REMC Act of 2018

Essential emergency medication shortages Mental health services for emergency psychiatric patients Price transparency, out-of-network reimbursement of emergency medical services H.Res.906-Congratulating the American College of Emergency Physicians on its 50th anniversary H.R.6-Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act H.R.372-Competetive Health Insurance Reform Act of 2017 H.R.548-Health Care Safety Net Enhancement Act of 2017 H.R.767-Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness Act of 2017 H.R.817-End Surprise Billing Act of 2017 H.R.880-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act H.R.1057-Synthetics Trafficking and Overdose Prevention Act of 2017 H.R.1215-Protecting Access to Care Act of 2017 H.R.1323-Reducing Unnecessary Emergency Room Visits under Medicaid Act H.R.1492-Medical Controlled Substances Transportation Act of 2017 H.R.1565-Saving Lives, Saving Costs Act H.R.1822-Good Samaritan Health Professionals Act of 2017 H.R.1876-Good Samaritan Health Professionals Act of 2017 H.R.2200-Frederick Douglass Trafficking Victims Prevention and Protection Reauthorization Act of 2017 H.R.2410-Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2017 H.R.2851-Stop the Importation and Trafficking of Synthetic Analogues (SITSA) Act of 2017 H.R.2957-Save Rural Hospitals Act H.R.3181-Medicare Choices Empowerment and Protection Act H.R.3258-Marketplace Certainty Act H.R.3545-Overdose Prevention and Patient Safety (OPPS) Act H.R.4922-Stopping Overdoses of Fentanyl Analogues Act H.R.5176-Preventing Overdoses While in Emergency Rooms Act of 2018 H.R.5197-Alternatives to Opioids (ALTO) in the Emergency Department Act H.R.5531-Opioid Emergency Response Act H.R.5558-Alternatives to Opioids Prescribing Act H.R.5678-Rural Emergency Medical Center Act of 2018 H.R.5734-Resident Education Deferred Interest Act H.R.6082-Overdose Prevention and Patient Safety (OPPS) Act H.R.6143-Patient Right to Know Drug Prices Act H.R.6144-Know the Lowest Price Act of 2018 H.R.6372-To require the Secretary of Health and Human Services issue regulations to ensure due process rights for physicians furnishing emergency medical services H.R.6502-Reducing Unnecessary Senior Hospitalizations Act of 2018 H.R.6733-Know the Cost Act of 2018 Senate resolution congratulating the American College of Emergency Physicians on its 50th anniversary S.191-Patient Freedom Act of 2017 S.256-SOAR to Health and Wellness Act of 2017 S.284-End Surprise Billing Act of 2017 S.372- Synthetics Trafficking and Overdose Prevention Act of 2017 S.527-Health Care Safety Net Enhancement Act of 2017 S.568-Improving Access to Medicare Coverage Act of 2017 S.781-Good Samaritan Health Professionals Act of 2017 S.1016-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 S.1022-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act S.1130-Rural Emergency Acute Care Hospital (REACH) Act S.1462-Marketplace Certainty Act S.1530- Medicare Choices Empowerment and Protection Act S.1553-Stopping Overdoses of Fentanyl Analogues Act S.1835-Lower Premiums Through Reinsurance Act of 2017 S.2465-Sickle Cell Disease Research, Surveillance, Prevention, and Treatment Act of 2018 S.2516-Alternatives to Opioids (ALTO) in the Emergency Department Act S.2544-Patient Right to Know Drug Prices Act S.2553-Know the Lowest Price Act of 2018 S.2609-Recovery Coaches Offer Addiction Counseling and Healing (COACH) Act S.2610-Preventing Overdoses While in Emergency Departments Act of 2018 S.2680-Opioid Crisis Response Act of 2018 S.3531-Emergency Care Improvement Act

Client expense: $402,721 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4710 340B PAUSE Act S. 2312 HELP Act S. 2957; H.R. 5385 Children's Hospital Support Graduate Medical Education Reauthorization H.R. 5678 Rural Emergency Medical Center Act Medicare Program: Proposed Changes to Hospital Outpatient Prospective Payment and Ambulatory Payment Systems and Quality Reporting Programs, CMS-1695-P Medicare and Medicaid Programs; Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction OPTN's Public Comment Proposal Liver and Intestine Distribution Using Distance from Donor Hospital

