Dr. Todd Graham Pain Management Improvement Act of 2018

Implementation/Expansion of CDC Falls Program Implementation of Affordable Care Act - provisions pertaining to Essential Health Benefits & Health Insurance Exchanges AHRQ provisions pertaining to PT Physician self-referra/Stark Law American Cures Act H.R. 930/S.497 Lymphadema Treatment Act Health Information Technology Nominations to PCORI Methodology Committees Medicaid Expansion HR. 1639/S.619 Physical Therapist Workforce & Patient Access Act Physician owned distributerships H.R. 302/S.808 Sports Medicine Licensure Clarity Act MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Insurance Benefit parameters H.R. 1361/S.486 Ensuring Access to Quality CRT Medicare Telehealth Parity Act HR2550 American Healthcare Act of 2017/CONNECT - H.R. 2556/S1016 H.R. 1628 - American Health Care Action of 2017 Opioid Epidemic/Pain Management Better Care Reconciliation Act of 2017 H.R.2066 Promoting Integrity in Medicare H.R. 2063 Opioid Pace Act of 2017 H.R. 5261 Teach Act H.R. 5197 Alto Act H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act S. 3120, the HEAL Act S. 2680, Opioid Crisis Response Act Association Retirement Plans State Relief and Empowerment Waivers D.O.L Information Collection Request Extensions Health Reimbursement Accounts HR 7217: Improve Act

Client expense: $252,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 807/S.253 Medicare Access to Rehabilitation Services Act (Medicare Appeals Procedures) QPP Prevention Initiatives for Fraud and Abuse in The Medicare program Accountable health care organizations/patient centered medical homes Electronic health records/health information technology incentives for Physical Therapists Local coverage determinations/EMG NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National priority for research and research agenda Health information technology Functional Limitation Reporting Therapy Cap: Targeted Medical Review Essential Health Benefits MIPS/PPP Medicaid essential health benefits EHR/LTPAC settings: transitions of care Medicare improvement standards Bundled payment models/CJR Common assessment tool for Medicare post-acute care Medicare appeals process Inclusion of physical therapists in quality programs Self-referral Coverage of telehealth APTA Registry Quality Programs Accelerating Innovation in Medicine Act (AIM) IMPACT Medicare Pilot Programs Chronic Care Management New evaluation and reevaluation CPT codes & misvalued codes Orthotics and Prosthetics Medicare Private Contracting S.870 - Chronic Care Act SNF 3-Day Rule Registry- ACI HR 2042 - Frontline Act Youth Concussion Management DME HR 3446 RBI Act H.R. 5261 Teach Act Opioid related H.R. 5197 Alto Act Opioid related Administrative Burden H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. S. 3120, HEAL Act S. 2680, Opioid Crisis Response Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Certified EHR technology HR 7217 Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act (IMPROVE ACT) S. 3458: Improvements to Home Health HR 3635: Local Coverage Determination Clarification Act of 2018

H.R. - 1628 American Health Care Act S.Con.Res.3 - Concurrent Resolution Setting Forth Budgetary Levels for FY 18-26 H.R. 1378 - National Health Service Corps Improvement Act H.R. 372 - Competitive Health Insurance Reform Act H.R. 302 - Sports Medicine Licensure Clarity Act S. 808 Sports Medicine Licensure Clarity Act H.R. 1628 Better Care Reconciliation Act H.R. 2202 Chiropractic Membership in the Public Health Service Commissioned Corps Act H.R. 1370 Continuing Resolution H.J. Res. 123 Continuing Resolution H.R. 1625 Vehicle for Consolidated Appropriations Act 2018 H.R. 2042 Access to Frontline Health Act H.R. 5722 Dr. Todd Graham Pain Management Improvement Act S. 3008 Dr. Todd Graham Pain Management Improvement Act H.R. 5776 MOST Act H.R. 4508 PROSPER Act H.R. 6157 Appropriations for DOD, Labor/HHS/Education and Continuing Appropriations for all other agencies

