To amend title XVIII of the Social Security Act to provide for direct payment to physician assistants under the Medicare program for certain services furnished by such physician assistants.

Medicare reimbursement including incident to billing; Medicare hospice restrictions; transparency; Veterans health care; opioid addiction treatment; ; H.R. 808/S. 237 - promoting access to diabetic shoes; S. 596/H.R. 1052 - PA direct payment; H.R. 900 - ACO Assignment Improvement Act; Telehealth, Cardiac and Pulmonary Rehabilitation and Care Act (S. 2842, HR 3911), Implementation issues with respect to H.R. 6201 - Families First Corona Virus Response Act; H.R. 748 - Corona Virus Relief and Economic Security Act (CARES)and Home Healthcare Planning and Improvement Act; H.R. 6800 - the Heroes Act.

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Emergency federal response to COVID-19 (including S 3548, HR 6800), Medicare reimbursement and incident to billing, Medicare hospice restrictions, Medicare definition of PA services, transparency, healthcare competition, PA Direct Payment Act (S 596, HR 1052), implementation of home health provisions and other provisions of the Coronavirus Aid, Relief, and Economic Security (CARES) Act ), Promoting Access to Diabetic Shoes Act (S 237, HR 808), the Mainstreaming Addiction Treatment Act (S 2074, HR 2482), Medication Access and Training Expansion Act (HR 4974), Increasing Access to Quality Cardiac Rehabilitation Care Act (S 2842, HR 3911), ACO Assignment Improvement Act (HR 900), PA Educational and Workforce Training Programs, surprise billing, Rural Health Clinic Modernization Act (S 1037 HR 2788), medical record documentation, federal PA workforce issues at the Departments of Veterans Affairs, Indian Health Services, and Bureau of Prisons, and requirements and restrictions related to federal DEA waivers to prescribe buprenorphine to treat opioid use disorder, ensuring PAs considered primary care and behavioral health providers (S 2793, HR 2774, HR 5575)

Client expense: $180,000 · Firm income: Not reported

Medicaid Fiscal Accountability Regulation Rural hospital policies (S. 586/H.R. 1041, Critical Access Hospital Relief Act of 2019; H.R. 1052; S. 895, Rural Hospital Regulatory Relief Act of 2019; S. 948/H.R. 2895, Conrad 30 and Physician Access Act; H.R. 3429, the HEARTS and Rural Relief Act; Rural Hospital Closure Relief Act (S. 3101/H.R. 5481) Ways and Means Health Task Force on Rural and Underserved Communities RFI Graduate Medical Education (GME) funding (S. 348/H.R. 1763, Resident Physician Shortage Reduction Act of 2019; H.R. 2349/H.R. 3414 Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts (H.R. 3022, Patient Access Protection Act) Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 3417 Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act) Extending the Medicaid demonstration program for certified community behavioral health clinics (H.R.3253, Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019; S. 824/H.R. 1767, Excellence in Mental Health and Addiction Treatment Expansion Act) Stark law reform Hospital outpatient payment policy Site neutral payment policy included in outpatient prospective payment system rule (H.R.2552, Protecting Local Access to Care for Everyone Act of 2019) Improving Seniors Timely Access to Care Act (H.R. 3107) Chronic Care Management Improvement Act (H.R. 3436) OPPS and physician fee schedule rules Executive Order Protecting and Improving Medicare for our Nation's Seniors

Client expense: $100,000 · Firm income: Not reported

Medicare reimbursement including incident to billing; Medicare hospice restrictions; transparency; Veterans health care; opioid addiction treatment; S. 296/H.R. 2150- Home Healthcare Planning and Improvement Act; H.R. 808/S. 237 - promoting access to diabetic shoes; S. 596/H.R. 1052 - PA direct payment; H.R. 900 - ACO Assignment Improvement Act; Telehealth, Cardiac and Pulmonary Rehabilitation and Care Act (S. 2842, HR 3911), H.R. 6201 - Families First Corona Virus Response Act; H.R. 748 - Corona Virus Relief and Economic Security Act (CARES)(S. 3548).