Client expense: Not reported · Firm income: $7,900

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

Opioid issues (S. 2680, the Opioid Crisis Response Act of 2018; H.R. 5176, Preventing Overdoses While in Emergency Rooms (POWER) Act; H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act; H.R. 5009, Jessies Law; H.R. 5818 / S. 2843, the Opioid Workforce Act; H.R. 5797, the IMD CARE Act; H.R. 6082/H.R. 5795, the Overdose Prevention and Patient Safety Act; S. 2905, Strengthening Partnerships to Prevent Opioid Abuse Act; S. 2460, Every Prescription Conveyed Securely Act; S. 2920, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors Act; H.R. 5582, the Abuse Deterrent Access Act; H.R. 5685, the Medicare Opioid Safety Education Act; Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018; H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act; S. 2899, Caring Recovery for Infants and Babies Act; S. 2898, Medication-Assisted Treatment Improvement Act; S.2911, Enhancing Patient Access to Non-Opioid Treatment Options) Draft Protecting Patients from Surprise Medical Bills Act HIPAA policy in mental and behavioral health information sharing 21st Century Cures Act implementation Pandemic and All Hazards Preparedness Reauthorization, including Hospital Preparedness Program (S. 2852, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPAI) of 2018) S.781/ HR 1876. Good Samaritan Health Professional Act of 2017 Health workforce reauthorizations (H.R. 959, the Title VIII Nursing Workforce Reauthorization Act; H.R. 3728, the Educating Medical Professionals and Optimizing Workforce Efficiency Readiness (EMPOWER) Act; H.R. 1676, the Palliative Care and Hospice Education and Training Act Liver allocation policy (H.R. 6458 National Organ Transplant Act Amendments of 2018; H.R. 6517 Fairness in Liver Allocation Act of 2018) H.R. 5678, Rural Emergency Medical Center (REMC) Act of 2018) Disproportionate share hospital payments (H.R. 1892, Bipartisan Budget Act of 2018; implementation of the S-10 worksheet) H.R. 2267 / S. 1301, Resident Physician Shortage Reduction Act H.R. 5818 / S. 2843, Opioid Workforce Act Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act) Stark law reform Hospital outpatient payment policy Site neutral payment policy included in outpatient prospective payment system proposed rule Physician fee schedule rule Evaluation and management coding and payment policy in physician fee schedule rule S. 2597 / H.R. 5385, Children's Hospital GME Support Reauthorization Act of 2018 Opioid funding (CARA implementation; S. 2004, Combating the Opioid Epidemic Act; H.R. 1892, Bipartisan Budget Act of 2018; Consolidated Appropriations Act, 2018) Behavioral health funding (H.R. 1892, Bipartisan Budget Act of 2018; Consolidated Appropriations Act, 2018; H.R. 6157) HR 6470 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2019 H.R. 5645, the Standard Merger and Acquisition Reviews Through Equal Rules (SMARTER) Act Public Charge proposed rule Q4 Submitted Letters SUBJECT: DHS Docket No. USCIS-2010-0012, Inadmissibility on Public Charge Grounds; Proposed Rule SUBJECT: Docket No. FDA-2018-N-3272, Identifying the Root Causes of Drug Shortages and Finding Enduring Solutions SUBJECT: CMS-1701-P, Medicare Program: Medicare Shared Savings Program; Accountable Care Organizations Pathways to Success Proposed Rule SUBJECT: OIG-0803-N, Request for Information Regarding Anti-Kickback Statute and Beneficiary Inducements CMP SUBJECT: CMS-3346-P, Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction SUBJECT: Notice of Proposed Rulemaking, 340B Drug Pricing Program Ceiling Price and Manufacturer Civil Monetary Penalties Effective Date Change

H.R. 4710 340B PAUSE Act S. 2312 HELP Act S. 2957; H.R. 5385 Children's Hospital Support Graduate Medical Education Reauthorization H.R. 5678 Rural Emergency Medical Center Act Medicare Program: Proposed Changes to Hospital Outpatient Prospective Payment and Ambulatory Payment Systems and Quality Reporting Programs, CMS-1695-P Medicare and Medicaid Programs; Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction OPTN's Public Comment Proposal Liver and Intestine Distribution Using Distance from Donor Hospital

