information AC1 2017--000423 Page 0000 M1518 Withheld pursuant to exemption (110(5) CIT thE CIT Information AC1 2017--000424 Page 0010 M1518 Withheld pursuant to exemption (htt?t CIT thE CIT Information AC1 2017--000425 Page DD110T1518 Withheld pursuant to exemption (131(5) CIT thE CIT Information AC1 2017--000426 In five years from April of 2010 to May of 2015, the Department of HHS promulgated 314 regulations implementing the Affordable Care Act. These regulations occupy 13,208 pages in the Federal Register. 1 Premium Review Process; Request for Comments Regarding Section 2294 of the Public 4f14f2010 Health Service Act 2 Medical Loss Ratios; Request for Comments Regarding Section 2718 of the Public Health 4(1412010 Service Act 3 Health Care Reform Insurance Web Portal Requirements [for Private Plans 8: Data 5f5f2010 Template} 4 Early Retiree Reinsurance Program 5 Medicare and Medicaid Programs; Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements; and Changes in Provider Agreements 6 Designation of Medically Underserved Populations and Health Professions Shortage 5f11f2010 Areas; Intent To Form Negotiated Rulemaking Committee 2 Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to 5f13f2010 Dependent Coverage ofChildren to Age 25 Under the Patient Protection and Affordable Care Act 8 Medicare Program; Medicare Coverage Gap Discount Program Model Manufacturer Agreement and Announcement of the June 1, 2010 Public Meeting 9 Public Health Service Act, Rural Physician Training Grant Program, Definition of 5f26f2010 ?Underserved Rural Community" 10 Public Health Service Act, Rural Physician Training Grant Program, Definition of ?Underserved Rural Community? 11 Hospital IPPS for Acute Ca re Hospitals and Fiscal Year 2010 Rates and to the Long-Term 63'2/2010 Care Hospital PPS and Rate Year 2010 Rates: Final Fiscal Year 2010 Wage Indices and Payment Rates Implementing the Affordable Care Act 12 Changes to the Hospital Inpatient Prospective Payment System Resulting from 2011 63'2/2010 Health Care Reform Provisions 13 Discretionary Grant Program 6f9l2010 14 "Grandfathering? under Group 8; Individual Insurance Market Reforms [Part 2] 61'12/2010 15 Medicare Program; Supplemental Proposed Changes to the Hospital Inpatient 6f17f2010 Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Supplemental Proposed Fiscal Year 2011 Rates; Corrections 16 Patient Protection and Affordable Care Act: Preexisting Condition Exclusions, Lifetime and 6f28f2010 Annual Limits, Rescissions, and Patient Protections 1? SEP: 010-003; 8/23f10; Patient Protection and Affordable Care Act Emerging 2?/2010 Infections Program (EIP), Enhancing Epidemiology and Laboratory Capacity 2017--000427 18 Civil Money Penalty Reduction for Self-Reporting 19 Revisions to Payment Policies Under the Physician Fee Schedule and Part for CY 2011 2f13f2010 20 Preventive Services [Part 4] 2/19/2010 21 Hospice Wage Index for FY 2011 7f22f2010 22 Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities? 21'22/2010 Update for 2011 23 The Negotiated Rulemaking Committee on the Designation of Medically Underserved 3"!22f2010 Populations and Health Professions Shortage Areas 24 Home Health Prospective Payment System Refinements and Rate Update for CY 2011 2f23f2010 25 Claims, Appeals Review [Market Conduct} 2f23f2010 26 Maternal, Infant, and Early Childhood Home Visiting Program 7/23f2010 2? SEP: Cl10-003; CURRECTIDN- DATE CHANGE 9l8f10; Patient Protection and Affordable H27f2010 Care Act Emerging Infections Program Enhancing Epidemiology and Laboratory Capacity 28 High Risk Pools 7i30f2010 29 Communities Putting Prevention to Work 8! 12.51010 30 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care 8/16f2010 Hospitals and the Long-Term Care Hospital Prospective Payment System Changes and FY2011 Rates; Provider Agreements and Supplier Approvals; and Hospital Conditions of Participation for Rehabilitation and Respiratory Care Services; Medicaid Program: Accreditation for Providers of Inpatient Services 31 SEP: 010-003; 9l21f10; Patient Protection and Affordable lCare Act Emerging 9f14f2010 Infections Program (EIP), Enhancing Epidemiology and Laboratory Capacity 32 3403 Drug Pricing Program 93'20312010 Manufacturer Civil Monetary Penalties 33 Proposed Information Collection Activity; Comment Request. Title: Affordable Care Act 10f22f2010 Tribal Maternal, Infant, and Early Childhood Home Visiting Program Needs Assessment and Plan for Responding to Identified Needs 34 Medicaid Program; Withdrawal of Determination of Average Manufacturer Price, 11f15f2010 Multiple Source Drug Definition, and Upper Limits for Multiple Source Drugs 35 Grandfathering Amendment 11f12f2010 2017--000428 36 Medicare Program; Home Health Prospective Payment System Rate Update for Calendar 11111272010 Year 2011; Changes in Certification Requirements for Home Health Agencies and Hospices 3? Medicare Program: Hospital Outpatient Prospective Payment System and CY 2011 11(24f2010 Payment Rates; Ambulatory Surgical Center Payment System and CY 2011 Payment Rates; Payments to Hospitals for Graduate Medical Education Costs; Physician Self- Referral Rules and Related Changes to Provider Agreement Regulations Payment for Certi?ed Registered Nurse Anesthetist Services Furnished in Rural Hospitals and Critical Access Hospitals 38 Medical Loss Ratio 12f1f2010 35 Adjustments for Disaster-Recovery States to the Fourth Quarter of Fiscal Year 2011 and 12f22f2010 Fiscal Year 2012 Federal Medical Assistance Percentage Rates for Federal Matching Shares for Medicaid and Title IV-E Foster Care, Adoption Assistance and Guardianship Assistance programs? Disaster Relief 40 Premium Rate Review 12f23i2010 41 Request for Info?Value?Based Insurance Design 12128f2010 42 Advisory Committee on Breast Cancer in Young Women Meeting 9121f11- 1f6f2011 9/23/11 43 Medicare Program; Payment Policies Under the Physician Fee Schedule and Other 1!10f2011 Revisions to Part for CY 2011 44 The Consumer Operated and Oriented Plan Advisory Board, February 7, 2011 1f22/2011 45 Implementation, Systems and Outcome Evaluation of the Tribal and Low?Income Health 13'27f2011 Profession Opportunity Grants (HPOG) 46 Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening Requirements, Application Fees, Temporary Enrollment Moratoria, Payment Suspensions and Compliance Plans for Providers and Suppliers 4? Student Health Insurance Coverage 2/11f2011 48 Children's Health Insurance Program Allotment Methodology and States' Fiscal 2/17f2011 Years 2009 Through 2015 CHIP Allotments 49 Medicare and Medicaid Programs; Requirements for Long?Term Care Facilities; Notice of Facility Closure 50 Waiver for State Innovation 3(143?11 51 Submission for 0MB Review; Comment Request. Title: Affordable Care Act Tribal 3,2'12f11 Maternal, Infant, and Early Childhood Home Visiting Program Needs Assessment and Plan for Responding to Identi?ed Needs 52 Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes 3f18/11 2017--000429 53 Agency Information Collection; Activities: Proposed Collection; Comment Request 3f29f2011 54 Early Retiree Reinsurance Program Notice 55 Food Labeling; Nutrition Labeling of Standard Menu Items in Restaurants and Similar 4.1612011 Retail Food Establishments 56 Food Labeling; Calorie Labeling of Articles of Food in Vending Machines 57 NCEZID Notice of Intent to Award Affordable Ca re Act Funding 4f12f2011 58 Notice of Intent to award supplemental Affordable Care Act funding to support 4;'12f2011 FDA 59 Medicare Program; Changes to the Medicare Advantage and the Medicare Prescription 41'152?2011 Drug Bene?t Programs for Contract Year 2012 and Other Changes 60 Evaluation of Tribal Health Profession Opportunity Grants (HPOG) 41'18/2011 61 NCIRD Notice of Intent to Award Patient Protection 3: Affordable Care Act funding 4,119/2011 62 Proposed Information Collection Activity; Comment Request 4130/2011 63 Medicare Program; Inpatient Facilities Prospective Payment System-Update 5f6f2011 for Rate ?i'ear Beginning July 1, 2011 2012] 64 Medicaid Program; Methods for Assuring Access to Covered Medicaid Services 65 SEP: 6(15f11; Affordable Care Act (ACAI: Childhood Obesity Research Funding 5/12f2011 Opportunity Announcement (FDA) Panel 66 SEP: - $9,111 Affordable Care Act Childhood Obesity Research 5/18f2011 Funding Opportunity Announcement (FOAI DP11-007, Panel A 6? Exclusion of Orphan Drugs for Certain Covered Entities under 3403 Program 5/20f2011 68 Premium Rate Review 5323312011 69 Agency Information Collection; Activities: Proposed Collection: Comment Request 5!27f2011 70 Inpatient Facilities Prospective Payment System - Update for Rate Year 6f3f2011 Beginning July 1, 2011 (RY 2012); Correction 11 Medicaid Program; Payment Adjustment for Provider-Preventable Conditions Including 61'6/2011 Health Ca re-Acquired Conditions 2017--000430 72 Implementation, Systems and Outcome Evaluation of the Tribal and Low-Income Health 6f11f2011 Profession Opportunity Grants (HPOG) 73 Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and 6,2'24f2011 Appeals and External Review Processes 74 Evaluation of Tribal Health Profession Opportunitv Grants 6f30f2011 75 Section 3113: The Treatment of Certain Complex Diagnostic Laboratory Tests Demonstration Submission for OMB Review; Comment Request 76 Administrative Simplification: Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status Transactions 7? Testing and Evaluation ofTobacco Communication Activities 2/12f2011 23 NCEH "Notice of Intent to award Affordable Care Act (ACAI funding to National 71?13f2011 Association for Health Data Organizations 79 NCEH "Notice of Intent to Award Affordable Ca re Act funding to ?National Association for 2/13f2011 Public Health Statistics and Information Systems 80 NCEH Notice of Intent to award Affordable Care Act funding to seventeen states 2113/2011 and local health departments to develop and implement tracking networks within their funded jurisdictions that is part of the National Tracking Network 81 Evaluation of Core Iv'iolence and Injury Prevention Program {Core 2,115/2011 82 Establishing Exchanges Part I 7/15f2011 83 State Requirements for reinsurance, risk cooridors and risk adjustment 2f15f2011 84 Establishing 7720/2011 85 Announcement of Five Single Source Grant Awards. Award of five single source grants 2127f2011 under the Tribal Home ?v'isiting Program to the Eastern Band of Cherokee Indians, Cherokee, Native American Health Center, Inc., Oakland, Riverside?San Bernardino Countv Indian Health, Inc., Banning, Taos Pueblo, Taos, and United Indians of All Tribes Foundation, Seattle, WA. 86 Preventive Services Sf3f2011 8? Medicare Program; Hospice Wage Index for Fiscal Year 2012 3/4l2011 2017--000431 88 Meeting 9f21f11-9f23f11 83'51'2011 89 Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2012; Changes in Size and Square Footage of Inpatient Rehabilitation Units and Inpatient Units 90 Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2012 91 Announcement of a Single Source Grant Award to the Tribal Law and Policy Institute. 8f12f2011 Notice to award a single source program expansion supplement grant to the Tribal Law and Policy Institute, located in West Hollywood, CA, to support activities of the National Resource Center for Tribes under the Tribal Maternal, Infant, Early Childhood Home Visiting Program. 92 Exchange Eligibility Bflell 93 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care 8f18f11 Hospitals and the Long-Term Care Hospital Prospective Payment System and FY 2012 Rates; Hospitals' FTE Resident Caps for Graduate Medical Education Payment 94 Uniform Disclosure to Consumers 8f22f2011 95 Summary of Benefits and Coverage and Uniform Glossary?Templates, Instructions, and 3,122,1?2011 Related Materials Under the Public Health Service Act 96 Notice of Intent to Award Affordable Care Act (ACAJ Funding 9? Notice of Intent to Award Affordable Care Act (ACAJ Funding 932/2011 98 Notice of Intent to Award Affordable Care Act (ACAJ Funding 99 Notice of Intent to Award Affordable Care Act (ACAJ Funding Sl212011 100 Notice of Intent to Award Affordable Care Act (ACAJ Funding 9f2f2011 101 Premium Rate Review?Amendment to the Final Rule 9/Bi'2011 2017--000432 102 CDC Diabetes Prevention Recognition Program 91'912011 103 Request for Info?Basic Health Program 9/14f2011 104 Medicaid Recovery Audit Contractors 9(163?2011 105 Notice of Intent to Award Affordable Care Act Funding 9f27f2011 106 Notice of Intent to Award Affordable Care Act (ACAJ Funding 9,122/2011 10? Testing and Evaluation of Tobacco Communication Activities 9f29f2011 103 Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified 91'30/2011 Health Plans, and Standards Related to Reinsurance, Risk Corridors and Risk Adjustment; Extension of Comment Period FDA Delegation of Authority 10f6f2011 110 Statement of Organization, Functions and Delegations of Authority 10!19f2011 111 Proposed Information Collection Activity; Comment Request. Title: Affordable Care Act 10/26f2011 Tribal Maternal, Infant and Early Childhood Home Visiting Program Annual Report. 112 Advanced Payment Model Initiative 11f2/2011 113 Medicare Shared Savings Program: Accountable Care Organizations 11f21'2011 114 Final Waivers in Connection with the Medicare Shared Savings Program 11f2/2011 115 Home Health Prospective Payment System Rate Update for 2012 11fdf2011 116 National Ambulatory Medical Care Survey 11f4f2011 11? Medicare Program; End-Stage Renal Disease Prospective Payment System and Quality 11f10f2011 Incentive Program; Ambulance Fee Schedule; Durable Medical Equipment; and Competitive Acquisition of Certain Durable Medical Equipment, Prosthetics, Orthotics and Supplies 118 Revisions to Payment Policies Under the Physician Fee Schedule and Part for CF 2012 11/23/2011 119 Evaluation of Core Iv'iolence and Injury Prevention Program {Core 11f30!2011 120 Changes to Hospital DPPS and CY 2012 Payment Rates; ASC Payment System and Cir 2012 11f30j2011 Payment Rates; Hospital Value-Based Purchasing Program; and Physician Self-Referral Rules 2017--000433 121 Medical Loss Ratio: Non-Federal Gov Plans 12f7f2011 122 Availability of Medicare Data for Performance Measurement 12f7f2011 123 Medical Loss Ratio 12f7/2011 124 Community Transformation Grants: Use of System Dynamic Modeling and Economic 12f9f2011 Analysis in Select Communities 125 12/ 1312011 125 ERRP Claims Announcement 1221312011 12? Transparency Reports and Reporting of Physician Ownership or Investment Interests 12f19f2011 123 Independence at Home Demonstration Program 12f21f2011 Proposed Information Collection Activity; Comment Request 12f28f2011 130 Adult Health Quality Measures Hal/2012 131 Administrative Simplification: Adoption of Standards for Electronic Funds Transfer (EFT) 1/10/2012 132 Request for Information Regarding the Reinsurance Program under the Affordable Care 1f30f2012 Act 133 ACIP Meeting 134 Covered Outpatient Drugs 2/2/2012 135 Summary of Benefits and Coverage and Uniform Glossa ry--Temp ates, Instructions, and 2f14f2012 Related Materials Under the Public Health Service Act; including template 136 Preventive Services 2/15/?20 12 132 Draft Guidance for Industry Scienti?c Considerations in Demonstrating Biosimilarity to a 2/15f2012 Reference Product; Availability 138 Draft Guidance for Industry on Quality Considerations in Demonstrating Biosimilarity to a 2/15f2012 Reference Product; Availability 139 National Practitioner Data Bank Healthcare Integrity and Protection Data Bank Merger 2f15f2012 14D CDC National Healthy Worksite Program 2f15f2012 141 Reporting and Returning of Overpayments 2f16f2012 142 Application, Review, and Reporting Process for Waivers for State Innovation 212272012 143 Draft Guidances Relating to the Development of Biosimilar Products; Public Hearing; 3f2f2012 Request for Comments 144 Meeting 4/18f12-4l20/12 3/20/2012 2017--000434 145 Medicaid Eligibility Expansion under the Affordable Care Act of 2010 with Interim Policies 3f23f2012 146 State Requirements for Exchange-Reinsurance and Risk Adjustments 3f23f2012 14? Adoption, Health Impact and Cost 3323,0012 143 Establishment of Exchanges, Exchange Eligibility, and Qualified Health Plans Part with 3(221?2012 Interim Policies 149 Draft Guidances Relating to the Development of Biosimilar Products; Public Hearing; Request for Comments; Correction 150 Draft Guidance for Industry on Compliance Policy for Reporting Drug Sample Distribution 4.1312012 151 National Quitline Data Warehouse dill/2012 152 Risk Adjustment Meeting?May 2, 2012 and May 8, 2012 4f11f2012 153 Meeting Cancellation for 4l20f12 4f17f2012 154 Targeted Surveillance and Biometric Studies for Enhanced Evaluation of Community 4f18f2012 Transformation Grants 155 Changes in Provider and Supplier Enrollment, Ordering and Referring, and 4f22f2012 Documentation Requirements; and Changes in Provider Agreements 156 Request for Information: Stop Loss Insurance 52112012 157 Home and Community-Based State Plan Services Program and Provider Payment 5f3f2012 Reassignments 158 Home and Community-Based State Plan Services Program and Provider Payment 51'312012 Reassignments; Correction 159I Medicaid Program; Community First Choice Option S?l2012 160 Monitoring and Reporting for Community Transformation Grant Awardees 5(11f2012 161 Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment 5f11f2012 Systems for Acute Ca re Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates 162 Payments for Services Furnished by Certain Primary Care Physicians and Charges for 51'11f2012 Vaccine Administration 163 Notice of the Award of a Single?Source Program Expansion Supplement to Pima County 5f11f2012 Community College District in Tucson, AZ Under the Health Profession Opportunity Grants (HPDG) 164 Medical Loss Ratio Requirements: Notice Requirements for Issuers 511612012 2017--000435 165 Correcting Amendment: Health Insurance Issuers Implementing Medical Loss Ratio under the Patient Protection and Affordable Care Act 166 Correction: Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment 5f17f2012 167 Solicitation for Proposals for the Medicare Graduate Nurse Education Demonstration 5/18f2012 Program?Deadline Extension 163 ACIP Meeting 5/21/2012 169 Evaluation ofthe Communities Putting Prevention to Work National Media Initiative 53'23f2012 170 Medicaid and Children's Health insurance Program's; Disallowance of Claims for FFP and 5729/2012 Technical Corrections 171 Correction: Establishment of Exchanges, Exchange Eligibility, and Quali?ed Health Plans 5!29f2012 Part with Interim Policies 172 Patient Protection and Affordable Care Act,- Data Collection to Support Standards Related to Essential Health Benefits,- Recognition of Entities for the Accreditation of Qualified Health Plans; Accreditation Requirement in the Federally?facilitated Exchange 173 Community Transformation Grants: Evaluation of Nutrition, Physical Activity, and Obesity-related Television Media Campaigns 174 CDC National Healthy Worksite Program 6f12f2012 175 Submission for 0MB Review; Comment Request. Title: Affordable Care Act Tribal 6/12f2012 Maternal, Infant and Early Childhood Home Visiting Program Annual Report. 176 School Environment Study: Evaluating the Effects of CTG-supported School-based 6/13/2012 Nurtrition, Physical Activity, and Obesity-related Television Media Campaigns 177 NCHM Notice of Intent to award Affordable Care Act funding to the Association of 6/15f2012 Public Health Laboratories to educate public health laboratories about the Environmental Public Tracking Network 178 Impact Studies of the Health Profession Opportunity Grants Submission for 0MB Review; 6f18f2012 Comment Request 179 Request for Measures and Domains for Development of a Standardized Instrument for 6/21f2012 Use in Public Reporting of Enrollee Satisfaction with their Qualified Health Plan and Exchange 180 Announcement of a New Application Deadline for the Advanced Payment Model 6f26f2012 181 National Health Interview Survey 6f27f2012 2017--000436 182 National Ouitline Data Warehouse 21'91'2012 183 CY 2013 End?Stage Renal Disease Prospective Payment System, Quality Incentive Program, and Bad Debt Reductions for all Medicare Providers 184 Home Health Prospective Payment System Rate Update for Calendar Year 2013, Hospice 7f13f2012 Quality Reporting Requirements, and Survey and Enforcement Requirements for Home Health Agencies 185 Patient Protection and Affordable Care Act; Data Collection to Support Standards Related ?!20f2012 to Essential Health Bene?ts; Recognition of Entities for the Accreditation of Qualified Health Plans 186 Proposed Changes to the Hospital Outpatient Prospective Payment System and CY 2013 Payment Rates; Proposed Changes to the Ambulatory Surgical Center Payment System and CY 2013 Payment Rates 18? Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, DME 2/30f2012 Face to Face Encounters, Elimination of the Requirement for Termination of Non?random Prepayment Complex Medical Review, and Other Revisions to Part for CT 2013 188 Targeted Surveillance and Biometric Studies for Enhanced Evaluation of Community Transformation Grants 189 Evaluation ofthe Communities Putting Prevention to Work National Media Initiative 3f7f2012 19D Adoption of Operating Rules for Electronic Funds Transfer (EFT) and Remittance Advice 81'101'2012 191 Office of Direct Service and Contracting Tribes; National Indian Health Outreach and 8,2'20f2012 Education Cooperative Agreement 192 Health Outreach and Education 3/31/2012 193 Cooperative Agreement 9512012 194 Notice of the Award of Single?Source Program Expansion Supplements to Multiple 10f3f2012 Grantees Under the Health Profession Opportunity Grants 19S Smoke-Free Multi-Unit Housing 10f9f2012 196 Announcement of the Award of Four Single?Source Program Expansion Supplement 10f31f2012 Grants To Support Activities Associated With the Tribal Early Learning Initiative. Notice of award of four single- source program expansion supplement grants to Tribal Maternal, Infant, and Early Childhood Home Iv'isiting (MIECHV) grantees to support their activities as participants in the Tribal Early Learning Initiative 2017--000437 19?r Payments for Services Furnished by Certain Primary Care Physicians and Charges for Vaccine Administration under the Vaccines for Children Program 198 CY 2013 Home Health Prospective Payment System Refinements and Rate Update, 11!8f2012 Hospice Quality Reporting Requirements, and Survey and Enforcement Requirements for Home Health Agencies 199 CY 2013 End?Stage Renal Disease Prospective Payment System, Quality Incentive 1119f2012 Program, and Bad Debt Reductions for all Medicare Providers 200 Proposed Changes to Hospital Outpatient Prospective Payment System and CV 2013 11f15f2012 Payment Rates; Ambulatory Surgical Center Payment System and CY 2013 Payment Rates 201 Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to 11/15f2012 Medicare Part for CT 2013 202 Recognition of the National Committee for Quality Assurance and Utilization 11f23f2012 Review Accreditation Commission for Accreditation of Qualified Health Plans 203 Exchanges Part Il--Standards Related to Essential Health Benefits; Health Insurance Issuer 11f2?f2012 and Exchange Responsibilities with Respect to Actuarial Value, Quality, and Accreditation 204 Patient Protection and Affordable Care Act; Health Insurance Market Rules 11/26f2012 205 Incentives for Nondiscriminatory Wellness Programs in Group Health Plans 11f2?f2012 206 Request for Information: Health Care Quality 11f22f2012 202r Request for Information to Aid in the Design and Development of a Survey Regarding 12(31?2012 Patient Experiences With Emergency Department Care 208 Notice of Bene?t and Payment Parameters 12!?!2012 209 Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and 1,1221?2013 Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment and Sharing 210 Request for Information for the Development of a Survey Regarding Patient Experiences 1/25/2013 with Hospital Outpatient Surgery Surgery Centers 211 Request for Information to Aid in the Design and Development of a Survey Regarding 1/25f2013 Experiences with Hospice Care 212 Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules 1(25f2013 under the Health Information Technology for Economic and Clinical Health Act and the Genetic Information Nondiscrimination Act; Other Modifications to the HIPAA Rules 2017--000438 213 ACIP Meeting 2/2o?s?2/21/13 Liza/2013 214 Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions 23'1/2013 215 Certain Preventive Services Under the Affordable Care Act NPRM 2f6l2013 216 Comprehensive End-Stage Renal Disease Care Model Announcement 21? Medicare, Medicaid; lChildren's Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests 218 Medicare Program; Medical Loss Ratio Requirements for the Medicare Advantage and 2f22f2013 the Medicare Prescription Drug Benefit Programs 219 Patient Protection and Affordable Care Act; Actuarial Value Calculator Methodology -- 2f25f2013 Essential Health Bene?t 220 Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review 2f27f2013 221 Solicitation for Nominations 3f8f2013 222 Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Sill/2013 Health Plans; Small Business Health Options Program 223 Patient Protection and Affordable Care Act; Amendments to the HHS Notice of Benefit 3f11f2013 and Payment Parameters for 2014 224 Patient Protection and Affordable Care Act; Notice of Benefit and Payment Parameters 3/11f2013 (SRSIMLRJ 225 Requirements for Long Term Care Facilities: Notification of Facility Closure 3f19f2013 226 Ninety-Day Waiting Period Limitation and Technical Amendments to Certain Health 3f21f2013 Coverage Requirements Under the Affordable Care Act 227 Federal Medical Assistance Percentages Methodologies for Calculation of Enhanced Rate 228 Merger of the Healthcare Integrity and Protection Data Bank with the National Practitioner Data Bank 2017--000439 229 Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators 4f5f2013 and Non-Navigator Assistance Personnel 230 Early Retiree Reinsurance Program- Process Update 4/23/2013 231 Requirements for the Medicare Incentive Reward Program and Provider Enrollment 4/29f2013 232 Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2014 51312013 233 Fr 2014 Hospice Wage Index and Payment Rate Update; Hospice Quality Reporting 5i10f2013 Requirements; and Updates on Payment Reform 234 State Disproportionate Share Hospital Allotment Reductions 5/15/2013 235 Bundled Payments for Care Improvement Model 1 Open Period 5!17f2013 236 Pro-Existing Condition Insurance Plan Program 5/22/2013 237 Medical Loss Ratio Requirements for the Medicare Advantage 8t Medicare Prescription 5,2'23f2013 Drug Bene?t Programs 233 HHS?Operated Risk Adjustment Data Validation Stakeholder Meeting?June 25, 5f29f2013 2013 239 Notification of Closure of Teaching Hospitals and Opportunity to Apply for Available Slots 5,2'31f2013 240 Increased Federal Medical Assistance Percentage Changes Under the Affordable Care Act 6.1312013 of 2010; Correction 241 Incentives for Nondiscriminatory Wellness Programs in Group Health Plans 242 Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans: Small Business Health Options Program 24.3 Program ntegrity:E xchange, SHOP, Premium Stabilization Programs, and Market 6f19f2013 Standards 244 Exchanges: Eligibility for Exemptions; Miscellaneous Minimum Essential Coverage 2f1f2013 Provisions 245 Certain Preventive Services under the Affordable Care Act 246 CY 2014 Changes to the End-Stage Renal Disease Prospective Payment System, End-Stage Renal Disease Quality Incentive Program, and Durable Medical Equipment 242r Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and 2f15f2013 Appeals Processes, and Premiums and Cost Sharing; Exchanges: Eligibility and Enrollment 2017--000440 243 Exchange Functions: Standards for Navigators and Non-Navigator Assistance Personnel; Nil/2013 Consumer Assistance Tools and Programs of an Exchange and Certi?ed Application Counselors 249 Medical Loss Ratio Requirements for the Medicare Advantage and the Medicare 7f22f2013 Prescription Drug Bene?t Programs; Corrections 250 Exclusion of Orphan Drugs for Certain Covered Entities Under 3403 Program 7/23f2013 251 Medicare Provider Enrollment Notice 7f31f2013 252 Pi" 2014 Hospice Payment Rate Update, Hospice Quality Reporting Requirements; and 3!?!2013 Update on Payment Reform 253 Program Integrity: Exchange, SHOP, Premium Stabilization Programs, and Market BIEOIZUB Standards {Including Eligibility Appeals 254 Application by the Accreditation Association for Ambulatory Health Care for 9113/2013 CMS Approval of its Federally Facilitated Exchange Accreditation Program 255 Disproportionate Share Hospital Payment Reduction 9f18f2013 256 Prospective Payment System for Federally Qualified Health Centers; Changes to 9323,1201?) Contracting Policies for Rural Health Clinics; and Changes to Clinical Laboratory Improvement Amendments of 1988 Enforcement Actions for Proficiency Testing Referral 257 Establishment of the Basic Health Program 9f25f2013 253 Program Integrity: Exchange, Premium Stabilization Programs, Market Standards, and 10f30f2013 Cost?sharing Reduction Reconciliation; Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 259 HHS Notice of Bene?t and Payment Parameters for 2014; Technical Amendment 260 Final Rules under the Paul Wellstone and Pete Domineici Mental Health Parity and 11/13/2013 Addiction Equity Act of 2008 261 Proposed Quality Rating System Framework and Measures 11f19I2013 262 CY 2015 Notice of Benefit and Payment Parameters 121'2/2013 263 Patient Protection and Affordable Care Act; Maximizing January 1, 2014 Coverage 12f17f2013 Opportunities 264 Proposed Basic Health Program 2015 Funding Methodology 12f23f2013 265 Approval of an Application by the Accreditation Association for Ambulatory Health Care 12f2312013 for Approval of its Federally Facilitated Exchange Accreditation Program 266 Amendments to Excepted Benefits 12f24f2013 26? Patient Protection and Affordable Care Act; Program Integrity: Exchange, Premium Stabilization Programs, and Market Standards; Amendments to the Notice of Benefit and Payment Parameters for 2014; Correction 263 Certification of Compliance for Health Plans 1f2y?2014 2017--000441 269 Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the 1,110/2014 Medicare Prescription Drug Benefit Programs [Includes Appeals Process for Medicare Parts Recovery Audit Contractor Determinations] 270 Home and Community?Based State Plan Services Program, Waivers, and Provider 1f16f2014 Payment Reassignments 221 Physician Compare Website: Town Hall Meeting February 2&1, 2014 1,2'29f2014 222 Frontier Community Health Integration Project 2(4/2014 273 Medicare Provider Enrollment Notice 3412014 274 Bundled Payments for Care Improvement Models 2, 3, and 4 2014 Winter Open Period 2/14f2014 225 Ninety-Day Waiting Period Limitation--0rientation Period 2l24f2014 226 Ninety-Day Waiting Period Limitation and Technical Amendments to Certain Health 2f24f201?l Coverage Requirements under the Affordable Care Act 27? CY 2015 Notice of Benefit and Payment Parameters 3!11f2014 278 Request for Information Regarding Provider Non?Discrimination 3f12y?2014 229 Basic Health Program; Final Federal Funding Methodology for Program Year 2015 3,2'12f2014 280 Establishment of the Basic Health Program 3f12f201?l 281 Patient Protection and Affordable Care Act; Third Party Payment of Quali?ed Health Plan 3,1191?2014 Premiums 282 Exchange and Insurance Market Standards for 2015 and 2016 3/21/2014 233 Prospective Payment System for Federally Qualified Health Centers; Changes to 5,12/2014 Contracting Policies for Rural Health Clinics; and Changes to Clinical Laboratory Improvement Amendments of 1933 Enforcement Actions for Pro?ciency Testing Referral Health Clinics; and Changes to Clinical Laboratory Improvement Amendments of 1983 Enforcement Actions for Proficiency Testing Referral 284 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription 5f23f201?l Drug Benefit Programs for Contract Year 2015 285 Exchange and Insurance Market Standards for 2015 and 2016 532772014 286 Medicare Program; Additional Extension ofthe Payment Adjustment for Low?Volume 5f17f201?l Hospitals and the Medicare-dependent Hospital Program Under the Hospital Inpatient Prospective Payment Systems (IPPSI for Acute Care Hospitals for Fiscal Year 2014 28? Ninety?Day Waiting Period Limitation?Orientation Period 6!25f2014 2017--000442 283 Annual Eligibility Determinations for Exchange Participation and Insurance Affordability #112014 Programs; Health Insurance Issuer Standards Under the Affordable Care Act, Including Standards Related to Exchanges 289 Medicare and Medicaid Programs; CY 2015 Home Health Prospective Payment System 21'2/2014 Rate Update; Home Health Quality Reporting Requirements; and Survey and Enforcement Requirements for Home Health Agencies 290 Exchange and Insurance Market Standards for 2015 and 2016; Correction 2124312014 291 Medicare Provider Enrollment Phase 1 and 2 Update Bil/2014 292 Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2015 233 Certain Preventive Services; Eligible Organizations Bi27f2014 294 Certain Preventive Services; Non-Profit Religiously Af?liated Organizations Bf27f2014 295 Annual Eligibility Determinations for Exchange Participation and Insurance Affordability 915/2014 Programs; Health Insurance Issuer Standards Under the Affordable Care Act, Including Standards Related to Exchanges 296 Amendments to Excepted Benefits 10f1f201d 23? Exchange and Insurance Market Standards for 2015 and 2016; Amendment 101(112014 298 Final Waivers in Connection with the Medicare Shared Savings Program; Continuation of 10f12f2014 Effectiveness and Extension ofTirneline for Publication of Final Rule 299 Basic Health Program; Federal Funding Methodology for Program Year 2016 10f2312014 300 Approval of Request for an Exception to the Prohibition on Expansion of Facility Capacity 10f31f2014 under the Hospital Ownership and Rural Provider Exceptions to the Physician Self- Referral Prohibition 301 CY 2015 Home Health Prospective Payment System Refinements and Rate Update 11512014 302 CY 2016 Notice of Benefit and Payment Parameters 11f26f2014 303 Food Labeling; Nutrition Labeling of Standard Menu Items in Restaurants and Similar 12(112014 Retail Food Establishments; Calorie Labeling of Articles of Food in Vending Machines 304 Food Labeling; Calorie Labeling of Articles of Food in Vending Machines 12ilf2014 305 Provider Enrollment Application Fee Amount CY 2015 12f5i2014 306 Medicare Shared Savings Program: Accountable Care Organizations 12/3f2014 30? Amendments to Excepted Benefits 303 Summary of Benefits and Coverage and Uniform Glossary 123012014 309 Medicare Provider Enrollment Phase 1 and 2--2nd Update 2f2f2015 310 Contract Year 2016 Policy and Technical Changes to the Medicare Advantage and the 2112/2015 Medicare Prescription Drug Benefit Programs 311 Reporting and Returning of Clverpayments; Continuation Notice 2f17f2015 2017--000443 312 CY 2016 Notice of Benefit and Payment Parameters 2f2?f2015 313 Amendments to Excepted Benefits 3f18f2015 314 Medicare Program; Updates to the List of Durable Medical Equipment Speci?ed 3f27f2015 Covered Items that Require a Face-to Face-Encounter and Written Order Prior to Delivery mien Sec 1001 Sec 1001 Sec. 1001 Sec. 1001 Sec. 1001 Sec. 1001 Sec 1001 Sec 1001 Sec. '1001 Sac. 1001 Sec. 1001 Sec. 1001 Sac 10m See. 1000- Language IN GENERAL- The Secretary shall establish a minimum interval between 1he date on which a recommendation dasr?nad in subsecticn or taK2}ora guideline under subsection [aim is issued and the plan year with respect to midi the requirement oesmeed In subsection tat ls afoot-re IMlh respect to the service desc'roed In such recommendallon 01' guideline VALUE-BASED INSURANCE Secretary may develop guidelines to permit a group health plan and a health Insurance issuer group or health nsurance coverages: utilize vauebased Insurance designs. developing the reporting requirements under paragraph (1). the Sacrelary may develop and impose penalties [or non-compliance with such requiements. devecpng the rooming reoL-rerhents under paragraph :11. the Secretary may prom-es tor exceptions to such requirements forgroup health plans and health insurance issuers that substantially meal the goals of this section. Regulations the Secretary anal promulgate regualicns to some the dependents Lc 'M'Iid'l cameos shal he niece amiable under subsection (at. In General? Not later than 12 months alter the date ol'enactment otthe Patient Protection and Affordable Cue Act. the Sartre-lainr shal develop standards foruse by a group health plan and a health Irrsuanoe issuer uttering erotic er indilndud health irrsuanoe COVEIEQB. in corruiling and providing to enrollees a summary of bene?ts and coverage aaplanaticn lhat accurately- clasu'ibas the bene?ts and coverage under the appicabia plan or coverage. In datrelcping such standards. the Secretary shal consult with the National Association of Insurance Commissimers [referred to in this section as the a wiring we composed of representatives at health Insurance-related consumer edvocaw orgmizalions. health issuers. hedth care professionals. patient advocates including those InGeneral- Not later than 12 months after the date of enactment of the Patient Protection and Affordable Care Act. the Secretary shall develop standards for use by a group health plan and a health insurance issuer offering group or individual health insurance coverage, in compiling and providing to a summary of bene?ts and coverage explanation that accurater describes the benefits and coverage under the applicable plan or coverage. hdeveloping such standards. the Secretaryr shall consultwith the National Association of Insurance Commissioners (refined to in 1his Periodic Review and Updating? The Secretaryl shall periodically review and update. as appropriate. the standards developed under this section. The Secretary shall, by regulation. provide for 1he development of standards forthe de?nitions of terms used In health Insurance coverage. including the in5urance-related terms described in paragraph i21and the medical terms described in paragraph AVAILABILITY OF REPORTS- The Secretary shall ma i00- "l3l Installing program data mder title and lille lotion race. ethmotu. sex. HHS AVAILABILITY OF SecretaryI mayI matte data described In la] and [hi air-arable for additional research. analyses. and osseminat-on to other Federal agenoes. non-governmental B?tltiB-S. and the public. it accordance with any Federal agency?s data user agreements. HHS REPORT ON later than ?10 rnonlhs etierthe date ofthe enactment otthis section. the Secretary shell subrrl't to Congess a report on the evaluation conducted under subsection (at. Such report shall. taking into cons-aeration the results at such avaluatlon? Identity approaches including methodologies: lor identifying and collecting and euatuding data on health care disparities on the basis of race. ethnicity. sear. primary tangtage. and disability slatus lorlhe programs anterlhis lille and tille ?(Bi include recommendations on the most e?ectiue strategies and apaoarhes to reporting HEDIS quality measures as required under sect-on redolent and other nationally recognised quality pertormance measures. as wpropr?ate. on such bases. HHS REPORTS ON DATA later than It years after the date at the enactment of this sect-on. and 4 years thereafter. the Secretary shall submit to Congess a report that indudes recommendations lorimprou'ng lhe Identlfoatrm of health care dlsparIt-es torbenelIc-arles mderth-s this and under htle Wheeled cn analyses of the data collected under subsection HHS IMPLEMENTING EFFECTIVE later than 24 months after me date or the enactment cl Ihas section. the Secretary shal mlement the approaches identified in the report submitted under subsection that} for the ongohg. accurate. and timely collection and eueluelion ofdats on health care disparities on the basis ol'raca. ethnicity. sea-t. primary language. and status." HHS 2017--000485 Sec 430? Sec. tram Sec. d305- Sac. ?1305 Sec. 4305 Sec 4306 Sec 11305 Sec. ?02 Sec. 5103 Sec. 5103 Sea 51:13 Sec 5201 Sec 5203 Sec. 5203 Sac. sane Sec 5204 Sec 5204 Sec 5204 ?'I'l're Sectetary shall evaluate. in accordance this part. all program funded through the Centers torDisease Control and Prevention before conducting such an evahetion programs mless an entity a privately fut-toad wellness program requests such an evaluation IN to the availability otepproorist-ons. the Swetsry. acting throuyr the Director or the Genius for Disease Control and Prevention. shall establish a1 Epidemiology and Laboratory Capacity Grant Program in swat! grants to State health departments as well as local health departments and tribal jurisdictions that meet such cribsria as the Diredor oetennines appropriate Academic centers that assist State and eligible local and trial health departments may also be eliynle forturicitg Lnder this section as the Diector determines appropriate. Grants shall be awarded under this section to assist public: health agencies in improving surveillance for. and response to. infectious diseases and other mnditlons 0' Erotic heath Importance by? epidemiologir: capacity to Identify and monitor DOWENING ?Not later men 1 year alter Imus are epoopriamo to carry out this substituted. the Secretary or Health and Services shall seek to enter into an aye-amen! with the Institute of Medicine otthe National Academies to carotene a lConference on Pain iin this subsection referred to es 'the Conference"[r. Sect-star)r establish not Iabertha'l 1 year afterthe date ofthe enactment ofthis section and as necessary manta?- a count-?ee. to be known as the P?s-n Rose-arm Coordhating Corr-Whoa [In this section relented to as the to cooranate all el'l'orts within the Department ot Health and l-turnan Serums and other Federal agencies that mists lio pain reseach. IN Secretary mayI melts awards ofgrants. cooperative agreements. and contracts to health schools. hosp-oes. and other Mlle and mate amines forthe development and Norman's to provide education and training to health care professionals in pain care. Secretary shal review the necessity of the Committee at least once every- 2 years". EVALUATION OF Secretary shall (directly or throum gents or contracts] providefor the evaiLation of program implemerrled unis! subsection [at in crderto determine the etferl ofsorh program on krrov?edge and Promise of pom care. Todatermine ?nettle: existing Federal health and wellness Initiatives are attractive in solievlng their stated goals. the Secretary ofHeellh and Human Services shell? conduct an evaluation of such pro-yams as they relate to changes in health status otthe American pubic and speci?cally on the health status ofthe Federal world?orce. inducing absentee-am or mop-see. the productivity oternployees. the rate olwonrolooe Injury. and the medical costs locum by employees. and health conditions. including workplace ?tness. health)l foo-cl and beverages. and incentives in the Federal Employee Health Benefits Program; aid {2i subrrc't to Congesa a report cormning such evaluation. which shall Include ooncluslons who the reasons that such oograrns have WOVEN wastul or not successful shall establish the National Carder for Health Workforce Analysis (retell-ed to in this section as the 'National Centar']. IN Secretary shall ansrd grants to. or enter into contracts with. eligible entities for purposes of? "(At collecting. malyzing. and reputlng data regarding programs unth? this title to the National Center and to the public: and prwidig techrical assistance to lo-cd a'rd regional entities on the collection. analysis. and reporlirg ot'data. IN Secretary shall Increase the amount are-erase to an ellgole under this the for a longitudinal aviation of individuals who have received education. bathing. or ?nancial assistance from programs undsl this title. STUDENT LOAN Secretary of Health and timer: Services shall not require parental financial tor an lndwendern student to deterring ?nancial need undersection tea or the Public Health Sent-ice Act [42 292a] and the determination ofneed Iorsuch 'nformation shall be at the discretion ofapplicebte school loan othcer. The Semetary shell amend gu'delines issued by the Health Resources and ServicesAckninistration in soot-cams it?ll! preoedlng sentence Secretary shall and carry out a neurotic specialty loan repayment Diagram mder which the eigible individual agrees to be employed full-tine fora speci?ed period tntich she] not be less "131 2 years) in providing pediatric medical subaperielty. pediatric sugicel specialty. or child and adolescent marital and behavioral health care. Including steers-hoe abuse oresentlon and treatment sauces. PROGRAM the program esteolls'lso unoer this sealer-l. the Secretary shall utter Into contracts with ouai??ad health professionds under "tit such quali?ed health professionals will ages to provide pediatric mecicsl stinspeoislty. pediatric aurgicsl specialty. or child and adolescent marital and behavioral health care it an area with a shortage otthe speci?ed oedlatrlo that has a suf?cient osdlatm: populate-n to support such pediatric subspacialty. as dehen'ri'red by the Secretary; and the Sonetary agrees to malts payments on the principd 31! interest ofundarg'aohatie. graduate. orgaduelis medical education loans of professionals described in paragraph of not me than 535.000 a year foreaoh year ofagreed upon service under such WW RX 8 period ol' entering into contracts under this subsection. the Secretary shall give priority to applicants ?{It are or 'Mll be working In a school or other or secondary education setting: have tertiianty with ell-idem methods and cultural and linguistic cancels-roe health care sen-ms. and demonstrate ?nantial need. Secretary shall establish the Public Health Workforce Loan Repayment Program [referred in in this section as the 'Fn?ogrom'] to assure an adequate supply or public health prolessonals to eliminate critical public health workforce shortages in Federal. State. local. and tribal public health agencies. FOR YERRS SERVE lit?For each year of collected send-cc that an contracts to serve under subsection tc] the Secretary may pay up to 335.000 on oer-latter the tor loans oesobeo In paw With respect to participants Lnderlhe Program whose total eligible EIE less than the Secretary shall pay an amount that does not exceed 123 eligible lee-n balance for each year strict-gated mloe ofthe minimal. HHS HHS HHS HHS HHS HHS HHS HHS HHS HHS HHS HHS 2017--000486 Sec 5204 See. 5206 Sec. 5208 Sec. 5301 Sec 5301 Sec 5301 Sec 5301 Sec. 5302 Sec. 5303 Sec. 5303 Sec 5304 Sec 5304 Sec 5304 See. 53th Sec. 5305 Sec 5305 Sec 5305 Sec 5305 TM the pupose cip'oviding reimbursements for tart liability resulting from payments under paragraph [21m hehatf of an individual. the SecretaryI shell. in addition to such payments. payments to the individual in an amount not to closed 39 percent of the total amount of loan repayments made For the taxable year molt-ed. HHS IN Secretary may make grants To. or enter Into contracts with. any ellgrote entityI to ward sdiolarshics to eligible Individuals to enroll in degree or protessicnal tradiing prove-Ins for the purpose of erraclhg mid- caeer professionals it the public health and ied heath workforce to receive additional training in the field of pdolic health and allied health. HHS AUTHORITYTCIIAWARD Sec-stay shall awad ganls list the cost ofthe operation ot'mse?mareged health clinics that meet the requirements cilhis section. HHS IN Secretary may make grants to. or neuter Into contracts with. an accredlted Mlle or nonpro?t private hospital. school ot'medlcine or osteopathic medic-1e. academically ark-sled physician assistant training program. or a pubic. or private nonpro?t entitywhich the Secretary has determined is capable of carrying nut such grant or contract? HHS IN Secretary may make grants to or enter into contracts Irlilh accredited schools of medicine or osteopathic medicine to establish. maintain. or in'prmre? "(At academic units or 'rnproue clinical teeohIng and research In ?elds de?ned In msectron [ak'l tied: or"[B} programs that Integrate academlc sdm-I'Ilstrathre units in ?elds de?ned in subsection [aunt-Hi to enhance interdisciplinary raanilmanL training. and facility development. HHS PREFERENCE IN AWARDS UNDER THIS making swarms of giants and contracts under paragraph the Secretary shall g've pre?erenoe to any guai?ed epplicent torsud'i an ewad that egees to expend the md Forthe pupose oi? esleb?shing academic units or programs in ?elds de?ned in subsection {e?t?hk or "[55 substanllalty expending such units or programs. HHS PRIORITIES IN WING awarding grants or contracts under paw {13. the Secretary sh?l give priority to quali?ed applicants thal? proposes a collaborative project between academic adrri'iislrat'ruie units of primary core: proposes innovative approaches to clln-oal teaching using of primary care. such as the pattern centered medical home. team management of chronic disease. and Interpmlessimal integrated modes of health care that i'rcorporete transilions in heatth care settings 31d i'rliegrelion physical 31d mental health pmsisicn; "(Ct have a record oftrs-nlng the greatest percentage of providers. ortnat have signi?cant Improvements in the percentage of providers trained. who mLer and main in primary? care practice; to} Ira-tea record of train-ring Individuals HHS IN Secretary shall award grants to eligible entities to enable such entities to provide newt-airi'rg For driest care Irior'ker's Mn are employed In long-term (are settings sum as nursing hen-es dented I1 section 1506mm tor the Social Seourlty Act [42 U.S.C tSS?g-ietitii. assisted living facilities and stated nursing facilities. i'rterrnediata care fadilies fori'rdiuidtals with mental retardation. home and community based settings. and any other selling the Secretary determines to be appropriate. HHS IN Secretary may make grants to. or enter Into contracts with. a school pmllo or nonpro?t private hospital. or a public or priyie nonprotitentily which the SecretaryI has determined is cadeIe ofcarrying out. such grant or corrlract? HHS PRIORITIES IN MAKING respect to treating prom'jeclfor under this section. the Secretary shall give priority in awarding grants or attracts lo the lollowing "m Qualified app-rants tnal propose collaborative wojects between departments ciprimary cane mus-cliche and departments of general. pediatric. or public health dentistry. Quali?ed applicants that haves record oftra'ting the greatest percentage ofprcuiders. orthet latte demonstrated s-gnl?cant movements In the percentage ct wonders. lr-rho enter and remain In general. pediatric. or publlc health dentistry. Quali?ed applicants lhat haves record of training individuals who are a nJral ordiactvantaged background. orfrorn underrepresented minorities. "tit: Dieli?ed applicants that establish formal relationships with HHS Secretary is authorized to awad pants to 15 elijila entities to enable such entities to establish a demonstration program to establish tram-ng programs to train. or to enuloy. elemattue oentel health mire provider's i1 orderto increase access to dental health care sen-ices in rur? and other underscored communities. HHS DISEURSEMENTS 1 year are the enactment of this section. the Secretary mayI disperse to anyI enlity receiving a grant under this section not more than 20 percent ofthe total fuming awarded to such entityI under such grant. torthe purpose of ensb?'rig the entity to plan the demonstration project to be oer-ducted under such grant HHS Secretary shall contract Iwith the Diec?lor oilhe Institute of Medicine to conduct. a stud)I ofthe demonstration pro-Jams conducted under this section that shall prouide analysis based upon cpantitstiue and qualitative data. regarding access to dental health care In the United States. HHS IN Secrelar)l shall award grants or contracts underthis subsection to entilies that operate a geriatric education center pursuant to subsection HHS The Secretary shall require such Centers to work 'I?rilh apoopriate community partners to limit]? training program content and to pubic'ae lhe availability of training causes in the- sen-ice aees. HHS IN Secretary shall award grants or contracts Iriderthis section to individuals described in paragraph to IosLer wearer interest among a variety or heart professionals In entenng the field or geriatrics. long-teen care. and chronic care management. HHS The Secretary shall determine the amountor an Mare under this section for Ind-viouatsnt'c are not pays-cans HHS PAYMENT TO Secretary shal cake to itslitutions which include schools of medicine. osteopathic mec?cine. nursing. social work. dentistry. and pham'recy. orother allied health discipline in an accredited heetth professions school that Is approved by the Secretary". HHS 2017--000487 Sec 5306 Sec. 5306 Sec. 5306 Sec. 5306 Sec. 530? Sec 5307 Sec 530? Sec. 5307 Sec. 5307 Sec. 5306 Sec 5309 Sec 5309 See 5309 Sec. 5309 Sec. 5309 Sec 5309 Sec 5311 Sec 5311 GRANTS Sea-em may award grants to eligible institutions of higher erlrcation to support the recruitment ofstudenta for. and education and clinical experience ofthe students baccalaureate. master?s. and doctoral degree program of social retort. as well as the deuoomlenl otters-in- In social nork: accredited master's. doctoral. intemship. and post-doctoral residency programs of [or lhe development and implementation of interdisciplinary tra'ting of graduate students for pro-riding babel-iota and mental health services. inciuii'lg substance abuse prevention and treatment sent-ms: "{Sl accredited Institutions or acoedlled professional training programs that an! establishing or expanditg internships or other ?eld placement programs in mild In selecting the grant recto-ants In sod-at wort: u'idersuosectron {ski}. the Secretary shall give priority to applicants that? are accredited by the Gwncil on Social Work Education. ha-rea graduation rate of not less than do percent for social work students; and exhiJit an ability to racruil social Irtorttars from and place social workers in areas with a higt need and high demand population. In selecting the grant recipients in graduate under subsection the Senetary shall gilre priority to institutions in which training focuses on the needs of uttera?e groups such as olderadulta and children. individuals mh mental health or suostanoerelated disorders. ?mime otabuse or trauma and of comba1 stress disorders such as posttraumalic stress disorder and traumatic brain' Injuries. homeless individuals. chronically in persons. 