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ASHINGTON — Nearly 1,200 lobbyists roamed the halls of Congress this year, trying to shape legislation to speed up the federal approval of new drugs and expand medical research. But the advocate who arguably has had the biggest impact on the process isn’t a registered lobbyist at all. It’s onetime junk bond king Michael Milken.

A 1980s icon of excess, Milken pleaded guilty in 1990 to six criminal charges stemming from securities transactions. He was initially sentenced to 10 years in prison, ultimately serving 22 months and paying $1.1 billion in fines and settlements.

But that was then. Today, after years building a reputation as one of the nation’s leading medical philanthropists, Milken has quietly added politics to his portfolio.

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He has pushed his agenda with a muted public presence, one that stresses quiet messaging over press releases and networking over campaign contributions. His goal is passage of the 21st Century Cures Act, a bill that would accelerate regulators’ review of new medical treatments and boost funding for the National Institutes of Health by nearly $9 billion over five years.

Milken has hosted retreats and receptions from Lake Tahoe, Nev., to New York, putting lawmakers in front of renowned scientists, patient advocates, Cabinet secretaries, and biomedical industry chief executives.

And he and others from his eponymous think tank have wined and dined a who’s who of the congressional leadership, including Senate minority leader Harry Reid, a Nevada Democrat; and onetime House majority leader Eric Cantor, Republican of Virginia, according to current and former lawmakers, congressional aides, and others.

In short, Milken has Washington’s attention once again.

“I talked to Mike several times on the phone and did visit with him face to face. I guess everybody has some sort of personal agenda and special interest that they want to promote,” said Representative Joe Barton, the Texas Republican who was an early proponent of the legislation. “Whatever it is with Michael Milken, I couldn’t tell you. It looks to me that he’s about helping the world to the best of his ability.”

Barton recalled first approaching Cantor several years ago about developing a proposal to spur medical innovation. Cantor responded: “Get Mike Milken.”

Not everyone is pleased with Milken’s behind-the-scenes advocacy. While supporters say the Cures Act, a version of which was passed by the House in July, would make it cheaper and faster to get cutting-edge drugs and medical devices to patients, critics warn that it would create dangerous regulatory shortcuts. They fear that Milken is doing the bidding of the Pharmaceutical Research and Manufacturers of America, the drug industry’s main trade group.

“This is a bill that has many provisions that are exactly what PhRMA wants and what the device companies want,” said Diana Zuckerman, president of the National Center for Health Research, a nonprofit think tank in Washington.

Milken has made no secret of his passion for the issue of medical research. His passage from financier to research champion has been long in the making and stems from his own brush with death.

Michael Milken, chairman, Milken Institute, and chairman, Faster Cures/The Center for Accelerating Medical Solutions, moderates the Lunch Panel: A Discussion With Nobel Laureates in Economics at the 2008 Milken Institute Global Conference in Beverly Hills, California April 29, 2008. REUTERS/Phil McCarten (UNITED STATES)
Michael Milken, moderating a panel at the Milken Institute Global Conference. Phil McCarten/Reuters

A week after emerging from prison in 1993, he was told he had terminal prostate cancer and would die within 12 to 18 months.

Instead, he survived — a recovery he attributed to a combination of medical treatment and an overhaul of his diet. Milken started lobbying for research dollars, and at the same time, trying to persuade pharmaceutical companies to make cancer treatment a higher priority. He established the Prostate Cancer Foundation and cofounded the Melanoma Research Alliance.

In all, a spokesman said, Milken, now 69, has donated about $750 million to medical research and public health causes and raised $650 million more from other donors, while using FasterCures — an advocacy campaign run out of the Milken Institute, based in Washington and Santa Monica, Calif. — to reach out to scientists and politicians.

Milken has also worked closely with pharmaceutical firms, including the giant drugmaker Sanofi, which was the major sponsor of at least one of his retreats.

His advocacy now dovetails with the push for what could be one of the most significant, and controversial, pieces of legislation on medical research in years.

Milken declined to be interviewed for this story, and Geoffrey Moore, his spokesman, said the former financier wants to keep attention on the issue of medical research, not himself.

But Moore acknowledged that Milken’s summits and retreats are “designed to spark collaboration and ideas that propel the system forward. . . . Hundreds of members of Congress and various administrations have participated in these events.”

On Capitol Hill, drugmakers have lobbied hard on the Cures Act. Pharmaceutical manufacturers and biotech companies have also doled out campaign contributions like pediatricians giving out lollipops.

Over the first six months of 2015, according to the Center for Responsive Politics, drug and device donors contributed $1.1 million to members of the House Energy and Commerce Committee, the Senate Committee on Health, Education, Labor and Pensions, and their respective leaders, with Republicans getting the larger share.

Milken’s own campaign contributions have been comparatively modest. But his role in helping to craft the legislation has been anything but.

The sponsors of the House bill, Representatives Fred Upton, Republican of Michigan, and Diana DeGette, Democrat of Colorado, have been conferring with Milken on medical research issues since well before the proposal was drafted. This summer he has been working with the lawmakers on ways to get the bill through the Senate, said Matthew Inzeo, a spokesman for DeGette.

Milken views his activities as education and collaboration, not lobbying, his spokesman said. In fact, Milken has not registered as a lobbyist. As the head of a nonprofit, he is not required to do so, as long as he follows rules restricting the amount of time his organization devotes to lobbying-like activities.

“I think he deserves an enormous amount of credit for the thrust of this legislation, and for bringing people together so that the Energy and Commerce committee had a lot of its work done for it,” said former representative Henry Waxman, a stalwart California Democrat who served on the panel until his retirement last year.

Online videos of Milken’s speeches show an advocate in his element — a lean, balding man speaking with a raspy voice, often out of the side of his mouth. But people listen.

“He is a force of nature, no doubt about that,” said Dr. Francis Collins, director of the National Institutes of Health.

“When Mike says, ‘I’m having a meeting and I want you to show up,’ everybody shows up,” Collins said. “I always go to the FasterCures meeting and I always make relationships that seem to matter.”

At this year’s Milken Institute Global Conference, in Los Angeles, Milken stressed a key part of his platform, the economic benefits of federal support of such research, asserting that more than 50 percent of all economic growth in the last 200 years can be traced to advances in medical research and public health.

“We can solve these problems,” Milken said. “We have to allow science to move at the speed it can move.”

Last year, Milken testified before Congress alongside Collins on the importance of supporting medical research and the 21st Century Cures Act.

Upton, the bill’s cosponsor, closed the session by taking note of the outsized role played by the onetime junk bond king, crediting him with many of the proposals in the legislation.

“Michael,” he said, “we stole a lot from you.”

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