Client expense: $72,063 · Firm income: Not reported

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

S. 977/HR 3820 and HR 6225: Medicare Home Health Flexibility Act - Advocate for passage . HR 2550: Medicare Telehealth Parity Act of 2017 - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. HR2556: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; S787: A bill to require the Center for Medicare and Medicaid Innovation to test the effect of including telehealth services in Medicare health care delivery reform models; HR3360: Telehealth Enhancement Act; HR3482: Evidence-Based Telehealth Expansion Act; S1016: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; and HR3727: A bill to amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes. - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. No bill# Red Tape Reduction Initiative from Ways and Means Committee: Submitted following priorities for occupational therapy red tape reduction - 1) Initiation of Home Health Therapy Services Under Medicare (S. 977/HR 3820 now HR 6225), 2) Recognition of Occupational Therapy as a Primary Rehab Service (no bill number), 3) Permanently Eliminate Outside Certification Requirement for Occupational Therapists to Fabricate Custom Orthotics and Prosthetic Items (no bill number), 4) Modify or Eliminate Claims-Based Data Collection of Functional Limitation Information for Therapy Services (no bill number), 5) Add Doctor-prescribed Compression Supplies to the Durable Medical Equipment category (S 497/HR 930), and 6) Medicare Opt-out Option (no bill number). No Bill: Discussed how Stark laws affect the ability of occupational therapy practitioners to provide coordinated care services, particularly as it relates to the management of chronic conditions. S. 497/HR 930: Lymphedema Treatment Act - Support passage. No bill: Advocate for role of skilled therapy in changing reimbursement under Medicare Part A and Part B. HR 6, HR 5722, HR 5774, HR 5776, HR 6110, S 3008 and S 3120: (Various Bills on Opioids) Educate Members of Congress about the role of occupational therapy in the non-pharmacological management of pain, and advocate for any legislation that includes studies or funding for these alternatives, includes occupational therapy. Discussed and examined the effect of changes to reimbursement for occupational therapy assistants included in the Bi-partisan Budget Act, and possibly requesting a report from the GAO.

No bill #: Educated about the role of occupational therapy in falls prevention. HR 1757 Trauma Informed Care for Children and Families: Educated about occupational therapy's role. HR 6, HR 5722, HR 5774, HR 5776, HR 6110, S 3008 and S 3120: (Various Bills on Opioids) Educate Members of Congress about the role of occupational therapy in the non-pharmacological management of pain, and advocate for any legislation that includes studies or funding for these alternatives, includes occupational therapy. No bill: Educate members of occupational therapy's role in general mental health care and trauma informed care.

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

Government targets: HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

H.R. - 1628 American Health Care Act S.Con.Res.3 - Concurrent Resolution Setting Forth Budgetary Levels for FY 18-26 H.R. 1378 - National Health Service Corps Improvement Act H.R. 372 - Competitive Health Insurance Reform Act H.R. 302 - Sports Medicine Licensure Clarity Act S. 808 Sports Medicine Licensure Clarity Act H.R. 1628 Better Care Reconciliation Act H.R. 2202 Chiropractic Membership in the Public Health Service Commissioned Corps Act H.R. 1370 Continuing Resolution H.J. Res. 123 Continuing Resolution H.R. 1625 Vehicle for Consolidated Appropriations Act 2018 H.R. 2042 Access to Frontline Health Act H.R. 5722 Dr. Todd Graham Pain Management Improvement Act S. 3008 Dr. Todd Graham Pain Management Improvement Act H.R. 5776 MOST Act H.R. 4508 PROSPER Act H.R. 6157 Appropriations for DOD, Labor/HHS/Education and Continuing Appropriations for all other agencies

Client expense: $72,063 · Firm income: Not reported

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

H.R. 807/S.253 Medicare Access to Rehabilitation Services Act (Repeal of Therapy Caps) QPP Prevention Initiatives for Fraud and Abuse in The Medicare program Accountable health care organizations/patient centered medical homes Electronic health records/health information technology incentives for Physical Therapists Local coverage determinations/EMG NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National priority for research and research agenda Health information technology Functional Limitation Reporting Therapy Cap: Targeted Medical Review Essential Health Benefits MIPS/PPP Medicaid essential health benefits EHR/LTPAC settings: transitions of care Medicare improvement standards Bundled payment models/CJR Common assessment tool for Medicare post-acute care Medicare appeals process Inclusion of physical therapists in quality programs Self-referral Coverage of telehealth APTA Registry Quality Programs Accelerating Innovation in Medicine Act (AIM) IMPACT Medicare Pilot Programs Chronic Care Management New evaluation and reevaluation CPT codes & misvalued codes Orthotics and Prosthetics Medicare Private Contracting S.870 - Chronic Care Act SNF 3-Day Rule Registry- ACI HR 2042 - Frontline Act Youth Concussion Management DME HR 3446 RBI Act H.R. 5261 Teach Act Opioid related H.R. 5197 Alto Act Opioid related Administrative Burden H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. S. 3120, HEAL Act S. 2680, Opioid Crisis Response Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Certified EHR technology