31d the" fur-lies. [El In selecting the grant recipients In training programs It child and adolescent mental health under subsections {aim and {and}. the Secretary shall give priority to applicants lhat? the ability to collect data on the numberof students trained in child a'id adolescent mental health and the populations asnrad by sud1 students atlar graduation orcompletion otpresenrice or in-san'ice training: "15] have demonstrated familiarity with eviriertoe?baeed thl'iOClS in Chll? and adolescent mental hm WWIDBS. Including substance abuse prevention and treatment services. "{Ci have progarns designed to increase the I'Iun'ber otprofessionals and paraprofessionals serving high-priority poptlations and to applicants also come from high-priority communities and plan to same medically Lr-darseryad carrying out subsection the Secretary shall collaborate with health professional societies. licensing and accreditation entities. health professions schools. and experts in ninority health and cultural competency. premm. and pubirc health and (instability groups. community-based organizations. and other oromlaatons as deten'ri'red appropnata by the Secretary. The Secrets-y shell coordinate with cum and research and projects moped utoer sedlon BUT. Secretary shall evaluate lhe adoption and the inptemenlation of corripelency. prevention. and public health. and I.rtrortting with individuals with a disability trairi'ig wn'icula. and the facilitate 'I'Iclusion ot'these compete-or measures In quality measurement systems as eooromete. carrying out subsection the Secretary shall collaborate saith the entities described in section The Secretary coordinate with currictla and research and demonstration projects developed umtar such section 1'41. RETENTION AREAS ?Tt1e Secretary may arm grants to. and enter into contracts with. eligiile entities to enhance the nursing workforce by initialing and maintaining nuse retention programs meant to subsection or ic]. GRANTS FOR CAREER LADDER Secretary may award grants to. and enter into contracts with. eligible entIt-es for ow? i to pro-note career advancement for Individuals Including licensed practical nurses. licensed I.Iocalicnnrarl nurses. certi?ed nurse assistants. norm health series, diploma demo; or associate degree nurses, to become baccalaureate prepaed registered nurses or athenced education nurses in orderto [treat the needs otthe registered nurse wortdome: "tZl deraioolngand Implementing Internships and residency programs In collaboration with an aooedlted school ot?nursing. as de?ned by section 501:2}. to entourage mtorhg and the oevdomrettot specialties; or '13} to assist inciuiduals in obtaining education and training replied to enter the nursing profession and GRANTS ?The Secretary may am grants to eligiile entities to trauma the retentim of nurses and enhance oatient that is directly related to nursing activities by erltanc'ng colaboration 31d among nuses and other health care professionals. and by promoting nurse introhementit the organizational and clinical decision-matting processes or a health care tacit-1y PRIORITY. matting awards ofgrants under this subsection. the Secretary shall givepreference to applicants that hairs not previously received an award under this subsection {or section 831(c) as such section artiste-d on the day before the date of enactment of this section] OF Seo'etary shall matte continuation otany award under lhis sucseollm beyond the second year of such award contingent. on the recipient ofsuch award having demonstrated to the SecretaryI measurable and substantive improvement in nurse retention or patient care. OTHER PRIORITY AREAS. ?Tne Secretary may shard grants to. o' ante Into contracts with. eligible entities to address that are ofhigh priority to nurse retention as daterrnined by the Secretary Secretary shall submit to the Congess before the end of each fiscal yeara report on the yants awarded and the contracts entered into Lnderlhis section. Each such report shal identify the mental number of such grams and contracts and prodde an smlanatlon each such grant orconlrect mil inset 1he priority need oftne nursing workforce. IN Secretary. acting hough the Adniniatratcr ofthe Heatlh Resources and Services Administration. may enter onto an agreement with eirglole forthe repayment ofeduoatidn loans. In aocordanoe with section. to increase the number of Quali?ed nursing faculty. not rim than 10 mmlt'rs arra- Inc :1an on which he 5-year period describes wear subsection neg-Its. our in no case before the individual starts as a full-time mariner otthe faculty of an accredited school of nursing the Secretary shall beg't miting payments. forand on behatfot'lhet inciuidud. on the outstanding principal of. and interest on. any loan of that Indiv-clual were: to pay for sum degree HHS HHS HHS HHS HHS HHS HHS HHS HHS HHS HHS 2017--000488 Sec 5311 Sec. 5313 Sec. 5313 Sec. 5313 Sao5313 Sec 5313 Sec 5313 Sec. 5314 Sec. 5314 Sac. 531-1- Soc 5315 Sec 5315 Set: 5401 Sec. 5101 Sec. 5401 Sec 5401 Sec 5400 Sec 303 WAIVER 0R SUSPENSION 0F the case of an Individual making an agreement for purposes of paragraph the Secretary shall prim-ids tor the waiver or suspension of liability u'tdersuch paragraph if compliance by lhe individual with the agreement mun-an is ?possible oruuduld involve extreme hardship to the individual or if enioroenm of the agreement with respect lo the Inauldual would be unconscionable. HHS awarding grants (at. the SecretaryI shall give priority to applicants that? propose to target geographic araas? with a higl percentage of residents who as eligible For health insu'anoa bul are uninsured or underlnsured; "iBl a mill percentage of residents who mron-t: diseases; or "iCi with a rich intmt mortality rate: mannerisms In pith-W health or sodal Barium to individuals wttoaro undersenred with respect to such services; and have documented oommurl't)r activity and eJ-tpen'enoe with community health workers. HHS WITH ACADEMIC INSTITUTIONS MD THE Secretary shall encourage community health worker orders-111s rooming funds under this section to collaborate Ml?t acodernlc institutions and one- stop doivery systems tnder section 134th of the Workforce hvesimont?cl of ISBE. Nolhing' In this seclien shall be construed to require such oelaboralien. HHS Secretari- shall encourage community health worker program receiving func?tig Lnderlhis section to iriplemenl a prooe-ss oran outloornebaeed payment system that I'E'Waltts. community t'lBBIIt't workers 003130009 populatims with tht! most appropriate 33111603 at IHB "1051 amidprlate lth. Nothing in this section shall be constnied to reunite such a payment. HHS ASSURANCE AND COST Secrelery shell esleblish guidelines foressuing the quality of the and supervisbn oloornrnunnly health workers orderlhe programs funded under this sect-on and lot sealing the oostalfediyenass ofsuch programs. HHS Secretary shall rrtonibor health worker programs identi?ed in epprouedepplications under this section and she! detemi'ie whether such programs are in compliance with lhe guidelines established under subsection igi. HHS Secretary may provide technical assislanoe to community haailh worker programs identified it waved applications under this section with respect to planting. developing. and operating oregano under the grant. HHS IN Secrelary may- carry out activities to address documented ?enforce mmes in State and local haailh departments in the critical areas olaopliad pdjlic health epidemiology and public health laboratory sciarioe and informatics and may expand the Epidemic Intelligence Sen-ice. HHS SPECIFIC out subsection lot. lhe Secrolanr shall amide lorlho expand-on of fellowship programs operated through the Centers for Disease Control and Prevention in a manner that is designed to alleviate shortages of the type described in subsection HHS OTHER PROGRAMS ?Tns Secretary mayr pro-Ms for the expansion clothe? aopllod epidemiology training progmms that meet objectives similar to the objectives of the prey-ans In subsection[b HHS In so prescribing lhe ruriber otp-ereona to be gaduatied frorn lhe Track. lhe Seaetary shall institute actions necessary to ensure the oldie-1mm numberof?rstyear enrollments In the Track consistent min the academic mpaclly of the a?lliatod sites and the needs of tho United States for mod-cal. dental. and ours-lg personnel. HHS Beginning with ?scal year 2010. the Secretary shall the Public Health and Social Services Emergency sud-I sums as may be necessary to carry out this part. HHS the Secretary shall matte available 512,000,000 For pants under aubsediori {at to health professions schools that meet the conditions In swsemion Ecli2ltiti: HHS and available after granls are made Iwith fu'tds under clause lhe Seaetary shall malra ausilable?' EEII percent ofsuch emou'ltfer grams under subsection {at to health professions schools that meet the conditions described' In paragraph or t4) of subsection [cl [midlng meeting Ins conditions undorsuhsoctlon tell: and' ['01 40 percent oi such amourttfor grants under subsection {at to hedth professions schools that meet the conditions described in subsection HHS FUNDING IN EXCESS OF 530000.000 ? farnounls approprlaled under subsedlon ill lot a llsoal 530.000.0013 but are less man 540.000.0011. Smtary shall malts am? not less than 512000.000 for grants under subsection ts} to health professions schools that meet the conditions described it subsection nel less then 512.000.0130 Iorgrenls Lndersubseclien to health protessiens schools that meet the conditions destined in or ctsubsection ic} [Including meeting conditions wrsuant l0 subsection "till not less than 53000000 [or yanks under subsection {at In heatth professions schools that meet the ooniitions described in subsection thIjS-i: and alter grertls are made finds under clauses througl any remaining eotce-ss slneunt HHS FUNDING IN EXCESS OF ?0.000.000 .?Ifemounls epproprialed under subsection {it tore Iiscel yearere Sd0?000000 or more. the Secretary shall make available? "Ill n01 less than $16. 000. 000 lot grants moor aubaoollon lo realm protassions schools that meat lhe conditions described in subsection not less than $13,000,000 [or gents under subsection ts} to health professions schools that meet the conditions described paragraph or?) of subsection to] tlnoludlng meet-no Dominant lo tell; "l-l not less than 55.000000 for grants under subsection (at to health professions schools that rneel the conditions described i1 subsection tc]t5]; and attier grants are made with funds ti] til-trough any remaining [Linda forgranta u'IdarstIJeaction ta}t1o health HHS ESTABLISHMENT OF Secretary snail make the fold-tum 2 types ole-horde. In acoordama lnilh section HHS INFRASTRUCTURE DEVELOPMENT Secretary stall malts awards to eligible entit-ss to enable such entities to initiate health care workforce educational proga'ns orto continue to cary out comparable proga'ns that He eperet'I'Ig at the lime the ward is made by pleming. developing. operating. and 9'1.an an area. heath educailon Denier program HHS 2017--000489 Sec 540% Sec. 51103 See. 5103 Sec. 5406- Sac. 5-103 Sec 54103 Sec Sec. 510:!- Sec. 5-104 Sec. 5405 Sec 5405 Sec 5405 Sec 5501 Sec. 5501 Sec. 5502 Sec 5502 Sec 5502 Sec 550? POINT OF SERVICE AND ENHIRNCEMENT Secretary shall malre awards to eligible entities to maintain and Irrorove the etlectiyeness and capabilities at an existing area health education center program. and make other modi?cations to the program that are appropriate due to changes in demographics. needs of the pepdations served. or other similar issues re?ecting the area hestlh education center pro-gram. For'lhe purposes of rule sect-on. the rem-r ?Progrsm' raters to the area heellh educator cotter program HHS With respect to a State in which no area health education oenterprogrem is in operation. the Secretary may award a grant or contract anler subsection [a][1]lcr school of nursing. HHS AREA HEALTH EDUCATION CENTER carrying out this section. the Secretary ensure the tailor-hiring: "(At An emny that reaches an me under this section snail oonouci at least 10 permit education required for medical students in community settings that are moved From the primary teaching tacility ottha contracting institution Iorgantees that op-Hate a school ofrnedicine or osteopathic: medicine. HHS In States in Irit'rich an entity that raoaivssan award meter this section is a nursing school or its plant institution. the a el alternatively ensure that? "ti]I the nursing school conducts at least percentaf clinical education required for nursing students In community settings that are rewrote From the puma-ry teaching oi the school: and "till the entity reoeinng the award maintains a written agreement with a school oi methane or osteopathic medicine to place students item that school in training sites in the area health education center pro-yam area. HHS AREA HEALTH EDUCATION Secretary shall ensure that each area health education center program Includes all least 1 area health education center. and that each such center? "trill is a clinic or private crgarlzatlon whose structure. govemanoe. and operation is the awadee and the parent institution oi the melee; is not a school of rnadicine or osteopathic medicine. the parent institution oisuch a school. ora branch campus or either emunil of a smear dtmedlone drosteopeiiuc men-one or its parent mstituilcn. or a consort-um of such entitles: "{Ct designates an underarm-ed area or population to be served by the center which Is In a location termed item the main location otthe leaching faciities otthe schools pa'ticipating i1 the program with such center and does not HHS To provide rreedacl ?exibility to newly funded area heath education center programs. the Secretary may waiveths requirernerlt in the sentence for the ?rst 2 years ofe. rrevraree health education center prognnfu'rded meter subsection [ant]. HHS If emou1ts appropriated to carryI out this section are not sufficient to comply with the preceding sentence. the Secretary may reduce the parcentsr amount provided iirin such sentence as necessay. provided the distribution estabishad in subsection Ult2} Is maintained. HHS IN Secretary shall make grants to. and enter this contracts with. eligible entries to Imcmwe health care. retention. increase maesentalicn family members. enhance the practice erlvirmment. and provide i1tormation dissemination and educational support to radios professional isolation through the timely dissemination of research ?nch-gs using ralevarl resources. HHS Secretary may": by soiling ?pro?entry preparation. and retention activities" and inserting the talc-Hing: "st-pends or associate degree nurses to sitter a bridge or degree comrlletlcn program. student sct'rolarships or stipends foraocelerated nursing degree programs. pro-antly preparation. advanced education preparation. and retention activities?; and HHS IN Secretary. acting through the Director at the Agency to Healthcare Research and Quality. shall establish a. Primary Cane Extension Progam. HHS GRANTS ?The Secretary shall award W?ltl?e grants to States for the establishment otStaie? or multistaielcvel primary as Primary Care Extension Program State Hubs {retened to in this section as 'Hubs']. HHS REQUIREMENTS ON THE carrying out this section. the Secretary shall consult with the heads at other Federal agencies with demonstrated eirperience and expertise in health care and preventive medicine. such as the Centers for Disease Control and Preyenlicn. the Substance Abuse and Mental Health ministration. the Health Ftesourcas 31d Services Adni1istration. the National Institutes of Health. the Critics oi'the National Coordinatorfor Health tntomrrsition Ted'rnology. the Indian Health Service. the Agricultural Cooperative Erhansion Service of the Depamrenl of Agriculture. and outer entities. as the Secretary determines wpropnste HHS In lieu the buckaetmutrality adjustments reqi'red under clause to relative value units to account for such costs for the year. the Secretary shall apply such budget-neutrality adjusb'nents lo the conversion Factor otherwise deten'rl-ned for the year. HHS For 3311 and smsequent years. the Secretary mosses the incentive paymem othenvise applicable section 18313th by a percent estimated to be equal to the additional expenditures estimated under the ?rst sentence oi this clause to such year that is applicable to physicians who prin'erily tumish services in areas designated {under section 332mm must the Public Health Service Act] as health professional shortage areas?. HHS IN Secretary shall a prosecute payment system For payment tor Federally quali?ed health services furnished by Federally matinee health centers meet this 1iiIe.Such system shall a process to appropriater describing the services fun'rished by Federally quali?ed health centers. HHS OF DATA AND Secretary shall requ're Federally quali?ed health centers to submit to the Secretary such information as the Secretary may require in orderto developend implement the prospective payment system undermls paragraph and paragraph r2i. respect-very. Including the recurring cfser'idces using codes. HHS IN GENERN..?Notwithstanci1g section the Soo'eIary shall proy?de. forcost reporti1g periods beg'm'rrg on oratterOctober 1. 20?. forpeyments for Federely qui?ed heath services funished by Federally quali?ed health centers undermls true In accordance with the prospective payment system developed by the Secrelaly under new HHS INITIAL Secretary she! ?element such prospecltye payment system so that the estimated amount ofetrpendilures under this title torFeclarally quali?ed health services in the ?rst year that the prospective payment system is implemented is equal to 103 percent ofthe estimated amount oteJ-rpenditures underlhis title that would have opened for such services in such year if the system had not been Imrtlemented HHS 2017--000490 Sec 550% Sec. 5503 Sec. 5503 Sac. ssoc Sec. 5503 Sec 5503 Sec Sec. 5504 Sec. 5505 Sec. 5506 Sara 5506 Sec 5506 See 5506 Sec. 5507 Sec. 5507 Sets 550? Sec 550? Sec 550? IN Secretary shall increase the o?lhamrise applicable resident lirII't For oath qualifying hospital that submits an applicarlim under this maragraph by such more as the Secretary may to! portims or cost reporting panods ocwning on or alter July 1. 2011. The aggragde numbarof increases in the otherwise appicdzrie resident limit under this shall be equal to the agg'egate reduction in such limits attributable to separagraph [at [as estimated by the Secretaryi. HHS The Secretary may Imt?ralhara hospital has met the raqtiemanls under this clause during such 5-year period in such manner and at such time as the Secretary determines appropriate. ?nding at the end olsuch 5-year period. HHS REDISTRIBUTION OF POSITIONS IF NO LONGER MEETS the case Mists the Secretary datem'lines that a hospital described in clause [ii] does nol meel ailharotthe requirements under subolause it: or EIIJ otsuch clause. the Secretary mall? reduce the otherwise applicable readent limit of the hospital by the amou'lt by which such limit was increased undsl this paragraph: and provide forthe distribution of positions attributable to such reduction in accordance with the requirements oithis paragraph HHS CONSIDERATIONS IN datemrining iorwhirh hospitals the increase in the otiletvrise applicable resident limit is presided under eubparagmh the Secretary shall take into account? the demoretrat-on likelihood of the hoop-tel the pot-lions made amiable under this paragraph within the ?rst 3 cost reporting periods timing on or alter July 1. son. as determined by the emery: and another the hospital has an accredited n.lraI training tract: tas described in paragraph HHS PRIORITY FOR CERTAIN fonthirh hospitals the increase in the otherwise appicebta residem ls promed under wbparagmdh tdi. subject to suhoeregraph iEt. the Secrelanr shal distnbute the Increase to hospitals base-st on the Following factors: Whether the hospitd is located in a State Iirrith a resident-to-popuhtion ratio in the lowest [as determined by the Secretary} "l:ii]l Whethertt'ua hospital is located in a State. a terribly otlhe United States. or the of that Is among the top 1p States. temlorles. or Districts in tents etlhe re?llo ot? "tilt the total population of the State. territory. or Diem Il-mg In an area designated [under such section a health prolassional shortage area [as ofthe date oianaetmanl oftliis paragqal'lj; to the total HHS IN to clause the Seaatary shall raserlra the positions avaldzla forlistlibu'tion under this paragraph as toilette: VD percent ofsuch positions fordistrizrution to hospitals deserted in clause {it olsubpaagraph (Di. "(lit 30 pesos-lit at such posit-ans for distribution to hospitals deserted in clause and [ill] of such subperagraph HHS EXCE PWIOH IF PUSIHDMS NOT REDSWIWTED 1. Wit?tn the cede We the Secretary does not dish-idute positions to hospitals in with clause Iii]: by July 1. 2011. the Secretary shall distribute such positions to other hospitals in accordance with the considerations described in subpaagraph and Ilia priority desalted In subweywh {Di- HHS by adding at the end the following ?ush sentence: "any hospital claiming wider thus subpe?mraph for time spent in a nonpro'uider setting shall maintain and matte available to the Secretary records regaining the amount ofsuch lime and such amoum in comparison Inith amou'lts of such time in such base yearas the Secretary shall specify." HHS IN as otherwise crowded. the Secretary of Health and Hurrah Seances shall Implement the arnenclnernts made by this section in a manner so as to apply to cost reporting periods beginnirg on or alter January1. 1983. HHS IN to the succeeding provisions of this clause. the Secretary shall. by regulation. establish a process under which. ii the case Mists a hospital {other than a hospital dasr?aad in clause {intuith arr medical residency program closes on or ahara data that is 2 years betore the data otthis clause. the Secretaryr shal mease the enemies atolls-able mident IImit under this paragraph for other hospitals in mnce with this clause. HHS PRIORITY FOR HOSPITALS IN CERTAIN AREAS?Subject to the succeeding provisions ol' this clause. in determining tour which hoop-tats the Imease the otrlemee applicable resident Irmit Is prodded mdersodl process. the SecretaryI shall distribute the i'lclease to hospitals in the tollorlrli'rg priority ordar{'nilh preterenoa ghai within each category to hospitals that are members of tl'lEl same af?liated group [as de?ned by the Seaetary u'ldarctauea as the dosed howltelti "test ?rst. to hospitals located In the same axe-based statist-oal area as. or a eorehesed statistical area contiguous to. the hospital that closed. "(obi Second. to hospitals located in the same State as the hose-tel that dosed. "tcc] Third. to hospitals located in the same region oftha country as the hospital that closed. 1de Fourth, only HHS REQUIREMENT HOSPITAL LIKELY TO FILL POSITION CERTAIN TIM-I Secretxy may only increase the otherwise applicable resident limit of a hospital mdarsuoh pmcess it the Secretary detemr'nas the hospital has demonstrated a likelihood or ?lling the positions made available mder thus clause with-n 3 years HHS EFFECT ON TEMPORARY I-TE CAP Secretary ofHesIIh and l-IJmsh Sen-ices shall give consideration to the effect tithe amendmenls by this section on arnr tremors? adruatrnent to a hospital's FTE 13p under section 413.?9ih} ol'titla 42. Code of Federal Regulations [as in sited on the data ofernactmerlt ot'lhis Act) in ordarto ensue that there is no chplication off-TE slots. Such amendments shall not application otsectiorl ol'lhe Social Security Act :42 use. Secretary. in consultation with the Seaetary of Labor. shall award grants to eligible entities to conduct demonstration projects that are designed to with eliWIe individuals with the to obtain education and training in the health care tield that pa}I well and are expected to either emanarisa labor shortages or be in him demand. Labor RESURANCE OF OPPORTUNITIES FOR Secretary ahead at least Ct- gents under this subsection to an eligible entity that is an Intia'l tribe. organization. or Tribe College or University. Labor Secretary shall. by gram.oontract.uln1eregehcy agreement. evaluate the demonstration projects conducted under this subsection Such etaluat?cn shall include identi?cation or successful activities to: creating opporttl'litie-s for developing and sustaining. particulaty Iwith respect to Iow-inooma 'rrdi-riduals and other entry-level writers. a health professions mricloroe that has accessible entry points. that meets high standards [a education. training, oertilicatlm. and professional derretoa'nent. and that pm Increased page and attendants bene?ts, lnclud-ig health care coverage. that as responsive to the ?endorses needs. HHS: Labor "{Bi REPORT Secretary shall submit Interim reports and. based on the evaluation outducted a ?nal report to Canvass on the projects conducted utter thus sudsecbon. HHS: Labor AUTHORITYTCIIAWARD later than 13 months alter the data ol?enactmerrt ol?this section. the Secretary shall award grants to eigibte entities that are States to conduct demonstration proiecta for purposes ofcleruetoping core training competeoo-es and cert?caoon programs to: persorlal of tune care dudes. HHS 2017--000491 Sec 550? Sec. 550? Sec. 5507 Sec. 5507 Sec. 550? Sec 550? Sec 550? Sec. 5507 Sec. 5507 Sec. 5508 Secs 5506 Sec 5508 Sec 5508 Sec. 5508 Sec. 5508 Secs 5506 Sec. 5503 Sec 5508 The Secretary shal? evaluate the ef?cacy ol'the core training competencies destsibed in peas-gash 133(k) [or newly hieol personal or home care aides and the methods used by States to ?Irnplemsnt such core training competencies in accordance with the issues speci?ed in paqaph and ensure that the numberof holes of training pmided by Slates underlhe demonstration project with respect to such core training competencies are not less than me numberof hours of training reamed under any apollceble 3131:: or Federal law or requiem-n. HHS: Labor NUMBER OF Sacralar)r shall enter into agreements with not more lha'I 6 States to conduct demonstration protects under this subsection. HHS The Escrow shall encourage participating States to consult with communlly and emotional colleges regarding 1hr: to imptement the project with respect to activities as applicable. wl'Iich may.I include mnsiderelion ol'euch colleges as putnere in such implemenlation. HHS SELECTION selecting States to In the mam. the Secreienr ehel establish criteria to ensure [it applicable with respect to the activities lnirdvedt? "tit geographic and demographic doe-oily: "till that participating States otter medical assistance for personal care services under the Slate Marisaid plan; that the existing training standards forparsonal or home care aides in each parddpating State??{l] are different Item such standards in the other participating States: and are Item the core training competencies described in paragraph that participating Slates do not rechce the number oThours dlrairving required under applicants State law orteguleljon after being selected to participate in the project: and that participating States recru't a HHS TECHNICAL Secretary shall provide techno-Isl assistance to Siatce In matenale and protocols for such core training competencies. HHS Secretary shell developm expenmarital orcontlol gmup testing protocol in constitution with mepetdent evaluation matador selected by the Secretary HHS REPORT ON IMTIAL later then 2 years afterlhe date ol'enactment ofthr's section. the Secreiary ehal Congress a recon on the Inltlal Imclementat-on of conducted under the demonstration project. including any amiable results ollhe evaluation conducted undarsubparagreph Iwith respect to such activities. Together with such recommendations forIagislstion or adni'iistratiire action as the Secretary detennlnee appreciate. HHS FINAL REPORT. ?Not later than 1 year after the completion or the demonstration project. the Secretary shall submil to Congress a report containing the results ofthe euahation conducted under subparaqaph tnga'lt'tet with such recommendations to legislation oradministratisa action as the Secrmy detemi'ras appropriate. HHS With respect to the demonstration projects under subsection the Setsetary shall use 55.000000 otlhe saneunt awaited under paragraph tiifpr each of?scel years 2010 much 2012 to carry out such orqeco. No I?unde appropriated under paragraph shall be used to carry out demonstration projects under subsection alter?liscal year 2 ]12. HHS PROGRAM AUTHORIZED ?The Secretary may award grants under this section to teaching malth setters for the purpose of establishing nIinIiI accredited or expa'Ided primaryI care residency programs HHS PREFERENCE FOR selecting reoipianls forgrants underthiis section. the Secretary well give preference to any such application that documents an afrlanm agreement 'Mlh an area health education center progan as dal'I'Ied ?ri sections T51 and T995. HHS PAYMENTS ?Subject to subsection thlt2i.1he Secretary shall make payments mder thus seo1lon fordlrect experience and for indirect expenses to quali?ed teaching health centers that He listed as sponsoring institutions by the [deviant accrediting body hrexpiansa'on of existing or estabishmanl of new apprmed gramme medical residency training programs. HHS lJl'Ir'll'l'ATiClN .?The Seclelary shall limit the Funding Infill-time eqtirvalanl residents In orderto ensue 1he direct 31d indirect payments as determined Lndaraubseclion [ct and {d3 do not exceed the Intel amount otfundsapproptiated In a ?scal year mder subsection la] HHS DETERMIMSTION 0F TEACHING HEALTH CENTER PER RESICIENT Secretary shall oorrpute Ioreach Individual maimed leaching health center a per resident amount? "tit by dividing the national average parrasidanl amount corrputed under section into a wage-related portion and a rein-wage related portion by apply-Ina the unaware-n darerrnined mdersucpe'eoraoh (Bi: ray munptyi-ng the waswelsted port-on by me fasten applied under section the Social Security riot {but without application oisection 4-110 or me Balanced Budget Act of 199? USE. nota]]rduring the preceding ?scal yeerfcr lha teaching heatth center's araa:a1d by adding the rummage-related portion to the amount computed Lndercleuse HHS UPDATING Secretary shall upehte such per resident amount for each such quali?ed leaching health center as datede appropliate by the Secretary. HHS FACTORS ?ln detenrimg the amount under paragraph me Secretary snatl? 131] sualrtate Ind?mect training costs relative in supp-orl'l'rg a primary cae resident;r program in suited teething health centers; and' based on this eyabation. assure that the aggregele oftha payments for indiect expenses under this section and the payments for direct graduate medical eoucatim 33 career-red under subsection tcamount appropriated for such expenses as dabeml'nsd in subsection HHS INTERIM PAYMENT ?Befora the Secretly mates 3 payment Ll'ldEll' ll'Iis sthsaclion pursua'It to a determination of indirect expenses Lndarpaagraph the Secretary may provide to gui?ad teaching health centers a payment. in addition to any payment made under subsection to). [or expected mdlred expenses assoclaicd With the addhmal costs of teaching residents [or a liscal year. based on an estimate try the Secretary HHS Secretary dalenTi'Ia any {hangars to ll'Ia numbarof residents reported by hospitd in the application ol'the hospital fortha can'anl ?scal year to determine the fetal amount payable to the hospital the orient fiscal year for both direct expense and indirect expense amounts HHS 2017--000492 Sec 5508 Sec. 5508 Sec. 5508 Sec. 5506 Sec. 5508 Sec 5509 Sec 5509 Sec. 5509 Sec. 5509 Sec. 5602 Sec. 5602 Sec 5502 Sec 560G Sec. 5802 Sec. 5602 Sec. 5602 Sec. 5604 Sec Slut Based at such determination. the Secretary shall any maymetts matte to pay any balance due to the extent possible. The ?nal amount so determined shall be considered a ?nal intermediary determination for the purposes at section 137?} ofthe Social Seounty Act and she! be subject to administrative and judicial review underthat section in the some mmneres the amount of payment under section iterator otsuch Itrot rs subleot to renew under such section. HHS Secretary may audit 3 quali?ed teaching health oenttertD ensue the accuracy and completeness ollhe inlormation submitted in a report underparagraph HHS MHCE AND OPPORTUNITY TO PROVIDE ADCIJRATE rerD MISSING imposing a reduction unoeramaragraph [All on the basis ota quali?ed leaching health centers Failure to mice complete and accurate infatuation described in siltparagraph the Secretary shall protride notice to the teaching health center ol?such failure and the Secretary?s intention to impose such reduction and shall protrude the teaching health center Iwith the opponmily to provide the required irradiation within the period or 30 days on the oats of such notice. lithe teaching health center prmides such intorrnalion within such period. no reduction shall be made under subpa'aglaph [Al on the basis of the preyicusf?ue to parade such inlormation. HHS Secreta'y shall promulgate raglalions to carry out this section. HHS IN Secretaryl shall establish a graduate nuree education demonstration Ll'rderlille ofthe Social Semity so [42 1385 et soot utderI-I-h-m an singlets hospital may recoil-e payment lorths hospital's reasonable costs (described it paragraph [or the provia'on otcpali?ed clinical training In advance practice nurses. HHS WAIVER Secretary ma;l ?late such requirements oftitles XI and ol'the Social Security Act as may be necessary to carry out the demonstration HHS later than October 2017. the Secretly shall submit to Congress a report on the demonsta?liort. Such report shall 'rrdude an analysis otthe following: Thegrowth in the number ot'adrranoed practice registered nurses with respect to a specillc base year as a result oi the demonstration. t2} The great-mt Ior each ol?the specialties descrijad in subparagraphs through [Dj of subsection [Entire-costs to the Medicare program under title oftha Social Security Act as a result ottha demonstration. Otharr'tems the Sect-elem determines appropriate and relevant HHS the aggregate payments to eligible hospitals under the demonstration exceed 550.000.000 lot a Ilscal yeardasuioad in paragaph the Secretary shall prorate the payment amounts to read-I eligible hospital in ordarto ensure that the aggregate payments do not such amount. HHS WAIVER OF REQUIREMENT MINING BE PROVIDED IN NON-HOSPITAL COMMUNITVMSED CARE SETTING IN CERTAIN Secretary may the requirement utder subpaagraph [AKiit respect to eligible hospitals located in ru'al or medically underaanrad areas. HHS IN Secretary or Health and l-lrmen Seances {in this section referred to as the "Secrets-y") shall establish. through a negotiated rLlemalti'Ig process under subchaptar 3 orchapter 5 ollitla 5. United States Code. a comprehensive methodology and criteria tordasignation of?Ij?t} medically u'rdarsened populations in accordance Irrilh section 330(c)(3ch the Public Health Service Act [112 U. S. C. 254mbit5ii: health professions shortage areas under section 332 ol'the Public Health Service?tcl {42 U.S 254e]. HHS FACTORS TO CONSIDER. establishing the urethra-doing}l and criteIia under tilt. the Secretary? shall consult with relevant stakeholders arm will be sign-?nality affected by a rule {m as national. State and regional organizations representing attested entities}. State health oilioes. community organizations. haallh centers and other a?acted entities. and other interested panias: atd {Bi shall take into account? {it the timely availability and amdemness pinata used to determine a designation to Doterttlal applicants for such designer-one; ill the Imcaot of the methodology and criteria on communities otvartms types and on health centers and other safety net providers: the degree ordif?culty that wil [aoa potential applicants forsudt designations in securitg the necessaryr data; HHS PUBLICATION OF oaTyi'Ig out the rulamaking process Lnderlhis subsection. the Sacretar)r shall publish the notice provided for under section 5Edrrai of title 5. United States Code. by not later than 45 days atterthe date otthe enactment of this Act. HHS APPOINTMENT OF IIEGOTIFITED RULEMAKING COMMITTEE MD Secretary shall provide for? the echo-Whom ole costumed mien-along committee under sect-on 565m citltle 5. United States Code. by not later that 30 days alter the end of the comment period provided for under section ol'such title; and the nomination ola facilitator under section 536(c} ol?such title 5 by not later than 10 days alter the date ofappointmant of the committee. HHS it the committee reports that 1.th COMES has failed to matte signi?cant WW tmara such consensus of IS unlltely to reach such consensus by the tagat date. the SecretaryI mayI temitate sud'I process and prouidefor the publication ofa rule under this section through such other methods as the Secretary may provide. HHS INTERIM FINAL Secrelay shall publish a ride under this section in the Federal Register by not later then the target publication date. Such rule shall be e?ectitre and ?nal immediately on an interim basis. but is subject to mango and revision alter notice and opportutlty for a period to! not less titan 9-3 trays: for public comment In connection IAlilh such rule. the Secretary shal specify the process the timely retiewa'ld moral ofapplications tor sudt deeigrations pursuant it) such rules and consistent with this section. HHS OF RULE AFTER PUBLIC Secretary shall prov-m for consideration otsuct'r comments and oisuch n.I e by not later titan 1 year attarthe target publication date. HHS PROGRAM ?The Secretary. acting throtgt the Administrator shall award grants and cooperatrre agreements to eligible entities to demonstration projects Iorlhe provision ofco-ordinated and integrated mass to sp-eoal populations through the etc-locat-on of winery and security we cortices It collimator-based mental and bahayicrd settings. HHS On an annual basis. the Secretaryl of Health and Harlan Senricas shall submit to the appropriate Committees of Congress a report on the activities canied out under the amendments made by this title. and the elieothrenesa ol?such activities HHS 2017--000493 Sec 51101 Sec. B??t Sec. Sac. EDEN Sac. BUM Sec Bout See some Sec. 5002 Sac. 131102 Sec. 51102 See. 6002 Sec. 5002 Sec. 6005 Sac. 61131 Sec. 6101 Sec 15th Sec. E102 Sec are: The Secretary ol'HIedth and Human Services may requi'e. as a condition ol'receilr'rrg funds under the amendments made by this title. that the entity receiving such award submit In such SecretaryI sudi reports as the sudi Secretary may require on canted out with such Md. and the effectii-cness el'sucn activities. HHS Sect-star)r mall establish and implement a process under int'rich an applicable hospital {as defined in aubparaigraph mag.I apply'for an amoeplion trorn lhe requirement Lriderparaigraph {11:13}. HHS later than July 1. 2011.1he Sacratary shall prormlgate regulations to carry out the process undar dauee ti}. HHS OF FINAL later Ihan at] days alter receiving a mists application mder thus parag'aph. the Secretaryr shall publish in the Federal Rag'ster the ?nal decision with respect to such application. HHS COLLECTION 0F OWNERSHIP AND INFORMATION purposes cfsubparegraphs [km and of paragraph the E?iecralar)l shall collect physician warship and inueabnent intom'ralion [preach hospilal. HHS The Secretary or Heath and Human Services shall establiei polices and procedures to ensure compliance with lhe mquirernanls descnbad in subsection ofsection 1 ?le oftha Social Act. as added by subsection beginrl'ng on the date such requirements ?rst apply. Such policies and procedures may indude unsrnounced site room of hospitals. HHS IN GENERAL ?On March 31. 2013. amt on the 90th (tailI otaach calendar year mg?mihg matter. any applicable manufacturer that provides a payment or other transfer oluahe to a covered recipient (or to an enlitir or'ndividual al the request otordeaignsled on behelfofa {uttered retinienl]. shall submit to the Secretary. in such electronic form as the Secrelanr shal require. the following information I.Iiith respect to the preceding calendar year; HHS later than October 2011. the Secretary shall establish pro-sadnes? *{il rorapplicaue manufacturers and applicable group purchasing organizations to submit information to the Secretary Ll'rdar subsection and fortha Secretary to make such inlom'rarr'cn submitted available to the public. HHS establishing the pmcadurea under paragraph the Secretary shall default with the hepactor General attire Department of Health and Human Services. alienated Industry. consumers. msumer advocates. and other i1berestecl parties in order to ensure that the information made avaHiIe to the u'rdersuch paragraph is presented in the appropriate oueral context HHS Mimi?. REPORT later than Apr! 1 oteadi year beginning with zero. the Secretary shal submit to Congress a report that includes the HHS AMMJAL REPORTS TO later than September 3-0. 2013 and on June Ell] of each calendar-guess thereafter. the Secretary.l shall submit to States a report that indudss a summary or the intomtallon sutrm-ltsd moer subsection during the preceding year Iilliill1raspecl to covered recipients in the State (except. in the case ol'inForrnai?ion submitted with respect to a payment or other oral-islero?f iratue destsibed in subsection [c??lnEEiL such shall he Included in lhe Itrst report lo Slates alter the date on whidr such Normaticn Is made sums to me purrilc undar such subsactiont. HHS Secretary shall consultwilli the Inspector General ofthe Department of Health and Human San-ices on the lmplemmlallon otthis section. HHS PROVISION OF health [)9nt plan or an;? shitty that pro-aides pharirnae}.l liar-ants management services on behalf ofa health bene?ts plan riin this section reliened to as a'PBl'Irl']lha1. manmes prescriziliorr drug morage Lridera contract Iaith? "{11 a PDP sponsor of a drug plat orm MA. organization otteringan plan wider Dart oftrlie Will: or"{2i a qualified health bene?ts plan altered Weigh an end-range established by a State under section 1311 otthe Patient Protection and Affordable Cue Act. shall provide the i'rformdion described in subsection the Secretary and. in the case ota FEM. lit] the plan with smith lhe PEIM is under contract with. at sua'i times. and In such term and manner. as the Several}; shall specify. HHS IN later than the date that Is 2 years after the date el'the enactment eflh-s subsection. the Secretary mall mitigate I?ihal regiatims. requiring. effective on the data that is SCI days after the data on Mich such Ilnal regulations are pdilishied in the Federal Fliegislier. a facility to rapor1 the information descnbad piaraqaph to the Secretary In a standardized format and such other regulations as are necessary to cam.- oul this subsection. Sour ?nal regulations shal ensure that the lasting certifies. as a cor-ditch of participation and payment under the program miter title the information reported by the faciity in accordance with such final regulations is. lo the best ol' the facility?s knowledge. accurate and cu'renl. HHS Sacralar)l shall prwida gidanca and technical assistance to States on how to adopt the standardized fom'iat under subparag'qi'r HHS later than 3 years a?artha data ottha promulgation ol'riegulations undertl1is parag'qih. the Secretary shal mists an am of the compliance and ethics programs required to be established tr-derlhc's whsaction. Such evaltetlon mall determine it such programs led to changes In de?ciency citations. changes it quality performance. or changes in other metrics ol?pelisrrt quality ofcara. The Secreiaqr shall submit to Courses a report on such evaluation and shall include in such report such recommendations rega?ti'tg changes in the requirements for such proqan'rs as the Secretary determines appropriate. HHS Semis-3' shall promulgate reg-.Iatims to carry out this subsection. HHS 2017--000494 Sec 6103 See. E103 Sec. S103 Sac. EIIZIG- Sac. E103 Sec B103 Sec 510% Sec. S103 Sac. E103 Sac. E103 Sec 5108 Sac B103 Sec 6103 See. E103 Sec. 3103 Sec 5108 Sac B103 Sec B103 IN Secretary shall ensue that the Department of Health and Human Services includes. as part ofthe intimation pnMded for comparison cfnurs'ng homes on the of?cial Intsmet website o'fme Federal Gomment Ior Medicare bene?ciaries [commonly referred to as the Nursing Heme Compare' Medicare website] [or a successor website]. the foliohhg information in a manner that is prominent. updated on a timely basis. easilg.I accessible. readin understandable to consumers ol' Icing-tens care services. arid seardiable.. . HHS IN as provided In clause ii]. the Secretary shall ensure that the information described In stbperegraph (A) is included on such website [era successorwebsibej not later than 1 year alter the data oftha enactment ofthis subsection. HHS Sedeterir shall ensure that me Intumetion described In maragraph than ls Included on such website {or a successor website] not later than the date on which the requirements undarseciion 112mg: are implemented. HHS IN Secretar)r mall establish a process? tD review the accuracy. clarity of presentation. timeliness. and compremumeness of Irrfomleilon resumed on such website as of the day befote the date of the enactment of this subsection: and not later than 1 year after Ihe date at the enactment subsecbon. to modify or raven-p such website in accordance Iwith Iha rsnuiaw conchciad tndarciause HHS conducting the reviewundersubperegraph [Attit- the Secretary sh?l consult with? Slate long- term care Women programs: consumer advocacy grows: "tiln provider stakeholder groups: and ?ill-Ii my other representatives ofprogiams or youps the Secretary determines appropriate". HHS The Secretary use the i'Ifcrmaiion submitted uncle the prism-?fig sentence to update the presided on the tit-sing Home Cornea-re Medea-e male as expeditiously as practicable but not less. freQuenIhr than quarterly-3'. HHS IN Secretary. shall conduct a special focus facility program forantoroaneni of remiramants tor skilled nursing facilities that the Secretary has identified as hating substantialy failed to meet applicable requiremerl ofthis Act HHS PERIODIC such pro-Jan the Secretary shall conduct surveys ofaach facility ii the program not less than once e-IeryS rrtonlhs.? HHS IN Secretary. shall ensue that the Department of Heth and Human Services includes. as part crithe information prmijedfcr comparison cfnurs'ng homes on the of?cial lrIIemet website cfihe FedsIal Gauerrment hr Medicare bene?ciaries toommonly referral to as the Hate Compare Medicare websitei [or a succesaol website]. the follow?rg information in a manner that is prominent. updated on a timely basis. easin accessible. readin understandable to consumers ollorIg-berm care sen-ices. and sasrchahla HHS IN as prodded in clause (it. the Secretary shall ensure that disinformation described in maragraph Is included on such website [or a successor website: not later than 1 year alter the dais of the enactment of Ihis subsection. HHS Secretary shall ensure that disinformation described in stbparagraph [A?ii is included on such website for a successor website] non later men the date on midi the requiremems undersection 1123191 are implemented. HHS IN GENERAL. ?The Secrslary shall establish a process; 'tIi to remme aowracy. clarity of presentation. timeliness. and of information reported on such web-site as of the day befcre the date cfthe enactment ofthis subsection; and not taberihan 1 year albarlhe date dthe enactment of'ihe's subsection. to modify {it rel-am: SUCH In accordance ?ll'ili'l the WOW conducted mt ?lm HHS CONSULTATION .?in conducting lhe revieirrundersuboarearaph the Secretary shall consult with?' State long- term care cutodsman programs; "(iiJ consumer advocacy growls; prmider stdteholder groups; ?ii-rt skilled nursing fatality employees and their representatives: and any other representatives cfprograms or Ilia Secretary detennlnes appropriate". HHS The Secretary use the information submitted under the precedi'g sentence to update the i'rformdion provided on the Musing Horne Calipers Medicare website as expeditiously as practicable but not less frecpantly than quarterly} HHS IN Secretary stiall conduct a special fonts facility pragam for enforcement of remiramants For nursing fadilies that the SecretaryI has identi?ed as having failed to meat applicable requirements of this Act. HHS PERIOUIC such pm? the Secretary shall conduct sunre'ys oieach facility the program not less often than once evergr? months. HHS Secretari- of Health and them Sconces {In this subtitle referee to as the "Secretary? shall guidance to States on how States can establish electronic links to Form 2567 State inspection reporis [bra successor form}. investigation reports. and a facility? plan of'correction or other response be such Form 253? State Inspection reports tors successor form:I on the Iniemei website otthe State that provides In?fonnailon on skilled nursing iacIIitIes and nursing facilities and the Secrets-y shall If possible. Include such Information :11 Nursing Home Cum. HHS DEVELOPMENT OF CONSJMER RIGHTS PAGE ON NURSING HOME COMPARE later than 1 year after the cane of this Act. the Secretary shall ensure that the Dwartment of Health and Hana-I Services. as part otlhe information provided cfnusing facilities on lhe Nursing Home Compare Medicare website devebnsend includes a consumer rights page that contains links to deeuiptions of. and infatuation with respect to. the HHS 2017--000495 Sec 6104 Sec. E1LE. Sec. E106 Sec. 5111 Sac. E111 Sec E1111 Sec 5112 Sec. E112 Sac. E112 Sec. E112 Sec E112 Sec B113 Sec 6114 Sec. E114 Sec.E114 Sec E121 Sac. E121 Sec E1201 OF INFORMATION Secretly shall establish procedures to matte information on eapencitures submitted underlhis aubsection reality auailable to interested parties upon request, subject to such requirements as the Secretary may specify undertne procedures established mder Ih-s paragraph". HHS DEVELOPMENT BY THE Secretary shall developa standardized cemplarnt term or use by a ttll' a person act'rig on the resident's bet-rail} in ?ling a cumieinl with a State survey and certi?calion agency and a State longerrn care ombudsman program with respect to a facility. HHS 0F STEFFIMG BASED 0N DATE IN A LINIFCRM not later than 2 years aflerthe date otthe enactment at this subsection. and alter consulting with State long-term care ombudsman programs. consumer advocacy groqzrs. providerstelteholder grams. employees and Ihe'I representatives. and other battles the Secrelanr deems appropriate. the Secretary snail reouwe a to electronicaly submlt lo the Secretary ditect care ata?i'rg i'rfoma?lion iincluting infotmaliorl reaped to agency. and contract staff]: based on payroll and olher Ireriiablia and auditabla data in a uniform tom-lat {according to aperi?calions erstabiehed by the Secretary In corouratlm with such programs. groups. and part-est. Sum speci?cations shall rem-re lhs1 the HHS REDUCTION OF Cl'il'l. MONEY PENALTIES IN CERTAIN to stindeuse till}. in the case We a facility self-reports and mommy corrects a de?ciency tormld'i a penalty was In'Iposed umlermls clause not later man 10 calendar days alter the date of such imposition. the Secretary may reduce the amen-it oi the pmalty irrposed by not more than percent. HHS COLLECTION 0F CIVIL MONEY the case 01a motley penalty ?oosed under cIaLoe. Ihe Secretary shal issue raglalioris lhat.._. HHS MLECTION OF CIVIL MONEY the case ot'a. civl money penalty irposed under this clause. the Secretary shal est-e regialims. HHS Seaetary shall select chairs ot skilled nursing taciilies aid nurs'rrg tacilities dasaiaed in paraqad'i to perodpiete 'n the demonstration protect under this section from among Ihoee chains that submit an application to me Escrelanil al such tlme. In such manner. and such Informetlon as the Secretary may require Senatery shall conduct the demonstration project Lnderlhis section tore 2-yeerpenod. HHS WAIVER Sears-Ianr may me such requlrements oftties Willano thol'the Soc-cl Seourlty Act [42 U.S.C.1355 at seq; 1396 et see? as may be necessary for the purpose of carrying out the demonstration project undartt1is section. HHS Secretary shall Inclement the demonstration pnject more this section not later men 1 year a?er the date of the enactment of this Act. HHS REQUIREMENTS ?The Secrelaw shall evaluate chains selected to In the oermnsIratlon project meet thus section based on criteria selected by the Secretary. includirg Mm evidence suggests that a number ofthe facilities of the chain are experiencing serious safety and quality- o?fcare problems. Such criteria may include the alienation of a main thal Includes a miner otfaolrlles part-opening In the "Special Focus Facility" program [or a successor program] or owllijle facilities with a record drapoated serious safety and quality ofcare deficiencies. HHS DONHNUATION OF PAYMENTS UNTIL RESIDENTS Secretary my. as the Secretary determines appropriate. oont'riue to make payments under this title Iwith respect to residents of a facility that has submitted a noti?cation Lnder paragraph the period beginning on Ihe date such noti?cation is submitted and ending on the date on Midi the resioenl Is successfully relocated. HHS IN 5ecrelaw shall conduct 2 ororects.1 for the osmium-em of best practices In stalled nursing facilities and nursing facilities thal are involved in the ctilure change movement frrduding the demelopment of resources tortan'lilias to ?nd and access funding in orderto undertake culture change) and 1 for the development of best practices In skilled and nursan For the use otlnlonriat-on tedinology to Improve resldent oars. HHS GRANT each demonstration project Lndierlhr's section. the Secretary shall award 1 or more grants to setting ler Ihe mmpment 0 best Dractnoee demo In subsection {at with respect to the demonstration proiect invoked. Such award shall be made on a competitive basis and may be ?ocated in 1 lump- sum payment. HHS later than 9 months otter the owner-on of me demor'istrallon project. the Seaman; shall submit to Congress a report on such project. together InIiIt1 recommendations for such legislation and a?n?r??trative action as the Secretary determines mpropriele. HHS IN raremmaxim dlhe Social Security Acl no: use. ramnejmjrixijj is amended by inserting "(Musing In the case of Initial trailing and. It Ihe Secretary determines approcnans. in the case of arming Ira?ning. dementia management trairlirrg. 