Client expense: Not reported · Firm income: $37,000

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

H.R. 4710 340B PAUSE Act S. 2312 HELP Act S. 2957; H.R. 5385 Children's Hospital Support Graduate Medical Education Reauthorization H.R. 5678 Rural Emergency Medical Center Act Medicare Program: Proposed Changes to Hospital Outpatient Prospective Payment and Ambulatory Payment Systems and Quality Reporting Programs, CMS-1695-P Medicare and Medicaid Programs; Regulatory Provisions To Promote Program Efficiency, Transparency, and Burden Reduction OPTNs Public Comment Proposal Liver and Intestine Distribution Using Distance from Donor Hospital

Client expense: $141,000 · Firm income: Not reported

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

Rural hospital policies (H.R. 741/S. 243, H.R. 1955/S. 872, S. 1130, straight policy extension of Medicare dependent hospital and low volume adjustment payments, H.R. 1892, Bipartisan Budget Act of 2018); H.R. 5678, Rural Emergency Medical Center (REMC) Act of 2018) Disproportionate share hospital payments (H.R. 1892, Bipartisan Budget Act of 2018; implementation of the S-10 worksheet) H.R. 2267 / S. 1301, Resident Physician Shortage Reduction Act H.R. 5818 / S. 2843, Opioid Workforce Act Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act) Stark law reform Hospital outpatient payment policy Site neutral payment policy included in outpatient prospective payment system proposed rule Physician fee schedule rule Evaluation and management coding and payment policy in physician fee schedule rule S. 2597 / H.R. 5385, Children's Hospital GME Support Reauthorization Act of 2018 Requirement for public posting of chargemaster in electronically readable form

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for Graduate Medical Education (GME) funding including the Resident Physician Shortage Reduction Act (S. 1301/H.R. 2267) and the Opioid Workforce Act of 2018 (H.R. 5818/S. 2843) Support for legislation to address opioid epidemic (SUPPORT for Patients and Communities Act (H.R. 6)) including bills to modify to institute of mental disease exclusion (H.R. 5797) and to align 42 CFR Part 2 with the Health Insurance Portability and Accountability Act (H.R. 6082) and policies to expand ability to prescribe buprenorphine treatment Support for full protection of Critical Access Hospital payments Support for REMC Act of 2018 (H.R. 5678) Support for Fairness in Liver Allocation Act (H.R. 6517) Support for changes to Medicare Volume Decrease Adjustment calculation Support for correction of erroneous reductions of GME residency positions Opposition to 340B program reductions in Centers for Medicare and Medicaid Services (CMS) 2018 Outpatient Prospective Payment System (OPPS) proposed rule [CMS-1678-P] and support for legislation (H.R. 4392, H.R. 6071) to halt these payment cut Opposition to changes to 340B program (H.R. 4710, H.R. 6240) Opposition to site-neutral payment reductions to hospital outpatient departments proposed in CMS 2019 OPPS proposed rule [CMS-1695-P] Support for policies to preserve Medicare Disproportionate Share Hospital funding as part of CMS 2019 Inpatient Prospective Payment System proposed rule [CMS-1694-P] Opposition to Department of Homeland Security Proposed Rule on Inadmissibility on Public Charge Grounds [DHS Docket No. USCIS-2010-0012]

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

Support for the 340b program, HR 4392. Support for continued funding for the Rural Health Care telemedicine program. Support for new models of care, HR 5678 and appropriations report language contained in H.R. 6157 by inference to S.Rpt. 115-289

Client expense: Not reported · Firm income: $20,000

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

H.R. 4392, a bill to restore cuts to hospitals as part of the 340b drug reimbursement program that were made in the final OPPS rule, particularly regarding Congressional cosponsorship and support of the measure. Support for eliminating sequestration for Medicare. Support for H.R. 5678, a bill that would establish a new model of Medicare reimbursement for rural hospitals that operate as rural emergency medical centers. Support for language included in S.Rpt. 115-289 related to new models of care and reimbursement including speaking with staff at Health and Human Services about the pilot project contained therein.