Implementation/Expansion of CDC Falls Program Implementation of Affordable Care Act - provisions pertaining to Essential Health Benefits & Health Insurance Exchanges AHRQ provisions pertaining to PT Physician self-referra/Stark Law American Cures Act H.R. 930/S.497 Lymphadema Treatment Act Health Information Technology Nominations to PCORI Methodology Committees Medicaid Expansion HR. 1639/S.619 Physical Therapist Workforce & Patient Access Act Physician owned distributerships H.R. 302/S.808 Sports Medicine Licensure Clarity Act MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Insurance Benefit parameters H.R. 1361/S.486 Ensuring Access to Quality CRT Medicare Telehealth Parity Act HR2550 American Healthcare Act of 2017/CONNECT - H.R. 2556/S1016 H.R. 1628 - American Health Care Action of 2017 Opioid Epidemic/Pain Management Better Care Reconciliation Act of 2017 H.R.2066 Promoting Integrity in Medicare H.R. 2063 Opioid Pace Act of 2017 H.R. 5261 Teach Act H.R. 5197 Alto Act H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act S. 3120, the HEAL Act S. 2680, Opioid Crisis Response Act

Client expense: $251,000 · Firm income: Not reported

H.R. 5818/S. 2843 - "Opioid Workforce Act of 2018" - Supported Legislation. H.R. 5675 - "To amend title XVIII of the Social Security Act to require prescription Drug Plan Sponsors Under the Medicare Program to Establish Drug Management Programs For At Risk Beneficiaries" - Review and monitor legislation. H.R. 4841 - "Standardizing Electronic Prior Authorization for Safe Prescribing Act of 2018" - Review and monitor legislation. H.R. 5676 - "Stop Excessive Narcotics in our Retirement Communities Protection Act of 2018" - Review and monitor legislation. H.R. 5684 - "Protecting Seniors From Opioid Abuse Act" - Review and monitor legislation. H.R. 5699 - "Hospital Opioid Solutions Toolkit (HOST) Act" - Review and monitor legislation. H.R. 5686 - "Medicare Clear Health Options in Care for Enrollees Act of 2018" - Review and monitor legislation. H.R. 5722 - "Dr. Todd Graham Pain Management Improvement Act of 2018" - Review and monitor legislation. S. 2852 - "The Pandemic and All Hazards Preparedness Act (PAHPA)" - Monitored and reviewed legislation. Monitored Congressional Proposals concerning health price transparency. H.R. 3415 - "Megan Rondini Act" - Monitored and provided comment. H.R. 4613 - "Ensuring Patient Access to Healthcare Records Act of 2017" - Monitored Legislation.

Client expense: $610,000 · Firm income: Not reported

No bill: Advocated for continuation of the Essential Health Benefits that are included in the Affordable Care Act, protection of Medicaid and no cuts. No bill #: Educated about the role of occupational therapy in falls prevention. HR 1757 Trauma Informed Care for Children and Families: Educated about occupational therapy's role. HR 6, HR 5722, HR 5774, HR 5776, HR 6110, S 3008 and S 3120: (Various Bills on Opioids) Educate Members of Congress about the role of occupational therapy in the non-pharmacological management of pain, and advocate for any legislation that includes studies or funding for these alternatives, includes occupational therapy. No bill: Educate regarding occupational therapy role with traumatic brain injury. No bill: Educate members of occupational therapy's role in general mental health care and trauma informed care.

Client expense: $270,000 · Firm income: Not reported

S. 977/HR 3820 and HR 6225: Medicare Home Health Flexibility Act - Advocate for passage . HR 2550: Medicare Telehealth Parity Act of 2017 - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. HR2556: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; S787: A bill to require the Center for Medicare and Medicaid Innovation to test the effect of including telehealth services in Medicare health care delivery reform models; HR3360: Telehealth Enhancement Act; HR3482: Evidence-Based Telehealth Expansion Act; S1016: Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; and HR3727: A bill to amend title XVIII of the Social Security Act to include additional telehealth services for purposes of MA organization bids, and for other purposes. - Advocated for the inclusion of occupational therapy as part of telehealth legislation that would allow for reimbursement of certain telehealth services under Medicare. No bill# Red Tape Reduction Initiative from Ways and Means Committee: Submitted following priorities for occupational therapy red tape reduction - 1) Initiation of Home Health Therapy Services Under Medicare (S. 977/HR 3820 now HR 6225), 2) Recognition of Occupational Therapy as a Primary Rehab Service (no bill number), 3) Permanently Eliminate Outside Certification Requirement for Occupational Therapists to Fabricate Custom Orthotics and Prosthetic Items (no bill number), 4) Modify or Eliminate Claims-Based Data Collection of Functional Limitation Information for Therapy Services (no bill number), 5) Add Doctor-prescribed Compression Supplies to the Durable Medical Equipment category (S 497/HR 930), and 6) Medicare Opt-out Option (no bill number). No Bill: Discussed how Stark laws affect the ability of occupational therapy practitioners to provide coordinated care services, particularly as it relates to the management of chronic conditions. S. 497/HR 930: Lymphedema Treatment Act - Support passage. No bill: Advocate for role of skilled therapy in changing reimbursement under Medicare Part A. HR 6, HR 5722, HR 5774, HR 5776, HR 6110, S 3008 and S 3120: (Various Bills on Opioids) Educate Members of Congress about the role of occupational therapy in the non-pharmacological management of pain, and advocate for any legislation that includes studies or funding for these alternatives, includes occupational therapy. Discussed and examined the effect of changes to reimbursement for occupational therapy assistants included in the Bi-partisan Budget Act, and possibly requesting a report from the GAO.