Client expense: Not reported · Firm income: $60,000

Emergency federal response to COVID-19 (HR 748, HR 6201, S 3548), Medicare reimbursement and incident to billing, Medicare hospice restrictions, Medicare definition of PA services, transparency, healthcare competition, PA Direct Payment Act (S 596, HR 1052), Home Health Care Planning Improvement Act (S 296, HR 2150), Promoting Access to Diabetic Shoes Act (S 237, HR 808), the Mainstreaming Addiction Treatment Act (S 2074, HR 2482), Medication Access and Training Expansion Act (HR 4974), Increasing Access to Quality Cardiac Rehabilitation Care Act (S 2842, HR 3911), ACO Assignment Improvement Act (HR 900), PA Educational and Workforce Training Programs, surprise billing, Rural Health Clinic Modernization Act (S 1037 HR 2788), medical record documentation, federal PA workforce issues at the Departments of Veterans Affairs, Indian Health Services, and Bureau of Prisons, and requirements and restrictions related to federal DEA waivers to prescribe buprenorphine to treat opioid use disorder, ensuring PAs considered primary care and behavioral health providers (S 2793, HR 2774, HR 5575)

Client expense: $170,000 · Firm income: Not reported

Medicare Fiscal Accountability Regulation Price Transparency Final Rule Information Blocking and Interoperability Final Rule Rural hospital policies (S. 586/H.R. 1041, Critical Access Hospital Relief Act of 2019; H.R. 1052; S. 895, Rural Hospital Regulatory Relief Act of 2019; S. 948/H.R. 2895, Conrad 30 and Physician Access Act; H.R. 3429, the HEARTS and Rural Relief Act; Rural Hospital Closure Relief Act (S. 3101/H.R. 5481) (Ways and Means Health Task Force on Rural and Underserved Communities, RFI, Rural America Health Corps Act S.2406/H.R. 4899) Graduate Medical Education (GME) funding (S. 348/H.R. 1763, Resident Physician Shortage Reduction Act of 2019; S. 2892/H.R. 3414 Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 3417 Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act Reform of the Stark Law and Anti-Kickback Statute Hospital outpatient payment policy (CY 2020 OPPS Proposed, Final Rule; Price Transparency Final Rule) Site neutral payment policy included in outpatient prospective payment system rule Improving Seniors Timely Access to Care Act (H.R. 3107) Chronic Care Management Improvement Act (H.R. 3436) Proposed AWI changes in inpatient prospective payment system proposed rule Executive Order on Improving Price and Quality Transparency Helping Medicaid Offer Maternity Services (MOMS) Act (H.R. 4996) Rural hospital policies (S. 586/H.R. 1041, Critical Access Hospital Relief Act of 2019; H.R. 1052; S. 895, Rural Hospital Regulatory Relief Act of 2019; S. 948/H.R. 2895, Conrad 30 and Physician Access Act; H.R. 3429, the HEARTS and Rural Relief Act; Rural Hospital Closure Relief Act (S. 3101/H.R. 5481) (Ways and Means Health Task Force on Rural and Underserved Communities, RFI, Rural America Health Corps Act S.2406/H.R. 4899) Graduate Medical Education (GME) funding (S. 348/H.R. 1763, Resident Physician Shortage Reduction Act of 2019; S. 2892/H.R. 3414 Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 3417 Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act) Reform of the Stark Law and Anti-Kickback Statute Hospital outpatient payment policy (CY 2020 OPPS Proposed, Final Rule; Price Transparency Final Rule) Site neutral payment policy included in outpatient prospective payment system rule Improving Seniors Timely Access to Care Act (H.R. 3107) Chronic Care Management Improvement Act (H.R. 3436) Proposed AWI changes in inpatient prospective payment system proposed rule Executive Order on Improving Price and Quality Transparency Helping Medicaid Offer Maternity Services (MOMS) Act (H.R. 4996)