31d patient abuse prevention tra?iing" beIore HHS IN ol'lhe Social Security no :42 use. mammalian): is amended by "inlet-ding. In the case vaunlng and. If the Secretary determlnes approprlate. In the case of ongohg training, dementia management training. and patient abuse prevention trailing? before HHS IN Secrelary at Health and l-Iurnen Some {in this section referee to as the "Smlaryj. shall establish a. progan to identify e?'icient. attache. and economical procedures for long term care facilities orprovidera lo oondud background checks on prospedi-re direct patient access employees on a nationwide basis {it this subsection. Such Program mall be referred to as the "nationwide anagram"). HHS 2017--000496 See 6201 Sec. 5201 See. 5201 Sec. 5201 Sec. 5201 Sec 3301 See 5301 Sec. 5301 Sec. 5301 Sec. 5401 Sec 5401 Sec til-tor See 6401 Sec. Sec. 5401 Sec 5401 Sec. 5101 Sac rum Ei-toapt hrthe following modi?cations. the Seuetery shall carry out the nationwide program Lridersimiler terms and conditions as the plot {Ingram under section all? or the Medicare Presc?iotim Dmg. hwement. and Moderrizatlpn Act 13(thth 11? Stat. inducing the prohibition on tii-rg abusive workers and the euthorizalion ofthe imposition of penalties by a participating State under subsection $13191] end reep-ediuely. of sum section 30? HHS NEWLY PARTICIPATNG Secretary shall enter Into agreements with each Stats; that the Secretary has not entered into an agreement with under sucsectlm otsuctl section that agrees to conduct background chedts Itnderlhe nationwide pro-gem on a. Statewide basis; 311 that submits an application to the Secretary containing such information and at such time as the Secretary rney specify. HHS CERTAIN PREVIOUSLY PARTICIPATING Secretary strait enter into agreements with each State? tit that the Secretary has entered into an ag?eemerilwilh urdersucl'r subsection tc][1]r. but only in the case ?here such agreement did not require the State to con?ict background checks under'the program established under subsection otsuch sect-en 30? an a Stalewlde casts; {ii} that agrees to conduct [tamed cheats un?t! the nsrtomtde on a Statewide basis: and till} that submits an application to the Secretary containing such information aid at such time as the Secrelary may specify. HHS Secretary of Health and Human shal netlf'y the Secretary olthe Treasury dlthe mount necessary to carry out the helium-ea mgram wider this section for the period of fiscal years 201D 2U12. except that in nocasa shall such amount emcee-d 5150.000000. HHS RESERVATION 0F FLNUS FOR 0F Secretary may reserve not one than SEWQOIJ of the amount transtened under sLtparagraph lo proe'de for the conduct olthe evaluation urda' subsection HHS IN Secretary shall. appropriate safeguards [or many. make evallable to the Institute such data collected try the Centers tor mulcate a Mecca-d Sen-ices under the prawns under titres m. and m. as well as prmrida access to the data nahvodts dot-doped under section 93111] ofthe Public Heath Service Act. as the Institute and its contractors rnsy require to carry out this section. The Institute may also request and obtain data from Federal. State. or citrate entities. including data hem clinical databases and registries. HHS BUILDING DATA FOR Secrelary shall provide For the compilation of Federal health programs to bulld data capaolty for comparattre clln-eal effectlveness research. Irvdudlng the developmentand use or clinical registries and health outcomes research data networks. it orderto develop and n'ra'ntain a ccn'rprehensive. interoperable date netwodt to collect. lint-c. and analyze data on outcomes and etfectiuenasstrom multiple sources. Includlng health records. HHS IN Secretary shall Wide to: the transfer. from the Federal Hospital Insurance Trust Fund under section 15-1? and the Faded Supplementary Medical Insurance Trust Find u'rdar section in proportion tea estimated by the Secretary} to the total expend'tures duirig such ?scal year that are made under'ti?tte the resrsectlve trust fund, re- the Pattern-Centered Outms Renee-rm Trust Fund tutored to In this section as the Ll'rder section 9511 ol the Internal Ftevenue Code ot1935. cllhe Following: For fiscal year 2013. an arriourrl equal to 31 multiplied by the average runb-er olirrciuiduelsenlitled to bene?ts under part A. or enrolled under part 13.01 true WII during such llsoal year. For each of?scal years 2014. Stats. 2016. 201T. 2013. and 2019. an HHS The Secretary may only use evidence and Ilndkigs hem research conducted utder section 1131 to make a determinalion regardng coverage under title XVII it such use is tt'rrcugh an iterelive and barrspaent process vrtu'ch includes public comment and considers the e?eot on aubpopulatr'ons. ?(by Nothing in section 1131 shall be construed as? "11 II sumo-1g the coverage of Items or alertness under title that the determlnes are reasonable and necessary u'rdersec?lim 15521119.?; or authorizing the Secrela'y to deny cow ofilams or senlicea undersuch title solely on the basis ofcomperative clinical etteotiirerriesa research. HHS 0F SCREENING ?The Secretary shall determme the Israel discreet-rig conducted under peso-am acceding to the of fraud. waste. and abuse. as deterrn-ted by the Secretary. with respect to the category of prouidar ofmedical brother items or services or supplier. HHS INEKVIDLW. ea prov?ed in clause the Secretary shall impose a tee on each indiuiclrel brother Items orsenrtees or supplier [web as a airman mass uraciltloner. or clinical nurse specialist] with respect to vrtich screening is conducted under this par-w in 31 anount equal to? "Ell each smsequerrt year. the erriourrl detennmed under this clause lorlhe preceding years adlusted by the percentage change in the consumer price ode): for all urban consumers tall items: United States city average] Forlhe 12?month period ending with Juneof the previousyear. HHS HARDSI-IIP EXCEPTION: WAIVER FOR CERTAIN MEDICAID Secretary may. on a casehyvcase basis. exempt a president medical or other items or sum-es or supplier from the imposition at an applcalipn lee utder this it'lhe Senatary determines that the irgnosition cftha application feemould result in a hardstip. The Secretary may wave the application fee under this aubperaigeph torproviders enrolled in a State Medicaid program for mm the State demonstrates that Immetidn at the tee would irroede beneficiary access to care. HHS EXPEDITED Secretary may cremains an Irrtenm llnal rule to carry our paragraph. HHS Secretary may aslebish by program mstruction orothervvise the procedures Itmderthis paragraph. HHS AUTHORITY TO Secretary detennlnes that such previous poses an undue offra.rd. waste. or abuse. the Secretary may deny such appiraticn. Such a darial shall be subject to appeal in accordance with paragraph HHS IN GENERAL?Notarilhslanci'rg an}r other precision of this title. in the case cla'i applicable provider of services or supplier. the Secretary may malte any necessary adjustments to payments to the applicable prouiderolaervices or stiopner under the program under this title In one to satiety any past-due obligations in maragraph [Elli-t ofan obligated provider ofsarvices or supplier. HHS IN Secretary may impose a temporary moratorium on the enrollment other? providers ctsarvices 31d suppliers. incluci'rg categories cfprovidars cfservices and suppliers. i1 the program Ll'rdarthis title. u'rdarthe Medicaid program underttle litmerurdsr'dre CHIP program under tllte ?(lithe Secretary determlnes such moratorium Is necessary to prevent or combat fraud, waste, or abuse under either such prog'an. HHS INSTITUTIONAL as presided in clause the Secretary shall impose a [as on each institutional brother Items ersewtpes or supplier [web as a hospital or With respect to Mich screen-t9 Is conducted utter lhis it an amount equal tor 2010. $500, and tour 2011 and each subsequent year. the amoutt determined under this clause torthe piaoeding year. adjusted by the percentage change in the consumer price index forall urban consumers (all items; United States city averagejfor the 12-morrlh perlod ending with June ol the crevlous year. HHS 2017--000497 Sec 6401 Sec. 5102 Sac. Sec. 5402 Sec. 6402 Sec odor: Sec 54m Sec. 6402 Sec. 13-102 Sec. 13-102 Sect 54m Sec til-too Sec 6403 Sac. Sac. sacs Sect 54m Sec. 6403 Sec Blue IN Secretary shall establish procedures to provide fora provisional pelted ofnot less than 30 days and not mom than 1 year during new pro-tumor medical or other Items orseryices and suppliers. as the Secretary detarrnines appropriate. including mtegories otproyiders or suppliers. would be subject to enhanced oversight. such as prepayment re'tlielmI and payment caps. under the program under this title. the Medicaid program Indarlitle the CHIP [Ingram under title 300. HHS IN Secretary shall other Inio easements with me Indira-duals oesoihod In clause in: under which such individuals share and match data in the system ol records oithe Willie agencles of such lndiylduale I?lth data In the system of records of the Department ol'Hedth and Human Service-star the purpose ofiderilifying potential fraud. waste. and abuse under the progams under titles and HHS IN GENERAL ?In addition to any outer applicable remedies. ii an applicable individual has knowingly participated in a Federal health care tram offense or a conspiracy to commit a Federal health care fraud offense. the Secretary shall impose an appropriate achrl'stralive penalty oommerreuabe with the offense or conspiracy. HHS INQUSION OF NATIONAL PROVIDER IDENTIFIER ON ALL APPLICATIONS AND Secretary shall promulgate a regilaiion that requires. not later than January I. 21311. 3 providers olme-dical orolher items orsen-ioes and suppliers under the programs Under titles sod )tlxihat maIIPyi?o-i a national provider Idol'itr?erto mdudc their national prov-rte identi?er on all applications to elicit in such prop-ans and on all claims for payment submitted under such pro-grams". HHS IN Secrelary may require a pronderolserinces or sumlier described in paragraph lo promo the on a continuing basis with a surety bend it a form speci?ed by the Secretary in an amount [not less Ihan the Secretary determines ia commensurate with the volume otthe billing ollhe proyicta ofeeryioeva or wopiloi. The Secretary may scheme requirement of a bond under the preceding sentence It the case cfa providerof services or supplier that provides a comparable alrety bond under State law. HHS IN GENERAL. ?The Secretaryr may suspend payments to a pl'oyiderof services or swplier under this title pending an investigation of a. credible allegation ofieud against the p?otridercl'aeryioes or supplier. unless the Secretary deteml'nee thee IS- good nut [0 W116 such payments. HHS Secreta'y shall oonsulTwilh the Inspector General ot'the Department of Health and Human Services In determine-g ehether there Is a credible allegation oihsin against a pro-alder oieeriiloeil or supplier. HHS FROMULGATDN OF Secretary shall promulgate regulations to carry out this subsection and section HHS Secretary shall conduct evaluations ol'eligible entities which the Secretary contracts with under the Program not less frequently than every 3 years. HHS EVALUATIONS. ?The Secretary shall conduct evaluations ol eligible entities Mich the Societary contracts 'I?rilh under the Program not less frequently that every 3 years." HHS IN GENERAL. ?The Secretary shall manta-n a national health care rim and sense data collect-on mam under this section for the reporting of certain Final adverse actions [not including settlements In Iwhich rIo findings of liability have been health care providers. suppiers. or practitioners as rqu'Ied by atlasectiion (bi. with access as set forth In subsection lei. and shall lunch the hfolnmlon collected under this section to me Mammal Practitioner Data Bank establ?ehed pursuatt to the Health CareOuality InuovementAc?l of 1955 {42 USC. at HHS APPROPRIATE CODREHNATICN. ?In irrplementing this section. the Secretary shall prmidefol the maximum appropriate coordination Inilh part ofthe Health Care QualityI lmproyernenl Act of 1966 (it? LI. 5. C. 11131 et seq. and section 1521! HHS respect to "formation reported pursuant to eweeciion iaitl i. the $ecretary shall? "i?i promo fordisclosure ol'the information. upon request. to the health caie practitionerhho. or the entity that. is the subject ottha information reported; and ":31 establish procedlas torthe case wharethe health care practitioner or entity disputes the accuracy of the Information reported. HHS IN to amparagiaph 18]. the term Trial adverse action' aganst a health care provider. supplier. orpractitionerin State court related to the dal'rueryof a health care item or service: Slate aininel convictions related to the delivery ole health care item or seryioe: seclusion Itom pal'licipeiim In State health care prewar-ms [as de?ned in section 1125th1: "tle any licensing or certi?cation described In subsectlon telten against a supplier by a State Ioensing or certi?cation agency; arid any other adjucicated actions or decisions that the Secretary shall establish by regulation. HHS 'In implementing this section the Secretarys shal ployide tor the madman wpropriate coordination I.Iiitl'i part of the Health Cere?uality IrrprouamentAct at 1936 U. S. C. '11 131 at seq. )arld section HHS FEES FOR Secretary may establish reasonable feesfor lha disdosure cl'ntormslion under this sect-on. The amoml of such a lee may not exceed the costs or processing the reouesls for disclosure and or providing such inIiormaIion. Such fees she] be available to lha Secretary.I to ooyersuch costs": HHS IN GENERAL?Effective on the date of enactment ofthis Act. the Secretary of Health and Sari-ices this section referred to as the "Sowetary'l shall Implement a transition process by not Islet than the end ol'lho transition pelted described in paragraph the Secretary shall cease operatirg the Heelthcare Integrity and Protection Diata EIanIt established Lndarsection ollhe Social Sacunty Act tats in eltect beforethe a?eoitredata speci?ed it paragraph and shell transfer all data collected In the Integrity and Protection Data Bank to the Nat-oncl Pradiltoner Data Bank established pursuant to the Health Caretiiuallty loll-ointment Act of 1955 [42 111EI1 et seg.J. During such transition process. the Secretary shall have in alts-ct appropriate procedures to ensure that data HHS Secretary shall promulgate reg?etions to carry out the amendTIenLe made by subsections {at and lb} HHS 2017--000498 Sec 6406 Sec. Sec. Sec. 5410 Sac. 6-110 Sec 5411 Sec 6504 Sec. 5506 Sec. 6507 Sac. Sela Sec 550? Sec 650? Sec. BEDS Sec. BEDS- Sec Sec. SEEKS Sec BEDS The Secretary may retolteenrolment. for a period other more than one year For each act. for a physician orsupplier under section 1566th If such physician or supplier Iails to maintain and. upon request at the Secretary. mode aooess to documentation relating to written orders or requests for payment [or cllabla medical equipment. certi?cations for home health services. crreferrele torctheritems orsenlices crordered by such physician or suppier under this title. as spouted ?y the Secretary". HHS REQUIREMENT FDR FACE TCI FNZE Secretary require that such an orderbe written pursuantto the physician do-ctlnerlling that a physician. a physician assistant. a nurse practitioner. ora cli'lical nurse spectator ias those terms are def-red I't semlon t?oitaaitstt has had a fooe?td-faoo encou'lter imudlng through use or telehealih untle' subsection {ml and other than with respect to encounters that are incident to mass mad] with the 'ndilridud invoked during the B- period preceding such miltan order. oroii'ler reasonable Iimel'rema as determined by the Secretary". HHS ?The Secretary may provide. in addition to any ott'ler remedies authorized by law. forany ofthe remedies described in paragraph I the Secretary deten'nlnes that any employee or agent or such organzalton, orany pronderor sumlier who contracts I.trilh such organization. has waged in an}.I conduct described in subpalaglaphs through (Kl ollhis paragaph.". HHS EXPANSION OF 2 OF THE DME BIDDING the Secretary shall Include We next 21 tarp-ea rrleoopolltan statistical areas by total population taller close selected ill] for such round: and". HHS PEDUIREMENTTCI EITHER BID AREAS CIR USE COMPETITIVE BID PRICES E?l? it the case of covered items funishecl on or after January I. 2016. the Secsatary shall continue to mal-ze such adjustments desalted In clause as. mdersudt competitive uogralns. motto-net covered items are phased In or information is Lpdated as contracts Ll'lder section 15-1? are in accordance Inrith section HHS "[Itr'i such program is carried out In accordance with surh requirements as the Secretary shal speclty. Including. . HHS IN 1mrH1itFJol the Social Security ?ol {42 C. Imam HFJJ is tame-wed by inserting alter "necessary" the following: "and including. for data aibmilted to the Secretary on or after January 1. 2010. data elements from the automated data system that the Secretary delerrnine-s to be necessary For progart integrity. progsn'l oversight arid at alum frequency as the Secretary snail delennme?. HHS CORRECTIVE ACTION ?l'he Swetery shall promulgate regulations lhelt reQui'e States to correct Federally identi?ed deims overpayment; otan ongoing or recumng nature. with new Medicaid Management System edits. audits. or shear consul-re action. HHS For purposes of paragraph Ihe Secletary shall do the tolerating: "(At Not later than September I. 201D: "(it Identify those methodologles of the National Correct Codlng IrItIatnre by the Secretary iorany successor initiative to promote correct curing and to control irrproper coding leading to inappropriate payment}which are corrpatible to claims ?led under this title. HHS For purposes of paragraph [math-rt. the Smtery shall do the tolonitg: "tat Not later than September 1. 201d Identify Ihcse methodologies of such Initiative {or such other national correct coti'tg methodologies) that should be Incorporated lnlo olalmo ?ied under this title with respect to items or services for winch Slates [reside medical assistance um this title and no national correct moing methodologies have been established um such Initiative 'Mlh respect to title HHS For purposes of paragraph Ihe Semetary shall do the Notify States of? the Identi?ed mtiersuooaragrapno and tEtJ tend clany other natlmal correct coding methodologies Identi?ed wider sthpalaglaph (Bi. HHS For purposes of paragraph Ihe Semetary shall do the Notify States of? how States are to incorporate such methodologies into claims lied under this title." HHS For purposes of paragraph the Secretary shall do the Not later than March 2011. submit a raped in Congress that includes the notice in States underdause olsubparagraph [A]l and an analysis sqoporting me ofme methodologies mane under clauses and of maragrapn rat". HHS The Secretary shall request the National Assooation of Insurance Commissioners to developa model unIIorrn report form for private health 'rlsuranca issuer seeking ID reisrsuspacted fraud and abuse to Stale insurance dapa'b'nen?la or State agencies for investigation. HHS The Secretary request that the National Association of Insurance Commissioners develop recommendations for uniform raporling standards for such referrals". HHS ?Tl'ua Secretary may. hrlhe pup-use otidenlit'yirllg. preventing. or prcseculing "all and abuse. adopl regulatory standards establishing. or result: an order relating to a specific carom establishing. that a person engaged In the business at wot-tong inst-once "weigh a multiple employer welfare amentent described in section 3:110} is subject to the laws ol'lhe States in which such person operate-swhid'l regulate insurance in such State. nomili'tstanding section 51 dib??] otthis Act or the Liability Risk Retention Act at 1985. and regardless afar-tether Ihe lawof the Slate is otherwise preempted moer any otsuch provts-ons. that section shall not apply to any plan or arrangement that does not tell I.tlilhin the meaning oflhe term 'mulliple errployerwelare anangamertt' under section account". Labor IN Secretary may issue a cease a'ld desist [ear part9) order under this title ifit appears to the Sweiary that the alleged conduct ofa rrlullizlla employer welfare arrangement described irl section Still}. other than a plan oranangoment described In subsemlon Is fraudulent. promotes an invnedlale danger to the public salety or welfare. or is causing or?tn be reasonably expected In cause sig'lil'lcant. imminent. a'ld irreparable pubic iriury. Labor person that is adlrersely attended by the issuance cll'a cease a'ld desist orderundersubseclion ta) may request a healing by the Secretary rega'd'ng such order. The Secretary may require that a proceeding under this section. Including all related lnlermation #?td endm. be conducted in a con?dential manner. LJDOF 2017--000499 Sec 5605 Sac. BEES Sec. Sac. EFIJG- Sec. EFIJG Sec aroc Sec one See. ems Sac. EFIJG Sec. Sac Sec Elmo Sec aroe Sec. 5703 Sac. EFIJG Sac Sec. EFIJG Sec aroc Secretary may issue a summary seizure otderunderthis title if it appears that a multiple employer ??are anangement us in a ?nancially hazardous condition. Labor Secreta'y may promulgate such regulations or other guidance as may be necessary or appropriate to carry out this section Labor The Secretary may We a mallet-m that [novices an evidettiary otvloge lot. and echoes tor the con?dentiality of communications between or among. an)I ot?the fclon?irg entities or lhei agents. ccmsultants. or employees: i A State insurance department. "(Qt A State ettomey general. Tl'e National Association of Insurance Cwmleetoners. The Deponment of Labor. 15] The Department otthe Treasury. The Department of Justice. "(Tl The Depa'lment of Health 311 Human Services. "(St Any oil'ier Federal or Stabs authority that the SecretaryI determines is appropriate Forthe puposes ola'rforcing the provisions ofthia title. Labor. Treasury. Justice. HHS PROTECHDN 0F oursulng activities under this the Secretary shall ensure the protect-on of mm health merry consistent 'Mlt?t the regulations mmigated undersection Ear-Ho} of me Health Insurance Portability and Accountability Act of 1996 and applicable State and local privacy rewlations. HHS SULICITAHDN UF Secretary shall publish a notice In the Federal Register nomlnallone for the appointment of members of the Advisory Board under subsection to). HHS Secretary ehal promulgate guidelines to assist researchers working in the sea ofelderabuse. negeect. and eitpioitelion. with Issues relating to human Subject protections HHS FORENSIC $cretary shall make -I of the gents described in sLIJsection to institutions oltl'g'iareducation with demonstrated expertise in forensics or commitment to preventing ortreeting elder abuse. neglect. oresptoiatton. to establish and operate stationary forensic centers. HHS MDEIILE Secretary shall malte ollhe gents described in subsection ta) to epproptiate entities to establish and operate mobia forensic centers. HHS TRAVEL EXPENSES ?The members or the Advise-y 303ml shall not receive Wheation for the periormance oi services forthe Advisory Board. The members shall be allowed bevel expenses for up to 4 meati'lgs paryear. i'ictuding perdiem in lieu olaulisisnenoe. at aud'ioriaed foremployees olagenciea under subchapter I ofchapter 57 ollille 5. United States Code. whlle away from ihelr hornee orteoularolacee ethos-tees In the perfume-ca of services for the Adviscty Board. Nohvithsland'ng section 13-1-2 ollitle 31. United States Code. the Secretary may accept the velunta?y end uncompensated services olthe members oltha Advisory Board. HHS tie ellgioIe to receive a grant under this section. an entityr shall submit an apolicalicn to the Secretary at such time. in such manner. and containing such infom'iatiorl as the Secretary may require. HHS be eligible to receive a grant undet this subpa'agiaph. an eligible entity shall submit an application to the Secretary at such time. in such manner. and containing such i'rfoumertion as the Secretary may rquire {Mich may Include evidence denomination th the State In which the eligible entity is located With respect to carrying out activities funded undEI the gait}. HHS STATE Stale receiving funds undarthis subsection submit to the Secretary. at such time and in such manner as the Secretary may require. a report on the number of elders served by the grants meted Lndarlhis subsection. HHS be eligible to receive a gent under this subsection. a State shall submit an application tie the Secreiary at such time. In such manner. and containing such Information on the Secretary may require. HHS STATE State that receives tmde mr this subsection shall submit to the Secretary a resort at such time. in such mannet. and containing such infatuation as the Secretary may require on the results otthe demonstration progem conducted by the Stale using funds made avielahle Lndarlhis subsection. HHS in the case clan applicant fora grant under sadion 20-11mm provide the Seaetary with such intermation as the Secretary may reqLi?e tio conduct an evaluation or audit Lndersubsection [c1 HHS be eigible to underperageph an entity shall submit an application to the Secretary at such time. In such manner. and containing sud-i iniumation es the Secretary my require. Including a proposal to: the evaluation. HHS IN covered incividual violates subsection tb}? the covered individual shall be to a ciin money penalty olnot more than 5200.030: and "t8: the Secretary may make a determination In the same proceedlng to emchde the covered indiuichal from participation in anyI Federal health care proqam [as dethed in section HHS IN Secretary shall carry out activities. including activiliee described in paagrapha {2t and (St. to provide imtivee for to vain for. seek. and maintain minim-men! prodding direct cane in long-term care HHS 2017--000500 Sec eroe Sec. 5703 Sec. 570:]- Sec. EFIJG- Sac. Sec area Sec Emit Sec. ems Sac. EFEIG Sec. SFIJG Sect Sec Elma Sec eroe Sec. 5703 Sac. SFIJG Sect Sac. Sec area WITH SECRETARY CIF LABOR TO RECRUIT AND TRAIN LONG-TERM CARE Secretary aha] mordinala activities under this subsection with the Secretary ctLaborin udarlo provide [a Indie-duals to train For and seek ermloument delng direct care In care IN Secrelar)l shall make gents lo entities to can). out prey-ans "though which 1119 entities? o?ar. to employees who provide direct care to residents of an eligible entity or individuals receiving community-based longterrn care from an entity. cemlnung lrelnlno and varying levels otcenll'loat-on. based on observed alnlcal care practlces and lhe amount of time lhe employees spam dlrect care. and *tllt promo. or treks arrengemenls to provide. bonuses er otter increased Dorrpanselion or bene?ts In ermloyaes 'M'lo achieve cerli?cat'en under such a program. IN Secretary shall make gents to eli?lle entities to endie the antilies to prwide training and technical assistance. ABCOJNYABILITY Secretary mall oat-rebut Resume to ensure that the ae?aulties conducted using Iunds niece available under this subsection benetil Individuals time proutdedlred care and Increase the stability ofthe long?term care workforce. ADCCIUNTABILITY SecretaryI shall deuelq: accot.l1t.el:lilitjI measures to ensure that the activities conducted using funds nude available under thle subsection help We pat-ant safety and reduce adverse aroma and haallh care complications rasultitg from medication errors. STANDARDS AND Secretary shall adopt electron-r: standards [or the exchange data by long-term care fatalities. vimere availatle, standards for messaging and nomenclature. Standards adapted by the Secretary.r under the preceding sentence shall be compatible with standards established under part ottitle standards established mderadzisiectione [a][4]ofsec1ion 136130?11. standards adopted under section 3004 of the F'ubllc Health Seance Act. and general health itton'natlon tedtnology standards. Secreta'y' shall promulgate raglalians lo carry out this subsection. Such regrlaliclns shall require a Stale. as a condition ofthe receipt offunds under this part. to conduct such dale collection and reporting as the Settretanrl delennlnea are necessary to satlefu the redulremmta subsection. IN Secretary shall were that the Department at Health and Human proeldes ?nding authonzad try this part to State and local adult protedilre sen-ices c?l?ces that investigate o?ftha abuse, nayact. and exploitation ofelders." IN Secretaw shall enema that the Dermnment of Health and Human Senioea?"tat collects and disseminates data annuallyI relating to lite abuse. exploitation. and neglect of elders in coordination with lhe Depa1rnent afJustice." IN Secretary shall metre that the Department at Health and Human Smloas?"tct develops and disseminates intern-ration on best practices regati'rg. and provides liaining on. cam-trig out adult protective services. IN Secretary shall enema that the Department of Health and Human Servioes?"IIDJ conducts research related to lhe provision ofadtlt protective services. IN Secretar)r mall ensue that the Depa't'rlent of Health and Human Services??(B provides tachrlicd assistance to States and timer entities that provide or find the provision otadult protective services. including through grants me undersuosections to: and to] is establisth an adult protective services grant program under which the Secretary shall annually award grants to States in the arncunls calculated undarparagraph fort-re purposes o?fanhancing adult oroteoltule services predicted by States and local units otgcvernment. ED to clause tilt. the amount moor eubpemgreoh for a State For a "steel year Is less than 0.75 percent of the amount appropriated for such year. lhe Semen-y shall increase such meant so that the total anount paid underlhis subsection to li'le Slate Iorthe year is equal In 0.75 percent oflhe aneunt so appropriated. FRO RATA Secretary she] make such pro rala reductions to the amounts desc'ibed in stbparagreph (A) as are necessary to comply- with li'le radian-rants Secretary shall grams In States tor the purposes of conducting demonstrat-an programs in accordance with paragraph IN Secretary shall make grants to entities with re euarl ewertlee and ewerlenee In abuse and new In long-Lem care facilities or long-term care ombudsman programs and responsibilities. tor the purpose ot? IN Secretary shall establish prograre to pmride 'rnproue cmbudsnm Ireiri'lg with respect to elder abuse. neglect. and exploitation tor national organizations and State long-Lem cane ombudsman anagrams. HHS. Labor HHS HHS HHS HHS HHS HHS HHS HHS HHS HHS HHS HHS 2017--000501 Sec Sim Sec. 5703 Sec. 5703 Sac. EFIZIG- Sac. EFEIG Sec area See arm Sec. Bitm- Sac. EFEIG Sac. Sac Sec See me Sec. 7DD2 Sac. Sac Sac. HIDE Sec t'Uth as provided in paragraph (Zt. the Secretary shall? use the funds hastened under ethparagraph to protrude assistance to eligible entities to conduct evaluations o?fthe activities funded under each program carried out undermle parr HHS as provided in paragraph the Secretary shall? reeanre a portion (not less than 2 percent] ofthe funds appropriated with respect to each program carried out trldarthis part". HH INCREASED covered violate-s subsection {bi and the I.Iiolalicrr exacerbates the harm to the rrictim of the crime or results in harm to anon-er the cheered shal be subject to a civil rrloney penalty of not more that and "(St the Secretary may make a determination in the same proceeding to exclude the covered inchidual from participation in any Federal health care program [as de?ned in section HHS UHDERSE FWED DEFINED ?ln paragraph. the lenn 'urrdereerved oopulatron' means the poouellon ofan area designated by the Secretary as an area with a shortage oI?eltlerjustice proga'ns ora population g'oup designated by the Seuelary as halting a shortage ctsud1 pregame. Such areas or process designated by the Secretary may lndlude? areas drorouos that are mnhloally Isolated [such as Irradiated In a mat area]; "ll-i rad-at and ethnic minority populations. and "(till populations undemed because of spec's needs [such as langume carriers. disabilities. alian status. orage}. HHS PENALTIES long-term care facility violates slbparagraph [Ni or [El-:r ot'paagqnh {til the facility shall be sucgect to ctr-I money penalty of not more than SNDDIJD orthe Secretary may classify 1he entity as an emcludad entity tor a period ot2 years pursuant to section 11293:}. or both. HHS Senatary shall an evaluation at the activities tundad under the csrlitiad EHR technology grarlt program Lndareedion ZMItb?l. Such evaluation shall include at evaluation ofwhe?lher the ?nd'rrg provided Lndar the grant us. excerpted only for the puppets Idr Mich II is made. HHS Secretary shall corrduct automate audrte digrante made under section Wiihl. HHS Not later than October 1. 2014. the Smelly shall submit to the Elder Justice Coordinating Council established under section 2021. the Cemmit'lae on Ways and Means arld tha Committee err Enargy and Commerce ottha House oi Representatives. and the Committee on Finance ottha Senate a report? HHS later that 15 ntonths atlarthe data otenactmant of this Act. lha Secretary shall submit to the Elder Justice Coorshating Council established under section 2021 clthe Social Security Act. as added by aection tB??tat. the Comm-nee on Finance etlhe Senate. and the Committee on Ways and Means and the Committee on Energy- and Gorrmerce ol'lhe Hausa of Representatives a report containing the timings aid Noam-dawns of the study conducted this paragaph. HHS Ihl Secretary may. public Issue guidance In accordance. ewowt as provided It maragraph [Elli-?1. with men Tutlhlel the Federal Food. Elmo. and Cosmetic Act with respect to the licensure ol'a biological product uncla this subsection. Any such guidance may be ganerd or speci?c. HHS Secretary may indicate in giidance document that the science and experience. as oftt'le date of scar gumanee. with respect to a product or product class [not raiding any reunite-ham protelnl does not allow approval ofan application tora license as provided under this subsection torsuch product or product class. HHS Uom remotan application tor a supplement to an duplication] submitted under this eubeec?llm. the Secretary mall license the biological product under this subsection if? the Secretary determines that the infon'nalicrr submitted it the application {or the supplementt is sul?cierrt to that the biologcal product? is biceimilar to the relerenca product. or meets the standards described In math and I'leretcr'e ls HHS Upcn ra?rriewo?lan application submitted u'rdarthis subsection relying on the same retaranca product for'nhich a prior biological product has received a determination of any condition refuse. the Secretaryr shall not make a determination under paragraph that the demand or meequent biological product Ie Interchangeable tarant- condllion or use uni-l the earlier ol? "rm 1 year alter the first commercial mameling or the first interchangeable bioaimilar biolog'cal product to be approyed as innerdtangedila forthat reference product 13 months alter? a ?nal cou't decision on all peterria in suit in at action instituted under subsection (IKE: against the applicant that submitted the applicatlm tor the Ilrst Interchangeable blosimilar biological product; or "m the dismissal with or HHS IN Secretary. shall provide the pdilic an opportunity to concurrent any proposed guidance issued under ethparagraph [Pit before isauing fuel guidance. HHS Beg'ming not Ialierthan October 1. 201:). the Secretary shall develop rem?rlnendationa presenttic with respect to the goals. and plans for meeting the goals. For the process terlhe revue-?ct mlogrcal product appliralicrrs undersection 351th] of the Health Service Act (as added by this Act} fortho ?rst 5 ?scal years after ?scal year 2012. In developing such recommendations. the Secretary shall consult with? tI'e Committee on Health. Education. Lac-or. and Pensions of the Senate; in: the Commrnee on Energy and Commerce of the House of Representatives: scienti?c and academic experts: tilt} health care protassionds: [vi rapreserrtativesof patient and consumer advocacyI grows; and [vi] the regulated industry HHS PUBLIC FtEluI'lEir'trI OF RECOMMENMTIONS ?Mter neootlatrone mh the regulated Industry. the Secretary anall? present the recommendations developed under euoparag'ach to the CongressimaI committees specified in sum sdiperag'mh; r:ii] publish such recommendations in the Federal Register. ?ll) provide fora period of 30 days for the pub?c to prorridewntten comments on such recommendations; [iv] hold ar meeting at Irlrl'rich the pililic may present its On such mnwalons. MCI {ytalleroonsideradon 01806" DUDE: VIEWS and comments. such recommendations as necessary. HHS later than January 15. 2012. the Secretaryr shall lio Congress the raised recomndatlons under moaragraph ?83. a summary of the yler-r-rs and moments recall-ed mderm sd'parag?aph. and any changes made lo the remnmaridations i1 reasonsa to such views and comments. HHS Dining the period beginning on the data ofenaclrnerrt otlhis Act and ending on October I. 2010. the Senatary shall collect and evaluate data regarding the corsts ol'reeiewingapptications forbiological products submitted under section 351th] of the Public Health Sewioe Act [as added by this Act} during such period. HHS 2017--000502 Sec Sec. 7002 Sec. 7002 Sec. 7002 Sac. T101 See that Sec T109 Sec. 7102 Sec. "(102 Sec. 9001 Secs 9001 Sec Boot Sec 9006 Sec. 9007 Sec. 9009 Secs 9009 Sec. 9009 Sec 5010 the data that is 2 years allar?rst receiving a usarfee to an application For a biological product under section 351(k1of the Public Health Seneca Act (as added by this Act). and on a biennial basis October 2013.173 Secretary shall perform an eudlt oftne posts of renewing such applicatlone ureter such sectlon 351w} HHS It the audit pertmterl under clams {it indicates that the ratios compared undersupclause tll] oil such clause dltler by more that 5 percent. then the Senatary shall alter the ussrfee applicable Ito applications stbmit?tsd under such section 351th] to more appropriately the poets of reasoning such eppioetilona. HHS the Secrets-y shall perform an audit underdeuee ti} In oonlormanoe Iillitlh the principles. slandaros. and requiren'ients prescribed by the Comptroller Genera ol?the United States under section 3511 of title 31. United State Code. to ensure the lralidity ofa'ry potential traiability. HHS the Secrets-y shall not extend a penod referred Lo In paragraph tenet. [21:31 (sum. or {3){Bl it the denomination under section Mis?t is made later then 9 months prior to the expiration otsudtpe HHS The Swetary ostinlish reamd?a exceptions to dause ti}? with respect to a covered outpatient drug that Is une-rela?e to be purchased througt Ihe pro-gem under this section to a dug shortage problem. mar'l?amrer noncompliance. or any other circumstance beyond the hospital's control; "tllJ Lo tacllilate generic substitution when a generic covered outpatient dn.ig is stratus at a. lowerprice: or to reduce in otherways the administrative turdens of managing both inventories subisct to this section and inIrB'itDries-of drugs that are not subject to this section. so long as the exceptions do not create a duplicate discount problem In violation ofsucoerepraph or a diverst problem in violation ot subpersgaph {El} HHS The Swetary ensure that: a hospital described in subpaagraph (H). or of subsection {ail} that is enrolled to participate In the crud discount program utderthis semlon shall hat-e multiple options for purchasing powered drugs for inpatients. lmluo-ng by utilizing a pump purchasing organization or other mp4 pirates-pg arrangemenL estdzilishing and utilizing its turn group purchasing program. puchasing directly from a manufacturer. and any other sna'igemenls that the Secretary ds?tierni'iss rs appropriae to ensure access to drug discount pricing this section tor inpatient drugs tailing into account the particular needs at emel and rural HHS From anounls ammpriatled underpaiagiaph the Secretary shall pro?le for improvements in compliance by manufacturers with the requirements otthis section in order to prayer! ouermarges and other Ii'ioletr'ons ct'lhe iiscotrrted requirements specltled In HHS From amounts appropnated under paragraph the Secretary shall provide for Improvements in compliance by covered entities with the requirements ofthis section in order to prevent divera'on and violations of the dupicate discount prohision and other requirements speci?ed undersubsection tsHS}. HHS Not later than 130 days alter the date of enactment ol the Patent Protection and Afro-cable Care Act. the Smtary shall prormlgabe regulations to establish and implement a1 administrative process for the resolution at claims by rotated entities that they rave been overcharged for drugs ptld'issed Ll'iderthi's section. and claims by mem?fsicturers. afterthe (mount of audlts as authorized by subsection oftiiela?uns plsubseclluns {alt?tl?t or iatl?ttB]. including appropriate proosdurlesfor this provision of remecies and enforcement otdetlerrninations made pursuant to such process through mechanisms and sanctions described in paragraphs and HHS EKCISE TFO: ON HIGH COST EMPLOYER-SPONSORED HEALTH COVERAGE - The Secretary shall {sesame such regulations as may be necessary In carry out this section. Treasury WAIVER BY the case oteny such felire which is the to reasonable cause and not to wlful neglect. the Secretary may we part or all otthe penalty mood by paragrapn [t t. to the extent that the pwnent o'such penalty.I would be excessive orotherwise inequitable relative to this failure in-rcNed. Treasury TAXABLE term 'Ietiteble period? means the celenderyear or such shorter period as the Secretary may prescribe. The Semtaay may rave dltIerent taxable penoas for employers at waning sizes. Treasury Secretary may prescribe such regulations and other guidance as may be appropriate or necessary to carry out the purposes of hits section. Including rules to prom ouplloe?ll-ie of transactlons'n Treasury The Secrets-y shall issue such rewlations and guidance as may be necessary to carry out the of this subsection. includi'ig guida'ioe relating to what oonslitutas rtatto the oli?ility ofa patient undere ?nancial assistance policy torpurpoaea at paragraph (Bi. Treasury The Swetary calculate the El'l'lmth ofeach covered entity's Fee [or any calendarysar under paragraph Treasury - Reloaded section In calculating such amount. the Secretary shall determine such metered entity?s gross receipts from medical device sales on the basis oI reports sub-limped by the covered enlity under subsection {0 and "1ow the use ot?any other source of inliom'tation available to the Secretary. Treasury Repealed section The Swetary publish gijdanoa necessaryr tio carryI out the purposes oftt'iis section. inducing identi?cation of medlcal echoes described at subsection and with respect to the treatment domes recelpts from sales of medical devices to another covered enlily ortp another entity by reason of the application olsubsectjon [ctLE]. Treasury - Repedeicl section The Secrets-y shall calculate the amen-lit of each covered entity's lee Ior any calwar year under paragraph Treasury 2017--000503 Sec 9010 Sec. 9010 Sec. 9014 Sec. 9023- Sec. 9023 Sec 5023 Sec 9?23 Sec.?1?tm Sec. 1D1EH Sec. Sec. Sec ?lEItdt Sec 10101 Sec.?1?tDG SeatUlD?l Sec.?tEltEtIl- Sec tutu-4 In calculating such amounL the SecretaryI shall determine such covered entity's gross receipts from medical device sales on the basis ctreports sutmtii'ltad by the covered entity under subaedidn and throug'i the use Many other source of Intonhattm available to the Secretary. Treasury The Secretary shall publish gut-dance necessary to carry out the purposes of this sect-on. Including iderrtilicalion of medical devices described it subsection tdK1KA}and with respect to lhe treatment org-loss receipts from sales of medical devices to another covered entity orto al'plflarentity by reason o?f'lt'le application olsuhsaclion Treasury REGULATORY Secretary may prescribe such widened. rules. or regulations as are necessa'y to carry out the purposes otthis paragraph". Treasury DISCLOSURE OF Seuetary mall. upon making a certificat-on under this subsection, outlast: disclose the identity ofthe applicant and the Ell'l'lDtI'l't oftha credit with respect to such applicatt. Treasuryl the case otlnyestmonts of an pogo-no nature. the Secretary shall Issue regulations to determ-ne the data on which a spati?ed investment shall be deemed to have been made for purposes otthis paragaph. Treasury AFFLIGATION epplica'lt to: certi?cation underthis pareg'aph shall submit an application contairi'ig such infomtation as the Seuetsry may require during the period bejning on the date the Secretaryl establishes the program under paragraph Treasury TO BE application fora grant most paragraph shall include such irIt?omtalion and be in such tum es the Secreta'y may retails to state the amcutt at the credit allowable (but for the receipth a gent under this subsection1urda section d-Bcht the taxable year to: the qusi'?ed investment Mitt respect to which such spot-cation Is made Treasury In dafri'ig the term 'restt'ictad annual limit' not pup-uses ollhe preceding sentence. the Secretary shal ensuta that access to needed services is made ayeiteble with a minimal inpect on premiums. HHS The Secretary make reports received Lndar this section audable to the public on the Intemet website of the Department of Health and l-hman Services. HHS with respect to a health insurance issuer o?anng mtaraga it the small group marital nr'ri the i1d'ruidual market at] percent. orauch higher percentage as a State may by regulation determine. accept that the Secretary may adjust such percentage with respect ID a State it the Secretary determines that the apolicalim olsuch 50 percent may destabize the individual market in such State. HHS Sweltery may adjust the rates desc'tced In subsection to: lithe Secretary determines appropt'ata on account dttha wletilit?y ol'the intlyiduat market due to the establishment of State Exchanges. HHS Senatary may deem the external review process ol'a group heatth plat orheallh insurance issuet. in operation as otthe date ofanactmanl ottfhis section. to be in compliance the applicable process established most sieseclicn (bi. as cistern-nee appromate by the Emmy". HHS Secretary shal promulgate Iagulations for enlorc'rig the provisions o?fthis section and may prodds portrait-es. HHS AHMJAL REPORT ON PLANS. The Secrets}:- shall submil such reports to the appropriate committees of Congress. Labor later that year attar the date ofanactmant of this Act. the Sea-relay shall submit to the appropriate committees of Congess a report concerri'ig the rasulls of the study conducted undel subsection {aj Labor RULES RELATING TO notice described in subpaagraph en}r advertising used by the issuer with respect to the plan. any 'rltomta'lion presided by the Exchange, and any other infcnaation speci?ed by the Secretary shall pm only 'Mth respecl to the total amount at the combined payments Ior services method in paragraph other services mated by the put HHS Not later than July 1. 