Client expense: Not reported · Firm income: $20,000

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

CMS proposed and final 2019 outpatient and physician fee schedule rules on site neutral and 340B Medicare reimbursement reductions. CMS final rule mandating the web posting of hospital charges Rural Emergency Medical Center Act of 2018 (H.R. 5678) Opioid Crisis Response Act (H.R. 6). The Overdose Prevention and Patient Safety Act (H.R. 6082) The Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, H.R. 6378)

Client expense: $110,000 · Firm income: Not reported

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

CMS proposed and final 2019 outpatient and physician fee schedule rules on site neutral and 340B Medicare reimbursement reductions. CMS final rule mandating the web posting of hospital charges Rural Emergency Medical Center Act of 2018 (H.R. 5678) Opioid Crisis Response Act (H.R. 6). The Overdose Prevention and Patient Safety Act (H.R. 6082) The Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, H.R. 6378)

Client expense: $110,000 · Firm income: Not reported

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

CMS proposed and final 2019 outpatient and physician fee schedule rules on site neutral and 340B Medicare reimbursement reductions. CMS final rule mandating the web posting of hospital charges Rural Emergency Medical Center Act of 2018 (H.R. 5678) Opioid Crisis Response Act (H.R. 6). The Overdose Prevention and Patient Safety Act (H.R. 6082) The Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, H.R. 6378)

Client expense: $110,000 · Firm income: Not reported

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

H.R. 4392, a bill to restore cuts to hospitals as part of the 340b drug reimbursement program that were made in the final OPPS rule, particularly regarding Congressional cosponsorship and support of the measure. Support for eliminating sequestration for Medicare. Support for H.R. 5678, a bill that would establish a new model of Medicare reimbursement for rural hospitals that operate as rural emergency medical centers. Support for language included in S.Rpt. 115-289 related to new models of care and reimbursement including speaking with staff at Health and Human Services about the pilot project contained therein.

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

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

Support for the 340b program, HR 4392. Support for continued funding for the Rural Health Care telemedicine program. Support for new models of care, HR 5678 and appropriations report language contained in H.R. 6157 by inference to S.Rpt. 115-289

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

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

H.R. 1892, Bipartisan Budget Act of 2018 Rural hospital policies (H.R. 741/S. 243, H.R. 1955/S. 872, S. 1130, straight policy extension of Medicare dependent hospital and low volume adjustment payments, H.R. 1892, Bipartisan Budget Act of 2018); H.R. 5678, Rural Emergency Medical Center (REMC) Act of 2018) Disproportionate share hospital payments (H.R. 1892, Bipartisan Budget Act of 2018; implementation of the S-10 worksheet) Hospital quality star ratings H.R. 2267 / S. 1301, Resident Physician Shortage Reduction Act H.R. 5818 / S. 2843, Opioid Workforce Act Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act) Stark law reform Hospital outpatient payment policy Site neutral payment policy included in outpatient prospective payment system proposed rule Physician fee schedule proposed rule Evaluation and management coding and payment proposal in physician fee schedule proposed rule 60 percent rule for inpatient rehab hospitals 25 percent rule for long term care hospitals S. 2597 / H.R. 5385, Children's Hospital GME Support Reauthorization Act of 2018 Opioid issues (incorporated under Health)

Client expense: $70,000 · Firm income: Not reported

H.R. 4710 340B PAUSE Act S. 2312 HELP Act S. 2957; H.R. 5385 Children's Hospital Support Graduate Medical Education Reauthorization H.R. 5678 Rural Emergency Medical Center Act CMS-1695-P Comments CMS-1694-P Comments on uncompensated care costs and worksheet, hospital standard charge requirements, Car T Cell reimbursement, Inpatient Quality Reporting Program (IQR) CMS Request for Information: Physician Self-referral law CMS-1693-P, Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2019; Medicare Shared Savings Program Requirements; Quality Payment Program; and Medicaid Promoting Interoperability Program