2019 Q4 Lobbying Report - October 1-December 31 H.R. 1865 -- Further Consolidated Appropriations Act H.R. 986, Protecting Americans with Preexisting Conditions Act of 2019 H.R. 1010, To provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force; Oversight of final rules on short-term, limited duration insurance (STLDI) and Association Health Plans) Medicare X-Choice Proposal H.R. 1384, the Medicare for All Act of 2019 S. 1129, Medicare-for-all national health insurance program Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First S. 1895 Lower Health Care Costs Act of 2019 S. 1531 Stopping the Outrageous Practice of Surprise Medical Bills Act S. 1266 the Protecting Patients from Surprise Medical Bills Act S. 1497 the Health Care Price Check Act H.R.861the End Surprise Billing Act of 2019 S. 1688 - A bill to amend the Public Health Service Act to provide for the full disclosure of billing and service information to patients H.R. 3502 the Protecting People from Surprise Medical Bills Act H.R. 3630 No Surprises Act H.R. 2328 the Reauthorizing and Extending Americas Community Health Act S. 340/H.R. 965 CREATES Act H.R. 1499 Protecting Consumer Access to Generic Drugs Act H.R. 2375 Preserve Access to Affordable Generics and Biosimilars Act H.R. 2296 the More Efficient Tools to Realize Information for Consumers (METRIC) Act H.R. 2062 Overdose Prevention and Patient Safety Act H.R. 938 BLOCKING Act of 2019 (H.R. 938) S. 1173/H.R. 776 Emergency Medical Services for Children Program Reauthorization Act of 2019 S. 1199 Poison Center Network Enhancement Act of 2019 H.R. 2781 the Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 H.R. 728 the Title VIII Nursing Workforce Reauthorization Act Hospital Star Ratings S. 586/H.R. 1041 Critical Access Hospital Relief Act of 2019 H.R. 1052 To amend title XVIII of the Social Security Act to provide for direct payment to physician assistants under the Medicare program for certain services furnished by such physician assistants. S. 348/H.R. 1763 Resident Physician Shortage Reduction Act of 2019 H.R. 2349/H.R. 3414 Opioid Workforce Act H.R. 3022 Patient Access Protection Act H.R. 1892 Bipartisan Budget Act of 2018 H.R. 6 SUPPORT for Patients and Communities Act H.R. 3417 Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act S. 824/H.R. 1767 Excellence in Mental Health and Addiction Treatment Expansion Act Stark law reform Hospital outpatient payment policy Site neutral payment policy included in outpatient prospective payment system rule H.R.2552 Protecting Local Access to Care for Everyone Act of 2019 H.R. 3436 Chronic Care Management Improvement Act Proposed AWI changes in inpatient prospective payment system proposed rule OPPS and physician fee schedule proposed rules NIH funding Title VII health professions education and training programs FY 2020 Appropriations bills H.R. 4378 - Continuing Appropriations Act, 2020, and Health Extenders Act of 2019 Public Charge proposed rule H.R. 3 - the Elijah Cummings Lower Drug Costs Now Act Submitted Comment Letters SUBJECT: CMS-1720-P, Medicare Program; Modernizing and Clarifying the Physician Self-Referral Regulations; Federal Register Vol. 84, No. 201, October 17, 2019 SUBJECT: OIG-0936-AA10-P, Medicare and State Healthcare Programs: Fraud and Abuse; Revisions to Safe Harbors Under the Anti-Kickback Statute, and Civil Monetary Penalty Rules Regarding Beneficiary Inducements; Federal Register (Vol. 84, No. 201), October 17, 2019 SUBJECT: Docket Number FDA-2017-D-6569, Draft Guidance for Industry and Food and Drug Administration Staff: Clinical Decision Support Software SUBJECT: Public Comments on Competitive Bidding Surveys SUBJECT: Request for Information on the Future of Program Integrity SUBJECT: SAMHSA-4162-20, Confidentiality of Substance Use Disorder Patient Records, Proposed Rule, Federal Register (Vol. 84, No. 165), August 26, 2019