2013. ad priortD awarding toms 31d grants Lndarlhe EDI-OF pregnant the Secretary shall promulgate registrants with respect to the repayme?l of such loans and grants In a manner that Is cons-stem rut-1th Slate solvency ragla?lions and other similar State laws that may apply. HHS In promulgallng such regulators. the Secretary shall amide that such loans shall be repaid within 5 years and such grants shall be rapid within 15 years. tailing into considetetion an}.r appropriate State resanle requirements. solvency regdalions. and requisite surplus note arrangements that must be constructed in a State to provide forsudi repayment prior to awe-dog such loans and grants HHS 2017--000504 Sec 10105 Sec_'1010t5 Sec.1010t5 Sac.10106 Sac10108 Sec 10109 Sec 10109 Sec.10109 Sec.10109 Sec. 10201 Sac 10201 Sec 10202 Sec 10200 Sec. 10206 Sec. 10212 Sac 10221 See. 10301 Sec 10301 IN Secretary shall conducts study to ananirie the faastility and implication cladjusli'rg the appics?iion ofthe Federal poverty level under this subtitle {snd Ihe smendmenls mscie by this smati'ilet fordit?ferent geographic areas so as to rellect Ihe Irartat-ciris In cost-ot-Ihmg mutg different areas within the United States. Treasury if the Summary detest-ruins that an adjustment is feasible. the studyl snouId Nude a methodology lo matte such an adjustment. Not later than January 1. 21013. the Secretary shall sublri't to Congress a report on such study and shall include such recum'iendslions as the Secretary determines spproprisle. Treasury IN Secretary shall shame that the study under subsection [at riot-ere irie territories of the United States and that special attention is paid to the disparity that exists among poverty levels and the cost of living in such territories and to the impact otsuth disparity on e?orts to expand health (peerage .md ensure health care. Treasury 'The Secretary shall have the suit-tonig- Io rev-euthe secrecy of the prom under suheedion. including the applicable large airployar's share under parag'aph Treasury In the case of any calenda yea beginning after 2014. the Secretary shall adjust the 0 percent under peregsph [1Kri?git and 9 8 percent under paragraph the calendar year to re?ect the rate ptprenlu'n grcM-th between the preceding calendar year and 2013 overthe late of income youth forsuch period. HHS For purposes otcaTy'I'ig out paragraph (1K5). the Secretary shal solicit. not latarlhan Ja'luary 1. 2012. and not less than every 3 years hereelter. Input from ent?tles ($er In whpan?g?o? ?it on? "ill whether there could be greater uniiormlor in financial and aorta-imam act-rites and itenns. as astronomer: wpropnare by the Secretary: and "tilt 'M'le?li'ler such activities should be considered ?nancial and adu'ristraliue transactions (as described in paragraph fortihith the adoption and operating nJes mud improtrr.I the operation ofthe heatth care system and reduce admiristalive costs. HHS For purposes of stitpalaglaph EA). the Secretary shall seek input trun? the National Contriltee on ?u'ital and Heallh Statistics. the Health lrlormaticn Technology Policy Committee. and the Health Iriem'lation Technotogy Standards Committee; setting organiza?dans and stakeholders. as deternmed appropnaie by the Secretary.? HHS The Secretary task the Coorlchatim and Maintenance Comrriltaa to comer-lea meeting. not later than January1.2011.te receive input from maniacs including health plans. health we aromas. and cinlclanst r?caret-lg the cosswelk bet-prom the Ninth and Tenth Revisions c'iihe international Classi?callm of Diseases [lCD?Elland respectiuely} that is posted on the website ofthe Centers for Medicare 8. Medicaid Services. and matte recommendations about appropriate remissions to such HHS For purposes of the crosswalk described in palaqaph (1 t. the Secretary shall mate appropriate revisions and post any such revised crosswalk on the website ctthe Centers for Medicare 8 Medicaid Services. HHS Not later than 18-0 days alter the date cr?enectmerrt cllhis subsection. the Secretary shall promulgate regulations relating to applications for. and renewals of. a oernonstratim project that moo Ior? "(All a process Ior while notice and comment at the State level. including public hearings. suf?cient to ensure a rnaaninyul eval ofpubic input: requirements relating to? "{ij the goals of the to be implemented or renewed Lnderlhe demonstration proied: the expected Slate and Federal costs and cpl-terage protections of the demonstration project: and "1-0 the speci?c plans at the State In ensure lhat the demonstration project will be in cornpiance with tille ?ller .100; "{Ct a process [or providing pubic notice and carmrant alterlhe application is recalled by the Secretary. that is suf?cient to ensure a HHS The Secre1ary shall annuaity report to Congress concerning actions taken by the Secretary hath respect to applications projects under this saction.? HHS The State submits an application to the Secretary that includes. in addition to such other infomliation as the Secretary mall HHS Report to the Secretary at least annually and in such manner as the Secretary shall requi'e. pediatric quality report-1g rreesures consistent with the pediatric quality reporting meiasu'es astebished under section 1139.11 otthe Social emf HHS FISCAL YEARS 2013 AND 201d.?Subject Io paragraphs {It-{l and (B). from the arnoum made alreis?e under megaphs [16] and {17] crismaection [at for ?scal years 2013 and 2014. respectively. the Secretary stall compute a State allotment for each State {including the District otColurrtlia and each con-monweallh and territoryt For each such ?scal yearas follows HHS be eigible to receives grant under subsection list. a State shall submit to the Serratary an application at such time. in such mariner. and cumming such intormat-cn as the Secretary may rent-re. Including a description otlha puposas tor-Mich tha gatt is being requested aid the designation ol?a State agency for receipt and administration cl't?unding received under this part. HHSJ'Education The Secretary shall not ?ll any vacancy for a cert-tied dentist In a program operated by the Seance can a dental health aida lt'raiapist HHS IN Secreter)r d1ell develop a pla'l to implement a value-based purchasing pro-yanfor payments under the Medicare program Willef the Act forambuletcry surgical centers tas demoed In section 1E33ti}oi the Social Security Act [42 HHS In developiig the plan wider palag'qah the Secretary shall consider the folowing issues: The ongoing development. selection. and modi?cation process for measures tinctuci'tg under section 10-921 ot'lhe Social Security Act [42 U.S.C 1305333: and sect-on Ime of such Act. as added by section 30141. to the extent freebie and waclimte. ofall dimensions of quality and aficiency in alrtlulatory sugical centers. The reporting. collection. and validation of quality dsits. The ohlelue?bsaad payment adjustments. including the plateaus-ration of thresholds or :1 quality that should a payment adlusimem. the size ptsuch payments. and the sauces of tuning hr the value-based bonus payments. Methods for the public disclosure on the perfonnanca of HHS 2017--000505 Sec 10301 Sec. 10301 Sec. 10300- Sec. 10300- Sac. 10306 Sec 10308 Sec 10305 See. 10305 Sac. 10305 Sec. 10305 Sec 10306 63:: 10306 Sec 10306 Sec. 10306 Sec. 1030? Sec 1030? Sac. 1030ir Sec 10306 In demelopirg the plan Inder Wish the Secreta?y shall? oonsull with relevant alts-cited parties: and consider experience wilh such demonstratims Iha?t the Secretary dabenninee are relevant to the I.IahJe-Isased program dawned In paragraph [11. HHS Not later than January 1. 21011.!he Senatary shell eubnit Congress a report curlsiri1g the plan developed unda paragraph HHS The Secretary develop. a1d periodically update [not less 0131 every 3 outcome measures for hospitals and pl1ysiu'ens.ea wall as other providers as dateminad appropriue by the Secretsry. HHS HOSPITAL ACQUIRED Secretary mall. to the extent practicable. publicly report on ?names for hdepltalaoquired oil-Idilldr-s trial are currenuy utilized by the Germ for Medicare 8- Medicaid Smlces tor lhe adjustment of the amount of payment to hospitals based on rates ofhospital?acquired infeuions. HHS Folowi1g receipt of the report stbmit?led under paragraph 31d not less tha1 every 3 years thereattier. the Secretly shell contract with the Institute to the raaulls ottha sthy performed under paragraph [1}snd Iha best methods Idemi?ed by the Institute iorthe purpose of Idemlfying existing and newcl-nlcal practice guidelnes that were developed using such best methods. includi'rg guidelines listed in the National Guideline Clearinghouse HHS In canying out the identi?cation process under siubparagsph (At. the Sauatary shell consullalion with professional meshes. voluntary nesllh care organizations. and expert panels HHS The Secretary shall est?nlish and implement :1 overall stralegic [rameworlt to carry out the public reporting of performance information. as described in section 3919.?. Such streleg'c I'rameimrtt may include methods and related hmellnes For Implementing nationally msimnt data cotter?tin". data aggregation. and melhods. HHS The Secretary shall coiled and aggegabe consistent data on quality and resource use measures from iniom'iaticn systems used no support health care delivery. and may gents or contracts for this pupose. HHS The Secreted}r shall align such collection and aggregation shots lr-rllh the requirements and assistance regarding the expansion dheallh i'rfoma?tion technology systems. the interoperdzlility ol?such technology systems. and related standards that are i1 a?act on the data of enactment oftha Patient Protection and Alfordable Cara Acl. HHS The Secretary shall ensure that the data collection. data aggregation. and analysis systems described in paragraph {11 twelve 31 increasingly broad Iarge olpatient populatims. providers. and geogrwhic areas wet lime. HHS TESTING CERTAIN GEOGRAPHIC AREAS .?For purposes of healing payment and service delivery models under this sect-on. the Secretary may elect to limit testing dta nodal In certain geographic areas 12: In subsection in arbparaqaph in the second sentence. by striking "the preceding senlance may include" amt inearting"lt1is subpaagraph may include. but are not limited and (it) by inserting after the ?rst sentence the following new smtence 'The Secretary snail Ideas on models divested to reduce Diagram com underthe applicable title while preserving cu? enhancing the quality OI care received by receiving benefits- under such in stbperagraph (E). by Edi'g at lhe end lhe mllo'wi'ig new clauses: "[xixt Utilizing. in particular in entities located in HHS The Secretly shall fours on models exp-acted to reduce pmgrem costs Lridarthe applicable title while presenting or lhe Qualily? dim received by ndiutauale rebelling mils under such tulle. HHS Tothia extent feasible. the Secretary shall select measures under this palagqjh lha?t retlect national priorities For quality Irrlordremerrl end patent-centered care consistent with the measures described In 1mxrirei. HHS In determining which models or denions?lralion projects In expand under the Feceding sentence. the Secreta?y shit focus on models and demonstration projects that inproue the quality of patient care and reduce sparid?'ng. HHS IN Secretary appropriate. the Secretary may use any dfme oayrnenl nicdele described in paragraph [21m {31 [or making payments under the program rather than the payment model described in subsection HHS IN PRIVATE PAYER AND ISITHER THIRD- PhRT?tr ARRMGELENTS ?The Secretary may gee preterm bo AEGswho are particinatmg in similar with other payers. HHS TREATMENT OF PHYSICIAN GROUP PRAETICE the period beginning on the date of the enactment oftl1is section and end'ng on the data the program is establid1ad. tl'ia Secretay may enter into an agreement with an AGO mder the mdersectim 1866A. subject to ?aliasing and other deemed by the Secretary". HHS Secretary may. at any point alter January I. 2016. expand the duraticn and scope of the pilot program. In the extent determined .mpropriets by the Secretary. if? "(it the Secretarydelarmines thel such expansion Is expected to? "ill reduce spacing under title XVII cllhe Social Security reducing the duality olcare: or 1?:le the quality til care and mice the ChierActusry cl lhe Setters for Medicare 3. Medicaid Services certi?es that such eupaneidn would reduce pmgrem spending uncle: such lille the Secretary determines that such expansion maid not deny or limit the coverage or pmm'sion of bene?ts Lridarthis tille for HHS 2017--000506 Sec 10309 Sec. 10313 Sec. 10313 Sac. 10313 Sac. 10313 Sec 10315 Sec 10315 Sec. 10315 Sac. 10315 Sac. 10315 Sec. 10315 Sec 1U315 Sec 1031? Sec. 1031? Sec. 1031? Sac 10320 Sec. 1032 Sec 10322 The Secretary shall make payments [in addition to the payments described in paragraph for such a discharge To sum hospital under subsection {di tor section as the case may loci In an amount equal to the product ct. HHS Subject to the succeeding provisions of this subsectim. the Secretary shall conduct the demonstration anagram under this section i] an additional 5-year period (in this section referred to as the '5?yaar extension period'] that begins on the date immediately the last clayI ef'lt'lla initial 5-year period Lndaraubsacticn HHS Notwithstanding subsection dunrg the 5?year extenaion pelted. the Secretary ahall expend the run'ber ofStatsa with low population densities determined by the Secretary Lrldar such subsection to 20. HHS In determining which States IO Include in Such experts-on. IHB $06wa 313? L133 the same criteria and data that the Secretary used to determine the States u'rdaraurh subsection for ptl'p-osas ottha initial 5?year period. HHS "[Ail prmride forthe continued participation dsuch rural community hospital in the program clai'rg the 5-year omens-on pelted unless the natal hospltal makes an electlm. in such form and manner as the Secretary may apacity. to tiscontima auch participation: and HHS In conducting the study under perangm {11 the Secretary shall consult with appropriate stakeholders. such as goups representing home health agencies and groups lemming Medicare benefrcarles. HHS If the Secretary detain-?res i1 mpropriste to conduct the demonstration project under this subsection. the Seaetary shall conduct the project For a Four year pend beginning not later than January 1. 2015 HHS The Secrdanr shall lorthe transfer from the Federal Hospital hsuanos Trust Fund ureter sectlon 131? ohm Social Security Act {42 U.S.C 1355i}and the Federal Supplementary Medical Insurance anst Fund established under section l?dl or?auch Act [4.2 Its-13.13951} it such pmportibn as the Secretary- detrarmi'ras appropriate. of the period of?scsl years 2015 through 2013. HHS If the Secretary determ-nes Ii wnropdate to conduct the demonstratcn stored under this subsection. the Secretary shall? provide for an agitation of the proiect and aubnit to Congress. by a date speci?ed by the Secretary. a rapod on the project. HHS In conducting the study. the Secretary may analyze items such as the fclow'rrg: Methods to potentially revise the home health prospective payment system under sect-on 1895 or the Social Security act :42 G. 1m to account torooats related to patient severity ofillnosa or to bene?ciary accsaa to care. such aa? "tit payment adjustments for services that may indie additional orfewerresources; "{iij changes to re?ect with home health serum to lew-incorne Medicare benenclanes or Medicare benenclanes residing in medically undarsarvad waya outiar payments might be revised to re?ect coats of treat-1g Medicare bene?ciaries with high levels bras-rent}! of illness: and Try] other issues danamimsd appropriate by the Secretary. Operational issues HHS conducting the study under paraqaph t1}. the Secretary may conaidar whether paliant severity of illness and access to rate could be measured by factors. such as? population density and relative patiem access to care: "[Ei variations In sen-ice costs to: providing care to Individuals are dually eligible wider the Medicare and Medicaid programs: the presence ofseyereordwnic diseases. which might be measured by multiple. discontinuous home health episodes; poverty status. such as evidenced by the receipt of Supplemental Semlly Income under1l1le DWI otths Social Security Act: and "El other factors detenln-ned appropriate by the Secretly. HHS IN to sucparagrach in}. taking into account the results of the study conducted under perm-wit the Serialary may. as appropriate. prutrida fora demonstration projecttio test whether making payment adjustments for home health services under the Medicare pro-gem would substantially i'nprova access to care [or patients with n-gn seventy levels otilness or for low-Income or underarm-ed Medicare bene?ciaries. HHS Begimlng on ?nal 1. 2010. In the ?lace Index applicable to nosnltals that quallfy For wage Index the Secretary. shall include the awayshourly was data ol'l'loapilala whoaa was attended pursuant be the amendment rnada by paragraph (1}only' it including such data results in a big-er applicable reclassn?od wags Index HHS The Secretary ahdl pay such hospital at additional payment that reflects the dilerenca between the Iluage index for such periods. HHS The Secretary ahdl make payments required under albparag'aph by not later than Dacerrbar 31. 21010. HHS The Secretary shall not inplemenl the recommendations contained i1 a proposal submitted in a proposal year by the Board or by reoesiwat-ng sucoaragnaol'ls [All and is: as clauses and respect-velar. and indenting mommy. and {ill} by at the and the following new aubpalagaph HHS Any reduction u'rdarsubpaagraph shall asply only with respect to the rate year introtlred and the Secretary she] not take Into acooum such reduction In combating the payment amount undertl'u: system deserted In persistent :1 Her sLIJaaguent lala year. HHS Not later than October 1. 2012. the Secretary shall pubish Ihe measues selected underthis sltparegraph that will be applicaue with respect lid rate year 2014. HHS 2017--000507 Sec 1032? Sec. 10322 Sec. 10323 Sac. 10323- Sec. 103233 Sec 10323 Sec 10323 See. 10323 Sec. 10323 Sac. 10323 Sect 10326 Sec tum Sec 1032?? Sec. 10329 Sac. 10329 Sect 10330 Sec. 1031 Sec 10331 the case at a specified area or medical tonic dammed by the Secretary for a feasible and practical measure has not been anchsed by the lentil)I Iirtiith a contract undarsection 15905:. the SecretaryI may specify a measure that is not so endorsed as long as due col'rsl'deralion is g'ven to measures that have been endorsed oradcioteo by a consest organization Idemtf-ed by the Secretary. HHS DEEMING. ?For pumaesh cl eligibility for benellts under this title. the Secretary may deem an 'ridividud determined Ll'ider subsection (cilia beat exposure e?ected individual dasuioad In subsection to meet the dentition-Is speci?ed In aecticin ??tat. HHS The Secretary a pilot mam in accordance with this subsection to plouide innovative apptoad'iesl furrl'shing comprehensive coordinaled. and mist-effective care underthie We to individuals described In paragraph [2km HHS For purposes ofcaTy'I'ig oul pilot pregame under this subsection. the Secretary shell prouidefor the transfer. from the Federal t-Icsoltol Insurance Fund under section 1:11? and the Federal Supplememaly Medical Insurance trust under section 1841. In such pmpoh'icn as the Secretary determines appmoriate. of such sums as the Semtary datarrninaa necessary. to the Centers brMecicaIe Medicaid Services Frog'a'n Management Account. HHS The Secretary shall not require that pllot programs undertnis subsection he budget neutral with respect to amend-tum under this title. HHS The Secrets-1r shall determine eligibility for pilot programs under subsection HHS OPTION-IL Secretary my establish a separate pilot program. In accordance with this subsection. IAiith respect to each geogaphic area subiact to an emergency declaration [other than the declaration of 17. 2009]. in order to timish such mmpreherrsiva. and ccat?e?ective care to 'ridiln'dials described in Wragranh [Hall who res-tie in each such area. HHS WAIVER Secretary maywta've such provisions o?fthis title and title It as are necessary to carry out pilot pro-yams under this subsection. HHS The Secrets-1r shall establish a program In accordance tIn'lh this section to matte competitive grants to elig't?e enllties speci?ed it subsection tb}for the purpose of? "{1Jscreeru'19 at-nstt individuals {as de?ned in subsection for emits-marital heatlh conditions [as de?ned in subsection (0)1333: and devetep'ng crud disserrl'iating public Informlcin and education monolng? the availamrty discreetlng under the program undermls sect-on: "t?i the detection. prevention. and treatment otemironmental health conditions; and the availability otMecicae bene?ts for certain individuals diagnosed with ernrircinmental health conditions undersection 1881A. HHS WAIVER Secretaryr may ties-e such requirements of titles it] and mill at the Sadat Security Act as may be necessary' solely torpurpcses ofcarrying out the pilot pro-yams under this section. HHS EXPANSION OF Secretary may. at an)I poi-It alter January 1. 201B. expa'id the duration and swipe of a pilot pro-gem iriderlhis silnsection. to the eicnent damned appropliate by the Secretary. it'? the Secretary determines that such expansion is emected to? [Ai mice spending under title :t'u'ltl at the Sadat SecLIity Act without reducing the quality of care; or the quality of care and reduce spending: the Chief Actuary oflhe Centers for Medicare ti. Medicaid Services certi?es that auch expansion would reduce program spending under such title and the Secretary determines that such expansion til-M not deny or rent: the maps or provision of bene?ts indar such title Nil for Medicare beneficiaries. HHS as the Secretary may reqLI'e. on the methods. measures. and dale used under the Maintenance o?fCertificatim Program and the dual-lied Maintenamae cl Stratification Program practice assessment. HHS atler 2014. if the Secreta'y otHe?th and Human Services determines it to be appropnatte. the Secretary may Income-rate peritoneum In a Maintenance atCenlficetlon Program and successful mist-on cta qualified Maintenance ot?Certi?calion Program practice assessment into the composite otmeasues cifquait)I of care tum'nhed ptlsuant lo the physician fee schedule payment modi?er. as described in section 1Mtp}{2] o?fthe Social Semlty that [42 U.S.C 13WDH2JJIZ HHS Not later than 18- months after the data of enactment ofthis Act. the Secretary shall subnit to Congess a report cot-teaming the methodology developed under subsection (at. HHS The Secretary ctHeelth and Human Services. In consultation 'Mltl relevmt stakeholders Including health Insurance issuers. health care consumers. employers. health care powders. and other entities determined appropriate by the Secretzy. shall develop a methodologytto rneesiure health plan value. HHS By not later than El months alter the date of the enactment of this not. the Secretary snail post on the website or the Centers in Medicare 8? Medicaid Services the plan described in subsection HHS Not later than January I. 2013. aid with respect to reporting periods that begin no easier than JantEI'y 1. 2012. the Secretary she] also implement a plan formatting pubidy available titrough Physician Conpara. consistent with subsection on phys-oen predominance that Inlormat-cn forthe public on quallty and patient expenence measues Iwith respect to physicians atrolled in the Medicare progan under such section 136%}. HHS The Secretary ensure that 'I'It'ormation on physician performance and patient experience is not disclosed uncle: this section in a. manner that vida?tiessections 552 or 55.22 cl'litle 5. Uniled Slates Code. with rega'd to the privacyo?f individually identi?able health HHS 2017--000508 Sec 10331 Sec. 10331 See. 10331 Sac. 10331 Sac. 10332 See 10332 Sec 1033 See. 10333 Sac. 10333 Sec. 1033-3 Sec 1040? Sac Sec 10-10? Sec. Sec. Sac 10408 Sec inane Sec 10409 Not later than Secretary shall submit to Congress a report on the Physician Compare Internet website developed [aki HHS EXPANSION tin-e helm the date on which the report is stemmed underaubeecten tn. the Secretary may stipend (including aspension to other prouidasof services and suppliers Lnderlitla otlhe Social SecurityI Act] the intomietion made available on such website HHS FINANCIAL INCENTIVES TU ENCUJRNGE CCNSUMERS TO CHOOSE HIGH Secretary may. establish a demonsb'atian pmgam. not later than January 1. 2019. to [amide financial incentives to Medicare berie?eisrie-stmo ale tumished senriee-a by high quality physicians. as determined by the Secretary based on fedora in whparayapha in! efaweecbcn talt2i. In no case may Medicare bene?ciaries be reoulreo to Day increased prerriums or cost sharing or be subiect to a reduction in bene?ts under tilie XVII ol?the Social Security Act as a result of such demonstration program. The Secretary shall ensure that any such demonstration progam does not dimmege those bene?ciaries witnaut reaamable access to high pertomihg physicians or create ?nancial Ineqult-es HHS The Secretary shall enema that any? such oemmetraaon ploy-am does not dime-artisans those mireianes without masoneble aiccess lo performing physicians prcreete ?nancial inequities under such title. HHS The Secreiary shall take act-one as the Seuetery deems necessary to protect Ihe Identity dimly-duals entlled 10 or enrolled for bene?ts LI'Iclersuch parts. HHS The Secretary not make data described in paragraph ey?dnle to a qui?ed entityI unless the quali?ed entity agreesbc releaae the infumation on the evaluation cl'perlormance of prouidera etsenlicee and suppliers. Such entity shall only use euch data. and derived from such evaluatim. for the repute understmaragraph HHS IN Secretary mayI award gents Io elijzile entities to support community-based collaborates care nemnte that meet the requirements of subsection tot. HHS subsequent years. based on the performance of grantees. the Secretary may provide renewal grants in prioryeergraru recipients. HHS GFWIIT FUNDS- HRSA GRANTEES. ?The Secretary may Ilmlt the percent ctgrant funolng that nay he went on direct rare services provided by grantees of programs administered by the Health Resources and Services Administration or impose other requirements on such grantees deemed necessary. HHS In awarding grants. the SecretaryI sl'iall give prionty to networks that include? "(Al the capability to provide the broadest range of standouts to Icw-hocme individuals: "is: the made-st serge dioroviders Inst currently eervea nigh IIrelteineoi low- income individuds; and a count)I or municipal department eihealih. HHS DIABETES IN Secretary. in oclaboraiion with the Director ctlhe Centers Disease Control and Prevention [referred in in this section as the ?Diredof't. shall prepare on a biennial basis a national alabeles reporl (and [retened to In IhIe section as a "Report Cam'i and. to the extent possible. For each State. HHS Secretary. in collaboration with the Director. shall malice each Report Card publicly available. including by posting the Report Card on the Internet. HHS IN Secretary. acting though the Director ctthe Centers for Disease Caitrcl and Prevention and in mleboretion agencies and States. shell? promote the education and training on the Invariance of lamb and death certi?cate data and limit to imperiy complete documents. Meeting the collection of such data fordiabelies ard other chronic diseases: encourage State adoption oi the latest standard revisions ol'birth and death certi?cates; and t6] worlcwilh States to re-engineeriheiruilal statistics systems in orderbo provide cost- ettecilve. timely. and accurate mat systems data. HHS IN Secretary shall. in mllahorstion with the Institute of Medicine and smpropriape associations and councils. conduct a study at the impact efdlabe?lae on the predlce of memos in the United States and the appropriateness ol?lhe level ofciabetes ?radical ecluiatiorl that shoIIJcI be required prior to licensure. board certi?cation. and board recerli?cariim. HHS REPORT. ?Nc1 later than 2 years a?erthe date afthe enactment afinls Acl. the Secretary shall submit a report an the study under paragraph [111.0 the Cumiltees on Ways aid Means and Energy and Commerce of the House at Fliqzuresenta?liues and the Committees on Finance and Health. Education. Lido-or. and Pensions ofthe Senate. HHS Secretary stall award grams to eligible mioyere to mice Instr mioyees With amass to workplace wellness proga'ns [as dean-iced under subsection HHS mlTEFttk??l'na Secretary shall develop pmgrarn criteria formeliensiveworkplaoe wellness proga'ns under this section that are based on and consistent with auidmoe?basecl research and best practices. including research and practices as provided in the Gu?e lo Community Pneyentiire Sewlces. the Guloe lo Clinical Prevenme Services. and the National Registry for Emma Programs. HHS ANDVICE .?The Seaeta'y shall designate. from among the 2-1 members applet-Iliad under clause lit. one Chairperson of the Board (refuted to in this section as the 'Chairperson' me Vice Chairperson HHS 2017--000509 Sec 10-109 Sec. 10409 Sec. 10409 Sac. 10410 Secc?lEl?ttO Sec 10-110 Sec 10410 Sec.'10410 Sec. 10410 Sec. 10410 Sac10410 Sec ?lotlo Sec 10-110 Sec_'10410 Sec. 10410 Sact10411 Sec Secretary. shall wooint i'ld'nriduals to the ?uid based solelyI upon the individuis established raoold otclistinguished service in one ottha areas ofaitperrise described in clause Each incinidual app-titted lo the Board shall be cfdlemgulshed eat-enema! and have a creed range ddleopllnery Interests. Secretary shall select individuals based upon the toltoeing requirements: For each of the ?elds of? "teat basic research: discovery erld delvery otme-dical products: blolnfonnence and gene therapy: ?{fft med-oat mammalian: and "(got regime-iv renew and approval otmedlcal products. the Secretary shall select at least 1 who is eminent in such fields Ieaet4il1riudtele shall he recognized leaders irl professiond venture capital or private equity organizations and have demonstrated experience in private equity hues?ng. least 3 individuals shall represent liseasa advocacy organizations. addition to the 2d Board merrbers described in paragraph the Secretary shall empol'rll as ex? olIIo-?c miners ctthe Board? "lIt a ol the National Inettutee at Health. recommended by the Secretary of the Department ofHealth and Human Sen-ices; a representative of the Of?ce ot the Assistant Secretary of Defense for Health Affairs. recommended by the Secretary of Defense; a representative ottha Df'?oe dftha Under Secrelary For Health forthe Veterans Health recall-melded by the Secretary ottl'ererane representative ctthe Nationd Science Foundation. recommended by the Chair ofthe National Science Bead: and a representative otthe Food 31d Drug?ldrri'list'ation. raccrm?uendad by the Commissioner-of Food and Drugs. IN Secretary. sound mugh the shall we grants on a competitive hes-s to el-gltle entities to establish national centers of excellence tor-depression trelerreo to in this sect-on as 'Certtes'i. which shall engage in activities related to the treatment ofdapressiva disorders. ALLOCATION OF the funds author'uad mder subsection [?are appropriated in the amou'rts provided for under such subsection. the Secselary shall allocate such amounts so that?"Mt not later than I year alter the date of enactment ofthe ENHANCED hot 0120-09. not more than 20 Centers may be established: and not later than September 30. 2016. not more than 30 Centers may be estebished. gent awarded under abparag'aph (A) may be rerouted. on a corrpatitiya basis. for 1 additional 5?year period. at the discretion of the Secretary. tn detenriri'ig nhett?ter to renew a grant. the Senatery shall consider Ihe report cards issued under subsection letizt. arradi'g grants under this section. the Secretary shall give priority to eligible entities that rrleel 1 or more dftha following criteria: Demonstrated capadty end expertise to aenre the targeted population. "[ii:l Existing Infrastructure erexoenlee to provide appropriate. mambo-see and culturally and linguist-catty competent serum A location in a geographic area with disproportionate numbers of underserved a'ld at?risk populations in medicallyI undersenred areas and health proteasional shortage areas. The] Proposed innoeabyeepproadles for outreach to initiate orewnd send-cos. ?ll-It Use of the most unto-date sclonce. practices. and Intementorts available. "tut Demonstrated capeoty to establish Witt! 31d collate-elite angtS \?I'Itt?t t't'll?'ll? health centers and other IN Secretary. acting through the Adn'li'listrator. shall designate 1 recipient o?fa grant Lrlderlhis section to be the coordinating center of excellence fordeprlesaion (refered to in this section as the coordinating center}. The Secretary select such coordinatirg center on a competitive basis. based upon the demonstrated capacityI of such oentarto perform the duties described in subperaquh Secretary may not was a grant orecntract 54:61ch to an entity the entity agrees that it 'rnl make available [directly or trh'oligh contributions from other or nitrate entitles} non-Federal contributions towad the activities to be can-led out u'llderlhe gent or contract in en emoutt equ? to $1Fcr each $5 at Federal funds prcwided under the gramor contract. Such non-Fedora matching funds may he provided directly or through donations from Milo cr nitrate entities and may be in cash or in-kind. lai'ly evaluated. Including plant. equipment. or services. ESTABLISHMENT OF Secretary. smug much the shall establish oertomtanoe standards for? "(At each Center: and "13] the network ofCentars as a whole. RE PORT Climbs?The Secretary. acting through the Administrator. anall? for each Cenlec not le1er than 3 years after the date on Mich such center ctencellence ie eelabhehed and annually mailer. seue a report card to the coordinating cerller to rate the pertorrnarlce of such Center. a'ld not later than El years after the date on 'M'lici'l the ?rst grant is awarded Ll'udar subsection and annually thereafter. issue a rep-art card to Congress to rate the perm-meme or the ctomrere otelioellenoe as a Merle. RECON-4E upon the report cards demoed In new it). the Seesaw shall. not later than September 30. make recommendations to the Centers regarding impmmements such centers shall melts; and malts recommendations to Congress For expanding the Centers to serve i'ld'rul'chels with othartyp-as of mental disorders. PARTY later than 3 years alter the date on Midi the first grant to awarded under subsection a'rd annu?y thereatter. the Secretary shal ara'lge foran independent third pat)I to conduct an evaluation ol'the nemark ofCenters to ensure that such centers are ?testing the goals of this section. ALLOCATION OF FUNDS amount appropriated Ll'udar paragraph bra fiscal year. the Secrelary ehal determine the allocation oteaa'l lL?.erl1erreloading a gram undermls sect-on. but In no case may the allocation be more than 35.000000. except that the Senetary may allocate not more than $10.000.000 to the coordinating center." IN Secretary. acting through the Director at the Cerders for Disease end Prevedion. may? enha'lce and expand i'rfrastructtle to tradt the epidemiology ofcongenitel heart disease and to orga'lioe such information into a population-based surveillance system that compiles dale oonoeming actual occurrences of congenital heart disease. to he know as the 'Netlonet Cmgenlat Heat Disease Sumlahoe System'. or award a gent to one elig'ble entity to undertake the activities described in parag'ai'l tit. PATIENT Secreter)r shell ensue that the Conga'litd Heart Disease Slunreila'lce System is maintained In a mannermat correlles lolth the regulellons promulgmed uncle sectlon 36-1 ctthe Health Insurance and Accountability Pact 011996 IN Secretary. acting Waugh the Directh cllhe Centers for Disease Callml and Prevention. shall oonducl a national evidence-based education campaig'l to increase menees otyoung women's knowledge regarding? "int breast health In young women or all rec-at. ethnic. and wltral backgrounds: "16] breast awareness and good breast hedlh habits; the occurrence of breast cancer and the genera and speci?c risk factors in women Men may be at high risk [or breast carner based on farnial. racial, ethnic. and cultural backgrou'ids such as Ashltenan' Jeweh populations; Interment that would ermurege young men and their health care prollassional to increase earlyl detection ofbreast cancers: and "(El the availability othealth ?rrtorrnalion and other HHS HHS HHS HHS HHS HHS HHS HHS HHS HHS HHS HHS 2017--000510 Sec 399m Sec. Sec. Sac. Sac. EQBNN Sec Sec accrue Sec. Sac. Sec. 10511 See Sec ?lEIsct Sec 10501 Sec. 10501 Sec. 10511 See Sac. Sec 10501 MEDIA CMPAIGN ?In mtducting the education campaign under paragraph the Secretary shall award grants to entities to establish national multinedia campaigns oriented to young women that may include advertising tltrough television. radio. print media. billboards. posters. all forms oter-cisling and especially ernery'ig social networking media. other Internet medla. and any omer nedlum detennlned aporocrlane by the Secretary. HHS later than 60 days atter the date of the enactment of this section. the Secretary. acting through the Direuor ofthe Centers for Disease Control and Prevention. establish an advisory committee to assist in creating and the education cempaig'rs erider paragaph {It and subsection [but]. HHS Secreta?y. acting through the Director of the Centers for Disease Control 31d Prevention. shall app-oi'rt to the advisory committee under subpsragraph [At such members as deemed necessary to properly advise the Secre1ary. and aha! amide organlzatons and expanlse In breast cancer. disease early detection. diagnosis. public health. social marketing. genetic screening and counseling. treatment. rehabitaliorl. palliative care. and Worshipin young won-ran. HHS WERE PRUFESSIONAL EDUCATIQN $ecretary. with the Dlector ofthe for Disease Control and Preyerrlion. and in consultat-on with the Admin-stralor oi the Health Resources and Sen-toes Administration. shall conclict an replication campaign among physicians and other health care prctassionals to awareneas? of breast health. and salty diagnosis and treatment of breast cancer in young women. including speci?c risk Iacliors such as family history of cancer and women that may he at high for breast cancer. such as Ashlrenazi Jewish population: on how to provide counseling to yourg women about their breast health. including knowledge oftheirfamily cancer history and importance ofproviding regular clinical breast examinations; "(Si HHS PREVENTION RESEARCH Secretary. acting through? "rjt :r the Director oithe Ger-iterator Disease Control and Preventlon. shall conduct detention research on breast cancer In younger woman. Includlng? behavioml. sustvorsh'p studies. and other research on the in?pact ot'breast cancer diagnosis on young women; "(Bi formative research to assist with the development ofedicational massages and infom'lation forthe public targeted populations. and their ahorn breast health. breast cancer. and and avaiatlng existing and neusocial mar-listing strategies targeted at young women: and surveys at health care ponders and the public regarirlg knmateige. attitudes. and practices related to breast health and breast catcerpreueriion 31d HHS IN Secretary shall award grants to orgarl'zations and institutions to preside health i'rformaiion from credible sources Hid substantive assistance directed to young woman diagnosed with breast cancer and breast diseases. HHS matting grants under paragaph it}. the Secretary shal g'ye priority to applicants that deal speci?cally with young woman dlamcsed saith breast cancer and tire-neoclasilc breast disease. HHS ND DUPLICATDN OF conducting an education campaign or other pro-Jan under subsections tbi. lot. or id). the Secretary shal avoid duplicating existing Federal breast cancer education efforts. HHS MEASUREME HT: REPORTING ?the Secretary. 301an through the Director ofthe ISeniors [cruises-so Control and Prevention. shall? "tilt young woman's awareness regarding breast health. including trr'rorrledga ot fatiy cancer listory. speci?c date Factors and eady wanting signs. and young woman's proadive e?orts at early detect-on: "(Bi the mm or percentage otyoung semen informa?don lifestyle Interventons that foster healthy more: the or percentage or young wetter resetting reply clinical breast eye-iris: and the numbarorparcentaga ofyoungwoman who peritrm breast self exams. aid the fraguencyof such asserts. before the inplamemalion ol'lhr's section; not less than every 3 years. measure the impact ol'suoh activities; and submit HHS Task Force shall be comprised ot Federal members vat-lo shall be appointed. not later than #5 days aherme date ofenaument of Act. as I'ollows: "m The Secretary of Health and Herr-m Services shall appoint one representalhe cteach ol the Iolomng: "let The Department of Health and Human Sewioes. The Centers for Medicare and Medicaid Sen-ices. The Indian Health Service. HHS chairpersm ofrne Task Force shall be apps-rites try the Secretary at 1ho Ilme of under subsection to}. selected Front among the members appointed paagraph HHS ESTABLISHMENT OF PROGRAM ?The Sacra1ary ul'Heallh and Human Services [referred To it this section as the Secretary: shall establish a training demonstration program for family nurse practitioners- lreterred to In this section as the 'progrern'] to employ and provide 1-yeertra'1ing for nurse pranitionars who have gaduebad from a nurse practitioner program torcareers as primary care providers in Federally quali?ed health centers [referred to it this section as and nurse-managed health clinics (referred to in this sect-on as HHS Secretary shall award 3-year grants to eligible entities that meet the requirements establist by the Secretary. for the purpose ofcperaling the nurse practitioner primary care programs described in subsection {at in such HHS PRIORITY IN AWARDING awarding grants this section. the Secretary shal guys o'ionry Io eligible entities that? '11} demonstrate suf?cient infrastructure in size. scope. a'ld capacity to undertake the rsng'sits training cfe minimum ot'3 nuse practitioners pa yea. amt to provide to each aurardae12 full months of Full-time. paid employment and mitts cmsislent with the benefits offered to error luI-time employees arm entity. will assign not less than 1 staff nurse prarditioner or physiciat to each of-I precapted clinics; 13] mi provide to each ausrdee specialty rotations. including specialty trains-lg in prenatal care and mman'a health. adth and child orthopedlrs. and at least 3 other high-volume. high-burden specialty areas: sessions on high- HHS Secretary may technical assistance grants to 1 or more or Nth-ICs that hayedernonstrated expenlse In a nurse practhimer residency training program Such technical assistance grants shall be for the purpose ol?prorid'rrg techrical assistance to other recipients otgrants Ll'td?t subsection to}. HHS IN Secretary. acting through the Director otlhe Centers for Disease Cor-root and Prevention. shall establish a national diabetes prevention program {reterred to in thus section as the 'program'} meted at adults at high risk tordiabetes in order to eliminate the preventdile tarnish otdiabetes. HHS IN Secretary shall develop a prospective payment system [or payment torFederally anli'?ed health center services furnished by Federally maimed health came-rs Lnder the Such system shall rndude a process for appropriately describing the services fumished by Federally dual?ied health centers aid shall establish payment rates for speci?c payment codes based on such appropriate descr'ptions of services. Such system shit be establi?ted lo take Into accounl the type. intensity. and durallon Olsen'Ioes burnished by Federally quali?ed health centers. Such system may include adjustments. including geographic adjustments. vdahen'ri'red appropriate by the Secretary. HHS MLECTIGH OF DATA AND not later than Jamey 1. Edit, the Secretary shal require Federally qualified centers to submit to the Secretary such information as the Secretary may require in orderto developand implement the prospective payment system under this subsection. including the reporting ofaeryices using codes. HHS 2017--000511 Sec 10501 Sec. 10501 See. 10501 Sac. 10501 Sac. 10501 Sec 10501 Sec 10501 Sac. 10501 Sac. 10501 Sac. 10501 See 10508 Sec 1U504 Sec 1060? Sec. 1060? Sec. 1060? Sec 1060? Sac. 1000ir Sec 1060? IN GENERAL. ?Notwithstanding section imaiistw. the Secretary shall pro-arias. for cost repermg periods begiming on oratter October 1. 201-1. for payments of prospective payment rates for Fit-derail)I quali?ed health center services turrnehed by Federally cpali?ed health centers Lrnder this titte In accordance with the prospective payment system deveoped births Secretary unasrperogramui. HHS INITIAL Secretary shal iimzriemenl such prospective payment system so that the estimated aggregate amountof prospective payment ralas pnortio the application otsedicn underlhis title for Federely healih center semoes In the first year that such system Is Implemmted Is equal 10100 percent of the estimated amourrtel reesoneue costs toetemrineo Iwithout the application era per visit payment limit or produdivity screen and priortio the application has occurred kl such services under this ?tter in such year iflhe system had not been implemenled. HHS PREPRRATION FOR PPS ?i~tc[wiihslanoing any other owe-m chew. the Secrets-y may establish and implement try i1s1ructi'on orotharw'?e the payment codes to be mad Lridarthe prosperiive payment system undertt'iis section." HHS IN Secretary. acting though the Adninietratnr otthe Heailh Resources and Services Administration. shrall establish a grant program [or the purposes mess-sting elrglale In rem-rung students most likely to practice ir'l MSW r'Lir?H Width}; mat-focused training 3M expuience. and #13083an the number of recent allopalt1ic 31d osteopathic medical school graduates 'M'io practice i1 u1darserved rilal communities HHS awarding grant [Linda section. the Severely shall give priority to eligible entities that? demonstrate a record of successfully ire-ring contents. as detennlned by the Secretary. who creates mecclne In uridersenied rural conInunilies; demonstrate that an existing academic program ol'the e?aible entity produces a high percentage. as delarrnined by the Secretary. otgraduatea from aud1 program who practice mediti'ra in underserved rural communities: rural community Irelltutlorral oarlneierI-os. such mechanisms as or services forirolementalion. oralisbence ottiaining partners with inberproi?assicnal eupartisa in communit)r heaith center training ocaliona oroIt'Iar siriar facililies; or submit. as part HHS later than 50 days ?ier the date cfenactmerit ol'lhie section. the Secretary shall by regulation de?ne 'urdereerved rural for purposes or this sect-en. HHS Secretary. acting through the Administrator otthe Health Resources and Services Administration and in consultation with the Diec?ior ofthe Cenlers for Disease and Prevention. shell grants to. or enter i1Iio contracts with. to Memlng to graduate medical residents In Dreventwe medicine speclames. HHS Secretary shall submit to the Congesa an annual report on the program {sorted out section." HHS in paragraph by slnking "In carrying out subpart and al that [allows lhroum the period and i1serti1g "In carrying out attiparl the Secretary may. in accordance thia suboec?iim. issue waivers to individuals who haveennered into a contract ferohllgated same under the Schoer?ahlc Program or the Loan Hemmer-1 Program under I.Iihlch the individuals are authorized to satisfy the requirementofobligated service through provicig clinical practice that is half time.": HHS by striking the second sentence and inserting the Iotlo-birigr The Secretary may treat teaching as clinical practice for upH to2?parcenlotsud1 period ofotigabedservicef': USE OF Secretary ci?Heallh and Human Services shall transfer amounts in the CHC. tc acoounls Minn the Depenmem of Health and Hurrah Services to mouse fuming. Deaths ?scal year 2008 level. For community health centers and the National Health Service Corps. HHS Ihl later than 5 months afterihe date otenactment ofmls Act. the Secretary of Health am Human Sen-ices [referee to in this section as the "Secretary"t. acting through the Health Resources and Services Administration. shall establish a 3 yea demonstration project in upto 10 States to provide access conuehansiva heallh care siervioea to the uninsured at reduced fees. The Secretary shall evatia?tethe feasibility otaaipanding lhe project to additional States. HHS IN Secretary ls authorized to award demonstration grants to States for the development. implementation. arid evaluation oldtematives to current bort litigation ior resolvi'g Elsputes overiniuries allegedly caused by heallh care providersorhaalth care organizations. I1 awarding such gents. the Secretary shall ensure the diversity of the alternatives so funded. HHS Secretary may award grants under subaection {at for a period not to exceed 5 years. HHS PREFERENCE IN AWARDING In sum grants under subsecltm the Secretary shall give preliarenoe to States? that have developed the proposed albemaliire through substantive consultation Iirrith ratevanl stakeholders. including patient advocatea. health care providers and health care organizations. arbomeya with exoenlse In reusaemtng patients and health care growers. medlcal malprocilce Insurers. and patient salary expens; that make proposals that are likely to enhance patient saFaty by detecting. analyzing. and helping to reduce medical errors and edvuseavents; arld?tC}tt1etmaioe pmp-osds that are likely lo improve access no liability insurance. HHS IN GENERAL ?In retrieving amiicaticns under paragraph [1 i. the Secrelary shall consult With a review cartel mused of appointed by the Comer Genera. HHS BY Secretary shall submit to Congress an annual oompenciam otthe reports submitted mder paragraph and an analysis ol'lhe activities funded under subsection ta} that examines any difermces that result from such activities In terms of the quelltv clears. rumba and nature olmedlcel errors. medical resources used. length at time tordispule restitution. and the availability and price ol liability insurance. HHS IN Secretary shall wide technical assistmca to the States applying fcrorensuded gents urda subsection tat. HHS 2017--000512 Sec 1060? Sec. 1060? Sec. 1060? Sac. ma}? Sac. 10905 Sec 10506 IN Secrelary. in mnsullallm wilh the renew panel aslabliahed under aubsedlon {dill}. shall enter Into a contract wilh an apptopriaba maid! uganization Lo oonducl an ovali of Ihe al'faciivanass dgranls amatdad Lndaraubaiamim and to annualy prepare and submit a report In Conga-ea. Such an euabalim aha! bagin not Iater1hm 13 monthe following me dale of Implemanraiion af1he ?rst program funded by a gram under subsection HHS shall 5 paroanl ofiha an'iounl appropriaiad in aazh ?scal year under suhaaciion tk] ho carry out this subsection. HHS OPTION TO PROVIDE FUR INITIAL PLAINING the Iunda awropnabed pursuanl to Ihe Secretary may use a podion not to amaad 3500.000 par State to provide ptmning gmia be such Slalaa for tha davdopnenl ofdemonalration proiaot applications rnaeting Ihe oriberia described in subsection HHS In selecting Slates In reclaim such planning grants, the Seaman; shall give perm Lo moae Staiee In which Slale law at tha tin1a oftha wouicl not prohibi'Hha adoplion oi'an aitan'laliue b0 run-an! tort li?gaiion. HHS Secrelary shall calculate the arroum of each covered en1lly's fee for any ?llandar year under paw HHS In calaulaling aud'l amount. 