Client expense: Not reported · Firm income: $37,000

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

H.R. 4710 340B PAUSE Act S. 2312 HELP Act S. 2957; H.R. 5385 Children's Hospital Support Graduate Medical Education Reauthorization H.R. 5678 Rural Emergency Medical Center Act CMS-1695-P Comments CMS-1694-P Comments on uncompensated care costs and worksheet, hospital standard charge requirements, Car T Cell reimbursement, Inpatient Quality Reporting Program (IQR) CMS Request for Information: Physician Self-referral law CMS-1693-P, Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2019; Medicare Shared Savings Program Requirements; Quality Payment Program; and Medicaid Promoting Interoperability Program

Client expense: Not reported · Firm income: $7,900

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

H.R. 4710 340B PAUSE Act S. 2312 HELP Act S. 2957; H.R. 5385 Children's Hospital Support Graduate Medical Education Reauthorization H.R. 5678 Rural Emergency Medical Center Act CMS-1695-P Comments CMS-1694-P Comments on uncompensated care costs and worksheet, hospital standard charge requirements, Car T Cell reimbursement, Inpatient Quality Reporting Program (IQR) CMS Request for Information: Physician Self-referral law CMS-1693-P, Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2019; Medicare Shared Savings Program Requirements; Quality Payment Program; and Medicaid Promoting Interoperability Program

Client expense: $66,000 · Firm income: Not reported

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

Support for Graduate Medical Education (GME) funding including the Resident Physician Shortage Reduction Act (S. 1301/H.R. 2267) and the Opioid Workforce Act of 2018 (H.R. 5818/S. 2843) Support for legislation to address opioid epidemic (SUPPORT for Patients and Communities Act (H.R. 6)) including bills to modify to institute of mental disease exclusion (H.R. 5797) and to align 42 CFR Part 2 with the Health Insurance Portability and Accountability Act (H.R. 6082) and policies to expand ability to prescribe buprenorphine treatment Support for full protection of Critical Access Hospital payments Support for REMC Act of 2018 (H.R. 5678) Support for Fairness in Liver Allocation Act (H.R. 6517) Support for changes to Medicare Volume Decrease Adjustment calculation Support for correction of erroneous reductions of GME residency positions Opposition to 340B program reductions in Centers for Medicare and Medicaid Services (CMS) 2018 Outpatient Prospective Payment System (OPPS) proposed rule [CMS-1678-P] and support for legislation (H.R. 4392, H.R. 6071) to halt these payment cut Opposition to changes to 340B program (H.R. 4710, H.R. 6240) Opposition to site-neutral payment reductions to hospital outpatient departments proposed in CMS 2019 OPPS proposed rule [CMS-1695-P] Support for policies to preserve Medicare Disproportionate Share Hospital funding as part of CMS 2019 Inpatient Prospective Payment System proposed rule [CMS-1694-P]

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

CMS proposed 2019 outpatient and physician fee schedule rules on site neutral and 340B Medicare reimbursement reductions. CMS proposed rule mandating the web posting of hospital charges Rural Emergency Medical Center Act of 2018 (H.R. 5678) Opioid Crisis Response Act (H.R. 6). The Overdose Prevention and Patient Safety Act (H.R. 6082) The Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, H.R. 6378)

Client expense: $50,000 · Firm income: Not reported

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

CMS proposed 2019 outpatient and physician fee schedule rules on site neutral and 340B Medicare reimbursement reductions. CMS proposed rule mandating the web posting of hospital charges Rural Emergency Medical Center Act of 2018 (H.R. 5678) Opioid Crisis Response Act (H.R. 6). The Overdose Prevention and Patient Safety Act (H.R. 6082) The Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, H.R. 6378)

Client expense: $50,000 · Firm income: Not reported

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

CMS proposed 2019 outpatient and physician fee schedule rules on site neutral and 340B Medicare reimbursement reductions. CMS proposed rule mandating the web posting of hospital charges Rural Emergency Medical Center Act of 2018 (H.R. 5678) Opioid Crisis Response Act (H.R. 6). The Overdose Prevention and Patient Safety Act (H.R. 6082) The Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018, H.R. 6378)

Client expense: $50,000 · Firm income: Not reported

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

H.R.817-End Surprise Billing Act of 2017 H.R.1323-Reducing Unnecessary Emergency Room Visits under Medicaid Act H.R.2957-Save Rural Hospitals Act H.R.3181-Medicare Choices Empowerment and Protection Act H.R.5678-Rural Emergency Medical Center Act of 2018 S.260-Protecting Seniors' Access to Medicare Act of 2017 S.284-End Surprise Billing Act of 2017 S.568-Improving Access to Medicare Coverage Act of 2017 S.1130-Rural Emergency Acute Care Hospital (REACH) Act S.1530- Medicare Choices Empowerment and Protection Act