Implementation/Expansion of CDC Falls Program Implementation of Affordable Care Act - provisions pertaining to Essential Health Benefits & Health Insurance Exchanges AHRQ provisions pertaining to PT Physician self-referra/Stark Law American Cures Act H.R. 930/S.497 Lymphadema Treatment Act Health Information Technology Nominations to PCORI Methodology Committees Medicaid Expansion HR. 1639/S.619 Physical Therapist Workforce & Patient Access Act Physician owned distributerships H.R. 302/S.808 Sports Medicine Licensure Clarity Act MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Insurance Benefit parameters H.R. 1361/S.486 Ensuring Access to Quality CRT Medicare Telehealth Parity Act HR2550 American Healthcare Act of 2017/CONNECT - H.R. 2556/S1016 H.R. 1628 - American Health Care Action of 2017 Opioid Epidemic/Pain Management Better Care Reconciliation Act of 2017 H.R.2066 Promoting Integrity in Medicare H.R. 2063 Opioid Pace Act of 2017 H.R. 5261 Teach Act H.R. 5197 Alto Act H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act S. 3120, the HEAL Act S. 2680, Opioid Crisis Response Act

Client expense: $292,000 · Firm income: Not reported

H.R. 807/S.253 Medicare Access to Rehabilitation Services Act (Repeal of Therapy Caps) QPP Prevention Initiatives for Fraud and Abuse in The Medicare program Accountable health care organizations/patient centered medical homes Electronic health records/health information technology incentives for Physical Therapists Local coverage determinations/EMG NCCI Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage PCORI National priority for research and research agenda Health information technology Functional Limitation Reporting Therapy Cap: Targeted Medical Review Essential Health Benefits MIPS/PPP Medicaid essential health benefits EHR/LTPAC settings: transitions of care Medicare improvement standards Bundled payment models/CJR Common assessment tool for Medicare post-acute care Medicare appeals process Inclusion of physical therapists in quality programs Self-referral Coverage of telehealth APTA Registry Quality Programs Accelerating Innovation in Medicine Act (AIM) IMPACT Medicare Pilot Programs Chronic Care Management New evaluation and reevaluation CPT codes & misvalued codes Orthotics and Prosthetics Medicare Private Contracting S.870 - Chronic Care Act SNF 3-Day Rule Registry- ACI HR 2042 - Frontline Act Youth Concussion Management DME HR 3446 RBI Act H.R. 5261 Teach Act Opioid related H.R. 5197 Alto Act Opioid related Administrative Burden H.R. 5686, Medicare Clear Health Options in Care for Enrollees Act H.R. 5773, Preventing Addiction for Susceptible Seniors Act H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act H.R. 5718, Perioperative Reduction for Opioids Act H.R. 5719, Reduce Overprescribing Opioids in Treatment Act H.R. 5722, Dr. Todd Graham Pain Management Improvement Act H.R. 6, Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. S. 3120, HEAL Act S. 2680, Opioid Crisis Response Act

H.R. - 1628 American Health Care Act S.Con.Res.3 - Concurrent Resolution Setting Forth Budgetary Levels for FY 18-26 H.R. 1378 - National Health Service Corps Improvement Act H.R. 372 - Competitive Health Insurance Reform Act H.R. 302 - Sports Medicine Licensure Clarity Act S. 808 Sports Medicine Licensure Clarity Act H.R. 1628 Better Care Reconciliation Act H.R. 2202 Chiropractic Membership in the Public Health Service Commissioned Corps Act H.R. 1370 Continuing Resolution H.J. Res. 123 Continuing Resolution H.R. 1625 Vehicle for Consolidated Appropriations Act 2018 H.R. 2042 Access to Frontline Health Act H.R. 5722 Dr. Todd Graham Pain Management Improvement Act S. 3008 Dr. Todd Graham Pain Management Improvement Act H.R. 5776 MOST Act H.R. 4508 PROSPER Act

Client expense: $46,125 · Firm income: Not reported

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