111a ahall daberrnina such ctr-Grad entity-'5 nat pmrniuma miinan wiih raspact In an;I United States he?lh rial: on the basis drapone aubni'lled by Ihe oouered emit;- under aubaedion {g5 and Ihroug'i the use olany oil-er source of Inlorrnaljm available to the Seminary.? HHS 2017--000513 Compilation of Frequently Asked Questions Regarding OHPs and the Offering of Coverage on Health Insurance Exchanges Issued through January 31, 2017 Legai Advice and Compliance Notice: This document compiles Frequentiy Asked Questions (FA Os) reieased by CMS (and seiected FA Os form other agencies) reiated to the ACA. FA Qs continue to be issued and are sometimes modi?ed by subsequent guidance. The information provided is not intended to advise any company on how it may compiy with any provisions of the referenced iaw or reguiations, nor is it otherwise intended to impart any iegai advice. if you have any questions about how to compiy with this or any other iaw or regulation, we recommend that you consult with appropriate iegai experts. Table of Contents ENROLLMENT 3 Applications 8 834 Enrollment File Processing 14 Direct Enrollment 29 Data Reconciliation 31 Special Enrollment Periods 37 Health Insurance Casework System 47 Grace Periods 65 Terminations and Cancellations 70 Renewals 76 NOTICE REQUIREMENTS 96 ELIGIBILITY 8 CHANGES IN ELIGIBILITY 115 CSRs AND APTCs 134 Eligibility 134 CSR Plan Variations 146 Clarifications to 2i27i14 Bulletin on Retroactive APTCs and CSRs for Exceptional Circumstances. 147 ISSUER PAYMENTS 150 Member Billing and Payment 150 834 Enrollment Filei820 Payment Data 153 Payments and Reconciliation - X12 HIX 820 165 Reconciliation of the CSR Component of Advance Payments for Bene?t Years 2014 Issuer Payment Informationi Establishing Payment Accounts 248 Initial PaymentiPayment Redirect 255 Payment Cycle 260 Interim Issuer Payment Process 263 Discrepancy Reporting 278 REINSURANCE, RISK ADJUSTMENT, AND RISK CORRIDORS 290 Reconsiderations and Appeals 291 Risk Adjustment Implementation 298 Reinsurance 432 Risk Corridors 488 ESSENTIAL HEALTH BENEFITS (EHBs) 515 Substantially Similar 528 State Mandates 528 Cost-Sharing 532 Mental Health Parity 540 Dental 541 Prescription Drugs 564 Ancillary Products 567 ACTUARIAL VALUE 568 Actuarial Value Calculator 572 TEMPLATES 576 Accreditation Template 582 Administrative Template 583 1 Updated 1-31-17 2017--000514 Bell, Michael Subject: Location: Start: End: Show Time As: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Optional Attendees: ACA Regulatory Reform Huddle Deputy Secretary Office, Suite 6146 Tue 3/28/2017 1:00 PM Tue 3f28/2017 2:00 PM Tentative Weekly Occurs every Tuesday, Thursday, and Friday from 1:00 PM to 2:00 PM effective 3/28/2017. Eastern Time (US 81 Canada) Tentatively accepted Pate, Randy (HHSXIOS) Horn, Wade Agnew, Ann Anderson, Jeffrey Schaefer, Nina Brooks, John Stannard, Paula Meszaros, Marie Street, Amanda O'Brien, John Bowman, Matthew Murphy, Ryan Brookes, Brady Wilkinson, Emily Lucas, Jane Trueman, Laura Pelekoudas, Kristina Lloyd, Matt Moughalian, Jen Note: This meeting will occur three times a week and will have to be changed frequently due to possible conflicts with everyone?s schedules. PARTICIPANTS Wade Horn Randy Pate Ann Agnew Jeff Anderson Nina Schaefer John Brooks Paula Stannard Marie Meszaros Amanda Street John O?Brien Matt Bowman Brady Brookes Ryan Murphy Emily Wilkinson Jane Lucas Laura Trueman 2017--001875 Bell, Michael Subject: Location: Start: End: Recurrence: Meeting Status: Organizer: Required Attendees: Secretary Price House LHHS Appropriations Subcommittee Hearing Prep Session - Hearing Overview 81 Strategy Large conference room- 610-F Wed 3/22/2017 4:00 PM Wed 3I22f2017 4:30 PM (none) Accepted Klimczak, Kate Moughalian, Jen Brooks, John Wynne, Maggie Stannard, Paula Flick, Heather Schaefer, Nina Horn, Wade Kristin Leggitt, Lance Lapinski, Mary-Sumpter Street, Amanda Cochran, Norris Coughlin, Janis Pollock, Rachel Harrison, Jessica (OSXIOS) The meeting has been moved to 4pm; a meeting agenda is attached. Also included below are the hearing prep materials that went to the Secretary last night. He received a hearing memo, draft written testimony for review, briefing papers, and Member profilesiim' min: lhur- iumr Iii-l lhur- iumr Ii: ll Ii 15' I: ill it'7 il: it" 2017--001876 Secretary Price House LHHS Appropriations Subcommittee Hearing Prep Session Hearing Overview Strategy Session March 4pm 4:30pm Agenda: I. Hearing logistics 0 Hearing Structure Staf?ng needs Press De?nition of success Other Budget hearings 0000 II. Member Call Time Testimony 0 Written testimony 0 Oral testimony IV. Guidance on hearing prep Brie?ng papers 0 sessions 0 AHCA Prep 0 Member Polling V. Hearing Strategy (W5) 2017--001877 . Fe ?1 if: A DEPARTMENT OF HEALTH 3; HUMAN SERVICES Of?ce of the Secretary 2% Washington, DC. 20201 DATE: March 21, 2017 TO: Thomas E. Price, M.D., Secretary FROM: Jen Moughalian, Acting Assistant Secretary for Financial ResourcesuniM CC: John Brooks Heather Flick Wade Horn Mary-Sumpter Lapinski Lance Leggitt Nina Schaefer Kristin Paula Stannard Amanda Street Maggie Wynne SUBJECT: Appropriations Hearing Preparation INFORMATION Details Hoose Laborp?HHS Subcommittee Appropriations Hearing Date: Wednesday, March 29 Time: 10:00 am. Attendees: Jen Moughalian, Norris Cochran Overview On Wednesday, March 29m you are scheduled to testify before the House Appropriations Subcommittee for Labor, Health and Human Services, Education, and Related Agencies on the President?s FY 2018 Budget Blueprint. We have prepared brie?ng materials for you based on key themes in the HHS chapter of the Budget Blueprint and current hot topics in health and human services policy, as well as issues of Speci?c interest to Committee Members based on incoming letters and staff interaction. In this brie?ng book you will ?nd: - Draft written testimony for your review; a Brie?ng papers on select policy issue areas; and I House LaborfI-IHS Appropriations Subcommittee Member Pro?les. Your brie?ng papers are organized by issue area (HHS cross-cutting issues, public health, and human services). Prior to the hearing, ASF will engage with subcommittee staff on potential topics and questions that may come up at the hearing (we refer to this as ?member polling"). Based on those conversations, ASFR will provide additional papers or talking points as needed. 201 7--001 878 We currently have four brie?ngs scheduled to help you prepare for this hearing: I Wednesday, March 22, 11:30am 12:00pm to discuss overall hearing strategy; 0 Friday, March 24, 3 :30?4z3 0pm to answer any questions you have from the bri e?ng book and conduct practice I Monday, March 27, 3:30-4:30pm to conduct practice and 0 Tuesday, March 28, 3:30-4:00pm to review member polling and address any ?nal concerns. We also have set aside time on your calendar on Monday, March 27th for you to make calls to all the members of the subcommittee. Reaching out to Members of Congress before your hearing allows you the opportunity to check in before the hearing and take the temperature of members. These calls are informal and may be placed pers0nally or arranged through your scheduler. Committee Activity in the 115''1 Congress Last week, the House Labor/HHS Appropriations Subcommittee held a hearing entitled ?Investing in the Future?Early Childhood Education Programs at the Department of Health and Human Services.? There were no government witnesses. During that hearing, members expressed concern over the possibility of deep cuts to Head Start and the impacts those cuts would have to the current waitlist for Head Start programs. Members were also concerned that cuts to Early Head Start and Head Start would undermine the results experts hoped to see in those programs. Members also asked questions about Federal funding for Head Start and the Child Care Block Grant. Masses A. Draft written testimony B. Brie?ng Papers C. Member Pro?les 201 7--001 879 Page 1465 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001880 Page 1465 01' 1518 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001881 Page 146? of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001882 Page 1468 01' 1518 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001883 Page 1469 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001884 Page 147'0 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001885 Page 147'1 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001886 Page 147'2 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001887 Page 147'3 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001888 Page 14?4 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001889 Page 147'5 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001890 Page 147'5 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001891 Page 14?? of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001892 Page 147'8 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001893 Page 147'9 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001894 Page 1480 01' 1518 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001895 Page 1481 01' 1518 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001896 Page 1482 01' 1518 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001897 Page 1483 01' 1518 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001898 Page 1484 01' 1518 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001899 Page 1485 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001900 Page 1485 01' 1518 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001901 Page 148? of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001902 Page 1488 01' 1518 11111111111818 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001903 Page 1489 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001904 Page 1490 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001905 Page 1491 01' 1518 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001906 Page 1492 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001907 Page 1493 01' 1518 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001908 Page 1494 of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001909 Page 1495 01' 1518 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001910 Page 1495 01' 1518 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001911 Page 149? of1518 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001912 Page 1498 01' 1518 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001913 Page 1499 01' 1518 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001914 Page 1500 01' 1518 DUFSUEHI TD exemption (133(5) 011113 Of Information HGT 2017--001915 House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies Jurisdiction: The panel oversees all of the Departments of Education and Labor and a large portion of the Health and Human Services Department (except for the FDA, IHS, National Institute of Environmental Sciences, and the Agency for Toxic Substances and Disease Registry). In addition, the subcommittee oversees the Social Security Administration, Medicaid and Payment and Access Commission, Medicare Payment Advisory Commissions, and several other related, smaller agencies. Members in the 115?1 Congress Maioritv {8 Republicans) Tom Cole, OK Chairman Mike Simpson, Steve Womack, AK, Vice Chair Chuck TN Andy Harris, MD Martha Roby, AL Jamie Herrera Bcutlcr, WA John Moolenaar, Ml Rodney Frelinghuysen, NJ (ex of?cio) Minority (5 Democrats) Rosa DeLauro, CT Ranking Member Lucille Roybal-Allard, CA Barbara Lee, CA Mark Pecan, WI Katherine Clark, MA Nita Lowey, NY (ex of?cio} 2017--001916 Maiorig; REP. TOM COLE (R), CHAIRMAN District of Oklahoma South central Norman, Lawton, part of Oklahoma City Residence: Moore Born: April 28; 1949; Shreveport, Louisiana Religion: Methodist Family: Wife; Ellen Cole; one child Education: Grinnell College, BA. 1971 (history); Yale MA. 19?4 (British history); U. of Oklahoma, 1984 (19th Century British history) Military Service: None Career: Political consultant; party of?cial; congressional district director; professor First Elected: 2002 (8th term) Latest Election: 2016 General (69.63%) Political Highlights: Okla. Republican Party chairman, 1985-89; Okla. Senate, 1989-91; Okla. secretary of state, l995-99 Committees: Appropriations (LHHS Chairman, Defense; Interior); Budget; and Ru] (W5) 2017--001917 2017--001918 REP. MIKE SIMPSON (R) 2nd District of Idaho East -- Pocatello, Idaho Falls, part of Boise Residence: Idaho Falls Born: Sept. 8, 1950; Barley, Idaho Religion: Mormon Family: Wife, Kathy Simpson Education: Utah State U., attended 1968-72 (me-dentistry); Washington U. D.M.D. 197'7; Utah State U., 3.8. 2002 (pro-dentistry] Military Service: None Career: Dentist First Elected: 1998 (10th term) Latest Election: 2016 General (62.93%) Political Highlights: Blackfoot City Council, 1980-84, Idaho House, 1984-98 (speaker, 1992? 98) Committees: Appropriations (Energy-Water chairman; Interior-Environment; Labor-HHS- Education) (W5) 2017--001919 REP. STEVE WOMACK (R), 3rd District of Arkansas Northwest Fort Smith, Fayetteville Residence: Rogers Born: Feb. 18, 1957; Russellville, Arkansas Religion: Southern Baptist Family: Wife, Terri Womack; three children Education: Arkansas Tech, BA. 1979 (speech) Military Service: Ark. National Guard 1979-2009 Career: Securities broker; college ROTC program director; radio station manager; National Guard First Elected: 2010 (41" term) Latest Election: 2016 General (77.32 Political Highlights: Rogers City Council, 1983-84, 1997-98; mayor of Rogers, 1999-2010 Committees: Appropriations Defense; Financial Services); Budget (131(5) 2017--001920 REP. CHUCK FLEISCHMANN (R) 3rd District of Tennessee East Chattanooga, Oak Ridge Residence: Ooltewah Born: Oct. 1 l, 1962; Manhattan, New York City, New York Religion: Roman Catholic Family: Wife, Brenda Fleischmann; three children Education: U. of Illinois, B.A.L.A.S. 1983 (political science); U. of Tennessee, JD. I986 Military Service: None Career: Attorney First Elected: 2010 (44lh term) Latest Election: 2016 General (66.39%) Political Highlights: No previous of?ce Committees: Appropriations Energy Water; Homeland Security) (W5) 2017--001921 REP. ANDY HARRIS (R) District of Maryland Northeast and Eastern Shore Residence: Cockeysville Born: Jan. 25, 1957; Brooklyn, New York Religion: Roman Catholic Family: Widowed; five children Education: U. of attended 1973-75; Johns Hopkins U., BA. 1977' (human biology), MD. 1980, M.H.S. 1995 (health ?nance 8; management) Military Service: Navy Reserve 1988-2005 Career: Physician (Anesthesiologist) First Elected: 2010 (3rd term) Latest Election: 2016 General (66.99%) Political Highlights: MD Senate, 1999-2010 (Republican whip, 2003-06); Republican nominee for US. House, 2008 Committees: Appropriations (LHHS, Commerce, Justice, and Related Agencies) 2017--001922 (b){5l 2017--001923 REP. MARTHA ROBY (R) 2nd District of Alabama Southeast part of Montgomery, Dothan Residence: Montgomery Born: July 26, 1976; Montgomery, AL Religion: Presbyterian Family: Husband, Riley Roby; two children Education: New York U., BM. 1998 (music, business and technology); Samford U., JD. 200] Military Service: None . Career: Lawyer First Elected: 2010 (3rd term) Latest Election: 2016 General (48.77%) Political Highlights: Montgomery City Council, 2004-l 1 Committees: Appropriations (LHHS, Legislative Branch, Military Constructiom?VA); Benghazi Attack {131(5) 2017--001924 REP. JAMIE HERRERA BEUTLER (R) 3rd District of Washington, Southwest Washington Residence: Battle Ground Born: November 3, 1978; Glendale, CA Religion: Christian Family: Husband, Daniel Beutler; two children Education: University of Washington, BA. 2004 (Communications) Military Service: None Career: Congressional aide First Elected: 2010 (4th term) Latest Election: 2016 General Political Highlights: Congressional aide for Congresswomcn Cathy MeMorris Rodgers (R- WA), State Representative (R-WA, District 18) Committees: Appropriations Energy and Water; Financial Services) (131(5) 2017--001925 REP. JOHN MOOLENAAR (R) 4th District of Michigan, Midland, Mt. Pleasant Residence: Midland Born: May IS, 196]; Midland, MI Religion: Christian Family: Wife, Amy Moolenaar; six children Education: Hope College, BS. 1983 (Chemistry); Harvard University, MPA I989 Military Service: None. Career: Chemist, worked at Dow Chemical Company First Elected: 2014 (2rd term) Latest Election: 2016 General Political Highlights: State Representative (R-MI, District 98), Michigan House of Representatives; State Senator (R-MI, District 36), Michigan Senate Committees: Appropriations Financial Services; Legislative Branch) (W5) 2017--001926 REP. RODNEY FRELINGHUYSEN (R) 11th District of New Jersey, North Central?eastern Morris Country, Wayne Residence: Harding Born: April 29, 1946; Manhattan, NY Religion: Episcopalian Family: Wife, Virginia; two children Education: Hobart College, BA. 1969 (American History) Military Service: Army, 1969 1971 Career: County board aide First Elected: 1994 (12?1?term) Latest Election: 2016 General Political Highlights: Morris County Board of reeholders (1974 1983]; New Jersey Assembly, 1983 1994 Committees: Appropriations, Chairman (131(5) 2017--001927 Minority REP. ROSA DELAURO (D) 3rd District of Connecticut South -- New Haven, Milford Residence: New Haven Born: March 2, 1943; New Haven, Conn. Religion: Roman Catholic Family: Husband, Stanley Greenberg; three children Education: London School of Economics, attended 1962-63; Marymount College (N.Y.), BA. 1964; Columbia U., MA. 1966 (international politics) Military Service: None Career: Political activist; congressional and mayoral aide First Elected: 1990 (14'1? term) Latest Election: 2016 General Political Highlights: No previous of?ce Committees: Appropriations (LHHS - ranking member; Agriculture) (W5) 2017--001928 East Los Angeles; Downey Residence: Downey Born: June 12, 1941; Boyle Heights, Calif. Religion: Roman Catholic Family: Husband, Edward Allard; four children Military Service: None Career: Nonpro?t worker First Elected: 1992 (13?1 term) Latest Election: 2016 General Political Highlights: Calif. Assembly: 1937-92 Committees: Appropriations Homeland Security - ranking member) REP. LUCILLE ROYBAL-ALLARD (D) 40th District of California Education: California State U., Los Angeles, BA. 1965 (speech therapy) (131(5) 2017--001929 REP. BARBARA LEE (D) 13th District of California Northwest Alameda County -- Oakland, Berkeley Residence: Oakland Born: July 16, 1946; El Paso, Texas Religion: Baptist Family: Divorced; two children Education: Mills College, BA. 1973 U. of California, Berkeley, M.S.W. 197'5 Military Service: None Career: Congressional aide First Elected: 1998 (9th full term) Latest Election: 2014 General (88.48%) Political Highlights: Calif. Assembly, 1990-96; Calif. Senate, 1996-98 Committees: Appropriations Military Construction-VA; State-Foreign Operations); Budget (W5) 2017--001930 REP. MARK POCAN (D) 2ml District of Wisconsin, Sou Residence: Madison Born: August 14, 1964; Kenosha, WI Religion: Unspeci?ed Family: Husband, Philip Frank Education: University of Wisconsin, BA. 1986 (journalism) Military Service: None Career: Sign manufacturing company owner First Elected: 2012 (31"Cl full term) Latest Election: 2014 General th?Madison Political Highlights: Dane County Board ofSupervisors, 1991-96; Wis. Assembly, 1999-2013 Committees: Appropriations Agriculture) (131(5) 2017--001931 REP. KATHERINE CLARK (D) 5th District of Massachusetts, North and west Boston suburbs; Framingham Residence: Melrose Born: July 17, 1963; New Haven, Connecticut Religion: Protestant Family: Husband, Rodney Dowell; three children - - Education: St. Lawrence University BA. 1985 (history); Cornell University JD. 1989; Harvard University, M.P.A. 1997 Military Service: None Career: Attorney; state assistant attorney general First Elected: 2013 (2?'21 full term) Latest Election: 2016 General Political Highlights: Mass. House, 2008-1 1; Mass. Senate, 2011-13 Committees: Appropriations Transportation-HUD) (W5) 2017--001932 REP. NITA LOWEY (D) 18th District of New York Rockland and part of Westchester counties White Plains, Peekskill Residence: Born: July 5, 193?; Bronx, New York Religion: Jewish Family: Husband, Stephen Lowe-y; three children Education: Mount Holyoke College, BA, 1955-59 (political science) Military Service: None Career: State government aide; homemaker First Elected: 1988 (15th term) Latest Election: 2016 General Political Highlights: NY. Assistant Secretary of State, 1985?87 Committees: Appropriations Ranking Member (State Foreign Ops - Ranking Member) {bli5i 2017--001933 Bell, Michael Subject: Location: Start: End: Recurrence: Meeting Status: Organizer: Required Attendees: Secretary Price House LHHS Appropriations Subcommittee Hearing Prep Session - Hearing Overview 81 Strategy Large conference room- 610-F Wed 3/22/2017 4:00 PM Wed 3I22f2017 4:30 PM (none) Accepted Klimczak, Kate Moughalian, Jen Brooks, John Wynne, Maggie Stannard, Paula Flick, Heather Schaefer, Nina Horn, Wade Kristin Leggitt, Lance Lapinski, Mary-Sumpter Street, Amanda Cochran, Norris Coughlin, Janis Pollock, Rachel Harrison, Jessica (OSXIOS) The meeting has been moved to 4pm; a meeting agenda is attached. Also included below are the hearing prep materials that went to the Secretary last night. He received a hearing memo, draft written testimony for review, briefing papers, and Member profilesiim' min: lhur- iumr Iii-l lhur- iumr Ii: ll Ii 15' I: ill it'7 il: it" 2017--001934 Secretary Price House LHHS Appropriations Subcommittee Hearing Prep Session Hearing Overview Strategy Session March 4pm 4:30pm Agenda: I. Hearing logistics 0 Hearing Structure Staf?ng needs Press De?nition of success Other Budget hearings 0000 II. Member Call Time Testimony 0 Written testimony 0 Oral testimony IV. Guidance on hearing prep Brie?ng papers 0 sessions 0 AHCA Prep 0 Member Polling V. Hearing Strategy (W5) 2017--001935 . Fe ?1 if: A DEPARTMENT OF HEALTH 3; HUMAN SERVICES Of?ce of the Secretary 2% Washington, DC. 20201 DATE: March 21, 2017 TO: Thomas E. Price, M.D., Secretary FROM: Jen Moughalian, Acting Assistant Secretary for Financial ResourcesuniM CC: John Brooks Heather Flick Wade Horn Mary-Sumpter Lapinski Lance Leggitt Nina Schaefer Kristin Paula Stannard Amanda Street Maggie Wynne SUBJECT: Appropriations Hearing Preparation INFORMATION Details Hoose Laborp?HHS Subcommittee Appropriations Hearing Date: Wednesday, March 29 Time: 10:00 am. Attendees: Jen Moughalian, Norris Cochran Overview On Wednesday, March 29m you are scheduled to testify before the House Appropriations Subcommittee for Labor, Health and Human Services, Education, and Related Agencies on the President?s FY 2018 Budget Blueprint. We have prepared brie?ng materials for you based on key themes in the HHS chapter of the Budget Blueprint and current hot topics in health and human services policy, as well as issues of Speci?c interest to Committee Members based on incoming letters and staff interaction. In this brie?ng book you will ?nd: - Draft written testimony for your review; a Brie?ng papers on select policy issue areas; and I House LaborfI-IHS Appropriations Subcommittee Member Pro?les. Your brie?ng papers are organized by issue area (HHS cross-cutting issues, public health, and human services). Prior to the hearing, ASF will engage with subcommittee staff on potential topics and questions that may come up at the hearing (we refer to this as ?member polling"). Based on those conversations, ASFR will provide additional papers or talking points as needed. 2017-?001936 We currently have four brie?ngs scheduled to help you prepare for this hearing: I Wednesday, March 22, 11:30am 12:00pm to discuss overall hearing strategy; 0 Friday, March 24, 3 :30?4z3 0pm to answer any questions you have from the bri e?ng book and conduct practice I Monday, March 27, 3:30-4:30pm to conduct practice and 0 Tuesday, March 28, 3:30-4:00pm to review member polling and address any ?nal concerns. We also have set aside time on your calendar on Monday, March 27th for you to make calls to all the members of the subcommittee. Reaching out to Members of Congress before your hearing allows you the opportunity to check in before the hearing and take the temperature of members. These calls are informal and may be placed pers0nally or arranged through your scheduler. Committee Activity in the 115''1 Congress Last week, the House Labor/HHS Appropriations Subcommittee held a hearing entitled ?Investing in the Future?Early Childhood Education Programs at the Department of Health and Human Services.? There were no government witnesses. During that hearing, members expressed concern over the possibility of deep cuts to Head Start and the impacts those cuts would have to the current waitlist for Head Start programs. Members were also concerned that cuts to Early Head Start and Head Start would undermine the results experts hoped to see in those programs. Members also asked questions about Federal funding for Head Start and the Child Care Block Grant. Masses A. Draft written testimony B. Brie?ng Papers C. Member Pro?les 201 7--001 937 Page 05 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001938 Page 05 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001939 Page 0? of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001940 Page US of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001941 Page 09 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001942 Page 10 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001943 Page 11 mas WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001944 Page 12 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001945 Page 13 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001946 Page 14 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001947 Page 15 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001948 Page 16 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001949 Page 1? of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001950 Page 18 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001951 Page 19 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001952 Page 20 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001953 Page 21 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001954 Page 22 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001955 Page 23 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001956 Page 24 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001957 Page 25 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001958 Page 25 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001959 Page 2? of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001960 Page 2% of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001961 Page 29 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001962 Page 30 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001963 Page 31 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001964 Page 32 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001965 Page 33 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001966 Page 34 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001967 Page 35 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001968 Page 35 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001969 Page 3? of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001970 Page 3% of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001971 Page 39 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001972 Page 40 of 53 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--001973 House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies Jurisdiction: The panel oversees all of the Departments of Education and Labor and a large portion of the Health and Human Services Department (except for the FDA, IHS, National Institute of Environmental Sciences, and the Agency for Toxic Substances and Disease Registry). In addition, the subcommittee oversees the Social Security Administration, Medicaid and Payment and Access Commission, Medicare Payment Advisory Commissions, and several other related, smaller agencies. Members in the 115?1 Congress Maioritv {8 Republicans) Tom Cole, OK Chairman Mike Simpson, Steve Womack, AK, Vice Chair Chuck TN Andy Harris, MD Martha Roby, AL Jamie Herrera Bcutlcr, WA John Moolenaar, Ml Rodney Frelinghuysen, NJ (ex of?cio) Minority (5 Democrats) Rosa DeLauro, CT Ranking Member Lucille Roybal-Allard, CA Barbara Lee, CA Mark Pecan, WI Katherine Clark, MA Nita Lowey, NY (ex of?cio} 2017--001974 Ma iorig; REP. TOM COLE (R), CHAIRMAN District of Oklahoma South central Norman, Lawton, part of Oklahoma City Residence: Moore Born: April 28, 1949; Shreveport, Louisiana Religion: Methodist Family: Wife, Ellen Cole; one child Education: Grinnell College, BA. 1971 (history); Yale U., MA. 197?4 (British history); U. of Oklahoma, 1984 (19th Century British history) Military Service: None Career: Political consultant; party of?cial; congressional district director; professor First Elected: 2002 (8th term) Latest Election: 2016 General (69.63%) Political Highlights: Okla. Republican Party chairman, 1985-89; Okla. Senate, 1989-91; Okla. secretary of state, l995-99 Committees: Appropriations (LHHS Chairman, Defense, Interior); Budget; and Bo] (W5) 2017--001975 (b){5l 2017--001976 REP. MIKE SIMPSON (R) 2nd District of Idaho East -- Pocatello, Idaho Falls, part of Boise Residence: Idaho Falls Born: Sept. 8, 1950; Barley, Idaho Religion: Mormon Family: Wife, Kathy Simpson Education: Utah State U., attended 1968-72 (pro-dentistry); Washington U. D.M.D. 1977; Utah State U., 3.8. 2002 (pro-dentistry] Military Service: None Career: Dentist First Elected: 1998 (10th term) Latest Election: 20l6 General (62.93%) Political Highlights: Blackfoot City Council, l980-84, Idaho House, 1984-98 (speaker, 1992- 98) Committees: Appropriations (Energy-Water chairman; Interior-Environment; Labor-HHS- Education) (W5) 2017--001977 REP. STEVE WOMACK (R), 3rd District of Arkansas Northwest Fort Smith, Fayetteville Residence: Rogers Born: Feb. 18, 1957; Russellville, Arkansas Religion: Southern Baptist Family: Wife, Terri Womack; three children Education: Arkansas Tech, BA. 1979 (speech) Military Service: Ark. National Guard 1979-2009 Career: Securities broker; college ROTC program director; radio station manager; National Guard First Elected: 2010 (41" term) Latest Election: 2016 General (77.32 Political Highlights: Rogers City Council, 1983-84, 1997-98; mayor of Rogers, 1999-2010 Committees: Appropriations Defense; Financial Services); Budget {131(5) 2017--001978 REP. CHUCK FLEISCHMANN (R) 3rd District of Tennessee East Chattanooga, Oak Ridge Residence: Ooltewah Born: Oct. 1 l, 1962; Manhattan, New York City, New York Religion: Roman Catholic Family: Wife, Brenda Fleischmann; three children Education: U. of Illinois, B.A.L.A.S. 1983 (political science); U. of Tennessee, JD. I986 Military Service: None Career: Attorney First Elected: 2010 (44lh term) Latest Election: 2016 General (66.39%) Political Highlights: No previous of?ce Committees: Appropriations Energy Water; Homeland Security) 033(5) 2017--001979 REP. ANDY HARRIS (R) District of Maryland Northeast and Eastern Shore Residence: Cockeysville Born: Jan. 25, 1957; Brooklyn, New York Religion: Roman Catholic Family: Widowed; ?ve children Education: U. of attended 1973-75; Johns Hopkins U., BA. 1977' (human biology), MD. 1980, M.H.S. 1995 (health ?nance 8; management) Military Service: Navy Reserve 1988-2005 Career: Physician (Anesthesiologist) First Elected: 2010 (3rd term) Latest Election: 2016 General (66.99%) Political Highlights: MD Senate, 1999-2010 (Republican whip, 2003-06); Republican nominee for US. House, 2008 Committees: Appropriations (LHHS, Commerce, Justice, and Related Agencies) (131(5) 2017--001980 {bl{5l 2017--001981 REP. MARTHA ROBY (R) 2nd District of Alabama Southeast part of Montgomery, Dothan Residence: Montgomery Born: July 26, 1976; Montgomery, AL Religion: Presbyterian Family: Husband, Riley Roby; two children Education: New York U., BM. 1998 (music, business and technology); Samford U., JD. 200] Military Service: None Career: Lawyer First Elected: 2010 (3rd term) Latest Election: 2016 General (48.77%) Political Highlights: Montgomery City Council, 2004-l 1 Committees: Appropriations (LHHS, Legislative Branch, Military Constructiom?VA); Benghazi Attack (131(5) 2017--001982 REP. JAMIE HERRERA BEUTLER (R) 3rd District of Washington, Southwest Washington Residence: Battle Ground Born: November 3, 1978; Glendale, CA Religion: Christian Family: Husband, Daniel Beutler; two children Education: University of Washington, BA. 2004 (Communications) Military Service: None Career: Congressional aide First Elected: 2010 (4th term) Latest Election: 2016 General Political Highlights: Congressional aide for Congresswomcn Cathy MeMorris Rodgers (R- WA), State Representative (R-WA, District 18) Committees: Appropriations Energy and Water; Financial Services) {131(5) 2017--001983 REP. JOHN MOOLENAAR (R) 4th District of Michigan, Midland, Mt. Pleasant Residence: Midland Born: May IS, 196]; Midland, MI Religion: Christian Family: Wife, Amy Moolenaar; six children Education: Hope College, BS. 1983 (Chemistry); Harvard University, MPA I989 Military Service: None. Career: Chemist, worked at Dow Chemical Company First Elected: 2014 (2rd term) Latest Election: 2016 General Political Highlights: State Representative (R-MI, District 98), Michigan House of Representatives; State Senator (R-MI, District 36), Michigan Senate Committees: Appropriations Financial Services; Legislative Branch) {bil5i 2017--001984 REP. RODNEY FRELINGHUYSEN (R) 11th District of New Jersey, North Central?eastern Morris Country, Wayne Residence: Harding Born: April 29, 1946; Manhattan, NY Religion: Episcopalian Family: Wife, Virginia; two children Education: Hobart College, BA. 1969 (American History) Military Service: Army, 1969 1971 Career: County board aide First Elected: 1994 (12?1?term) Latest Election: 2016 General Political Highlights: Morris County Board of reeholders (1974 1983]; New Jersey Assembly, 1983 1994 Committees: Appropriations, Chairman (131(5) 2017--001985 Minority REP. ROSA DELAURO (D) 3rd District of Connecticut South -- New Haven, Milford Residence: New Haven Born: March 2, 1943; New Haven, Conn. Religion: Roman Catholic Family: Husband, Stanley Greenberg; three children Education: London School of Economics, attended 1962-63; Marymount College (N.Y.), BA. 1964; Columbia U., MA. 1966 (international politics) Military Service: None Career: Political activist; congressional and mayoral aide First Elected: 1990 (14'1? term) Latest Election: 2016 General Political Highlights: No previous of?ce Committees: Appropriations (LHHS - ranking member; Agriculture) 033(5) 2017--001986 East Los Angeles; Downey Residence: Downey Born: June 12, 1941; Boyle Heights, Calif. Religion: Roman Catholic Family: Husband, Edward Allard; four children Military Service: None Career: Nonpro?t worker First Elected: 1992 (13?1 term) Latest Election: 2016 General Political Highlights: Calif. Assembly: 1937-92 Committees: Appropriations Homeland Security - ranking member) REP. LUCILLE ROYBAL-ALLARD (D) 40th District of California Education: California State U., Los Angeles, BA. 1965 (speech therapy) (131(5) 2017--001987 REP. BARBARA LEE (D) 13th District of California Northwest Alameda County -- Oakland, Berkeley Residence: Oakland Born: July 16, 1946; El Paso, Texas Religion: Baptist Family: Divorced; two children Education: Mills College, BA. 1973 U. of California, Berkeley, M.S.W. 197'5 Military Service: None Career: Congressional aide First Elected: 1998 (9th full term) Latest Election: 2014 General (88.48%) Political Highlights: Calif. Assembly, 1990-96; Calif. Senate, 1996-98 Committees: Appropriations Military Construction-VA; State-Foreign Operations); Budget (W5) 2017--001988 REP. MARK POCAN (D) District of Wisconsin, Sou Residence: Madison Born: August 14, 1964; Kenosha, WI Religion: Unspeci?ed Family: Husband, Philip Frank Education: University of Wisconsin, BA. 1986 (journalism) Military Service: None Career: Sign manufacturing company owner First Elected: 2012 (31"Cl full term) Latest Election: 2014 General th?Madison Political Highlights: Dane County Board ofSupervisors, 1991-96; Wis. Assembly, 1999-2013 Committees: Appropriations Agriculture) {131(5) 2017--001989 REP. KATHERINE CLARK (D) 5th District of Massachusetts, North and west Boston suburbs; Framingham Residence: Melrose Born: July 17, 1963; New Haven, Connecticut Religion: Protestant Family: Husband, Rodney Dowell; three children 1 Education: St. Lawrence University BA. 1985 (history); Cornell University JD. 1989; Harvard University, M.P.A. 1997 Military Service: None Career: Attorney; state assistant attorney general First Elected: 2013 (2?'21 full term) Latest Election: 2016 General Political Highlights: Mass. House, 2008-1 1; Mass. Senate, 2011-13 Committees: Appropriations Transportation-HUD) (131(5) 2017--001990 REP. NITA LOWEY (D) 18th District of New York Rockland and part of Westchester counties White Plains, Peekskill Residence: Born: July 5, 193?; Bronx, New York Religion: Jewish Family: Husband, Stephen Lowe-y; three children Education: Mount Holyoke College, BA, 1955-59 (political science) Military Service: None Career: State government aide; homemaker First Elected: 1988 (15th term) Latest Election: 2016 General Political Highlights: NY. Assistant Secretary of State, 1985?87 Committees: Appropriations Ranking Member (State Foreign Ops - Ranking Member) (bit5l 2017--001991 Bell, Michael Subject: Location: Start: End: Show Time As: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Canceled: Daily Health Care Reform Meeting 610F Fri 3f24/2017 4:30 PM Fri 3j24/2017 5:30 PM Free Daily every weekday from 5:00 PM to 5:30 PM Not yet responded 6 (OSHOS) Daily Healthcare 2017--001992 Bell, Michael Subject: Location: Start: End: Show Time As: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Daily Health Care Reform Meeting 610F Fri 3/31/2017 3:30 PM Fri 3/31/2017 4:30 PM Tentative Daily every weekday from 4:30 PM to 5:30 PM Not yet responded (W5) (03105} Dal Healthcare; Agnew, Ann Anderson, Jeffrey Arbes, Sarah Barcus, Lea Bardis, John Brookes, Brady Brooks, John DiBIasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Marre, Alleigh Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Perez-Rivera, Diana Schaefer, Nina Seema Verma; Kristin Stannard, Paula Street, Amanda Twomey, John K. (OSIIOS) 2017--001993 Bell, Michael Subject: Location: Start: End: Show Time As: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Daily Health Care Reform Meeting 610F Thu 3/30/2017 3:00 PM Thu 3/30/2017 4:00 PM Tentative Daily every weekday from 4:30 PM to 5:30 PM Not yet responded Daily Healthcare; Agnew, Ann Anderson, Jeffrey Arbes, Sarah Barcus, Lea Bardis, John Brookes, Brady Brooks, John DiBIasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Marre, Alleigh Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Perez-Rivera, Diana Schaefer, Nina Seema Verma; Kristin Stannard, Paula Street, Amanda Twomey, John K. (OSIIOS) 2017--001994 Bell, Michael Subject: Location: Start: End: Show Time As: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Daily Health Care Reform Meeting 610F Mon 3/27/2017 4:30 PM Mon 5:30 PM Tentative Daily every weekday from 4:30 PM to 5:30 PM Not yet responded -(osn05) Agnew, Ann Anderson, Jeffrey Arbes, Sarah Barcus, Lea Bardis, John Brookes, Brady Brooks, John (H DiBIasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios (CMSICM): Leggitt, Lance Lloyd, Matt Marre, Alleigh Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Perez-Rivera, Diana Schaefer, Nina Seema Verma,? Kristin Stannard, Paula Street, Amanda Twomey, John K. (OSIIOS) 2017--001995 Bell, Michael Subject: Location: Start: End: Show Time As: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Canceled: Daily Health Care Reform Meeting 610F Fri 3f24/2017 4:30 PM Fri 324/2017 5:30 PM Free Daily every weekday from 5:00 PM to 5:30 PM Not yet responded (W6) OSHOS) Daily Healthcare 2017--001996 Bell, Michael Subject: Location: Start: End: Show Time As: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Daily Health Care Reform Meeting 610F Thu 3/23/2017 2:30 PM Thu 3/23/2017 3:30 PM Tentative Daily every weekday from 5:00 PM to 5:30 PM Not yet responded -(om Daily Healthcare; Agnew, Ann Anderson, Jeffrey Arbes, Sarah Bardis, John Brookes, Brady Brooks, John DiBIasio, Carla Harrison, Jessica Horn, Wade Kouzoukas. Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Perez-Rivera, Diana Schaefer, Nina Seema Verma; Kristin Stannard. Paula Street. Amanda Twomey, John K. 2017--001997 Bell, Michael Subject: Canceled: Daily Health Care Reform Meeting Location: 610F Start: Fri 3f24/2017 4:30 PM End: Fri 394/2017 5:30 PM Show Time As: Free Recurrence: Daily Recurrence Pattern: every weekday from 5:00 PM to 5:30 PM Meeting Status: Not yet responded Organizer: (05mg) Required Attendees: Daily Healthcare 2017--001998 Bell, Michael Subject: Location: Start: End: Show Time As: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Daily Health Care Reform Meeting 610F Mon 3/20/2017 5:00 PM Mon 3f20/201? 5:30 PM Tentative Daily every weekday from 5:00 PM to 5:30 PM Not yet responded _os,,os, Agnew, Ann Anderson, Jeffrey Arbes, Sarah Bardis, John Brookes, Brady Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Perez-Rivera, Diana Schaefer, Nina (H Seema Verma; Kristin Stannard, Paula Street, Amanda Twomey, John K. (OSXIOS) 2017--001999 Bell, Michael Subject: Location: Start: End: Show Time As: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Daily Health Care Reform Meeting 610F Wed 3/22/2017 3:00 PM Wed 3/22f2017 4:00 PM Tentative Daily every weekday from 5:00 PM to 5:30 PM Not yet responded 033(5) OSHOS) Brady Perez-Rivera, Diana 2017--002000 Bell, Michael Subject: Location: Start: End: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Daily Health Care Reform Meeting 610F Fri 3/24/2017 4:30 PM Fri 3j24/2017 5:30 PM Daily every weekday from 5:00 PM to 5:30 PM Accepted ?33(5) DiBlasio, Carla Stannard, Paula 2017--002001 Bell, Michael Subject: Location: Start: End: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Daily Health Care Reform Meeting 610F Tue 3/21/2017 4:30 PM Tue 3/91/2017 5:30 PM Daily every weekday from 5:00 PM to 5:30 PM Accepted DiBlasio, Carla Stannard, Paula 2017--002002 Bell, Michael Subject: Location: Start: End: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Daily Health Care Reform Meeting 610F Mon 3/20/2017 4:30 PM Mon 3/20f2017 5:30 PM Daily every weekday from 5:00 PM to 5:30 PM Accepted DiBlasio, Carla Stannard, Paula 2017--002003 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Fri 4:30 PM End: Fri 3/17/2017 5:30 PM Show Time As: Tentative Recurrence: (none) Meeting Status: Not yet responded Organizer: (W6) Required Attendees: Agnew, Ann Anderson, Jeffrey Arbes, Sarah Bardis, John Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Schaefer, Nina Seema Verma; Kristin Stannard, Paula Street, Amanda Twomey, John K. 2017--002004 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Thu 4:00 PM End: Thu 3/16/2017 5:00 PM Show Time As: Tentative Recurrence: (none) Meeting Status: Not yet responded Organizer: (W53 OSXIOS) Required Attendees: Agnew, Ann Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Keith; Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Schaefer, Nina Kristin Stannard, Paula Street, Amanda (H Twomey, John K. 2017--002005 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Thu 5:10 PM End: Thu 3/9201? 5:30 PM Recurrence: (none) Meeting Status: Accepted Organizer: (W5) Required Attendees: Agnew, Ann Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Keith; Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakleyr Caitlin B, Pate, Randy Schaefer, Nina (H Kristin Street, Amanda Twomey, John Stannard, Paula NOTE: Participants to include staff from Legislative Affairs and Public Affairs, and appropriate policy personnel. Lance Leggitt determines the appropriate staff for inclusion. 2017--002006 Bell, Michael Subject: Daily Health Care Reform Meeting Location: Start: Tue 2/28/2017 3:30 PM End: Tue 2/28[2017 4:00 PM Show Time As: Tentative Recurrence: (none) Meeting Status: Not yet responded Organizer: Twomey, John K. Required Attendees: Agnew, Ann Brooks, John DiBlasio, Carla Horn, Wade Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Pate, Randy Schaefer, Nina Kristin Stannard, Paula Street, Amanda Kouzoukas, Demetrios (HHSHOS) The Seeretarwr has to go to the White House at 5:00 PM today so he asked to move up the dailyr health care reform meeting so he could participate. 2017--002007 Bell, Michael Subject: Location: Start: End: Show Time As: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Daily Health Care Reform Meeting 610F Mon 3/27/2017 4:30 PM Mon 5:30 PM Tentative Daily every weekday from 4:30 PM to 5:30 PM Not yet responded -(osn05) Agnew, Ann Anderson, Jeffrey Arbes, Sarah Barcus, Lea Bardis, John Brookes, Brady Brooks, John (H DiBIasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios (CMSICM): Leggitt, Lance Lloyd, Matt Marre, Alleigh Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Perez-Rivera, Diana Schaefer, Nina Seema Verma,? Kristin Stannard, Paula Street, Amanda Twomey, John K. (OSIIOS) 2017--002008 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Mon 3X20I2017 5:00 PM End: Mon 3(20/201? 5:30 PM Recurrence: Daily Recurrence Pattern: every weekday from 5:00 PM to 5:30 PM Meeting Status: Accepted Organizer: (W5) Required Attendees: Agnew, Ann Anderson, Jeffrey Arbes, Sarah Bardis, John Brookes, Brady Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. (OSXASPA): Pate, Randy (H Perez?Rivera, Diana Schaefer, Nina Seema Verma; Kristin Stannard, Paula Street, Amanda Twomey, John K. 2017--002009 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Tue 3114/2017 4:30 PM End: Tue 3f14f2017 5:30 PM Recurrence: (none) Meeting Status: Accepted Organizer: (W6) Required Attendees: Agnew, Ann Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Kouzoukas, Demetrios Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakleyr Caitlin B, Pate, Randy Schaefer, Nina Kristin Stannard, Paula Street, Amanda Twomey, John K. 2017--002010 Bell, Michael Subject: Location: Start: End: Show Time As: Recurrence: Recurrence Pattern: Meeting Status: Organizer: Required Attendees: Daily Health Care Reform Meeting 610F Thu 3/93/2017 2:00 PM Thu 323/2017 3:00 PM Tentative Daily every weekday from 5:00 PM to 5:30 PM Not yet responded 033(5) DiBlasio. Carla Stannard, Paula (HHSXIOS) 2017--002011 Bell, Michael Subject: Daily Health Care Reform Meeting Location: 610F Start: Wed 315/201? 3100 PM End: Wed 4:00 PM Recurrence: (none) Meeting Status: Accepted Organizer: (W6) Required Attendees: Agnew, Ann Brooks, John DiBlasio, Carla Harrison, Jessica Horn, Wade Keith; Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakleyr Caitlin B, Pate, Randy Schaefer, Nina Kristin Stannard, Paula Street, Amanda Twomey, John K. 2017--002012 Bell, Michael Subject: Daily Health Care Reform Meeting Location: Secretary's Conference Room Start: Fri 4:15 PM End: Fri 3/19/2017 4:45 PM Recurrence: (none) Meeting Status: Accepted Organizer: Leggitt, Lance (HHSIIOS) Required Attendees: Agnew, Ann Brooks, John DiBlasio, Carla Horn, Wade Keith Nahigian; Kouzoukas, Demetrios Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Schaefer, Nina Kristin (H Stannard, Paula Street, Amanda (HHSXIOS) 2017--002013 Bell, Michael Subject: Daily Health Care Reform Meeting Location: Secretary's Large Conf Room Start: Mon 3/6/2017 4:30 PM End: Mon 3/6/2017 5:30 PM Show Time As: Tentative Recurrence: (none) Meeting Status: Tentatively accepted Organizer: (We) OSXIOS) Required Attendees: Agnew, Ann Brooks, John DiBlasio, Carla Horn, Wade Kouzoukas, Demetrios Kouzoukas, Demetrius Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian (H Oakley, Caitlin B. Pate, Randy Schaefer, Nina Kristin Stannard, Paula Street, Amanda Harrison, Jessica Neale, Brian 2017--002014 Bell, Michael Subject: Daily Health Care Reform Meeting Location: Start: Tue 2/28/2017 3:30 PM End: Tue 2/28/2017 4:30 PM Recurrence: (none) Meeting Status: Accepted Organizer: Twomey, John K. Required Attendees: Twomey, John Agnew, Ann Brooks. John DiBlasio. Carla Horn, Wade Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Patei Randy Schaefer, Nina Kristin Stannard, Paula Street, Amanda Kouzoukas, Demetrios (HHSHOS) Optional Attendees: Kouzoukas. Demetrios (CMSICM) The Secretaryr has to go to the White House at 5:00 PM today so he asked to move up the dailyr health care reform meeting so he could participate. 2017--002015 Bell, Michael Subject: Daily Health Care Reform Meeting Location: Secretary Large Conference Room Start: Mon 2X27I2017 5:30 PM End: Mon 327/201? 6:00 PM Show Time As: Tentative Recurrence: (none) Meeting Status: Tentatively accepted Organizer: HHS Secretary Required Attendees: Agnew, Ann Brooks, John DiBlasio, Carla Horn, Wade Keith Nahigian; Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Schaefer, Nina Kristin Stannard, Paula Street, Amanda (HHSXIOS) NOTE: The Secretary will not be here but Kris will run the meeting on his behalf. 2017--002016 Bell, Michael Subject: Location: Start: End: Show Time As: Recurrence: Meeting Status: Organizer: Required Attendees: Daily Health Care Reform Meeting Secretary Large Conference Room Fri 4:15 PM Fri 2/24/2017 4:45 PM Tentative (none) Tentatively accepted HHS Secretary Agnew, Ann Brooks, John Demetrios Kouzoukas DiBlasio, Carla Horn, Wade Keith Nahigian; Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Oakley, Caitlin B. Pate, Randy Schaefer, Nina Kristin Stannard, Paula Street, Amanda (HHSXIOS) 2017--002017 Bell, Michael Subject: Daily Health Care Reform Meeting Location: Start: Thu 223/201? 