Client expense: $702,392 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

Essential emergency medication shortages Mental health services for emergency psychiatric patients Price transparency of emergency medical services Due process rights for physicians furnishing emergency medical services H.Res.906-Congratulating the American College of Emergency Physicians on its 50th anniversary H.R.6-Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act H.R.372-Competetive Health Insurance Reform Act of 2017 H.R.548-Health Care Safety Net Enhancement Act of 2017 H.R.767-Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness Act of 2017 H.R.817-End Surprise Billing Act of 2017 H.R.880-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act H.R.1057-Synthetics Trafficking and Overdose Prevention Act of 2017 H.R.1215-Protecting Access to Care Act of 2017 H.R.1323-Reducing Unnecessary Emergency Room Visits under Medicaid Act H.R.1492-Medical Controlled Substances Transportation Act of 2017 H.R.1565-Saving Lives, Saving Costs Act H.R.1822-Good Samaritan Health Professionals Act of 2017 H.R.1876-Good Samaritan Health Professionals Act of 2017 H.R.2200-Frederick Douglass Trafficking Victims Prevention and Protection Reauthorization Act of 2017 H.R.2851-Stop the Importation and Trafficking of Synthetic Analogues (SITSA) Act of 2017 H.R.2957-Save Rural Hospitals Act H.R.3181-Medicare Choices Empowerment and Protection Act H.R.3258-Marketplace Certainty Act H.R.3545-Overdose Prevention and Patient Safety (OPPS) Act H.R.4922-Stopping Overdoses of Fentanyl Analogues Act H.R.5176-Preventing Overdoses While in Emergency Rooms Act of 2018 H.R.5197-Alternatives to Opioids (ALTO) in the Emergency Department Act H.R.5531-Opioid Emergency Response Act H.R.5558-Alternatives to Opioids Prescribing Act H.R.5678-Rural Emergency Medical Center Act of 2018 H.R.6082-Overdose Prevention and Patient Safety (OPPS) Act S.191-Patient Freedom Act of 2017 S.256-SOAR to Health and Wellness Act of 2017 S.284-End Surprise Billing Act of 2017 S.372- Synthetics Trafficking and Overdose Prevention Act of 2017 S.527-Health Care Safety Net Enhancement Act of 2017 S.568-Improving Access to Medicare Coverage Act of 2017 S.781-Good Samaritan Health Professionals Act of 2017 S.1016-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 S.1022-Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act S.1130-Rural Emergency Acute Care Hospital (REACH) Act S.1462-Marketplace Certainty Act S.1530- Medicare Choices Empowerment and Protection Act S.1553-Stopping Overdoses of Fentanyl Analogues Act S.1835-Lower Premiums Through Reinsurance Act of 2017 S.2516-Alternatives to Opioids (ALTO) in the Emergency Department Act S.2609-Recovery Coaches Offer Addiction Counseling and Healing (COACH) Act S.2610-Preventing Overdoses While in Emergency Departments Act of 2018

H.R. 4710 - 340B PAUSE Act S. 2312 HELP Act S. 2957; H.R. 5385 Children's Hospital Graduate Medical Education Reauthorization H.R. 5678 Rural Emergency Medical Center Act 2019 IPPS - CMS-1689-P

Client expense: Not reported · Firm income: $7,900

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

H.R. 4710 340B PAUSE Act S. 2312 HELP Act S. 2957; H.R. 5385 Children's Hospital Graduate Medical Education Reauthorization H.R. 5678 Rural Emergency Medical Center Act 2019 IPPS- CMS-1689-P

Client expense: $125,000 · Firm income: Not reported

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

H.R. 4710 340B PAUSE Act S. 2312 HELP Act S. 2957; H.R. 5385 Children's Hospital Support Graduate Medical Education Reauthorization H.R. 5678 Rural Emergency Medical Center Act 2019 IPPS - CMS-1689-P

