THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES) for THE CIGNA GROUP AND SUBSIDIARIES (FORMERLY CIGNA CORPORATION AND SUBSIDIARIES)

Taxation/Internal Revenue Code TAX

-Issues related to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act. -Issues related to the implementation of international tax provisions under P.L. 115-97, the Tax Cuts and Jobs Act. -H.R. 748/S. 684, Middle Class Health Benefits Tax Repeal Act of 2019, legislation to repeal a 40% ACA excise tax on certain employer-sponsored health insurance plans. -S.172/H.R. 1398, the Health Insurance Tax (HIT) Relief Act of 2019, legislation to suspend the ACA's health insurance tax (HIT) in 2020 and 2021. S.80, Jobs and Premium Protection Act, full repeal of the HIT.

Contacted: White House Office; Executive Office of the President (EOP); Health & Human Services, Dept of (HHS); SENATE; Labor, Dept of (DOL); Centers For Medicare and Medicaid Services (CMS); Government Accountability Office (GAO); HOUSE OF REPRESENTATIVES; Office of Management & Budget (OMB); Commerce, Dept of (DOC); Congressional Budget Office (CBO); U.S. Trade Representative (USTR)

Bills named: S. 684 (116th), H.R. 748 (116th), S. 172 (116th), H.R. 1398 (116th), S. 80 (116th)

Labor Issues/Antitrust/Workplace LBR

Issues related to paid family leave and H.R. 1185/S. 463, the FAMILY Act.

Contacted: Executive Office of the President (EOP); SENATE; White House Office; Government Accountability Office (GAO); Commerce, Dept of (DOC); Health & Human Services, Dept of (HHS); Centers For Medicare and Medicaid Services (CMS); Labor, Dept of (DOL); U.S. Trade Representative (USTR); Office of Management & Budget (OMB); Congressional Budget Office (CBO); HOUSE OF REPRESENTATIVES

Bills named: S. 463 (116th), H.R. 1185 (116th)

Trade (domestic/foreign) TRD

Developments regarding Korean Trade Agreement (KORUS), China trade and tariffs, NAFTA.

Contacted: Health & Human Services, Dept of (HHS); Labor, Dept of (DOL); SENATE; Executive Office of the President (EOP); U.S. Trade Representative (USTR); HOUSE OF REPRESENTATIVES; Government Accountability Office (GAO); Centers For Medicare and Medicaid Services (CMS); Congressional Budget Office (CBO); White House Office; Commerce, Dept of (DOC); Office of Management & Budget (OMB)

Defense DEF

Pharmacy issues related to the 2019 National Defense Authorization Act and implementation.

Contacted: Government Accountability Office (GAO); Health & Human Services, Dept of (HHS); HOUSE OF REPRESENTATIVES; Congressional Budget Office (CBO); Executive Office of the President (EOP); Centers For Medicare and Medicaid Services (CMS); White House Office; Labor, Dept of (DOL); Commerce, Dept of (DOC); SENATE; U.S. Trade Representative (USTR); Office of Management & Budget (OMB)

Health Issues HCR

-Issues relating to P.L. 111-148, the Patient Protection and Affordable Care Act and P.L. 111-152, the Health Care and Education Reconciliation Act, including exchanges, cost sharing reduction, market reforms and coverage expansion proposals, and non-discrimination provisions. -21st Century Cures Act, section 4004, Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs, information blocking and interoperability. -Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act, the 21st Century Cures Act, and ERISA, including DOL proposed FAQs about Mental Health and Substance Use Disorder Parity Implementation. -Issues related to H.R. 861, the End Surprise Billing Act.

Contacted: Executive Office of the President (EOP); Labor, Dept of (DOL); Office of Management & Budget (OMB); Congressional Budget Office (CBO); HOUSE OF REPRESENTATIVES; SENATE; Commerce, Dept of (DOC); U.S. Trade Representative (USTR); Centers For Medicare and Medicaid Services (CMS); White House Office; Government Accountability Office (GAO); Health & Human Services, Dept of (HHS)

Bills named: H.R. 861 (116th)

Medicare/Medicaid MMM

-Ongoing implementation of payment and regulatory issues for the Medicare Advantage program. CMS-4182-P/CMS-4182-CN: Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2019. Medical utilization management and Medicare Advantage program policy and operations. -Issues related to the drug pricing RFI, the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. -Proposals that impact Medicare Part D such as formulary requirements, pharmacy benefit manager (PBM) disclosure provisions, closing the Part D coverage gap and direct negotiation of prescription drug prices. -Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020 (CMS-4185-P). -Pharmacy Direct and Indirect Remuneration (DIR) H.R. 1034, the Phair Pricing Act of 2019; S.640, the Phair Pricing Act of 2019; H.R. 803, the Improving Transparency and Accuracy in Medicare Part D Spending Act; H.R. 1035, the Improving Transparency and Accuracy in Medicare Part D Spending Act. -Medicare Part B reforms. S 476, the Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019; S.657, the Drug Price Transparency Act.

Contacted: Health & Human Services, Dept of (HHS); White House Office; Government Accountability Office (GAO); Commerce, Dept of (DOC); U.S. Trade Representative (USTR); Labor, Dept of (DOL); Centers For Medicare and Medicaid Services (CMS); Congressional Budget Office (CBO); SENATE; Office of Management & Budget (OMB); HOUSE OF REPRESENTATIVES; Executive Office of the President (EOP)

Bills named: H.R. 1035 (116th), S. 657 (116th), H.R. 1034 (116th), S. 640 (116th), H.R. 803 (116th)

Pharmacy PHA

-Design, coverage and affordability of pharmacy benefits in Exchanges and the commercial market, including: e-Prescribing (eRx), Electronic Prescribing for Controlled Substances (EPCS), electronic prior authorization, Pharmacy Benefit Manager (PBM) disclosure, medical loss ratio (MLR), and specialty pharmacy tiering. Implementation of biosimilars pathway from the Biologics Price Competition and Innovation Act (BPCIA). -Issues related to the proposed rule: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees. -Draft Patient Affordability, Value and Efficiency Act, legislation to facilitate new pharmacy payment models. -Risk Evaluation and Mitigation Strategies (REMS) reform. H.R. 965/S. 340, the CREATES Act of 2019. -Drug patent settlements. H.R. 1499, the Protecting Consumer Access to Generic Drugs Act of 2019; S.64, the Preserve Access to Affordable Generics and Biosimilars Act.

Contacted: Congressional Budget Office (CBO); Government Accountability Office (GAO); Executive Office of the President (EOP); Health & Human Services, Dept of (HHS); Labor, Dept of (DOL); SENATE; Commerce, Dept of (DOC); Office of Management & Budget (OMB); Centers For Medicare and Medicaid Services (CMS); White House Office; U.S. Trade Representative (USTR); HOUSE OF REPRESENTATIVES

Bills named: H.R. 965 (116th), S. 340 (116th), S. 64 (116th), H.R. 1499 (116th)