5130 PM End: Thu 2/23/2017 6:00 PM Show Time As: Tentative Recurrence: (none) Meeting Status: Tentatively accepted Organizer: Twomey, John K. Required Attendees: Agnew, Ann Brooks, John DiBlasio, Carla Horn, Wade Kouzoukas, Demetrios Leggitt, Lance Lloyd, Matt Murphy, Ryan Neale, Brian Pate, Randy (H Schaefer, Nina Kristin Stannard, Paula Street, Amanda 2017--002018 Bell, Michael Subject: Daily Health Care Reform Meeting Location: Room Start: Mon 2f13f2017 5:30 PM End: Mon 2f13j2017 6:30 PM Show Time As: Tentative Recurrence: (none) Meeting Status: Tentatively accepted Organizer: HHS Secretary Required Attendees: Brooks, John Stannard, Paula Schaefer, Nina Murphy, Ryan Lloyd, Matt Oakley, Caitlin Leggitt, Lance 2017--002019 Bell, Michael From: McGuffee, Tyler Ann (HHSIASL) Sent: Wednesday, March 08, 2017 1:07 PM To: {bi(63 Cc: Aramanda, Alec (OSIASL) Subject: Dr. Price Call w/ Sen. Capito Adam, My name is Tyler Ann McGuffee with the HHS Office of the Assistant Secretary for Legislation. I wanted to give you a heads up that our scheduler, Jessica Harrison, will be reaching out to your office soon to see if we can schedule a call between Dr. Price and Sen. Capito to talk health care reform. Thank you, Tyler Ann McGuffee 2017--002020 Bell, Michael From: McGuffee, Tyler Ann (HHSIASL) Sent: Wednesday, March 08, 2017 1:03 PM To: I Cc: Aramanda, Alec (OSIASL) Subject: Dr. Price Call wf Sen. Murkowski Garrett, My name is Tyler Ann McGuffee with the HHS Office of the Assistant Secretary for Legislation. I wanted to give you a heads up that our scheduler, Jessica Harrison, will be reaching out to your office soon to see if we can schedule a call between Dr. Price and Sen. Murkowski to talk health care reform. Thank you, Tyler Ann McGuffee 2017--002021 Bell, Michael From: McGuffee, Tyler Ann (HHSIASL) Sent: Friday, March 10, 201? 4:50 PM To: Aramanda, Alec Twomey, John K. Cc: Harrison, Jessica (OSXIOS) Subject: FW: Dr. Price Call w} Rep. McClintock FYI thoughts on this? From: Tudor, Chris [mailtolmml Sent: Friday, March 10, 2017 4:47 PM To: McGuffee, Tyler Ann Subject: Re: Dr. Price Call wf Rep. McCIintock Original Message Subject: Dr. Price Call Rep. McClintock From: uffee, Tyler Ann Date: Mar 10, 201?, 3:30 PM To: "Tudor, Chris" Hello Chris, My name is Tyler Ann McGuffee with the HHS Office of the Assistant Secretary for Legislation. I wanted to give you a heads up that our scheduler,Jessica Harrison, will be reaching out to your office today to see if we can schedule a call between Dr. Price and Rep. McClintock this weekend to talk health care reform. Thank you, Tyler Ann McGuffee 2017--002022 Bell, Michael From: McGuffee, Tyler Ann (HHSIASL) Sent: Friday, March 10, 201? 6:12 PM To: Aramanda, Alec (OSIASL) Subject: FW: House Healthcare bill ideas 001(5) Thanks, From: Kristin Sent: Friday, March 10, 2017 10:15 AM To: Aramanda, Alec McGuffee, Tyler Ann (HHSIIOS) Subject: FW: House Healthcare bill - ideas {bi{5l From: Stirrup, Heidi (HHSIIOS) Sent: Thursday, March 09, 2017 8:45 AM To: Stannard, Paula (HHSIIOS) Cc: Leggitt, Lance Kristin Subject: FW: House Healthcare bill - ideas (W5) From: Stirrup, Heidi (HHSIIOS) Sent: Thursday, March 09, 2017 8:36 AM To: 'Burns, Stuart' Cc: Aramanda, Alec (bl{5l Subject: RE: House Healthcare bill - ideas {bi{5l Stirer Office of White House Liaison US. Depui'lmenl of Health and Human Sen-?ices From: Burns, Stuart [mailto Sent: Wednesday, March 0b, 201! 10:15 AM To: Stirrup, Heidi Subject: House Healthcare bill - ideas 2017--002023 Page 05 of 43 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--002024 Stuart (DEE) Stuart Burns Cnfefof?ran? Rep. Brian Bani}? (TX-36) 376 Cannon H03 DC 205 f5 Sign up for 2017--002025 Bell, Michael Subject: Location: Start: End: Recurrence: Meeting Status: Organizer: Required Attendees: Optional Attendees: Staff: Carla and Demetrios Attendees: Marshall Roe Buschon Babin Ferguson DesJarIais Abraham Gosar Black Wenstrup Carter Dunn Murphy Brugess Topic: Mtg. w! Doctors Cacus Secretary's Large Conference Room Fri 31?17/2017 7:30 AM Fri 8:15 AM (none) Accepted (W5) 05/105) DiBlasio, Carla Kouzoukas, Demetrios Leggitt, Lance Harrison, Jessica Kristin Twomey, John K. Aramandai Alec McGuffee, Tyler Ann Morse, Sara (HHSIASL) The discussion will be about the regulatory efforts that HHS plans to undertake, as well as how the Docs Caucus can be helpful in messaging the ACA replacement. They just want the opportunity to connect with Dr. Price in a less formal setting than some of these Conference meetings. 2017--002029 Confidential Pre?decisional Draft {bll{5l 2017--002030 Confidential Pre?decisional Draft {b){5ll 2017--002031 Confidential Pre?decisional Draft {bl{5l 2017--002032 Confidential Pre?decisional Draft (b]{5ll 2017--002033 Confidential Pre?decisional Draft (b){5l 2017--002034 Confidential Pre?decisional Draft 2017--002035 Confidential Pre?decisional Draft 2017--002036 Bell, Michael Subject: Mtg. w! Senator Orrin Hatch and GOP Members of the Senate Finance Committee Location: 5?124; US. Capitol Start: Wed 3/15/2017 10:30 AM End: Wed 3/15/2017 11:30 AM Recurrence: (none) Meeting Status: Accepted Organizer: (W6) OSHOS) Required Attendees: Harrison, Jessica Kristin Twomey, John Leggitt. Lance (H Aramanda, Alec McGu??ee, Tyler Ann Tepic: Healthcare Bill The Republican senators attending are: Senators Hatch, Grassley, Crapo, Roberts, Enzi, Cornyn, Thune, Burr, Portman, Toomey, Heller, Scott, and Cassidy. 2017--002037 Confidential Pre?decisional Draft {bl{5l 2017--002038 Confidential Pre?decisional Draft (b]{5ll 2017--002039 Confidential Pre?decisional Draft 2017--002040 Confidential Pre?decisional Draft 2017--002041 Confidential Pre?decisional Draft {bl{5l 2017--002042 Confidential Pre?decisional Draft {bll{5l 2017--002043 Confidential Pre?decisional Draft {bl{5l 2017--002044 Confidential Pre?decisional Draft 2017--002045 Confidential Pre?decisional Draft {bl{5l 2017--002046 Confidential Pre?decisional Draft {b){5ll 2017--002047 Confidential Pre?decisional Draft (b){5l 2017--002048 Bell, Michael From: McGuffee, Tyler Ann Sent: Wednesday, March 08, 2017 3:31 PM To: Thompson, Dean Cc: Aramanda, Alec Subject: RE: Dr. Price Call w/ Chairman Black Thank you. Yes, glued to email or I can be reached directly at (We) Tyler Ann From: Thompson, Dean lmailtolw?} Sent: Wednesday, March 08, 2017 3:26 PM To: McGuffee, Tyler Ann (HHSIIOS) Cc: Aramanda, Alec (HHSIIOS) Subject: RE: Dr. Price Call w! Chairman Black Thanks for the heads up! Mrs. Black will be glad to connect. Please don't hesitate to get in touch with me whenever I can be of service. I'm glued to email (like you, I?m sure) and my cell islbii?i Dean Dean Thompson Deputy Chief of Staff 8-: Legislative Director Congressman Diane Black From: McGuffee, Tyler Ann [mailto {bii?i Sent: Wednesday, March 8, 2017 3:1'3 PM To: Thompson, Dean I Cc: Aramanda, Alec (HHSIIOS) 1033(5) Subject: Dr. Price Call w/ Chairman Black Hello Dean, My name is Tyler Ann McGuffee with the HHS Office of the Assistant Secretary for Legislation. I wanted to give you a heads up that our scheduler, Jessica Harrison, will be reaching out to your office soon to see if we can schedule a call between Dr. Price and Chairman Black to talk health care reform. Thank you, Tyler Ann McGuffee 2017--002049 Bell, Michael From: McGuffee, Tyler Ann (HHSIASL) Sent: Wednesday, March 08, 2017 1:05 PM To: Cc: Aramanda, Alec (OSIASL) Subject: Dr. Price Call w/ Sen. Portman Parn, My name is Tyler Ann McGuffee with the HHS Office of the Assistant Secretary for Legislation. I wanted to give you a heads up that our scheduler, Jessica Harrison, will be reaching out to your office soon to see if we can schedule a call between Dr. Price and Sen. Portman to talk health care reform. Thank you, Tyler Ann McGuffee 2017--002050 Bell, Michael Subject: Call w! Rep Dave Brat Location: Start: Sun 3/12f2017 6:00 PM End: Sun 3121201? 6:30 PM Recurrence: (none) Meeting Status: Accepted Organizer: (OS/log) Required Attendees: Harrison, Jessica Kristin Twomey. John Ara manda. Alec McGuffee, Tyler Ann Leggitt, Lance Contact: Zoe O?Herin 2017--002051 Confidential Pre?decisional Draft 2017--002052 Confidential Pre?decisional Draft {b){5ll 2017--002053 Bell, Michael Subject: Call w! Re. Matt Gaetz Location: Start: Sun 3/12f2017 1:00 PM End: Sun 3f12j2017 1:30 PM Recurrence: (none) Meeting Status: Accepted Organizer: ?33(5) Required Attendees: Harrison, Jessica Kristin Twomey, John Leggitt. Lance (H Aramanda, Alec McGuffee, Tyler Ann (HHSXIOS) Contact: Kendall Kelley 2017--002054 Confidential Pre?decisional Draft (W5) 2017--002055 Confidential Pre?decisional Draft (W5) 2017--002056 Bell, Michael Subject: Call w! Rep. McClintock Location: Start: Sun 3/12f2017 12:30 PM End: Sun 3f12j2017 1:00 PM Show Time As: Tentative Recurrence: (none) Meeting Status: Not yet responded Organizer: (We) Required Attendees: Harrison, Jessica Kristin John Leggitt, Lance Aramanda, Alec McGuffee, Tyler Ann Back (W53 1'5 2017--002057 Confidential Pre?decisional Draft 2017--002058 Bell, Michael Subject: Call w! Senator Murkowski Location: Start: Thu 3f16/2017 2:15 PM End: Thu 3/16/2017 2:45 PM Recurrence: (none) Meeting Status: Accepted Organizer: Required Attendees: Harrison, Jessica Kristin Tworney, John K.: Leggitt. Lance Aramanda, Alec McGu??ee, Tyler Ann Contact: (W6) The senator will call John and he will patch her through to Dr. Price Senators numberjust in case-) 2017--002059 Confidential Pre?decisional Draft (W5) 2017--002060 Confidential Pre?decisional Draft (W5) 2017--002061 Confidential Pre?decisional Draft (W5) 2017--002062 Bell, Michael Subject: Daily War Room Location: Capitol Start: Wed 3/8/2017 8:15 AM End: Wed 3/3/2017 8:45 AM Recurrence: Weekly Recurrence Pattern: every Monday, Tuesday, Wednesday, Thursday, and Friday from 8:15 AM to 8:45 AM Meeting Status: Declined Organizer: Kristin Required Attendees: Arbes, Sarah (H The new dial?in is: TimefDate: Dial In: (WE) Passcode: (W5) War Room is on for tomorrow. For those who want to dial?in, please note that I'm changing the dial?in numberipasscode. The operator will verify names as people dial in. If someone is not represented on this list and you need for them to dial in, please email Sage. 2017--002063 Bell, Michael From: McGuffee, Tyler Ann Sent: Wednesday, March 08, 2017 3:19 PM To: Cc: Aramanda, Alec (OSXASL) Subject: Dr. Price Call wf Chairman Black Hello Dean, My name is Tyler Ann McGuffee with the HHS Office of the Assistant Secretary for Legislation. I wanted to give you a heads up that our scheduler, Jessica Harrison, will be reaching out to your office soon to see if we can schedule a call between Dr. Price and Chairman Black to talk health care reform. Thank you, Tyler Ann McGuffee 2017--002064 Bell, Michael From: McGuffee, Tyler Ann Sent: Friday, March 10, 201? 3:28 PM To: Subject: Dr. Price Call wf Rep. Gaetz Hello Heather, My name is Tyler Ann McGuffee with the HHS Office of the Assistant Secretary for Legislation. I wanted to give you a heads up that our scheduler,Jessica Harrison, will be reaching out to your office today to see if we can schedule a call between Dr. Price and Gaetz this weekend to talk health care reform. Thank you, Tyler Ann McGuffee 2017--002065 Bell, Michael From: McGuffee, Tyler Ann Sent: Friday, March 10, 201? 3:30 PM To: Subject: Dr. Price Call wf Rep. McClintock Hello Chris, My name is Tyler Ann McGuffee with the HHS Office of the Assistant Secretary for Legislation. I wanted to give you a heads up that our scheduler,Jessica Harrison, will be reaching out to your office today to see if we can schedule a call between Dr. Price and Rep. McCIintock this weekend to talk health care reform. Thank you, Tyler Ann McGuffee 2017--002066 Bell, Michael From: McGuffee, Tyler Ann Sent: Friday, March 10, 201? 3:29 PM To: Subject: Dr. Price Call wf Rep. Renacci Hello Randy, My name is Tyler Ann McGuffee with the HHS Office of the Assistant Secretary for Legislation. I wanted to give you a heads up that our scheduler,Jessica Harrison, will be reaching out to your office today to see if we can schedule a call between Dr. Price and Rep. Renacci this weekend to talk health care reform. Thank you, Tyler Ann McGuffee 2017--002067 Bell, Michael Subject: Call w! Rep. McClintock Location: Call?? {wa) Start: Sun 3/12f2017 12:30 PM End: Sun 3f12j2017 1:00 PM Show Time As: Tentative Recurrence: (none) Meeting Status: Not yet responded Organizer: (We) Required Attendees: Harrison, Jessica Kristin John Leggitt, Lance Aramanda, Alec McGuffee, Tyler Ann A Back We) 1'5 2017--002068 Confidential Pre?decisional Draft 2017--002069 Bell, Michael Subject: Call w! Senator Murkowski Location: Start: Thu 3f16/2017 2:15 PM End: Thu 3/16/2017 2:45 PM Recurrence: (none) Meeting Status: Accepted Organizer: Required Attendees: Harrison, Jessica Kristin Tworney, John K.: Leggitt. Lance Aramanda, Alec McGu??ee, Tyler Ann Contact: The senator will call John and he will patch her through to Dr. Price Senators numberjust in case-) (W53 2017--002070 Confidential Pre?decisional Draft (W5) 2017--002071 Confidential Pre?decisional Draft (W5) 2017--002072 Confidential Pre?decisional Draft (W5) 2017--002073 Bell, Michael Subject: Call w/ Senator Sullivan Location: Start: Tue 11:30 AM End: Tue 321/2017 12:00 PM Recurrence: (none) Meeting Status: Accepted Organizer: (osmos; Required Attendees: Harrison, Jessica Kristin Twomey. John K. Leggitt, Lance Arbes, Sarah Morse, Sara Schedulers direct and scheduler will patch TEP into the Senator Suggested Messages: (bi{5i - .0 Ii hill [Padilla 2'13: Iii-:ill ite'ili'?! Ill mm 2017--002074 {Ll 5l i iltl-?Hk? Sen. Dan Sullivan (R?Alaska) Junior Senator from Alaska ResidencezAnchorage BermNov. 13. 1964; Fairview Park, Ohio Religion:Roman Catholic Family:Wife, Julie Fate Sullivan; three children Education?larvard U., AB. 1987 (economics); U. ot?Birmingham (England), MA. 1988; Georgetown U., M.S.F.S. 1993, JD. 1993 Military Service:Marine Corps 1993-1997; Marine Corps Reserve l997-present (awarded Defense Meritorious Service Medal} Career:White House aide; lawyer; author First Elected?OM {1 st term); Defeated Sen. Mark Begieh, Latest Election:2[ll4 General (47.96%) Political Highlights:U.S. State Department assistant secretary for economic and business affairs, 2006?09; Alaska attorney general, 2009?] OAlaska Department of Natural Resources commissioner, 2010?13 Committees: 0 Armed Services (Airland; Seapower; Strategic Forces} 0 Commerce, Science Transportation (Aviation Operations, Safety Sc Security: Communications, Technology, Innovation the Internet; Oceans, Atmosphere, Fisheries Coast Guard - chairman; Space, Science Sc Competitiveness) 0 Environment 8: Public Works (Fisheries, Wildlife Water: Superfund, Waste Management Regulatory Oversight; Transportation 85 Infrastructure) 0 Veterans' Affairs Phone:202-224-3DO4 Faxz202?224?6501 702 Hart Bldg. Washington, DC 20510 CQ Politics in America Profile (Updated: June 17, 2015) Energy policy and other natural resource issues will likely be the driving force in Sullivan?s tenure, as it has been for his Alaska colleague, senior Sen. Lisa Murkowski, who chairs the Energy and Natural Resources Committee. Sullivan has foreign policy credentials and was Alaska?s attorney general, but he also directed the state?s Department of Natural Resources and in the George W. Bush administration?s State Department, he worked on 2017--002075 international energy policy, Alaska?s natural gas pipeline, and oil and gas pipeline projects in other regions of the world. He now has a seat on the Senate Environment and Public Works Committee. Alaska?s oil and gas industry have particular importance to the state, which bene?ts from the payrolls and the royalties. Sullivan weighed in on the Keystone XL pipeline just a month after being sworn into of?ce. He voted to approve construction of the energy project, cosponsored the legislation and highlighted the issue in his maiden speech. The pipeline would transport hundreds of thousands barrels of tar sands oil from Alberta, Canada, along with some US. oil, to southern Nebraska, where it would connect with an existing pipeline network that would carry it to Gulf Coast re?neries. The administration didn?t decide whether to approve the project in light of environmental concerns and related court proceedings. ?In supporting Keystone," Sullivan said in his first floor speech, ?I?m also standing for a larger, more important principle: the idea that the federal government should be a partner in opportunity, a partner in progress, not an obstacle." Sullivan wanted to put his own stamp on the bill to approve the Keystone project with an amendment that would have prohibited Environmental Protection Agency personnel from carrying firearms, saying he was ?not for a country with an armed bureaucracy." He characterized his provision as limiting the scope of the federal government as opposed to restricting gun rights. But the amendment was not adopted. The underlying Keystone measure passed the Senate, cleared the House but was vetoed by President Barack Obama. The EPA and environmental regulations are particular targets for Sullivan, who promotes his record of challenging the Obama administration?s regulatory policy ?every step of the way.? Sullivan had an immediate opportunity to showcase his position after the White House announced in January 2015 it would recommend designating 12.3 million acres of the Arctic National Wildlife Refuge (ANWR) as wilderness, making the region totallyr off-limits to oil and gas exploration and drilling. ?This outrageous proposal from the Obama Administration will undermine Alaska?s future and America?s energy security. It will never see the light of day in Congress,? Sullivan said in a statement. ?President Obama?s goal of starving the Trans-Alaska Pipeline of oil and turnng our state into a giant national park will not stand.? Sullivan teamed up with Murkowski on legislation that would permit limited oil and natural gas activity in the non-wilderness coastal plain of ANWR, which Alaska lawmakers have been trying to pry open for development since the mid-1970s. A 1980 conservation law made most ofthe refuge off-limits to drilling, but it included an option for future congresses to allow energy development on a 1.5?million?acre section of the coastal plain. Sullivan also hopes that an ongoing state lawsuit against the federal government to try to compel the Interior Department to accept a state?written exploration plan for ANWR could provide another opening for Frontier State priorities. pledge to do everything in my power to protect the economic growth and prosperity of our state, and defend the promises made to Alaskans under" the conservation law, Sullivan said at a news conference. There could be some room for compromise in Sullivan?s legislative agenda. His first hearing as chairman of the Environment and Public Works Subcommittee on Fisheries, Water, and Wildlife was on his bipartisan sportsmen?s bill to case some regulations for recreational hunting and ?shing, among other things. ?This legislation represents years of hard work by the sporting community, and I am appreciative of the cf forts that have gone into crafting what is a collection of bills that have demonstrated broad bipartisan support over the years, including some that enjoy the support of the Obama Administration,? he said at the hearing. am hopeful that in this Congress, we will be able to take this effort across the ?nish line.? 2017--002076 Sullivan took the reins on the measure, which was previously championed by Democratic Sen. Kay Hagan of North Carolina, who lost her seat to Republican Thom Tillis in 2014. That version picked up some steam in the last Congress, but stalled in the Democratic-controlled Senate. Sullivan also takes on the White House on national security and foreign policy. He is on the Armed Services Committee, which in?uences national security defense. In an appearance at a local chamber of commerce in September 2014, he said: ?We have gotten to the point where our friends no longer trust us and our adversaries no longer fear us in the international world. We have been a country that?s been exhibiting weakness, and weakness in my view is provocative.? So far on the committee, he has pressed administration witnesses for information on risk assessments of Guantanamo Bay detainees and criticized them for not notifying Congress before exchanging ?ve Taliban prisoners for Sgt. Bowe Bergdahl last year. ?This was a clear directive frotn the Congress in the law that this administration violated,? he said at the Gitmo hearing. ?And, as far as I can tell, there?s been no good explanation.? Sullivan was one of 46 Republican senators who signed a letter written by fellow GOP freshman Tom Cotton of Arkansas warning Iran?s leaders that any nuclear deal signed with President Obama would be subject to change by Congress or by the next president. Cotton and Sullivan are two of five GOP freshman on Armed Services. His assignment to the Veterans? Affairs Committee suits his portfolio well. He joined the Marine Corps after earning graduate and law degrees from Georgetown University, and entered the Marine Corps Reserves after four years of active duty. Although he told the Alaska Public Radio Network that he planned to remain in the military, the Marine Corps removed Sullivan from his post as a reserve commander in March 2015, citing a provision in the Constitution that bars members of Congress from holding of?ce in the executive branch. Sullivan was sent overseas three times while in the reserves, including deployments to provide strategic analysis for commanders and on an anti-terror task force. agree with comments about this being the most important committee in the United States Senate,? he said at the VA panel?s ?rst hearing in 2015. ?I?m very honored to be here and to start to rebuild the sacred trust and responsibility that we have in the Congress and the federal government to our veterans.? Alaska?s military bases are home to tens of thousands of service members. Sullivan said Alaska ?has the highest number of veterans per capita of any state." His ?promises delivered? pledge addresses VA backlogs, preventative care, access to health care for veterans living in remote areas, re?cvaluations of combat zone designations and programs to provide incentives for hiring veterans. Sullivan didn?t move to Alaska until after leaving active duty, and despite his time in Alaska government, opponents have called him an outsider. Sullivan met his wife, an Alaska Native, when they were both in Washington, DC. he was at Georgetown, she was working for Republican Sen. Ted Stevens. After his stints in federal and state government, Sullivan jumped into the US. Senate race. He narrowly defeated incumbent Democratic Sen. Mark Begich with 48 percent ofthe vote. Sullivan?s win declared after weeks ofcounting absentee ballots helped Republicans ultimately capture control of the Senate. 2017--002077 Confidential Pre?decisional Draft (W5) 2017--002078 Dan Sullivan United States Senator - Alaska Graghs Highlighting Alaska?s Health Care Challenges: Legislative Priorities American Health Care Act Premium Tax Credits Would Fall Sharply Under House Republican Plan Difference in 2020 between average cred il fer marketplace consumers under Affordable Care Act and Republican plan 510243 $5.350 $4.542 $4.293 54.224 -$4.133 $4.133 $3.830 $3.548 $3.461" $2.850 527.114 $2.549 $2.512 $2.320 $2.312 $2.294 $2.214 $2.188 $2.031 51.91"? $1.455 $1.361 $1.230 $1.123 $1.043 $950 $79? $622 3569 $519 5429 ?$110 $41 Nan-11" exit:- ?lew Hen eel me- A :?lRl?fr'l C1152 '1a Oddl'U'Wd r'l Nebraska Wee! 'u'nglr' rl W-f'r 3-1" r11; lennessee 501111 Dakum Nornar?a 301111 Ce'uli'm M1 '19 lU'n'U'rl 5130111 .1 11? 251:2 pr; Fla-'Icld Kansas A r'I?lH llama-1 Tuner. Dnlu'lb-I (7-9an Nevada. Uld'] 0'110 Ir?rl ms: $9 $5415 2017--002079 Page 013 M145 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--002080 Page 014 M145 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--002081 From: Fitzsimons, Maura Sent: 21 Mar 201? 15:12:03 +0000 To: LettersToSecretary Cc: Ara manda, Alec Tyler Ann (HHSIASL) Subject: Dem Letter on CMS Market Rule Attachments: ACA letter.pdf Letter to the Secretary from Ranking Members Murray, Pallone, Wyden, and Neal regarding the Patient Protection and Affordable Care Act Market Stabilization proposed rule. Maura Fitzsimons Legislative Analyst Office of the Assistant Secretary for Legislation Department of Health and Human Services (bli?l 2017--002082 (tongues of the ?ttm?trh ?tatta Washington, EC 20510 March 20, 2017 The Honorable Thomas Price Department of Health and Human Services Centers for Medicare and Medicaid Services Attention: CMS-9929-P PO. Box 8010 Baltimore, MD 21244-1850 Re: Patient Protection and Affordable Care Act; Market Stabilization Dear Secretary Price, We write in response to the proposed regulation, Patient Protection and A?ordobie Care Act; Market Stobfifzort?oa, published by the Centers for Medicare and Medicaid Services (CMS) regarding the individual and small group health insurance markets. Unfortunately, we are not convinced that the proposed changes would meaningfully improve the stability of the Marketplaces, and we are very concerned that the rule, if finalized, would block access to coverage for millions of Americans and signi?cantly raise the cost of that health insurance coverage. The proposal of this regulation comes at a particularly consequential time for the health and ?nancial security of millions of Americans?and ?rst and foremost, we urge you to abandon the reckless, dangerous plan to rip apart our health care system that your administration is currently pursuing. Before the Affordable Care Act (ACA), far too many Americans were one illness away from bankruptcy, locked out of a discriminatory, unaffordable insurance market. The Administration is actively supporting the American Health Care Act, legislation that would rip comprehensive, affordable coverage away from 24 million Americans, raise deductibles and cost-sharing in the individual market, and lower ?nancial assistance for individuals purchasing insurance in the individual market, according to the Congressional Budget Office. You were quoted on the legislation saying, ?This is about patients at the end of the day. This isn't about politicians. This isn't about insurance companies. This is about patients. And patients in this nation, especially those in the individual and small-group market, these are the folks.?1 You also claimed that ?Nobody will be worse off ?nancially? under the bill.2 We disagree, as do the American Hospital Association, AARP, the American Medical Association, and countless other I The White House, Press Brie?ng by Press Secretary Sean Spicer (Mar. 07, 2017) 13). 2 HHS Sec. Tom Price: 'Noboo?; Will Be Worse 0,15? tnonciaibx" Under GOP Health Plan, NBC News (Mar. 13, 2017) n732376} 2017--002083 stakeholders and health care experts. Indeed, if enacted, this legislation would create the very problems you explicitly aim to address in the proposed rule throwing markets into chaos, eliminating insurance options for consumers, and creating a ?death spiral? of premium increases. We believe that such legislation is utterly misguided and urge you to step back from the prec1p1ce. We are further concerned that the policies proposed in this the aforementioned rule address only the interests of the health insurance industry, leaving consumer considerations outside of the proposed policy. While we agree that there is a need to strengthen the market, doing so without appropriate consumer safeguards and protections risks leaving consumers without access to affordable care. Speci?cally, we are concerned that the proposed regulation: - Reduces the 2018 open enrollment period by half, making it more dif?cult to enroll and worsening the risk pool; II Discourages uninsured Americans from signing up for coverage, by exploring requirements that would penalize consumers in the individual market who did not maintain continuous coverage for 6 to 12 months prior to enrollment; - Makes health care less affordable by allowing insurers to increase out-of?pocket expenses for consumers by changing the actuarial value variation allowances; and I Limits access for vulnerable populations by rolling back network adequacy standards and unnecessarily lowering the Essential Community Providers standard. Such an approach runs counter to the core Congressional intent in enacting the providing more affordable, accessible coverage for all Americans. The legislative history of the ACA makes very clear that Congress core aim was to ensure affordable, accessible, quality health insurance5 for all Americans} Congress designed the advanced premium tax credits, cost- sharing subsidies5 ,expanded minimum bene?ts, and critical consumer protections to ful?ll this goal Congress recognized that the fundamental purpose was to ?[S]ay for every American, for every member of our American family, access to quality affordable care will be a right, not a ?6 3 ?We are united in the belief that there are fundamental things that need to be changed in our health care system. First, it needs to be more affordable. People cannot afford this dramatic escalation in the cost of health care.? Senator Durbin, ?Service Members Home Ownership Tax Act Of 2009.? (Dec. 21, 2009) Congressional Record p. 13648. 4 ?Our approach will be to offer affordable options for Americans struggling under the skyrocketing costs of healthcare.? Senator Dodd, Hearing of the Committee on Health, Education, Labor and Pension on Examining Health Care (June 11, 2009). 5 1311 and 1402 of the Patient Protection and Affordable Care Act. 6 Senator Harkin, ?Service Members Home Ownership Tax Act Of 2009.? (Dec. 23, 2009) Congressional Record 13. 13847. 2017--002084 Affordability for Consumers Many members of Congress noted during the drafting and passage of the ACA that affordability was a key issue facing consumers. To address this lssue, Congress crafted two measures designed to work in tandem to increase affordability for working families. Congress understood that without ?nancial help for families, insurance would not be truly accessible.3 The ?rst of these reforms are the cost- sharing subsidies9 that help families with Incomes up to roughly $29, 000 for an individual and $60, 000 for a family of four pay their deductibles and out- of-pocket health care costs. In 2016, as many as seven million people bene?tted from this provision] ?Unfortunately, these payments are under threat thanks to 2litigation brought by the House of Representatives?, and their future remains uncertain. 2Iiloth Republicans and Democrats' 1n Congress agree that the Administration must continue making these payments to provide certaing; and stability In the market. 3If the Administration fails to make these payments, insurance companies will have a legal basis to exit the market within a short period, reducing choice and increasing premiums creating a ?death spiral? for millions of Americans. These payments are critical to affordable health care and the very purpose of this proposed rule and the law?but in spite of the immediate threat to their continuance, the ?Affordability is already one of the key barriers to obtaining coverage in my State. Since 2000, premiums for residents have risen 10 percent. As a result, almost one in four people doesn?t have insurance, giving us the second highest uninsured rate in the Nation. Enactment of this reform legislation would make as many as 249,000 middleclass New Mexico residents eligible for premium credits to ease the burden of these high costs.? Senator Udall, ?Service Members Home Ownership Tax Act of 2009?Motion To Proceed.? (Nov. 21, 2009) Congressional Record p. 311912. 3 ?We want to make sure all Americans have the opportunity to ?nd affordable insurance." Senator Stabenow, "Service Members Home Ownership Tax Act Of 2009?Motion To Proceed.? Congressional Record (November 20, 2009) p. 811839; ?It is a debate we cannot afford not to have. What is before us is to make health insurance available and affordable.? Senator Nelson, "Service Members Home Ownership Tax Act Of 2009?Motion To Proceed." Congressional Record (November 20, 2009) p. Si 1844; ?In the richest country in the world, no one should die because they cannot afford health coverage.? Senator Feinstein, ?Service Members Home Ownership Tax Act Of 2009.? (December 24, 2009) p. 14131. 9 ?1402 of the Patient Protection and Affordable Care Act. 10 The Commonwealth Fund, The ACA's arr?Snoring Reduction Plans: A Key to Affordable Health Coverage for Millions of US. Workers (Oct. 13, 2016) Final Vote Results for Roll Call 466, Providing for consideration of 6776, providing for authority to initiate litigation for actions by the President or other executive branch of?cials inconsistent with their duties under the Constitution of the United States and HR. 935, Reducing Regulatory Burdens Act of 2013; and for other purposes 12 House Choir: Obomocore Subsidies Must Continue 1" Avoid Collapse Amid Repeal, TPM Livewire (Jan. 16, 2017) livewirei 13 House Energy and Commerce Chairman Greg Walden stated that he wants to see the subsidy program funded ?one way or another,? explaining ?if you don?t, the plans have the ability to cancel midyear, and we said we wouldn't pull the rug out from under people and we shouldn?t, House Choir: Ooamocore Subsidies Must Continue To Avoid Coiiopse Amid Repeal, TPM Livewirc (Jan. 16, 2017) Senator Tammy Baldwin, LES. Senator Tummy Baichvin and Senators Coil on President Tramp to Protect Americans ?'om Higher Heoiih Costs (Jan. 30, 2017) (press release) 1., .3 2017--002085 proposed rule is silent on the matter. Without a commitment from the Administration to continue making these payments, the other policies explored in this rule mean nothing. We urge you to make the cost-sharing reductions permanent in the ?nal rule. Advanced premium tax credits also play a critical role in ensuring that health insurance coverage is affordable. According to the Department of Health and Human Services (HHS), in 2016, 85 percent of Marketplace plan selections in Healthcare. gov states were with an advanced premium tax credit, and, among those individuals bene?ting, advanced premium tax credits covered 73 percent of the total premium 4Congress designed the advanced premium tax credit to adjust with the premium of the benchmark plan5 to protect consumers If premiums in an area increase, the difference between a consumer contribution and the benchmark plan also merease, resulting in a higher advanced premium tax credit and reducing a consumer?s premiums. The advanced premium tax credits are critical to the affordability of health insurance coverage and must be protected. Stability and Predictability in the Market The ACA banned insurance company discrimination against consumers based on pre?existing conditions, prohibited insurers from increasing premiums on those with preexisting conditions, and guaranlt?eed that health insurance companies must offer health msurance coverage to every American.16 Congress understood that these were dramatic improvements to the governing health insurance issue and rating rules in most states before the ACA, especially in the individual market. Recognizing that these changes could cause short-term uncertainty for insurers, Congress took steps in the ACA to mitigate this risk as much as possible to insulate consumers and help provide market certainty. The risks to be protected against included: the lack of information on the risk pool 1n the new market and the potential risk of adverse selection to consumers.l With this 1n mind, Congress 1? Department of Health and Human Services, Assistant Secretary of Flaming and Evaluation, The E??ect of Shopping and Premium Tax Credits on the ofMar-kemiace Coverage, page 2 (Aug. 24, 2016} [5 The benchmark plan is the plan that has the second-lowest premium according to the proportion of the premium that goes toward essential health bene?ts (EH13). The benchmark plan may not always be the second- lowest cost gross premium in the silver tier, and there may not be a plan priced lower than the benchmark, if plans have EHB percentages less than 100%. For the purpose of this hypothetical analysis, we have assumed that all plans have 100% EHB. See note 3. '6 ?Health reform will also ensure all Americans have access to quality and affordable insurance. We prevent insurance companies from the current practices in which they are engaged. One of the worst of these practices is the practice of denying health coverage for preexisting medical conditions. If one has a preexisting medical condition and is able to buy a policy, perhaps, the policy in its own language will exclude them from getting medical treatment that might result from that preexisting medical condition. This legislation would end that. It would end the discrimination of charges that currently exist where the charge for health care is based on one?s health status or gender.? Sen. Bingaman, Congressional Record, 311827 (N ov. 20 2009) 17 ?Ensuring a stable market for consumers: A broadly funded mechanism which spreads costs for hi gh-risk individuals across a broader base needs to be put in place to ensure premium stability for those with existing coverage.? Karen Ignagni, Hearing of the Committee on Health, Education, Labor, and Pensions, S. Hrg. [-960 (Mar. 24, 2009) 4 2017--002086 included measures for the individual insurance market modeled on the Medicare Part program, implementing the risk corridor, reinsurance and risk adjustment programs to stabilize and run the market more predictably.l3 These risk mitigation programs have been a part of the Part program for nine years and are sound federal investments that protect the taxpayer. We encourage the Administration to continue these programs or explore ways in which to extend them. As the Administration considers policies to improve the risk pool and promote stability in the individual market, we encourage you to consider additional policy changes. In the ?nal 2018 Notice of Bene?ts and Payment Parameters rule, HHS ?nalized a proposal to improve the risk adjustment policy in response to ongoing discussions with the insurance industry.? This proposal adds prescription drug data to the risk adjustment model, alters risk adjustment to incorporate very high cost cases into the risk adjustment formula, and updates the payment transfer model to remove plan administrative costs from transfers. These proposals are proposed for 2018 and were established in a public and transparent process with input from stakeholders. We urge you to consider accelerating these policies as soon as possible for 2017. Balancing Consumer Safeguards with Market Stability While we have always supported improving the risk pool and promoting stability in the individual insurance market, we believe that balancing such actions with strong safeguards to protect consumer access to affordable care is essential. To that end, we recommend: Speciesl enrollment periods The proposed changes to special enrollment periods should include a good faith exception to protect consumers who attempt to provide documentation in a pre-enrollment veri?cation process, but cannot provide the information in the 30-day window or experience dif?culty in providing such documentation, and allow for additional assistance. The rule notes that consumers? enrollment would be ?pended? until veri?cation, meaning that the enrollees? plan selection would not be effective until documentation was submitted during the 30-day period.20 This does not seem to leave room for outside of the box cases and leaves consumers in the process without coverage until an administrative process is complete. Until HHS comes up with an exception or process of temporary coverage during the pre-enrollment veri?cation period, the proposed process would leave those with medical needs with no help. Many individuals will face unique hardships in providing such documentatiOn, demonstrating a need to provide consumer assistance during the pre-enrollment veri?cation process from a neutral third party not associated with the health insurance company. Finally, the policy differences between the group and individual markets ?3 Georgetown University Health Policy Institute, Center for Children and Families, How the Three ?s Contributed to the Success of Medicare Part (Jan. 28, 2014) 4t01t28thow-the- 15' Department of Health and Human Services, Centers for Medicare ti: Medicaid Services, Patient Protection and A?ordobte Care Act: HHS Notice of Benefit and Payment Parameters for 2018; Amendments to Special Enrollment Periods and the Consumer Operated and Oriented Plan Program (?nal rule) (Dec. 22, 2016) 2? Department of Health and Human Services, Centers for Medicare Medicaid Services, Patient Protection and A?ordoote Core Act; Market Stabilization, page 44 (proposed rule) (Feb. 17, 2017) 5 2017--002087 present a confusing process that could result in consumers ending up with incorrect information as they churn between the two markets. We encourage the Administration to (1) design a good faith exception that recognizes the wide array of unique circumstances consumers face in meeting the proposed requirement; (2) provide a longer transition before these special enrollment period changes take effect; and (3) invest in targeted consumer outreach to ensure individuals have information to make the best possible care decisions. Continuous coverage: The preposed regulation seeks comment on whether HHS should consider a ?continuous coverage? requirement from a 1996 law mirroring a similar concept from the House repeal legislation. Speci?cally, the proposal contemplates policies that would deprive consumers of the pre-existing condition protections in current law if they fail to maintain continuous, creditable coverage without a 63-day break in the group market prior to enrollment. The individual reSponsibility requirement provides consumers with an important incentive to enroll in coverage year-round, not just when health care is needed. This incentive fosters more healthy risk pools and, in turn, stability in the individual market.21 According to HHS, nearly a third of the population experienced ga in coverage of at least a month due to hardships such as job loss or being too sick to work.2 A draconian policy that allows waiting periods, surcharge penalty payments, or discrimination by insurance companies for individuals that do not maintain continuous coverage penalizes consumers and puts care out of reach for millions. Further, Congress very intentionally crafted the ACA to prevent insurance companies from charging people more when they are too sick to work from a pre?existing condition or experiencing a hardship like job loss.23 The proposed continuous coverage requirement would therefore run counter to the Congressional intent in enacting the ACA and its protections for consumers? providing more affordable, accessible coverage for all Americans regardless of health condition. For this reason, you should withdraw the continuous coverage proposals proposed in the rule for comment and commit to enforcement of current law. Levels of coverage (actuarial value) 56.140): The proposed rule will increase out of pocket costs for consumers. Current law requires health plans sold in the individual and small group markets to meet minimum standards for the actuarial value ?the percentage of medical costs the plan must cover for an average enrollee population. The law also allows for a de minimis deviation from the required AV. The proposed rule would increase the allowable 21 ?Ensuring that no one falls through the cracks by combining guarantee-issue coverage (with no pro-existing condition exclusions) with an enforceable individual mandate: For guarantee-issue to work, it is necessary for everyone to be brought into the system and participate in obtaining coverage. Achieving this objective will require speci?c attention to the mechanisms for making the mandate enforceable and will require coordinated action at multiple levels of government." (In a Supplemental Letter to Sen. Hatch] Karen [gnagni, Hearing of the Committee on Health, Education, Labor, and Pensions, S. Hrg. 111-960 (Mar. 24, 2009) 22 Department of Health and Human Services, Assistant Secretary of Planning and Evaluation, Health Insurance Coverage for Americans with Pro-Existing Condiments: The Impact ofrhe A?ordoble Care Act (Jan. 5, 201?) 23 ?We want to create a system with consumer protections so that insurance companies can?t drop people for preexisting conditions; can?t put a limit on their coverage so that when they get sick they lose their insurance; can?t discriminate against women, whom they usually charge more for premium costs for their insurance policies than they charge men; can?t discriminate based on geography or disability.? Senator Brown 31 1830 Nov. 20 2009 available at: l-ZUpdf 6 2017--002088 negative deviation by 2 percent. own analysis notes the negative impact of this change on consumers: ..the impact of this proposed change would be to generate a transfer from consumers to insurers. The proposed change in AV could reduce the value of coverage for consumers, which could lead to more consumers facing increases in out-of-pocket expenses, thus increasing their exposure to ?nancial risks associated with high medical costs.?24 We are opposed to any policy that results in higher health costs for consumers and believe that this proposal runs counter to Congressional intent to provide more affordable coverage. You should withdraw this proposed policy in the ?nal rule. Initial and annual open enrollment periods The proposed rule seeks to shorten the open enrollment period. The regulation stipulates, ?We would intend to conduct extensive outreach to ensure that all consumers are aware of this changes and have the opportunity to enroll in coverage within this shorter time frame.?25 However, the Administration?s record on the issue shows otherwise.26 We encourage the Administration to rethink this policy and allow the market to mature further, rather than hastily rushing to shorten the open enrollment period. Network adequacy The proposed rule limits access to care by weakening the essential community provider network adequacy requirements. The ACA requires health plans to include in-network ECPs that serve ?predominantly low-income, medically- underserved individuals.?2l ECPs include vital and reliable sources of care, like community health centers, public hospitals, family planning clinics, safety-net hospitals (including children?s hospitals), Ryan-White HIWAIDS providers, Indian Health Services Centers, and community mental health centers. These providers are an important safety net for communities with severely limited access to the health care they need, including specialized treatment for low-income individuals and those in rural communities. ECPs provide services speci?cally designed to address the health needs of low-income communities. For women, particularly low-income women and women of color, clinic-based providers, family planning clinics and health centers are a critical source of reproductive healthcare.23 We oppose the proposed change to this provision, as it will result in less access to the safety?net for those individuals who are low. income or are medically underserved by allowing insurance companies to provide less access. Finally, we are gravely concerned with the rushed timeline and limited stakeholder engagement of this regulation, coupled with the Republican congressional efforts to repeal the ACA. In order to help us understand the full implications and impact on our constituents, we have included additional questions for HHS to provide answers in Appendix A. 2" act-market-stahilization 25 Id. at note 2?5 White House stops ads, outreach for last days of 201? ACA enrollment, storv.html?utm term=.7ef5e5e036c6 27 PPACA 1311 more); 45 CR 156.235 28h womens-heaith? olic - 7 2017--002089 The ACA was designed to help working families and empower patients to control their own health care. We, the undersigned, strongly support the ACA and urge the Administratioxi to protect consumer interests, protections, and affordability while also working to stabilize the market. Sincerely, ?Ra ?l Patty MUM Frank Pallone, Jr. Ranking Member Ranking Member Senate HELP House Energy and Commerce Committee Committee sewing @574 Ron Wyden Richard Neal Ranking Member Ranking Member Senate Finance House Ways and Means Committee Committee Cc: Seema Verma, Centers for Medicare and Medicaid Services Administrator 2017--002090 Appendix-A Enrofimem Will the CMS track and regulate denials and delay of coverage due to prior nonpayment with the same issuer? If so, how? Why did CMS decide to require pre-enrollment veri?cation for 100% of new SEP applications instead of moving ahead with the pilot as proposed in the 2018 Notice of Bene?t and Payment Parameters? When CMS began requiring documentation for SEP enrollment in 2016, younger consumers age 13 to 24 were 18% less likely to complete the veri?cation process compared to older consumers aged 55 to 64. Comments on that policy change questioned whether pre-enrollment veri?cation would have a net adverse impact on the risk pool, leading to the pilot study with 50% of new applications. Many stakeholders have suggested that promoting greater enrollment through SEPs by those eligible?especially younger consumers?would better address concerns about the risk pooL During Open Enrollment for plan year 2017, the Trump Administration opted to cancel contracts for outreach activities. The proposed rule says that ?extensive outreach? would be needed to cope with a shorter enrollment period. How would Open Enrollment outreach efforts for plan year 2018 increase or change from prior years? Newark Adeq Will changes to network adequacy protections also roll back improved standards in provider directory transparency and accuracy? Which states are considered able and willing to assess network adequacy to ensure reasonable access to providers? In states that cannot Or will not oversee network adequacy for Marketplace plans, how will CMS ensure that network adequacy standards are met? The Proposed Rule states that issuers in such states will be deemed compliant if they are accredited by an HHS- recognized entity. However, some accrediting bodies do not share, much less have the capacity to enforce, their network adequacy standards. Will the Center for Consumer Information and Insurance Oversight (CCIIO) continue to monitor compliance with remaining network adequacy standards at the same level for quali?ed health plans through complaint tracking? Capacity CCIIO has substantial responsibility for plan certi?cation, rate review, and issuer oversight. However, it has been impacted by the hiring freeze; current vacancies include directors for special initiatives and pricing, issuer compliance and monitoring, state support functions, and business operations. Will CCIIO receive a reprieve from the freeze as it works on an expedited schedule? Will any changes need to be made or additional costs incurred through the agreement with the plan certi?cation contractor? 2017--002091 From: Sent: To: Cc: Subject: Attachments: Whitley, Edward 11 Mewr 2017 19:09:57 +0000 McGuffee, Tyler Ann Morse, Sara Emailing: Letter to HHS Tom Price on 170509 HHS Tom Price on Per Sara; this is for the tracker. Thanks, Edward 2017--002092 ANN M. LANE KUSTEP. null ll-_l Hi I. lien-i -u -n LINNUN ?tn-m WAMIWIHIJN, 20515 29-02 "-791 Hun-mi .2: - .13: 52D5 tuMMlTil-F cm AHAIRS A, new MI mm 13:4?: ?Wt; V-t 3.1131 IL9 IHI AI a 1] ll 5 "Its tatrg NAniv-Amill . Pr . 