Client expense: Not reported · Firm income: $37,000

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

H.R. 1892, Bipartisan Budget Act of 2018 Rural hospital policies (H.R. 741/S. 243, H.R. 1955/S. 872, S. 1130, straight policy extension of Medicare dependent hospital and low volume adjustment payments, H.R. 1892, Bipartisan Budget Act of 2018); H.R. 5678, Rural Emergency Medical Center (REMC) Act of 2018) Childrens Health Insurance Program (CHIP) (H.R. 3, Spending Cuts to Expired and Unnecessary Programs Act) Disproportionate share hospital payments (H.R. 1892, Bipartisan Budget Act of 2018; implementation of the S-10 worksheet) Hospital quality star ratings H.R. 2267 / S. 1301, Resident Physician Shortage Reduction Act H.R. 5818 / S. 2843, Opioid Workforce Act Medicaid Graduate Medical Education Transparency Act Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018) Stark law reform Hospital outpatient payment policy 60 percent rule for inpatient rehab hospitals 25 percent rule for long term care hospitals Graduate Nurse Education pilot program S. 2597 / H.R. 5385, Children's Hospital GME Support Reauthorization Act of 2018 Opioid issues (incorporated under Health)

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

Support for Graduate Medical Education (GME) funding including the Resident Physician Shortage Reduction Act (S. 1301/H.R. 2267) and the Opioid Workforce Act of 2018 (H.R. 5818/S. 2843) Support for legislation to address opioid epidemic including bills to modify to institute of mental disease exclusion (H.R. 5797) and to align 42 CFR Part 2 with the Health Insurance Portability and Accountability Act (H.R. 6082) Support for full protection of Critical Access Hospital payments Support for REMC Act of 2018 (H.R. 5678) Support for changes to Medicare Volume Decrease Adjustment calculation Support for correction of erroneous reductions of GME residency positions Opposition to 340B program reductions in Centers for Medicare and Medicaid Services (CMS) 2018 Outpatient Prospective Payment System proposed rule [CMS-1678-P] and support for legislation (H.R. 4392, H.R. 6071) to halt these payment cut Support for policies to preserve Medicare Disproportionate Share Hospital funding as part of CMS 2019 Inpatient Prospective Payment System proposed rule [CMS-1694-P]

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

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

Rural Hospital Regulatory Relief Act of 2017 (HR 741. S 243) 340B Drug Pricing Program Rural Emergency Medical Center Act of 2018 (HR 5678) Poison Center Network Enhancement Act (HR 5329) Post-Surgical Injections as an Opioid Alternative Act (HR 5804) IMD Care Act (HR 5797) Overdose Prevention and Patient Safety Act (HR 5797) Illinois Hospital Assessment

Client expense: $160,000 · Firm income: Not reported

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

Rural Hospital Regulatory Relief Act of 2017 (HR 741. S 243) 340B Drug Pricing Program Rural Emergency Medical Center Act of 2018 (HR 5678) Poison Center Network Enhancement Act (HR 5329) Illinois Hospital Assessment

Client expense: $160,000 · Firm income: Not reported

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

Rural Hospital Regulatory Relief Act of 2017 (HR 741. S 243) 340B Drug Pricing Program Rural Emergency Medical Center Act of 2018 (HR 5678) Poison Center Network Enhancement Act (HR 5329) Post-Surgical Injections as an Opioid Alternative Act (HR 5804) IMD Care Act (HR 5797) Overdose Prevention and Patient Safety Act (HR 5797) Illinois Hospital Assessment

Client expense: $160,000 · Firm income: Not reported

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

H.R. 4392, a bill to restore cuts to hospitals as part of the 340b drug reimbursement program that were made in the final OPPS rule, particularly regarding Congressional cosponsorship and support of the measure. Support for eliminating sequestration for Medicare. Support for H.R. 5678, a bill that would establish a new model of Medicare reimbursement for rural hospitals that operate as rural emergency medical centers.

Client expense: Not reported · Firm income: $30,000

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, SENATE

Support for the 340b program, HR 4392. Support for full funding for the Rural Health Care telemedicine program. Support for new models of care, HR 5678.

Client expense: Not reported · Firm income: $30,000

Government targets: Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, SENATE