5 on ithIuEl? of ?420,353 Sum iamnru uni lul' innit". [Mk-Hr"; hl I [Hl?f?t UH In 'ulct null HI Am -I 33 ?All. Sud? r_ Sun? 202 mm May 2017 imam? The Honorable Tom Price Secretary Department of Health and Human Services 200 Independence Avenue, SW. Washington, D.C. 20201 Dear Secretary Price, You have chosen an Incredible time of year to travel to New Hampshire. Spring is in full bloom and the scenery in the Granite State cannot be matched. I hope you enjoy your visit. However, I also hope that you'll take the time to listen to the concerns of Granite Staters, as have, about the impact of legislation to repeal the Affordable Care Act (ACA). The ACA has its challenges, and I?m the first to acknowledge that we need bipartisan solutions to improve access to care for all Americans. But, repealing the ACA without regard for the consequences is not the answer. The ongoing debate about the future of healthcare in our country has left me deeply concerned that the Trump Administration does not appreciate the need to maintain a system that provides for the well-being of all Americans. The American Health Care Act (AHEAD, which was jammed through the House along party lines last week, would leapardize access to healthcare for thousands of Granite Staters and millions of Americans, including seven million veterans. It would allow those with ore-existing conditions to be priced out of care. It would allow women to be charged more based on their gender. It includes an ?age tau? allowing Americans fifty years and up to be charged more, and it raids the Medicare Trust Fund. As I've traveled around New Hampshire's rural communities, I've heard from hospital administrators concerned that they may need to close their doors if the Affordable Care Act is repealed, hurting those in already underserved areas. As I?m sure you are aware, the Granite State, along with much of the country, Is facing a heroin and opioid crisis. in 2015, New Hampshire experienced the second most overdose deaths per capita in the country. Just this week, a report showed the economic impact of substance misuse, both alcohol and drug, is in the billions of dollars for our state, adding a ?nancial component to a crisis with an already devastating human toll. As we've worked to address this crisis, Medicaid expansion offered through the ACA has helped thousands of Granite Staters seeking recovery services get the treatment and care they need. Now on top of the serious threat that the AHCA poses to recovery and treatment services, it?s been reported that the Administration is considering cutting the Of?ce of National Drug Control Policy (ON DCP) by 94 2017--002093 percent. As you can imagine, have grave concerns about the seriousoass of the Administration's efforts to address the opioid epidemic. As you are in New Hampshire, and as a representative of this Administration, I hope you?ll consider the following questions: 1. The House-passed bill makes it harder for those with preexisting conditions to get coverage. What is your plan to ensure quality and affordable coverage for the nearly 1 in 4 Granite Staters who have a preexisting condition? 2. Rural hospitals in New Hampshire have told me during roundtable meetings that the Republican health care bill could force their facilities in New Hampshire and around the country to close. Going forward, how do you propose to protect access to care in rural communities? 3. Are you and the Administration aware of the scope of the opioid crisis in New Hampshire and the role of Medicaid expansion in improving access to treatment for Granite Staters? Given the Republican bill?s provision ending Medicaid expansion, what is your policy to protect access to treatment for those suffering from substance use disorder? 4. The Repubiican health care bill allows insurers to charge premiums that are five times as much for older Americans. What is your plan to promote affordable coverage for Americans 50 and over? These are only a few of the many questions we in the Granite State have about the American Health Care Act. I hope y0u'll take the time to address these concerns during your visit and consider the negative impact an ill-conceived and misguided piece of legislation would have on people in New Hampshire and Americans across the country. Sincerely, 43w?. Congresswoman Ann McLane Kus 2017--002094 From: Arbes, Sarah HSIASL) Sent: 11 Apr 2017r 20:15:54 +0000 To: libil??} lMeyer, Katie;Reiser, Martin;Edattel, Paul;Murry, Emily Cc: Palmer, Ashley Subject: FW: HHS 'currently deciding' whether to fund Dbamacare subsidy FYI Below is the full statement that went to press on this issue. Please let me or Ashley know if you have questions. Regarding the recent New York Times report about the administration?s position on cost sharing subsidies, please include the following statement in your reporting: ?The New York Times report is inaccurate. The administration is currently deciding its position on this matter. We have not been contacted by Democrats to help save Obamacare, perhaps because they consider Obamacare to be a losing cause. Democrats need to help solve this failed Obamacare plan. The report was in reference to the current status of the lawsuit and is not an indication of what will happen in the future. No decisions have been made about how the administration will proceed.? Alleigh Marre, HHS National Spokesperson Thank you. From: POLITICO Pro Health Care Whiteboard Sent: Tuesday, April 11, 2017 3:33 PM To: Arbes, Sarah Subject: HHS 'currently deciding? whether to fund Obamacare subsidy By Dan Diamond 04f11f2017 03:23 PM EDT The Trump administration says it?s still considering whether to pay disputed subsidies to health insurance companies through the Affordable Care Act, rebuf?n a New York Times report that I-II-IS would continue to do so. "The New York Times report is inaccurate," HHS spokeswoman Alleigh Marr? said in a statement. ?The administration is currently deciding its position on this matter.? The cost-sharing subsidies, worth about $7 billion per year to insurers on Obamacare?s exchanges, have been the subject of a long-running lawsuit ?led by House Republicans, who argue the Obama administration illegally funded the payments without a congressional appropriation. A federal judge agreed with House Republicans, but the Obama administration appealed the ruling, essentially pausing the lawsuit. 2017--002095 However, the Trump administration could drop the appeal at any time, eliminating the subsidies a decision that Democrats and health policy experts would unravel the ACA's insurance markets. While the New York Times reported on Monday that HHS was ?willing? to continue those payments which could be interpreted as a signal to keep insurers in the market Marr? said ?no decisions have been made about how the administration will proceed." To View online: fund-obamacare-subsidv-0862l 9 Was this Pro content helpful? Tell us what you think in one click, uh lb 0 Yes, veg Somewhat Neutral Not really Not at all You received this POLITICO Pro content because your customized settings include: Health Care: all tags. To change your alert settings, please go to This email was sent by: LLC 1000 Wilson Blvd. Arlington. VA, 22209, USA 2017--002096 From: Arbes, Sarah HSIASL) Sent: 11 Apr 2017r 20:17:21 +0000 To: Raab, Scott {McConnell);Popp, Monica (Cornyn};Seidman, Lindsey (HELP Committeel;Wroe, Elizabeth (HELP Committeelday Khosla Jennifer (Finance) Cc: Palmer, Ashley Subject: FW: HHS 'currently deciding' whether to fund Obamacare subsidy FYI Below is the full statement that went to press on this issue. Please let me or Ashley know if you have questions. Regarding the recent New York Times report about the administration?s position on cost sharing subsidies, please include the following statement in your reporting: ?The New York Times report is inaccurate. The administration is currently deciding its position on this matter. We have not been contacted by Democrats to help save Obamacare, perhaps because they consider Obamacare to be a losing cause. Democrats need to help solve this failed Obamacare plan. The report was in reference to the current status of the lawsuit and is not an indication of what will happen in the future. No decisions have been made about how the administration will proceed.? Alleigh Marr?, National Spokesperson Thank you. From: POLITICO Pro Health Care Whiteboard Sent: Tuesday, April 11, 2017 3:33 PM To: Arbes, Sarah (HHSIASL) Subject: HHS ?currently deciding? whether to fund Obamacare subsidy By Dan Diamond 04!] 03:23 PM EDT The Trump administration says it?s still considering whether to pay disputed subsidies to health insurance companies through the Affordable Care Act, rebuf?n a New York Times report that I-II-IS would continue to do so. ?The New York Times report is inaccurate," HHS spokeswoman Alleigh Marr? said in a statement. ?The administration is currently deciding its position on this matter.? The cost?sharing subsidies, worth about $7 billion per year to insurers on Obamacare?s exchanges, have been the subject of a long-running lawsuit filed by House Republicans, who argue the Obama administration illegally funded the payments without a congressional appropriation. A federal judge agreed with House Republicans, but the Obama administration appealed the ruling, essentially pausing the lawsuit. 2017--002097 However, the Trump administration could drop the appeal at any time, eliminating the subsidies a decision that Democrats and health policy experts would unravel the ACA's insurance markets. While the New York Times reported on Monday that HHS was ?willing? to continue those payments which could be interpreted as a signal to keep insurers in the market Marr? said ?no decisions have been made about how the administration will proceed." To View online: fund-obamacare-subsidv-0862l 9 Was this Pro content helpful? Tell us what you think in one click, uh lb 0 Yes, veg Somewhat Neutral Not really Not at all You received this POLITICO Pro content because your customized settings include: Health Care: all tags. To change your alert settings, please go to This email was sent by: LLC 1000 Wilson Blvd. Arlington. VA, 22209, USA 2017--002098 From: Clark, Barbara Sent: 11 Apr 2017 21:47:22 +0000 To: Hayes, Sean Subject: FW: Letter to Secretary Price Attachments: 031417 Letter Price AHCA Statements.pdf (W5) From: Gold?nch, Colin (HELP Committee) [mailto Sent: Tuesday, March 14, 201? 12:58 PM To: Clark, Barbara (HHSIASL) Cc: Letter, Elizabeth Committee); Bath, Nick (HELP Committee) Subject: Letter to SECretary Price Hi Barbara, Please find attached a letter from Senator Murray for Secretaryr Price. Let me know if you have any questions. Thanks! Colin 2017--002099 PATTY MURRAY WASHINGTON APPROPRIATIONS BUDGET HEALTH, EDUCATION. LABOR. ?mttd ,%tatrs ,?etnatt WASHINGTON, DC 20510-4704 March 14, 2017 The Honorable Thomas E. Price, MD. Secretary U.S. Department of Health and Human Services 200 Independence Avenue, SW. Washington, DC. 20201 Dear Secretary Price: I write with concerns regarding your comments on coverage and cost estimates under the Republicans? Affordable Care Act (ACA) repeal bill, the American Health Care Act (AHCA). Your claim that ?no one will be worse off financially? under the Republican plan suggests a fundamental misunderstanding of the US. healtheare system and the needs of those who rely on the ACA reforms for coverage?and it echoes promises made by President Trump and Republicans that simply do not square with rigorous, independent, publieally available analysis. I would like to understand what led to your ?nancial estimates and to your rejection of reputable, independent sources of information about our health care system and this clearly harmful legislation. You stated in an interview on Sunday, ?rmly believe that nobody will be worse off ?nancially in the process that we?re going through, understanding that they?ll have choices that they can select the kind of coverage that they want for themselves and for their family, not [that] the government forces them to buy.?1 Yesterday, however, the non-partisan, independent Congressional Budget Of?ce (CBO) released its cost estimate for the AHCA. CEO found that ?in 2018, 14 million more people would be uninsured under the than under current law.?2 The law continues to add millions to the uninsured rolls: by 2026, a total of 24 million more than under current law. Additionally, CBO determined that the AHCA would signi?cantly increase premiums in the near term and impose disproportionate costs on seniors in later years as a result of permitting age-rating. In other words, a nonpartisan, independent analysis directly contradicted your statements and the President?s promise to provide ?insurance for everybody.? You have previously praised CBO Director Dr. Keith Hall, highlighting his non-partisan work and the role of the agency in helping Congress ?enact policies that support a healthy and growing economy.?3 Yet, immediately following the cost estimate release, you appeared outside the White House, noting that you ?disagree strenuously? with analysis stating, ?We 1 3 . go visite sfdefaullf? lesf lith-c on gross-20 1 7-201 .pdf 3 1E4 RUSSELL SENATE BUILDING 2930 WETMORE AVENUE 2938 FEDERAL 10 NORTH POST 950 AVENUE DC 213510?4?14 SUITE 903 5315 2ND AVENUE 600 SUITE 650 [202i 224?2621 EVERETT. WA 93201 411 07 WA sand?1003 sPo KANE, WA 99201?0?12 WA 93402?4450 [4253 253?6515 553?5545 (509] 624?9515 [253i TOLL FREE: {366} 481-9186 THE 402 EAST YAKIMA AVENUE 1323 ROW SUITE 420 WA 98661?3355 e'me'li ?npi'h?lum?v'smaWJU?WMH? YAKIMA. WA 98901-2760 case: PFIINTED oN neevctan PAPER 20176392393462 believe that our plan will cover more individuals at a lower cost and give them the choices that they want for the coverage that they want for themselves and their family, not that the government forces them to buy.?4 You criticized CBO for only looking at ?a portion of our plan but not the entire plan.? You went on to say, ?In fact, the entire plan includes the regulatory apparatus that we?ve got the ability to use at Health and Human Services They also ignored completely the other legislative activities that we?ll be putting into place that will make certain that we have an insurance market that actually works.? CBO was tasked, however, with providing ?an estimate of the budgetary effects of the American Health Care Act,? which was based on the budget reconciliation recommendations approved by the House Committees on Ways and Means and Energy and Commerce last week.? To my knowledge, CBO was not provided with additional regulatory or legislative text that would have allowed them to score the ?entire plan.? You have also rejected coverage and cost predictions by the Brookings Institution5 and the Kaiser Family Foundation?, arguing that such analyses were ?looking at it in a silo? and that the AHCA will ?have more individuals covered.? It was also revealed yesterday that the White House?s own internal analysis of the Republican plan found even steeper coverage losses than those projected by C807 The White House predicted that 26 million people would lose coverage over the next decade. This would include 17 million Medicaid enrollees, six million enrolled in the individual market, and three million enrolled in employer?based plans. Given these coverage and cost estimates from the White House, CBC), and various health care experts, your confidence in the success of Trumpcare to increase coverage and lower costs calls into question your commitment to the HHS mission: to ?enhance and protect the health and well- being of all Americans.? In your capacity as the head of the federal health care system, you have an obligation to provide the public with accurate information to make appropriate and accurate health care decisions. I am concerned that your efforts to spread misinformation violate this duty. To get a better understanding of the basis of your assertions, please provide the following answers and documents no later than March 3 I 2017: 1. On what document or information do you base the claim that ?nobody will be worse off ?nancially? under the Please provide all documents and communications that reference or refer to any cost estimates to support your conclusion. 4 5 The Brookings Institution estimated a reduction of 15 million insured under the GOP ACA repeal bill. gop-health-care-planf ?5 The Kaiser Family Foundation found that ?people who are older, lower?income, or live in high?premium areas (like Alaska and Arizona} receive larger tax credits under the ACA than they would under the American Health Care Act replacement.? interactive-map! 7 2017--002101 2. On what document or information do you rely to contradict the estimates that 14 million more people will be uninsured by 2018 and 24 million more people will be uninsured by 2026?? Please provide all documents and communications that reference or refer to any coverage estimates to support your conclusion. 3. On what document or information should CBO have relied to capture the coverage and cost effects of your ?entire plan?? Please provide all documents and communications that reference or refer to any coverage and cost estimates that CBO could have used to conduct a full analysis. 4. On what document or information do you rely to contradict the White House?s estimates that 26 million more people will be uninsured by 2026'? Please provide all documents and communications that reference or refer to any coverage estimates to support your conclusion. 5. On what document or information do you rely to disprove the Brookings Institution?s ?nding that the AHCA will result in at least 15 million people losing coverage? Please provide all documents and communications that reference or refer to any coverage estimates to support your conclusion. 6. On what document or information do you rely to disprove the Kaiser Family Foundation?s finding that the AHCA will result in smaller tax credits for those in rural areas, those with low incomes, and older Americans? Please provide all documents and communications that reference or refer to any cost estimates to support your conclusion. I appreciate your prompt reaponse to my request. If you have any questions, please contact Colin Gold?nch (202?224-7675) or Elizabeth Letter (202-224-6403) with Senator Murray?s HELP Committee staff. Sincerely, as, SenatorPatty Murray Ranking Member US. Senate Committee on Health, Education, Labor, and Pensions 2017--002102 From: Clark, Barbara (HHSIASL) Sent: 12 Apr 2017 19:44:48 +0000 To: Hayes, Sean Subject: FW: Sen. Murray Oversight Letter to Secretary Price Attachments: 031417 Letter Price AHCA From: Clark, Barbara (HHSIASL) Sent: Tuesday, March 14, 2017 220 PM To: LettersToSecretary (HHSIIDS) Cc: Moore, Hannah McGuffee, Tyler Ann (HHSJIOS) lrbita} Aramanda, Alec (OSXASL) Subject: Sen. Murray Oversight Letter to Secretary Price Please log in the attached oversight letter to the Secretary from Sen. Murray. Thank you. Barbara Barbara Pisara Clark Acting Assistant Secretary for Legislation U.S. Department of Health and Human Services {202) 690-7627 l(direct} (W5) 2017--002103 PATTY MURRAY WASHINGTON APPROPRIATIONS BUDGET HEALTH, EDUCATION. LABOR. ?mttd ,%tatrs ,?etnatt WASHINGTON, DC 20510-4704 March 14, 2017 The Honorable Thomas E. Price, MD. Secretary U.S. Department of Health and Human Services 200 Independence Avenue, SW. Washington, DC. 20201 Dear Secretary Price: I write with concerns regarding your comments on coverage and cost estimates under the Republicans? Affordable Care Act (ACA) repeal bill, the American Health Care Act (AHCA). Your claim that ?no one will be worse off financially? under the Republican plan suggests a fundamental misunderstanding of the US. healtheare system and the needs of those who rely on the ACA reforms for coverage?and it echoes promises made by President Trump and Republicans that simply do not square with rigorous, independent, publieally available analysis. I would like to understand what led to your ?nancial estimates and to your rejection of reputable, independent sources of information about our health care system and this clearly harmful legislation. You stated in an interview on Sunday, ?rmly believe that nobody will be worse off ?nancially in the process that we?re going through, understanding that they?ll have choices that they can select the kind of coverage that they want for themselves and for their family, not [that] the government forces them to buy.?1 Yesterday, however, the non-partisan, independent Congressional Budget Of?ce (CBO) released its cost estimate for the AHCA. CEO found that ?in 2018, 14 million more people would be uninsured under the than under current law.?2 The law continues to add millions to the uninsured rolls: by 2026, a total of 24 million more than under current law. Additionally, CBO determined that the AHCA would signi?cantly increase premiums in the near term and impose disproportionate costs on seniors in later years as a result of permitting age-rating. In other words, a nonpartisan, independent analysis directly contradicted your statements and the President?s promise to provide ?insurance for everybody.? You have previously praised CBO Director Dr. Keith Hall, highlighting his non-partisan work and the role of the agency in helping Congress ?enact policies that support a healthy and growing economy.?3 Yet, immediately following the cost estimate release, you appeared outside the White House, noting that you ?disagree strenuously? with analysis stating, ?We 1 3 . go visite sfdefaullf? lesf lith-c on gross-20 1 7-201 .pdf 3 1E4 RUSSELL SENATE BUILDING 2930 WETMORE AVENUE 2938 FEDERAL 10 NORTH POST 950 AVENUE DC 213510?4?14 SUITE 903 5315 2ND AVENUE 600 SUITE 650 [202i 224?2621 EVERETT. WA 93201 411 07 WA sand?1003 sPo KANE, WA 99201?0?12 WA 93402?4450 [4253 253?6515 553?5545 (509] 624?9515 [253i TOLL FREE: {366} 481-9186 THE 402 EAST YAKIMA AVENUE 1323 ROW SUITE 420 WA 98661?3355 e'me'li ?npi'h?lum?v'smaWJU?WMH? YAKIMA. WA 98901-2760 case: PFIINTED oN neevctan PAPER 20176392394462 believe that our plan will cover more individuals at a lower cost and give them the choices that they want for the coverage that they want for themselves and their family, not that the government forces them to buy.?4 You criticized CBO for only looking at ?a portion of our plan but not the entire plan.? You went on to say, ?In fact, the entire plan includes the regulatory apparatus that we?ve got the ability to use at Health and Human Services They also ignored completely the other legislative activities that we?ll be putting into place that will make certain that we have an insurance market that actually works.? CBO was tasked, however, with providing ?an estimate of the budgetary effects of the American Health Care Act,? which was based on the budget reconciliation recommendations approved by the House Committees on Ways and Means and Energy and Commerce last week.? To my knowledge, CBO was not provided with additional regulatory or legislative text that would have allowed them to score the ?entire plan.? You have also rejected coverage and cost predictions by the Brookings Institution5 and the Kaiser Family Foundation?, arguing that such analyses were ?looking at it in a silo? and that the AHCA will ?have more individuals covered.? It was also revealed yesterday that the White House?s own internal analysis of the Republican plan found even steeper coverage losses than those projected by C807 The White House predicted that 26 million people would lose coverage over the next decade. This would include 17 million Medicaid enrollees, six million enrolled in the individual market, and three million enrolled in employer?based plans. Given these coverage and cost estimates from the White House, CBC), and various health care experts, your confidence in the success of Trumpcare to increase coverage and lower costs calls into question your commitment to the HHS mission: to ?enhance and protect the health and well- being of all Americans.? In your capacity as the head of the federal health care system, you have an obligation to provide the public with accurate information to make appropriate and accurate health care decisions. I am concerned that your efforts to spread misinformation violate this duty. To get a better understanding of the basis of your assertions, please provide the following answers and documents no later than March 3 I 2017: 1. On what document or information do you base the claim that ?nobody will be worse off ?nancially? under the Please provide all documents and communications that reference or refer to any cost estimates to support your conclusion. 4 5 The Brookings Institution estimated a reduction of 15 million insured under the GOP ACA repeal bill. gop-health-care-planf ?5 The Kaiser Family Foundation found that ?people who are older, lower?income, or live in high?premium areas (like Alaska and Arizona} receive larger tax credits under the ACA than they would under the American Health Care Act replacement.? interactive-map! 7 2017--002105 2. On what document or information do you rely to contradict the estimates that 14 million more people will be uninsured by 2018 and 24 million more people will be uninsured by 2026?? Please provide all documents and communications that reference or refer to any coverage estimates to support your conclusion. 3. On what document or information should CBO have relied to capture the coverage and cost effects of your ?entire plan?? Please provide all documents and communications that reference or refer to any coverage and cost estimates that CBO could have used to conduct a full analysis. 4. On what document or information do you rely to contradict the White House?s estimates that 26 million more people will be uninsured by 2026'? Please provide all documents and communications that reference or refer to any coverage estimates to support your conclusion. 5. On what document or information do you rely to disprove the Brookings Institution?s ?nding that the AHCA will result in at least 15 million people losing coverage? Please provide all documents and communications that reference or refer to any coverage estimates to support your conclusion. 6. On what document or information do you rely to disprove the Kaiser Family Foundation?s finding that the AHCA will result in smaller tax credits for those in rural areas, those with low incomes, and older Americans? Please provide all documents and communications that reference or refer to any cost estimates to support your conclusion. I appreciate your prompt reaponse to my request. If you have any questions, please contact Colin Gold?nch (202?224-7675) or Elizabeth Letter (202-224-6403) with Senator Murray?s HELP Committee staff. Sincerely, as, SenatorPatty Murray Ranking Member US. Senate Committee on Health, Education, Labor, and Pensions 2017--002106 From: Clark, Barbara Sent: 9 Mar 201? 18:37:44? +0000 To: Clark, Barbara (HHSIASL) Cc: Ara manda, Alec Bcc: {bil?i Subject: ICYMI: HHS Secretary Tom Price Outlines Repeal and Replace Phases Hello, Earlier this week, US. Department of Health and Human Services (HHS) Secretary Tom Price outlined the three phases to the repeal and reform effort. The Secretary?s next steps can be found below, and the announcement is available at: If you have any questions, please contact Alec Aramanda. - at]! r. News Release U.S. Department of Health and Human 202?690?6343 Services 2017--002107 Twitter @HHSMedia FOR IMMEDIATE RELEASE Tuesday, March 7, 2017 The American Health Care Act Is Critical First Step Toward Protecting Patients Washington, American Care Act, the healthcare reconciliation legislation recently released in the US. House of Representatives, is a critical ?rst step toward implementing patient-centered solutions and rescuing Americans from the failures of the status quo. As Health and Human Services Secretary Tom Price, M.D., has outlined, there are three phases to the repeal and reform effort, including both legislative and administrative actions. With Congress considering reconciliation legislation, the Department of Health and Human Services (HHS) continues its work on the next two steps: taking administrative actions that will create a healthier insurance market and alleviate the burden the current healthcare law imposed on Americans, and supporting work on legislation that will include reforms not permitted under reconciliation, such as purchase of insurance across state lines. Ongoing Administrative Actions To relieve the burden that the current healthcare law has placed on millions of Americans, HHS has already begun a number of key administrative actions, including: Reforms to stabilize insurance markets and increase coverage choices for patients beginning as early as 2018; - Loosening restrictions on the ?nancial structure of insurance plans offered on the exchanges to allow patients access to lower premium options; and I Improving choices for patients and putting downward pressure on prices by curbing abuses of the enrollment periods and encouraging full-year enrollment. Future administrative actions will help provide more options for patients, give states flexibility on how they spend their Medicaid dollars, and ensure a stable transition to any law Congress passes. nrther Congressional Action In addition to the reconciliation bill, HHS supports legislation to take action on other priorities President Trump has laid out for healthcare, including: I- Increasing competition and choice by promoting the sale of insurance across state lines; Removing even more of the current healthcare law?s regulations on insurance; Reducing out?of?control drug costs; and New legal reforms to cut costs for patients and doctors. America?s healthcare system should be focused on the patient, by promoting quality, accessibility, affordability, innovation, and empowerment. Secretary Price looks forward 2017--002108 to working with Congress to ensure that these principles become a reality for all Americans. Like HHS on Facebook, follow HHS on Twitter @HHSgov, and sign up for HHS Email Ugdates Like HHS Secretarv Tom Price, MD. on Facebook and follow HHS Secretaryr Price on Twitter @SecPriceMD If you would rather not receive future communications from US. Department of Health and Human Services (HHS), let us know by clicking here. US. Department of Health and Human Services (HHS), 200 Independence Avenue. SW 6th Floor Room 64T-D1Washington1 DC 20201 United States Barbara Pisaro Clark Acting Assistant Secretary for Legislation US. Department of Health and Human Services 202 590-7527 Ildirect} 2017--002109 From: Barstovv, Kevin (Aging) Sent: 4 Apr 2017 12:55:25 +0000 To: Clark, Barbara (HHSIASL) Subject: Letter to Secretary Price - ACA Attachments: Letter to HHS - ACA (4.4.17).pdf Barbara: I hope all is well with you. Please find attached a letter from Sens. Casey, Carper, Murray, and Wyden and 17 other Senators addressed to Secretary Price. As the letter states, we expect to receive the requested document no later than Thursday, April 6. If there are any questions about this request, I can be reached albll?l Thank you. Kevin Kevin S. Barstow Chief Counsel for Ranking Member Robert P. Casey, Jr. Special Cornrnitteo on Aging United States Senate {bli?l 2017--002110 sauna ?tting ?natr WASHINGTON, DC 20510 April 4, 2017 The Honorable Thomas E. Price, MD. Secretary US Department of Health and Human Services Washington, DC 20201 Dear Secretary Price: Over the last week, President Trump said that he wants to work with Democrats to improve access to high-quality, affordable health care.l House Speaker Ryan acknowledged that the Affordable Care Act (ACA) is ?the law of the land?: We remain concerned, however, that you will not take the necessary actions to strengthen the individual health insurance market in order to provide families with affordable, comprehensive coverage. In fact, we have reason to believe that you may take actions to undermine our health care system, harming the vital health care services needed for children to grow and learn, limiting the ability of people with disabilities to receive care in their homes and communities, and making health care unaffordable for older and hard-working Americans. We intend to use every tool at our disposal to hold you and the Administration accountable for actions that would have serious repercussions on the health and welfare ofall Americans. According to reports, the Administration presented a letter to a privileged group of Congressional Republicans on March 23 outlining a plan to dismantle and repeal the Affordable Care Act (ACA) through regulatory action. As such actions could negatively affect tens of millions of Americans, we ask that you share this letter with all Members of Congress no later than April 6, 2017. The House of Representative?s destructive American Health Care Act never received a vote in the House of Representatives because it was wildly unpopular. One survey found that only 17 percent of Americans supported the bill.3 In fact, more Americans want the ACA to be improved than fully repealed.4 Despite this, the Trump Administration continues to take actions that would undermine coverage for millions of Americans, including: Tramp Hosts Senator's in Bipartisan Outreach Since Health Bill atlure, The Wall Street Journal (March 28, 2017) (online at 2 In Major Defeatfor Thump, Push to Repeal Health Law Fails, The New York Times (March 24, 20 7) (online at ?#03 1 3 US. Voters Oppose GOP Health Ptan Quinnipiac University Poll (March 23, 2017) (available at 4 Supportfor 2010 Health Care Law Reaches New High, Pew Research Center (February 23, 201?) (online at l7t02t23 tsupport-for-20 2017--002111 0 Executive Order 13765, issued on January 20, directing the Secretary of Health and Human Services and other Federal departments and agencies to repeal and undermine the ACA ?to the maximum extent permitted by law?; I The Department of Health and Human Services halting advertisements and suspending e- mail and social enrollment outreach during the crucial ?nal days of the Open Enrollment for 201?? in January, an action which is now under review by the Department of Health and Human Services? Inspector General; 0 The Internal Revenue Service issuing a decision in February to not enforce provisions of the ACA, and the Centers for Medicare Medicaid Services issuing a proposed regulation to undermine insurance coverage for Americans by weakening requirements on health insurance companies; and 0 Even after the public outcry supporting access to affordable health insurance, which resulted in House Speaker Ryan?s declaration that the ACA is ?the law of the land,? Administration of?cials continuing calls to repeal the ACA. For example, on March 27, in West Virginia, Vice President Pence stated the Administration ?will not rest, will not relent? until the ACA is repealed and replaced. Rather than continuing down this path, we request that you heed Democrats? calls to stop working to repeal the ACA and stop taking actions that would undermine our health care system. In order to provide much needed oversight and transparency regarding the Administration?s path forward on the ACA, please provide the document that was presented to Congressional Republicans on March 23, 2017, which outlined ACA regulations the Administration could repeal on its own. We hope you will set aside your plans to unravel these regulations so that we can move forward to improve our health care system, but until you make the commitment, we will continue our efforts to hold you accountable. Given the limited scope of the request, and since there is no reasonable basis to withhold this record, please provide a copy of this letter no later than April 6, 2017. Thank you for your assistance in this matter. Sincerely, Robert mCaseer a Tom Carper 5? United States Senator United States Senat idE mm? Patty was Ron Wyden United States Senator United States Senator 2 2017--002112 Richard J. Durbin United States Senator Sheldon Whitehouse United States Senator Patrick Leahy 5 United States Senator A. . erkley United States Senator Ada; [Tamm aldwin 3 Senator MOM um Tom Udall United States Senator Unit States Senator Edward J. arkey United States Senator Jae ed Un StateW I Christopher Murphy United States Senator Sherrod Brown United States Senator Chris Van Hollen United States Senator Kirsten Gillibrand United States Senator Marg ood assan United States Senator 2017--002113 Meat, Ianne Feinstein A. Booker United States Senator United States Senator Benjamin L. Cardin United States Senator 2017--002114 From: Bath, Nick Committee} Sent: 17 Feb 2017 19:24:22 +0000 To: Boulanger, Jennifer L. Barbara Cc: Jurinka, Elizabeth {Finance);5tein, Beth (HELP Committee);Gartrell, Peter [Finance] Subject: letter to secretaryr price Attachments: 021717 letter.pdf Hello all, please find attached a letter from senators murray and wyden to secretary price. Have a great weekend! Nick Bath Sen. Patt?i.r Murray Senate HELP Committee (bii?i 2017--002115 annual ?rms 0%znatt WASHINGTON. DC 20510 February 2017 The Honorable Thomas E. Price Secretary US. Department of Health Human Services 200 Independence Avenue, SW. Washington, DC. 20201 Dear Secretary Price: We write with great concern regarding the Trump Administration?s decision to eliminate basic information and resources on Healthcare. gov, the website that millions of Americans use to understand, shop for, and purchase health insurance coverage. The Department?s decision to strip the website of basic information about healthcare coverage will leave many Americans in the dark as they try to make informed healthcare decisions. Furthermore, it raises the specter of the Administration intentionally causing the Affordable Care Act (ACA) to fail while the law remains on the books. When paired with the Administration?s termination late last month of advertising and outreach during the ?nal, most important week of the open enrollment period, the changes to Healthcare. gov appear aimed at concealing information about affordable coverage options from the American people. While the President during his campaign promised to provide ?insurance for everybody? that is higher quality and lower cost, this latest step is yet another effort to do the opposite. Taken together, these actions are clearly designed to reduce the number of people who sign up for insurance through the ACA, putting unnecessary strain on insurance markets, risking American families? access to health care, and creating Trumpcare by sabotage. Last week, visitors to Healthcaregov noticed that a great deal of information about the ACA had been deleted, including critical consumer protections available under the law.1 Where there had once been easy~to~ understand explanations of health care bene?ts available to consumers, the website now only links to the legislative text of the ACA. Site visitors can no longer see key information about the provisions, such as: - Prohibiting insurers from dropping coverage for individuals with pre-existing conditions; - Allowing young adults - until age 26 to stay on their parents? health plans; I Requiring insurers to provide preventive care such as cancer screenings and birth control at no cost to consumers; I Banning insurance companies from placing monetary caps on lifetime health care coverage; and 0 Ensuring that health insurers cover emergency room care; Dan Mangcn, ?Trump administration scrubs federal health-care website of positive words about Obamacare,? CNBC, February 10, 2017, 1/02.! 1 (iftrum Paige Win?eld Cunningham, ?Trump administration strips down Obamacare website,? Washington Examiner, February 9, 2017, shingtonexaminer. aeare-websiter?articlefZ? 144 4 1 2017--002116 In addition, the Trump Administration deleted information for consumers about choosing a doctor; insurance bene?ts information; reviews of insurance premium increases, and plan cancellationfappeals rights.2 Many references or mentions of the Affordable Care Act also have been changed, referencing ?current law? or ?healthcare law.? In your testimony before the Committees on Finance and Health Education Labor and Pensions (HELP), you repeatedly stated your commitment to health care accessibility. Yet, the deletions from Healthcare. gov noted above will make it harder for Americans to access basic healthcare information from a trusted clearinghouse. Furthermore, by making it more dif?cult for consumers to learn about coverage opportunities through a One-stop website, the Trump Administration will put greater demand on call centers, state insurance assistance staff, and local providers? staff to answer basic questions. It is dif?cult to reconcile your commitment to affordable, accessible coverage with the Department?s decision to remove information about the ACA that helps consumers understand and obtain just that type of coverage. As ranking members of the Finance and HELP Committees we share a strong commitment to ensuring that Americans have access to affordable and effective healthcare, and that the ACA is implemented as Congress intended. Given our concerns that the inferrnation deleted from Healthcaregov could have a detrimental effect on millions of Americans, we request that you provide answers to the following questions: 1. Who made the decision to remove information on coverage options and ACA resources from Healthcaregov? When were you noti?ed of this decision? Please provide a detailed timeline of when the resources previously available on Healthcaregov became inaccessible to public view. 2. Because millions of consumers use this site to inform health care purchasing decisions, any changes to the site should be care?Jlly researched and supported by data. a. What type of data and analytics did HHS use to support making changes the information on Healthcaregov?? b. Did HHS survey or discuss the changes with any patient groups or other stakeholders? c. Did HHS ensure that the changes were compliant with the Americans with Disabilities Act? (1. Please explain how HHS tested the readability of such changes for censumers to ensure they were compliant with federal law. e. Please explain how the potential for lower enrollment in the ACA was evaluated and considered in making changes to Healthcaregov. f. Please provide all enrollment projections that were undertaken to understand the consequences of potential changes to Healthcare. gov g. Please provide all enrollment projections that were undertaken to understand the consequences of cancellation of advertising in connection with open enrollment. 3 Healthcare. gov, ?About the Law,? February 1, 201? (cached on the Internet Archive), 2 2017--002117 In addition to the public-facing components of the Healthcare. gov website, the website?s ?back end? provides critical services to supplement information for enrollees, ensure individuals are properly enrolled, and assist health insurance companies in receiving the information they need. Were any changes made to the ?back end? of the website? If so, please detail these changes and provide a detailed outline of notice provided to insurance companies and consumers about such changes. Individuals in 39 states rely on the Healthcaregov platform to shop for and enroll in health insurance coverage. Did HHS of?cials inform the relevant state government of?cials in those 39 states of the plans to remove information from Healthcaregov? If so, please provide these communications. Eleven states and the District of Columbia operate state~based Marketplaces for their citizens to enroll for coverage. Did HHS of?cials inform the relevant government of?cials in those states of the plans to remove information from Healthcaregov? If so, please provide these communications. To the extent there are (or were) technical problems that led to the removal of information on Healthcare. gov, please provide a technical report on the issue and how it was resolved andr'or when it is expected to be resolved. Please provide answers to the above questions no later than the close of business on Friday, March 3, 2017. In the meantime, if you or your staff have any questions, please contact Beth Stein with the HELP Committee at 202-224-2931 and Peter Gartrell with Senator Wyden at 202- 224-451 5. Thank you for your attention to this matter. Sincerely, Patty Mfrray Ron Wyden United States Senator United States Senator 2017--002118 From: Goldfinch, Colin (HELP Committee) Sent: 14 Mar 2017 16:58:16 +0000 To: Clark, Barbara (HHSIASL) Cc: Letter, Elizabeth (HELP Committee);Bath, Nick (HELP Committee) Subject: Letter to Secretary Price Attachments: 03141? Letter Price AHCA Hi Barba ra, Please find attached a letter from Senator Murray for Secretary Price. Let me know if you have any questions. Thanks! Colin 2017--002119 PATTY MURRAY WASHINGTON APPROPRIATIONS BUDGET HEALTH, EDUCATION. LABOR. ?mttd ,%tatrs ,?etnatt WASHINGTON, DC 20510-4704 March 14, 2017 The Honorable Thomas E. Price, MD. Secretary U.S. Department of Health and Human Services 200 Independence Avenue, SW. Washington, DC. 20201 Dear Secretary Price: I write with concerns regarding your comments on coverage and cost estimates under the Republicans? Affordable Care Act (ACA) repeal bill, the American Health Care Act (AHCA). Your claim that ?no one will be worse off financially? under the Republican plan suggests a fundamental misunderstanding of the US. healtheare system and the needs of those who rely on the ACA reforms for coverage?and it echoes promises made by President Trump and Republicans that simply do not square with rigorous, independent, publieally available analysis. I would like to understand what led to your ?nancial estimates and to your rejection of reputable, independent sources of information about our health care system and this clearly harmful legislation. You stated in an interview on Sunday, ?rmly believe that nobody will be worse off ?nancially in the process that we?re going through, understanding that they?ll have choices that they can select the kind of coverage that they want for themselves and for their family, not [that] the government forces them to buy.?1 Yesterday, however, the non-partisan, independent Congressional Budget Of?ce (CBO) released its cost estimate for the AHCA. CEO found that ?in 2018, 14 million more people would be uninsured under the than under current law.?2 The law continues to add millions to the uninsured rolls: by 2026, a total of 24 million more than under current law. Additionally, CBO determined that the AHCA would signi?cantly increase premiums in the near term and impose disproportionate costs on seniors in later years as a result of permitting age-rating. In other words, a nonpartisan, independent analysis directly contradicted your statements and the President?s promise to provide ?insurance for everybody.? You have previously praised CBO Director Dr. Keith Hall, highlighting his non-partisan work and the role of the agency in helping Congress ?enact policies that support a healthy and growing economy.?3 Yet, immediately following the cost estimate release, you appeared outside the White House, noting that you ?disagree strenuously? with analysis stating, ?We 1 3 . go visite sfdefaullf? lesf lith-c on gross-20 1 7-201 .pdf 3 1E4 RUSSELL SENATE BUILDING 2930 WETMORE AVENUE 2938 FEDERAL 10 NORTH POST 950 AVENUE DC 213510?4?14 SUITE 903 5315 2ND AVENUE 600 SUITE 650 [202i 224?2621 EVERETT. WA 93201 411 07 WA sand?1003 sPo KANE, WA 99201?0?12 WA 93402?4450 [4253 253?6515 553?5545 (509] 624?9515 [253i TOLL FREE: {366} 481-9186 THE 402 EAST YAKIMA AVENUE 1323 ROW SUITE 420 WA 98661?3355 e'me'li ?npi'h?lum?v'smaWJU?WMH? YAKIMA. WA 98901-2760 case: PFIINTED oN neevctan PAPER 20176392323462 believe that our plan will cover more individuals at a lower cost and give them the choices that they want for the coverage that they want for themselves and their family, not that the government forces them to buy.?4 You criticized CBO for only looking at ?a portion of our plan but not the entire plan.? You went on to say, ?In fact, the entire plan includes the regulatory apparatus that we?ve got the ability to use at Health and Human Services They also ignored completely the other legislative activities that we?ll be putting into place that will make certain that we have an insurance market that actually works.? CBO was tasked, however, with providing ?an estimate of the budgetary effects of the American Health Care Act,? which was based on the budget reconciliation recommendations approved by the House Committees on Ways and Means and Energy and Commerce last week.? To my knowledge, CBO was not provided with additional regulatory or legislative text that would have allowed them to score the ?entire plan.? You have also rejected coverage and cost predictions by the Brookings Institution5 and the Kaiser Family Foundation?, arguing that such analyses were ?looking at it in a silo? and that the AHCA will ?have more individuals covered.? It was also revealed yesterday that the White House?s own internal analysis of the Republican plan found even steeper coverage losses than those projected by C807 The White House predicted that 26 million people would lose coverage over the next decade. This would include 17 million Medicaid enrollees, six million enrolled in the individual market, and three million enrolled in employer?based plans. Given these coverage and cost estimates from the White House, CBC), and various health care experts, your confidence in the success of Trumpcare to increase coverage and lower costs calls into question your commitment to the HHS mission: to ?enhance and protect the health and well- being of all Americans.? In your capacity as the head of the federal health care system, you have an obligation to provide the public with accurate information to make appropriate and accurate health care decisions. I am concerned that your efforts to spread misinformation violate this duty. To get a better understanding of the basis of your assertions, please provide the following answers and documents no later than March 3 I 2017: 1. On what document or information do you base the claim that ?nobody will be worse off ?nancially? under the Please provide all documents and communications that reference or refer to any cost estimates to support your conclusion. 4 5 The Brookings Institution estimated a reduction of 15 million insured under the GOP ACA repeal bill. gop-health-care-planf ?5 The Kaiser Family Foundation found that ?people who are older, lower?income, or live in high?premium areas (like Alaska and Arizona} receive larger tax credits under the ACA than they would under the American Health Care Act replacement.? interactive-map! 7 2017--002121 2. On what document or information do you rely to contradict the estimates that 14 million more people will be uninsured by 2018 and 24 million more people will be uninsured by 2026?? Please provide all documents and communications that reference or refer to any coverage estimates to support your conclusion. 3. On what document or information should CBO have relied to capture the coverage and cost effects of your ?entire plan?? Please provide all documents and communications that reference or refer to any coverage and cost estimates that CBO could have used to conduct a full analysis. 4. On what document or information do you rely to contradict the White House?s estimates that 26 million more people will be uninsured by 2026'? Please provide all documents and communications that reference or refer to any coverage estimates to support your conclusion. 5. On what document or information do you rely to disprove the Brookings Institution?s ?nding that the AHCA will result in at least 15 million people losing coverage? Please provide all documents and communications that reference or refer to any coverage estimates to support your conclusion. 6. On what document or information do you rely to disprove the Kaiser Family Foundation?s finding that the AHCA will result in smaller tax credits for those in rural areas, those with low incomes, and older Americans? Please provide all documents and communications that reference or refer to any cost estimates to support your conclusion. I appreciate your prompt reaponse to my request. If you have any questions, please contact Colin Gold?nch (202?224-7675) or Elizabeth Letter (202-224-6403) with Senator Murray?s HELP Committee staff. Sincerely, as, SenatorPatty Murray Ranking Member US. Senate Committee on Health, Education, Labor, and Pensions 2017--002122 Bell, Michael Subject: Meeting with Rep. Walker Location: Start: Wed 3/1/2017?' 1:45 PM End: Wed 3/1/2017 2:15 PM Recurrence: (none) Meeting Status: Accepted Organizer: Twomey, John K. Required Attendees: McGuffee, Tyler Ann Kristin Topic: To discuss thoughts on repealfreplace Staff: Kris Tyler Ann McGuffee Attendees: Chairman Walker Scott Parkinson Executive Director of RSC 2017--002123 Page 05? M145 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--002124 Page 058 M145 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--002125 Page 059 M145 WitthlU DUFSUEHI TD exemption 033(5) 0f the 0f HGT 2017--002126 Bell, Michael Subject: Location: Start: End: Recurrence: Meeting Status: Organizer: Required Attendees: Optional Attendees: Staff: Carla and Demetrios Attendees: Marshall Roe Buschon Babin Ferguson DesJarIais Abraham Gosar Black Wenstrup Carter Dunn Murphy Brugess Topic: Mtg. w! Doctors Cacus Secretary's Large Conference Room Fri 31?17/2017 7:30 AM Fri 8:15 AM (none) Accepted DiBlasio, Carla Kouzoukas, Demetrios Leggitt, Lance Harrison, Jessica Kristin Twomey, John K. Aramandai Alec McGuffee, Tyler Ann Morse, Sara (HHSIASL) The discussion will be about the regulatory efforts that HHS plans to undertake, as well as how the Docs Caucus can be helpful in messaging the ACA replacement. They just want the opportunity to connect with Dr. Price in a less formal setting than some of these Conference meetings. 2017--002127 Confidential Pre?decisional Draft 2017--002128 Confidential Pre?decisional Draft 2017--002129 Confidential Pre?decisional Draft (W5) 2017--002130 Confidential Pre?decisional Draft 2017--002131 Confidential Pre?decisional Draft (W5) 2017--002132 Confidential Pre?decisional Draft (W5) 2017--002133 Confidential Pre?decisional Draft (W5) 2017--002134 Bell, Michael Subject: Location: Start: End: Recurrence: Meeting Status: Organizer: Required Attendees: Mtg. WI Rep Vern Buchanan Wed 4/5/2017 11:30 AM Wed 4/5/2017 12:00 PM (none) Accepted (W3) (OSHOS) Harrison, Jessica Kristin Twomey. John K. Leggitt, Lance Arbes, Sarah Aramanda, Alec (OSXASL) Event Name: Mtg. w/ Rep Vern Buchanan Location: Time: 11:30a Topic: Social visit! mayr discuss AHCA Reason: Rep. Buchanan requested the meeting to discuss the Florida Safety Net Alliance Role: Listen and ask questions Lead: Sarah Arbes Event POC: Name, Cell and email: Dylan Allen; Attendees: Rep Buchanan Dave Karvelas, HHS Staff Attendees: Sarah Arbes Alec Ara manda Remarks: nfa Press: nfa Press Contact: n/a HHS Staff: John Twomey cell ?33(6) ?33(5) Mailing Address for thank you notes and photos: Briefing Materials: 2017--002135 Bell, Michael Subject: Mtg. w! Senator Orrin Hatch and GOP Members of the Senate Finance Committee Location: 5?124; US. Capitol Start: Wed 3/15/2017 10:30 AM End: Wed 3/15/2017 11:30 AM Recurrence: (none) Meeting Status: Accepted Organizer: OSHOS) Required Attendees: Harrison, Jessica Kristin Twomey, John Leggitt. Lance (H Aramanda, Alec McGu??ee, Tyler Ann Tepic: Healthcare Bill The Republican senators attending are: Senators Hatch, Grassley, Crapo, Roberts, Enzi, Cornyn, Thune, Burr, Portman, Toomey, Heller, Scott, and Cassidy. 2017--002136 Confidential Pre?decisional Draft 2017--002137 Confidential Pre?decisional Draft 2017--002138 Confidential Pre?decisional Draft (W5) 2017--002139 Confidential Pre?decisional Draft (W5) 2017--002140 Confidential Pre?decisional Draft (W5) 2017--002141 Confidential Pre?decisional Draft (W5) 2017--002142 Confidential Pre?decisional Draft 2017--002143 Confidential Pre?decisional Draft 2017--002144 Confidential Pre?decisional Draft (W5) 2017--002145 Confidential Pre?decisional Draft (W5) 2017--002146 Confidential Pre?decisional Draft (W5) 2017--002147 From: Clark, Barbara Sent: 16 Mar 201? 19:46:56 +0000 Bcc: (W6) Subject: New HHS Health Care Webpages This afternoon, the U.S. Department of Health and Human Services (HHS) is launching new webpages outlining specifics on Secretaryr Price?s commitment to empowering patients and stabilizing the individual health insurance market. HHS continues its work on taking administrative actions that will create a healthier insurance market and alleviate the burden the current healthcare law imposed on Americans. Future administrative actions will help provide more options for patients, give states flexibility on how they spend their Medicaid dollars, and ensure a stable transition to any law Congress passes. To view the new webpages, visit: Barbara Pisaro Clark Acting Assistant Secretarv for Legislation US. Department of Health and Human Services {202) 690-7627 lldirect} llbil?i I 2017--002148 From: Clark, Barbara Sent: 16 Mar 201? 193171211r +0000 Bcc: (W6) Subject: New HHS Health Care Webpages This afternoon, the US. Department of Health and Human Services (HHS) is launching new webpages outlining specifics on Secretary Price?s commitment to empowering patients and stabilizing the individual health insurance market. HHS continues its work on taking administrative actions that will create a healthier insurance market and alleviate the burden the current healthcare law imposed on Americans. Future administrative actions will help provide more options for patients, give states flexibility on how they spend their Medicaid dollars, and ensure a stable transition to any law Congress passes. To view the new webpages, visit: Barbara Pfsaro Clark Acting Assistant Secretary for Legislation U.S. Department of Health and Human Services 202 690-7627 kdirect} (W5) 2017--002149 From: Clark, Barbara Sent: 16 Mar 201? 19:47:28 +0000 Bcc: {bil?i Subject: New HHS Health Care Webpages This afternoon, the US. Department of Health and Human Services (HHS) is launching new webpages outlining specifics on Secretary Price?s commitment to empowering patients and stabilizing the individual health insurance market. HHS continues its work on taking administrative actions that will create a healthier insurance market and alleviate the burden the current healthcare law imposed on Americans. Future administrative actions will help provide more options for patients, give states flexibility on how they spend their Medicaid dollars, and ensure a stable transition to any law Congress passes. To view the new webpages, visit: Barbara Pfsaro Clark Acting Assistant Secretary for Legislation U.S. Department of Health and Human Services {202) 690?762? (b}{5i direct} 2017--002150 From: Clark, Barbara Sent: 16 Mar 201? 19:46:22 +0000 Bcc: {bll5} I;Mvrie, Simone Alec Tvler Ann Matt Rvan Jennifer L. Kate Maura Sarah Subject: New HHS Health Care Webpages This afternoon, the US. Department of Health and Human Services (HHS) is launching new webpages outlining specifics on Secretary Price?s commitment to empowering patients and stabilizing the individual health insurance market. HHS continues its work on taking administrative actions that will create a healthier insurance market and alleviate the burden the current healthcare law imposed on Americans. Future administrative actions will help provide more options for patients, give states flexibility on how they spend their Medicaid dollars, and ensure a stable transition to any law Congress passes. To view the new webpages, visit: Barbara Pfsaro Clark Acting Assistant Secretary for Legislation U.S. Department of Health and Human Services [202) 690?7627 ?53(5) ldirect} {bll?l 2017--002151 From: Bath, Nick Committee) Sent: 22 Mar 2017? 16:20:35 +0000 To: Clark, Barbara (HHSIASL) Subject: part 2 of 2 Attachments: ACA letter part 2.pdf Nick Bath Sen. Patty Murray Senate HELP Committee (W5) 2017--002152 (tongues of the ?ttm?trh ?tatta Washington, EC 20510 March 20, 2017 The Honorable Thomas Price Department of Health and Human Services Centers for Medicare and Medicaid Services Attention: CMS-9929-P PO. Box 8010 Baltimore, MD 21244-1850 Re: Patient Protection and Affordable Care Act; Market Stabilization Dear Secretary Price, We write in response to the proposed regulation, Patient Protection and A?ordobie Care Act; Market Stobfifzort?oa, published by the Centers for Medicare and Medicaid Services (CMS) regarding the individual and small group health insurance markets. Unfortunately, we are not convinced that the proposed changes would meaningfully improve the stability of the Marketplaces, and we are very concerned that the rule, if finalized, would block access to coverage for millions of Americans and signi?cantly raise the cost of that health insurance coverage. The proposal of this regulation comes at a particularly consequential time for the health and ?nancial security of millions of Americans?and ?rst and foremost, we urge you to abandon the reckless, dangerous plan to rip apart our health care system that your administration is currently pursuing. Before the Affordable Care Act (ACA), far too many Americans were one illness away from bankruptcy, locked out of a discriminatory, unaffordable insurance market. The Administration is actively supporting the American Health Care Act, legislation that would rip comprehensive, affordable coverage away from 24 million Americans, raise deductibles and cost-sharing in the individual market, and lower ?nancial assistance for individuals purchasing insurance in the individual market, according to the Congressional Budget Office. You were quoted on the legislation saying, ?This is about patients at the end of the day. This isn't about politicians. This isn't about insurance companies. This is about patients. And patients in this nation, especially those in the individual and small-group market, these are the folks.?1 You also claimed that ?Nobody will be worse off ?nancially? under the bill.2 We disagree, as do the American Hospital Association, AARP, the American Medical Association, and countless other I The White House, Press Brie?ng by Press Secretary Sean Spicer (Mar. 07, 2017) 13). 2 HHS Sec. Tom Price: 'Noboo?; Will Be Worse 0,15? tnonciaibx" Under GOP Health Plan, NBC News (Mar. 13, 2017) n732376} 2017--002153 stakeholders and health care experts. Indeed, if enacted, this legislation would create the very problems you explicitly aim to address in the proposed rule throwing markets into chaos, eliminating insurance options for consumers, and creating a ?death spiral? of premium increases. We believe that such legislation is utterly misguided and urge you to step back from the prec1p1ce. We are further concerned that the policies proposed in this the aforementioned rule address only the interests of the health insurance industry, leaving consumer considerations outside of the proposed policy. While we agree that there is a need to strengthen the market, doing so without appropriate consumer safeguards and protections risks leaving consumers without access to affordable care. Speci?cally, we are concerned that the proposed regulation: - Reduces the 2018 open enrollment period by half, making it more dif?cult to enroll and worsening the risk pool; II Discourages uninsured Americans from signing up for coverage, by exploring requirements that would penalize consumers in the individual market who did not maintain continuous coverage for 6 to 12 months prior to enrollment; - Makes health care less affordable by allowing insurers to increase out-of?pocket expenses for consumers by changing the actuarial value variation allowances; and I Limits access for vulnerable populations by rolling back network adequacy standards and unnecessarily lowering the Essential Community Providers standard. Such an approach runs counter to the core Congressional intent in enacting the providing more affordable, accessible coverage for all Americans. The legislative history of the ACA makes very clear that Congress core aim was to ensure affordable, accessible, quality health insurance5 for all Americans} Congress designed the advanced premium tax credits, cost- sharing subsidies5 ,expanded minimum bene?ts, and critical consumer protections to ful?ll this goal Congress recognized that the fundamental purpose was to ?[S]ay for every American, for every member of our American family, access to quality affordable care will be a right, not a ?6 3 ?We are united in the belief that there are fundamental things that need to be changed in our health care system. First, it needs to be more affordable. People cannot afford this dramatic escalation in the cost of health care.? Senator Durbin, ?Service Members Home Ownership Tax Act Of 2009.? (Dec. 21, 2009) Congressional Record p. 13648. 4 ?Our approach will be to offer affordable options for Americans struggling under the skyrocketing costs of healthcare.? Senator Dodd, Hearing of the Committee on Health, Education, Labor and Pension on Examining Health Care (June 11, 2009). 5 1311 and 1402 of the Patient Protection and Affordable Care Act. 6 Senator Harkin, ?Service Members Home Ownership Tax Act Of 2009.? (Dec. 23, 2009) Congressional Record 13. 13847. 2017--002154 Affordability for Consumers Many members of Congress noted during the drafting and passage of the ACA that affordability was a key issue facing consumers. To address this lssue, Congress crafted two measures designed to work in tandem to increase affordability for working families. Congress understood that without ?nancial help for families, insurance would not be truly accessible.3 The ?rst of these reforms are the cost- sharing subsidies9 that help families with Incomes up to roughly $29, 000 for an individual and $60, 000 for a family of four pay their deductibles and out- of-pocket health care costs. In 2016, as many as seven million people bene?tted from this provision] ?Unfortunately, these payments are under threat thanks to 2litigation brought by the House of Representatives?, and their future remains uncertain. 2Iiloth Republicans and Democrats' 1n Congress agree that the Administration must continue making these payments to provide certaing; and stability In the market. 3If the Administration fails to make these payments, insurance companies will have a legal basis to exit the market within a short period, reducing choice and increasing premiums creating a ?death spiral? for millions of Americans. These payments are critical to affordable health care and the very purpose of this proposed rule and the law?but in spite of the immediate threat to their continuance, the ?Affordability is already one of the key barriers to obtaining coverage in my State. Since 2000, premiums for residents have risen 10 percent. As a result, almost one in four people doesn?t have insurance, giving us the second highest uninsured rate in the Nation. Enactment of this reform legislation would make as many as 249,000 middleclass New Mexico residents eligible for premium credits to ease the burden of these high costs.? Senator Udall, ?Service Members Home Ownership Tax Act of 2009?Motion To Proceed.? (Nov. 21, 2009) Congressional Record p. 311912. 3 ?We want to make sure all Americans have the opportunity to ?nd affordable insurance." Senator Stabenow, "Service Members Home Ownership Tax Act Of 2009?Motion To Proceed.? Congressional Record (November 20, 2009) p. 811839; ?It is a debate we cannot afford not to have. What is before us is to make health insurance available and affordable.? Senator Nelson, "Service Members Home Ownership Tax Act Of 2009?Motion To Proceed." Congressional Record (November 20, 2009) p. Si 1844; ?In the richest country in the world, no one should die because they cannot afford health coverage.? Senator Feinstein, ?Service Members Home Ownership Tax Act Of 2009.? (December 24, 2009) p. 14131. 9 ?1402 of the Patient Protection and Affordable Care Act. 10 The Commonwealth Fund, The ACA's arr?Snoring Reduction Plans: A Key to Affordable Health Coverage for Millions of US. Workers (Oct. 13, 2016) Final Vote Results for Roll Call 466, Providing for consideration of 6776, providing for authority to initiate litigation for actions by the President or other executive branch of?cials inconsistent with their duties under the Constitution of the United States and HR. 935, Reducing Regulatory Burdens Act of 2013; and for other purposes 12 House Choir: Obomocore Subsidies Must Continue 1" Avoid Collapse Amid Repeal, TPM Livewire (Jan. 16, 2017) livewirei 13 House Energy and Commerce Chairman Greg Walden stated that he wants to see the subsidy program funded ?one way or another,? explaining ?if you don?t, the plans have the ability to cancel midyear, and we said we wouldn't pull the rug out from under people and we shouldn?t, House Choir: Ooamocore Subsidies Must Continue To Avoid Coiiopse Amid Repeal, TPM Livewirc (Jan. 16, 2017) Senator Tammy Baldwin, LES. Senator Tummy Baichvin and Senators Coil on President Tramp to Protect Americans ?'om Higher Heoiih Costs (Jan. 30, 2017) (press release) 1., .3 2017--002155 proposed rule is silent on the matter. Without a commitment from the Administration to continue making these payments, the other policies explored in this rule mean nothing. We urge you to make the cost-sharing reductions permanent in the ?nal rule. Advanced premium tax credits also play a critical role in ensuring that health insurance coverage is affordable. According to the Department of Health and Human Services (HHS), in 2016, 85 percent of Marketplace plan selections in Healthcare. gov states were with an advanced premium tax credit, and, among those individuals bene?ting, advanced premium tax credits covered 73 percent of the total premium 4Congress designed the advanced premium tax credit to adjust with the premium of the benchmark plan5 to protect consumers If premiums in an area increase, the difference between a consumer contribution and the benchmark plan also merease, resulting in a higher advanced premium tax credit and reducing a consumer?s premiums. The advanced premium tax credits are critical to the affordability of health insurance coverage and must be protected. Stability and Predictability in the Market The ACA banned insurance company discrimination against consumers based on pre?existing conditions, prohibited insurers from increasing premiums on those with preexisting conditions, and guaranlt?eed that health insurance companies must offer health msurance coverage to every American.16 Congress understood that these were dramatic improvements to the governing health insurance issue and rating rules in most states before the ACA, especially in the individual market. Recognizing that these changes could cause short-term uncertainty for insurers, Congress took steps in the ACA to mitigate this risk as much as possible to insulate consumers and help provide market certainty. The risks to be protected against included: the lack of information on the risk pool 1n the new market and the potential risk of adverse selection to consumers.l With this 1n mind, Congress 1? Department of Health and Human Services, Assistant Secretary of Flaming and Evaluation, The E??ect of Shopping and Premium Tax Credits on the ofMar-kemiace Coverage, page 2 (Aug. 24, 2016} [5 The benchmark plan is the plan that has the second-lowest premium according to the proportion of the premium that goes toward essential health bene?ts (EH13). The benchmark plan may not always be the second- lowest cost gross premium in the silver tier, and there may not be a plan priced lower than the benchmark, if plans have EHB percentages less than 100%. For the purpose of this hypothetical analysis, we have assumed that all plans have 100% EHB. See note 3. '6 ?Health reform will also ensure all Americans have access to quality and affordable insurance. We prevent insurance companies from the current practices in which they are engaged. One of the worst of these practices is the practice of denying health coverage for preexisting medical conditions. If one has a preexisting medical condition and is able to buy a policy, perhaps, the policy in its own language will exclude them from getting medical treatment that might result from that preexisting medical condition. This legislation would end that. It would end the discrimination of charges that currently exist where the charge for health care is based on one?s health status or gender.? Sen. Bingaman, Congressional Record, 311827 (N ov. 20 2009) 17 ?Ensuring a stable market for consumers: A broadly funded mechanism which spreads costs for hi gh-risk individuals across a broader base needs to be put in place to ensure premium stability for those with existing coverage.? Karen Ignagni, Hearing of the Committee on Health, Education, Labor, and Pensions, S. Hrg. [-960 (Mar. 24, 2009) 4 2017--002156 included measures for the individual insurance market modeled on the Medicare Part program, implementing the risk corridor, reinsurance and risk adjustment programs to stabilize and run the market more predictably.l3 These risk mitigation programs have been a part of the Part program for nine years and are sound federal investments that protect the taxpayer. We encourage the Administration to continue these programs or explore ways in which to extend them. As the Administration considers policies to improve the risk pool and promote stability in the individual market, we encourage you to consider additional policy changes. In the ?nal 2018 Notice of Bene?ts and Payment Parameters rule, HHS ?nalized a proposal to improve the risk adjustment policy in response to ongoing discussions with the insurance industry.? This proposal adds prescription drug data to the risk adjustment model, alters risk adjustment to incorporate very high cost cases into the risk adjustment formula, and updates the payment transfer model to remove plan administrative costs from transfers. These proposals are proposed for 2018 and were established in a public and transparent process with input from stakeholders. We urge you to consider accelerating these policies as soon as possible for 2017. Balancing Consumer Safeguards with Market Stability While we have always supported improving the risk pool and promoting stability in the individual insurance market, we believe that balancing such actions with strong safeguards to protect consumer access to affordable care is essential. To that end, we recommend: Speciesl enrollment periods The proposed changes to special enrollment periods should include a good faith exception to protect consumers who attempt to provide documentation in a pre-enrollment veri?cation process, but cannot provide the information in the 30-day window or experience dif?culty in providing such documentation, and allow for additional assistance. The rule notes that consumers? enrollment would be ?pended? until veri?cation, meaning that the enrollees? plan selection would not be effective until documentation was submitted during the 30-day period.20 This does not seem to leave room for outside of the box cases and leaves consumers in the process without coverage until an administrative process is complete. Until HHS comes up with an exception or process of temporary coverage during the pre-enrollment veri?cation period, the proposed process would leave those with medical needs with no help. Many individuals will face unique hardships in providing such documentatiOn, demonstrating a need to provide consumer assistance during the pre-enrollment veri?cation process from a neutral third party not associated with the health insurance company. Finally, the policy differences between the group and individual markets ?3 Georgetown University Health Policy Institute, Center for Children and Families, How the Three ?s Contributed to the Success of Medicare Part (Jan. 28, 2014) 4t01t28thow-the- 15' Department of Health and Human Services, Centers for Medicare ti: Medicaid Services, Patient Protection and A?ordobte Care Act: HHS Notice of Benefit and Payment Parameters for 2018; Amendments to Special Enrollment Periods and the Consumer Operated and Oriented Plan Program (?nal rule) (Dec. 22, 2016) 2? Department of Health and Human Services, Centers for Medicare Medicaid Services, Patient Protection and A?ordoote Core Act; Market Stabilization, page 44 (proposed rule) (Feb. 17, 2017) 5 2017--002157 present a confusing process that could result in consumers ending up with incorrect information as they churn between the two markets. We encourage the Administration to (1) design a good faith exception that recognizes the wide array of unique circumstances consumers face in meeting the proposed requirement; (2) provide a longer transition before these special enrollment period changes take effect; and (3) invest in targeted consumer outreach to ensure individuals have information to make the best possible care decisions. Continuous coverage: The preposed regulation seeks comment on whether HHS should consider a ?continuous coverage? requirement from a 1996 law mirroring a similar concept from the House repeal legislation. Speci?cally, the proposal contemplates policies that would deprive consumers of the pre-existing condition protections in current law if they fail to maintain continuous, creditable coverage without a 63-day break in the group market prior to enrollment. The individual reSponsibility requirement provides consumers with an important incentive to enroll in coverage year-round, not just when health care is needed. This incentive fosters more healthy risk pools and, in turn, stability in the individual market.21 According to HHS, nearly a third of the population experienced ga in coverage of at least a month due to hardships such as job loss or being too sick to work.2 A draconian policy that allows waiting periods, surcharge penalty payments, or discrimination by insurance companies for individuals that do not maintain continuous coverage penalizes consumers and puts care out of reach for millions. Further, Congress very intentionally crafted the ACA to prevent insurance companies from charging people more when they are too sick to work from a pre?existing condition or experiencing a hardship like job loss.23 The proposed continuous coverage requirement would therefore run counter to the Congressional intent in enacting the ACA and its protections for consumers? providing more affordable, accessible coverage for all Americans regardless of health condition. For this reason, you should withdraw the continuous coverage proposals proposed in the rule for comment and commit to enforcement of current law. Levels of coverage (actuarial value) 56.140): The proposed rule will increase out of pocket costs for consumers. Current law requires health plans sold in the individual and small group markets to meet minimum standards for the actuarial value ?the percentage of medical costs the plan must cover for an average enrollee population. The law also allows for a de minimis deviation from the required AV. The proposed rule would increase the allowable 21 ?Ensuring that no one falls through the cracks by combining guarantee-issue coverage (with no pro-existing condition exclusions) with an enforceable individual mandate: For guarantee-issue to work, it is necessary for everyone to be brought into the system and participate in obtaining coverage. Achieving this objective will require speci?c attention to the mechanisms for making the mandate enforceable and will require coordinated action at multiple levels of government." (In a Supplemental Letter to Sen. Hatch] Karen [gnagni, Hearing of the Committee on Health, Education, Labor, and Pensions, S. Hrg. 111-960 (Mar. 24, 2009) 22 Department of Health and Human Services, Assistant Secretary of Planning and Evaluation, Health Insurance Coverage for Americans with Pro-Existing Condiments: The Impact ofrhe A?ordoble Care Act (Jan. 5, 201?) 23 ?We want to create a system with consumer protections so that insurance companies can?t drop people for preexisting conditions; can?t put a limit on their coverage so that when they get sick they lose their insurance; can?t discriminate against women, whom they usually charge more for premium costs for their insurance policies than they charge men; can?t discriminate based on geography or disability.? Senator Brown 31 1830 Nov. 20 2009 available at: l-ZUpdf 6 2017--002158 negative deviation by 2 percent. own analysis notes the negative impact of this change on consumers: ..the impact of this proposed change would be to generate a transfer from consumers to insurers. The proposed change in AV could reduce the value of coverage for consumers, which could lead to more consumers facing increases in out-of-pocket expenses, thus increasing their exposure to ?nancial risks associated with high medical costs.?24 We are opposed to any policy that results in higher health costs for consumers and believe that this proposal runs counter to Congressional intent to provide more affordable coverage. You should withdraw this proposed policy in the ?nal rule. Initial and annual open enrollment periods The proposed rule seeks to shorten the open enrollment period. The regulation stipulates, ?We would intend to conduct extensive outreach to ensure that all consumers are aware of this changes and have the opportunity to enroll in coverage within this shorter time frame.?25 However, the Administration?s record on the issue shows otherwise.26 We encourage the Administration to rethink this policy and allow the market to mature further, rather than hastily rushing to shorten the open enrollment period. Network adequacy The proposed rule limits access to care by weakening the essential community provider network adequacy requirements. The ACA requires health plans to include in-network ECPs that serve ?predominantly low-income, medically- underserved individuals.?2l ECPs include vital and reliable sources of care, like community health centers, public hospitals, family planning clinics, safety-net hospitals (including children?s hospitals), Ryan-White HIWAIDS providers, Indian Health Services Centers, and community mental health centers. These providers are an important safety net for communities with severely limited access to the health care they need, including specialized treatment for low-income individuals and those in rural communities. ECPs provide services speci?cally designed to address the health needs of low-income communities. For women, particularly low-income women and women of color, clinic-based providers, family planning clinics and health centers are a critical source of reproductive healthcare.23 We oppose the proposed change to this provision, as it will result in less access to the safety?net for those individuals who are low. income or are medically underserved by allowing insurance companies to provide less access. Finally, we are gravely concerned with the rushed timeline and limited stakeholder engagement of this regulation, coupled with the Republican congressional efforts to repeal the ACA. In order to help us understand the full implications and impact on our constituents, we have included additional questions for HHS to provide answers in Appendix A. 2" act-market-stahilization 25 Id. at note 2?5 White House stops ads, outreach for last days of 201? ACA enrollment, storv.html?utm term=.7ef5e5e036c6 27 PPACA 1311 more); 45 CR 156.235 28h womens-heaith? olic - 7 2017--002159 The ACA was designed to help working families and empower patients to control their own health care. We, the undersigned, strongly support the ACA and urge the Administratioxi to protect consumer interests, protections, and affordability while also working to stabilize the market. Sincerely, ?Ra ?l Patty MUM Frank Pallone, Jr. Ranking Member Ranking Member Senate HELP House Energy and Commerce Committee Committee sewing @574 Ron Wyden Richard Neal Ranking Member Ranking Member Senate Finance House Ways and Means Committee Committee Cc: Seema Verma, Centers for Medicare and Medicaid Services Administrator 2017--002160 Appendix-A Enrofimem Will the CMS track and regulate denials and delay of coverage due to prior nonpayment with the same issuer? If so, how? Why did CMS decide to require pre-enrollment veri?cation for 100% of new SEP applications instead of moving ahead with the pilot as proposed in the 2018 Notice of Bene?t and Payment Parameters? When CMS began requiring documentation for SEP enrollment in 2016, younger consumers age 13 to 24 were 18% less likely to complete the veri?cation process compared to older consumers aged 55 to 64. Comments on that policy change questioned whether pre-enrollment veri?cation would have a net adverse impact on the risk pool, leading to the pilot study with 50% of new applications. Many stakeholders have suggested that promoting greater enrollment through SEPs by those eligible?especially younger consumers?would better address concerns about the risk pooL During Open Enrollment for plan year 2017, the Trump Administration opted to cancel contracts for outreach activities. The proposed rule says that ?extensive outreach? would be needed to cope with a shorter enrollment period. How would Open Enrollment outreach efforts for plan year 2018 increase or change from prior years? Newark Adeq Will changes to network adequacy protections also roll back improved standards in provider directory transparency and accuracy? Which states are considered able and willing to assess network adequacy to ensure reasonable access to providers? In states that cannot Or will not oversee network adequacy for Marketplace plans, how will CMS ensure that network adequacy standards are met? The Proposed Rule states that issuers in such states will be deemed compliant if they are accredited by an HHS- recognized entity. However, some accrediting bodies do not share, much less have the capacity to enforce, their network adequacy standards. Will the Center for Consumer Information and Insurance Oversight (CCIIO) continue to monitor compliance with remaining network adequacy standards at the same level for quali?ed health plans through complaint tracking? Capacity CCIIO has substantial responsibility for plan certi?cation, rate review, and issuer oversight. However, it has been impacted by the hiring freeze; current vacancies include directors for special initiatives and pricing, issuer compliance and monitoring, state support functions, and business operations. Will CCIIO receive a reprieve from the freeze as it works on an expedited schedule? Will any changes need to be made or additional costs incurred through the agreement with the plan certi?cation contractor? 2017--002161 From: McGuffee, Tyler Ann Sent: 1? Apr 2017 16:30:33 +0000 To: Thiessen, Pam {Portman} Subject: Portman contact info 2' FW: Dr. Price Call wz' Sen. Portman Hi Pam, I tried to call your of?ce but was unable to connect with a staff member. I am reaching out today on behalf of HHS Secretary Price with a special request for Senator Portman?s cell phone number and preferred email addressnot looking to speak with Senator Portman at this time, just hoping to have this contact information on hand in the event he needs to reach the Senator quickly. This information will be for the Secretary?s use only. Please let me know if Senator Portman would be willing to provide this information for Secretary Price. Sincerely, Tyler Ann Tyler Ann McGuffee Special Adyisor Of?ce of the Assistant Secretary for Legislation Department of Health and Human Services Washin nton DC 20201 f; b, i 1 C. Ill-Ill From: Thiessen, Pam (Portman) Sent: Wednesday, March 08, 2017 1:09 PM To: McGuffee, Tyler Ann Cc: Aramanda, Alec (HHSIIOS) Subject: Re: Dr. Price Call w] Sen. Portman Thanks for the heads up Sent from my iPhone On Mar 8, 2017, at 1:05 PM, McGuffee, Tyler Ann wrote: Pam, My name is Tyler Ann McGuffee with the HHS Office of the Assistant Secretary for Legislation. 2017--002162 I wanted to give you a heads up that our scheduler, Jessica Harrison, will be reaching out to your office soon to see if we can schedule a call between Dr. Price and Sen. Portn'lan to talk health care reform. Thank you, Tyler Ann McGuffee 2017--002163 From: Arbes, Sarah Sent: 4 May 2017 16:22:02 +0000 To: Bravo, Matt Subject: Re: AHCA floor vote time Thank you! On: 04 May 201? 12:13, ?Bravo, Matt" wrote: We still start the series around 130?140. AHCA vote will be around 205?215. From: Arbes, Sarah [mailtclibii?i Sent: Thursday, Mav 04, 201? 12:14 PM To: Bravo, Mattlib??) Subject: AHCA floor vote time Seeretay price is on his way to Capitol. What time is vote for ?nal passage? Just ensuring now time slippage 2017--002164 From: Arbes, Sarah (HHSKASL) Sent: 14 Apr 2017 00:09:21 +0000 To: Wroe, Elizabeth Committee);Palmer, Ashley Cc: Seidman, Lindsey (HELP Committee} Subject: Re: *Alexander: Secretary Price is Taking an Important Step to Begin Stabilizing Collapsing Individual Insurance Market Thanks! I On: 13 April 2017 19:52, "Wroe, Elizabeth (HELP Committee)" (W5) wrote: FYI Begin forwarded message: From: "Wolgemuth, Liz (Alexander}? ltbli?l Date: April 13, 2017 at 7:40:33 PM EDT To: "Haulsee, Taylor (Alexander)" Subject: *Alexander: Secretary Price is Taking an Important Step to Begin Stabilizing Collapsing Individual Insurance Market ans.? SENATE ON HEALTH. EDUCATION, LABOR 8 PENSIONS CHAIRMAN LAMAR ALEXANDER HELPSENAIE For Immediate Release Contact: Tavlor llaulsce: 202-224-8816 2017--002165 Alexander: Secretary Price is Taking an Important Step to Begin Stabilizing Collapsing Individual Insurance Market Says urgency remainsfor Congress and the Tramp Administration help the 4' percent ofinsared Americans who face higher premiums and fewer options, don ?t get insarancefrorn work or Medicare or Medicaid NASHVILLE, April 13 Senate health committee Chairman Lamar Alexander (R-Tenn.) today released the following statement after Secretary of Health and Human Services Tom Price released a ?nal rule on health insurance market stabilization: ?Today?s action by Secretary Price is an important step to begin stabilizing the Affordable Care Act?s collapsing individual insurance market,? Alexander said. ?The urgency remains for Congress and the administration to continue helping the 4 percent of insured Americans--approximately 230,000 Tennesseans-- who don?t get insurance from work or Medicare or Medicaid and buy their insurance on an Affordable Care Act exchange. These are millions of our most vulnerable citizens, and they?re facing higher premiums and few options. Some are even likely to have zero options next year, which means their Obamacare subsidy will be as useful as having a bus ticket in a town with no buses." Senator Alexander added: look forward to working with my colleagues in Congress and the Trump Administration to give states ?exibility to offer more choices of lower-cost insurance, stabilize the individual market, and pass my legislation with Senator Corker to give Americans with a subsidy and zero insurers the option to buy insurance offered outside of the Affordable Care Act exchanges.? Senator Alexander and Senator Bob Corker (R-Tenn.) last month introduced the Health Care Options Act of 2017, legislation to rescue Americans with Affordable Care Act subsidies who have zero options for health insurance on the exchanges for the 2018 and 2019 plan years. Speci?cally, the Health Core Options Act of 2017: Will allow Americans who live in counties in which there are zero health insurance options on the Affordable Care Act exchange to use their subsidy to purchase any health insurance plan outside of the exchanges, as long as the insurance is approved for sale by the state. That means Americans on the exchanges will have options to purchase insurance where the Affordable Care Act has left them with none. This option would be given to individuals who live in a county where the Secretary of Health and Human Services certifies there are no options on the ACA exchange. 2017--002166 When the HHS Secretary certi?es that there are zero insurance options on the exchange, the legislation will waive the Affordable Care Act?s requirement to buy a speci?c health care plan or pay a ?ne. The law?s individual mandate penalty will not apply to these individuals. The legislation?s temporary authority would only be in place through the end of the 2019 plan year. 2017--002167 From: Arbes, Sarah Sent: 1? Apr 2017 14:55:00 -0400 To: Raab, Scott (McConnell) Subject: Re: Call todayr with HHS Secretary Price {bit5i On: 17 April 2017 14:34, ?Raab, Scott (McConnell)" {{bit?i lfrotc: {bl{5l From: Arbes, Sarah I Sent: Monday, April 17, 2017 2:33 PM To: Vincent, Laura (McConneIHI'lbliSl Cc: Harrison, Jessica Raab, Scott {McConnell} W5) Kristin (H lama) Subject: Call today with HHS Secretary Price Hi Laura, {bl{5i Sarah Sarah Arbes Principal Deputyr Assistant Secretary for Legislation ll C: Deoartmen' of Health and Human Services (W5) . direct) I 2017--002168 From: Arbes, Sarah Sent: 13 May 2017 12:13:00 +0000 To: Eberle, Jay {Barrasso} Subject: RE: Call 003(5) From: Eberle, Jay (Barrasso) [mailtoimm Sent: Friday, May 12, 201? 11:12 AM To: Arbes, Sarah Subject: Call Just wanted to touch base on the agenda for the call with the Secretary. Thanks! Jayr 003(6) Jay Eberle Legislative Assistant Senator John Barrasso Chairman, Senate Republican Policy Committee 202.224.6441 (office) 202.224.1T24 (fax) 2017--002169 From: Bartley, Catherine Sent: 16 Mar 201? 21:59:23r +0000 To: Moore, Katie;Harrison, Jessica (05,005} Cc: Stevens, Amanda;Robertson, Brent;Meyer, Matt;Twomey, John K. Alec Tyler Ann Aaron Subject: RE: Doc Caucus Meeting Hi Jessica, 001(5) Best, Catherine From: Moore, Katie Sent: Thursday, March 16, 2017 4:56 PM To: Harrison, Jessica (05,005) Co: Stevens, Amanda; Bartley, Catherine; Robertson, Brent; Meyer, Matt; Twomey, John K. Aramanda, Alec McGuffee, Tyler Ann (HHSIIOS) Subject: Re: Doc Caucus Meeting (130(5) Katie Moore Director of Operations Rep. Roger Marshall On Mar 16, 201?, at 9:46 AM, Harrison, Jessica (OSIIOS) wrote: Jessica From: Moore, Katie I Sent: Wednesday, March 15, 201? 12:25 PM To: Stevens, Amanda; Bartley, Catherine; Harrison, Jessica (OSXIOS) Cc: Robertson, Brent; Meyer, Matt; Twomey, John K. Aramanda, Alec McGuffee, Tyler Ann Subject: RE: Doc Caucus Meeting 2017--002170 Yes, of course From: Stevens, Amanda Sent: Wednesday, March 15, 201? 12:24 PM To: Moore, Katie 4W5) Bartley, Catherine I 'Harrison, Jessica has) Cc: Robertson, Brent thMB) Meyer, Matt mno 'Aramanda, Alec 'McGuffee, Tyler Ann Subject: RE: Doc Caucus Meeting (bl{5} Sent with Good Original From: Moore, Katie Sent: Wednesday, March 15, 2017 12:20 PM Eastern Standard Time To: Bartley, Catherine; ?Harrison, Jessica (OSJIOST Cc: Robertson, Brent; Meyer, Matt; Twomey, John K. Aramanda, Alec MeGuffee, Tyler Ann Stevens, Amanda Subject: RE: Doe Caucus Meeting Thanks Catherine! Jessica, here?s the list that I have right now: (W5) 2017--002171 Murphy Let me know if you need anything else! KM Katie Moore Director of Operations Congressman Roger Marshall, MD. {ms} 312 Cannon Washington, D.C. 20515 From: Bartley, Catherine Sent: Wednesday, March 15, 201? 12:09 PM To: 'Harrison, Jessica (osrlosnibii?i Cc: Robertson, Brent I Meyer, Matt libii?i ITwomey, John K. Aramanda, Alec uffee, Tyler Ann libii?i Stevens, Amanda libii?i Moore, Katie Subject: RE: Doc Caucus Meeting Adding Katie, she?s been collecting. From: Harrison, Jessica [mailto Sent: Wednesday, March 15, 201? 11:48 AM To: Bartley, Catherine Cc: Robertson, Brent; Meyer, Matt; Twomey, John K. Aramanda, Alec McGuffee, Tyler Ann Stevens, Amanda Subject: RE: Doc Caucus Meeting Can we have a full list of attendees when you all get that? Thank you, Jessica From: Bartley, Catherine Sent: Monday, March 13, 2017 10:14 AM To: Harrison, Jessica Cc: Robertson, Brent; Meyer, Matt; Twomey, John Aramanda, Alec McGuffee, Tyler Ann Stevens, Amanda Subject: RE: Doc Caucus Meeting Works great for us! Thanks for checking. From: Harrison, Jessica [mailto (W5) Sent: Monday, March 13, 2017? 9:57 AM 2017--002172 To: Bartley, Catherine Cc: Robertson, Brent; Meyer, Matt; Twomey, John Aramanda, Alec McGuffee, Tyler Ann Stevens, Amanda Subject: RE: Doc Caucus Meeting Hi all, lhaye looped in Amanda with Rep. Burgess? office. We would like to move this meeting back to ?:30am on 3/1? so Rep Burgess is able to attend for a part ofthe meeting. Does this work for everyone? Thank you, Jessica From: Bartley, Catherine [mailtollmi?i Sent: Thursday, March 09, 2017 To: Harrison, Jessica Cc: Robertson, Brent; Meyer, Matt; Kristin Twomey, John Aramanda, Alec McGuffee, Tyler Ann (HHSJIOS) Subject: Re: Doc Caucus Meeting Thanks! We'll get a notice sent out and send the your way soon. Catherine Ba rtley Director of Operations Conressman Phil Roe, MD (TN-01) (bit?i On Mar 9, 201?, at 12:02 PM, Harrison, Jessica 403%) wrote: Please come to the Hubert H. Humphrey Building located at 200 Independence Ave SW, Washington, DC 20201.The meeting will be on the 6th floor in Secretary Price?s suite. When you arrive there will be metal detectors and a front desk. Please tell the front desk that you have a meeting with the Secretary and ask them to call Damaris Kendall or Rose Lusi at (202) 690- 7000. We will also plan to have staff down there ready to escort the group up once they arrive. If you have any further questions, please don?t hesitate to reach out. Thank you, Jessica Harrison 2017--002173 From: Bartley, Catherine Sent: Thursday, March 09, 2017 12:00 PM To: Robertson, Brent; Harrison, Jessica Meyer, Matt; Kristin Cc: Twomey, John K. Aramanda, Alec McGuffee, Tyler Ann Subject: RE: Doc Caucus Meeting Greatl Can you provide the location for the meeting and any other logistical details needed? From: Robertson, Brent Sent: Thursday, March 09, 2017 11:58 AM To: Harrison, Jessica Meyer, Matt,- Kristin Cc: Twomey, John K. Aramanda, Alec McGuffee, Tyler Ann Bartley, Catherine Subject: Re: Doc Caucus Meeting Outstanding. From: "Harrison, Jessica (053005)" ,{bii?i Date: Thursday, March 9, 2017 at 11:57 AM To: "Robertson, Brent" libli?i I "Meyer, Matt" libliEil Kristin (bl(5l Cc: "Twomey, John "Aramanda, Alec (bile) "McGuffee, Tyler Ann {blt?i H'bartley, Catherine" More) Subject: RE: Doc Caucus Meeting Great, thanks to you both. Secretary Price has the full hour available that morning. Happy to schedule the group from 8-9am on and if it doesn?t go that long, that is fine. As Kris mentioned, 3/15 at 7am will not work for Secretary Price he has a scheduling conflict/ prior commitment on that day and time. Please send me the full list of Doctors attending once you have it. Thank you again, I know Dr. Price is looking forward to the meeting. Jessica From: Robertson, Brent [mailto (bli?i Sent: Thursday, March 09, 2017 11:52 AM 2017--002174 To: Harrison, Jessica Meyer, Matt; Kristin (HHSIIOS) Cc: Twomey, John K. Aramanda, Alec McGuffee, Tyler Ann Bartley, Catherine Subject: Re: Doc Caucus Meeting Terrific Thanks for everyone?s help on this. 30 minutes is more than adequate for what the physicians are wanting. As a caveat We could also do and are prepared to do 7am next Wednesday 3/15 as well. We?ve been in contact with the other Doc offices and I think Tam or ?3CIam would work that day as well. Otherwise, I think 3/17 at 8am will also work just fine! Brent Robertson Chief of Staff Congressman Roger Marshall, MD. From: "Harrison, Jessica Date: Thursday, March 9, 201? at AM To: "Meyer, Matt? Kristin Cc: "Twomey, John "Aramanda, Alec Ilbll?l cGuffee, Tyler Ann I "Bartley, Catherine" {one} "Robertson, Brent? Subject: RE: Doc Caucus Meeting Hi Matt, I am also looping in Brent Robertson because he has also been working with our team on getting this on Secretary Price?s calendar. March 17 at 8am works well for this. Willa 30 minute meeting suffice for your group? Thank you, Jessica From: Meyer, Matt [mailto ?33(5) I Sent: Thursday, March 09, 2017 11:31 AM To: Kristin (HHSIIOS) Cc: Harrison, Jessica Twomey, John K. Aramanda, Alec McGuffee, Tyler Ann Bartley, Catherine Subject: RE: Doc Caucus Meeting 2017--002175 OK, got it glad we checked. We definitely have a conflict at 8 that is immovable with another Secretary, and my understanding is some of the other docs said they were unable to join later. Knowing that the Secretary?s schedule will be pretty tight, let me throw out all the dates in the next two weeks that might work any time between 7 and 9: March 17, 20, 21, 22, 23. From: Kristin (HHSIIOS) Sent: Thursday, March 9, 2017 11:18 AM To: Meyer, Matt Cc: Harrison, Jessica Twomey, John K. Aramanda, Alec McGuffee, Tyler Ann (HHSIIOS) Subject: RE: Doc Caucus Meeting Hey, Matt3f15 we have a conflict earlier. Does that work? Depending on how many members are coming, we may permit some staff {room size constraints). From: Meyer, Matt Sent: Thursday, March 09, 2017 10:58 AM To: Kristin (HHSIIOS) Subject: Doc Caucus Meeting Hey Kris Just wanted to confirm this with you believe Dr. Price and Dr. Marshall (or maybe Brent and you, not sure) have been in touch about a meeting between Secretary Price and the Doctors Caucus next Wednesday at 7 am. at the Secretary?s office. Just wanted to confirm everything looks good on your end, as well as confirm you want this to be members only? Crazy week hope things are going well! Matt Klujxcr Hep. I?li?l Rn: (me (DEE) lL'] 2017--002176 From: Harrison, Jessica Sent: 16 Mar 201? 22:01:17? +0000 To: Bartley, Catherine;Moore, Katie Cc: Stevens, Amanda;Robertson, Brent;Meyer, Matt;Twomey, John K. Alec Tyler Ann Aaron Subject: RE: Doc Caucus Meeting Thanks, staff can attend. Jessica From: Bartley, Catherine Sent: Thursday, March 16, 2017 6:69 PM To: Moore, Katie; Harrison, Jessica Cc: Stevens, Amanda; Robertson, Brent; Meyer, Matt; Twomey, John K. Aramanda, Alec McGuffee, Tyler Ann Bill, Aaron Subject: RE: Doc Caucus Meeting Hi Jessica, (W5) Best, Catherine From: Moore, Katie Sent: Thursday, March 16, 2017 4:56 PM To: Harrison, Jessica (OSIIOS) Cc: Stevens, Amanda; Bartley, Catherine; Robertson, Brent; Meyer, Matt; Twomey, John K. (05,005}; Aramanda, Alec McGuffee, Tyler Ann (HHSJIOS) Subject: Re: Doc Caucus Meeting {bl{5i Katie Moore Director of Operations Rep. Roger Marshall On Mar 16, 2017, at 9:45 AM, Harrison, Jessica i wrote: {bl{5i 2017--002177 Jessica From: Moore, Katie [mailto {blt?i I Sent: Wednesday, March 15, 2017 12:25 PM To: Stevens, Amanda; Bartley, Catherine; Harrison, Jessica (OSIIOS) Cc: Robertson, Brent; Meyer, Matt; Twomev, John K. Aramanda, Alec McGuffee, Tyler Ann Subject: RE: Doc Caucus Meeting Yes, of course From: Stevens, Amanda Sent: Wednesday, March 15, 2017 12:24 PM To: Moore, Katie l; Bartley, Catherine I'Harrison, Jessica linE} Cc: Robertson, Brent 4030(5) I Meyer, Matt libll?l 'Twomey, John K. 'Aramanda, Alec 'l?vIcGuffee, Tyler Ann (HHS/Iosl1ibit?i Subject: RE: Doc Caucus Meeting Sent with Good Original From: Moore, Katie Sent: Wednesday, March 15, 2017 12:20 PM Eastern Standard Time To: Catherine; 'Harrison, Jessica (OSJIOST Ce: Robertson, Brent; Meyer, Matt; Twomey, John K. Aramanda, Alec McGuffee, Tyler Ann Stevens, Amanda Subject: RE: Doc Caucus Meeting Thanks Catherine! Jessica, here?s the list that have right now: {bit5} 2017--002178 (W5) Let me know if you need anything else! KM Katie Moore Director of Operations Congressman Roger Marshall, MD. (MB) 312 Cannon Washington, D.C. 20515 From: Bartley, Catherine Sent: Wednesday, March 15, 2017 12:09 PM To: 'Harrison, Jessica I Cc: Robertson, Brent 403MB) Meyer, Matt Ilbll?l ITwomey, John K. I(bi(6i I Aramanda, Alec McGuffee, Tyler Ann Iibi(6i Stevens, Amanda Moore, Katie