Rural hospital policies (S. 586/H.R. 1041, Critical Access Hospital Relief Act of 2019; H.R. 1052; S. 895, Rural Hospital Regulatory Relief Act of 2019; S. 948/H.R. 2895, Conrad 30 and Physician Access Act; H.R. 3429, the HEARTS and Rural Relief Act) Graduate Medical Education (GME) funding (S. 348/H.R. 1763, Resident Physician Shortage Reduction Act of 2019; H.R. 2349/H.R. 3414 Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts (H.R. 3022, Patient Access Protection Act) Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 3417 Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act) Extending the Medicaid demonstration program for certified community behavioral health clinics (H.R.3253, Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019; S. 824/H.R. 1767, Excellence in Mental Health and Addiction Treatment Expansion Act) Stark law reform Hospital outpatient payment policy Site neutral payment policy included in outpatient prospective payment system rule (H.R.2552, Protecting Local Access to Care for Everyone Act of 2019) Improving Seniors Timely Access to Care Act (H.R. 3107) Chronic Care Management Improvement Act (H.R. 3436) OPPS and physician fee schedule rules Executive Order Protecting and Improving Medicare for our Nation's Seniors

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

Medicare reimbursement including incident to billing; Medicare hospice restrictions; transparency; Veterans health care; opioid addiction treatment; S. 296/H.R. 2150- Home Healthcare Planning and Improvement Act; H.R. 808/S. 237 - promoting access to diabetic shoes; S. 596/H.R. 1052 - PA direct payment; H.R. 900 - ACO Assignment Improvement Act

Client expense: Not reported · Firm income: $60,000

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Medicare reimbursement and incident to billing, Medicare hospice restrictions, Medicare definition of PA services, transparency, healthcare competition, PA Direct Payment Act (S 596, HR 1052), Home Health Care Planning Improvement Act (S 296, HR 2150), Promoting Access to Diabetic Shoes Act (S 237, HR 808), the Mainstreaming Addiction Treatment Act (S 2074, HR 2482), Increasing Access to Quality Cardiac Rehabilitation Care Act (S 2842, HR 3911), ACO Assignment Improvement Act (HR 900), PA Educational and Workforce Training Programs, surprise billing, Rural Health Clinic Modernization Act (S 1037 HR 2788), medical record documentation, issues related to federal PA workforce at the Departments of Veterans Affairs, Defense and Indian Health Services, requirements and restrictions related to federal DEA waivers to prescribe buprenorphine to treat opioid use disorder.

Client expense: $170,000 · Firm income: Not reported

Rural hospital policies (S. 586/H.R. 1041, Critical Access Hospital Relief Act of 2019; H.R. 1052; S. 895, Rural Hospital Regulatory Relief Act of 2019; S. 948/H.R. 2895, Conrad 30 and Physician Access Act; H.R. 3429, the HEARTS and Rural Relief Act; Rural Hospital Closure Relief Act (S. 3101/H.R. 5481) (Ways and Means Health Task Force on Rural and Underserved Communities, RFI, Rural America Health Corps Act S.2406/H.R. 4899) Graduate Medical Education (GME) funding (S. 348/H.R. 1763, Resident Physician Shortage Reduction Act of 2019; S. 2892/H.R. 3414 Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 3417 Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act) Reform of the Stark Law and Anti-Kickback Statute Hospital outpatient payment policy (CY 2020 OPPS Proposed, Final Rule; Price Transparency Final Rule) Site neutral payment policy included in outpatient prospective payment system rule Improving Seniors Timely Access to Care Act (H.R. 3107) Chronic Care Management Improvement Act (H.R. 3436) Proposed AWI changes in inpatient prospective payment system proposed rule Executive Order on Improving Price and Quality Transparency Helping Medicaid Offer Maternity Services (MOMS) Act (H.R. 4996)

Client expense: $210,000 · Firm income: Not reported

Medicare reimbursement including incident to billing; Medicare hospice restrictions; transparency; Veterans health care; opioid addiction treatment; S. 296/H.R. 2150- Home Healthcare Planning and Improvement Act; H.R. 808/S. 237 - promoting access to diabetic shoes; S. 596/H.R. 1052 - PA direct payment; H.R. 900 - ACO Assignment Improvement Act

Client expense: Not reported · Firm income: $60,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

2019 Q3 Lobbying Report - July 1-September 30 H.R. 986, Protecting Americans with Preexisting Conditions Act of 2019 H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs H.R. 1010, To provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force; Oversight of final rules on short-term, limited duration insurance (STLDI) and Association Health Plans) Medicare X-Choice Proposal H.R. 1384, the Medicare for All Act of 2019 S. 1129, Medicare-for-all national health insurance program Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First S. 1895 Lower Health Care Costs Act of 2019 S. 1531 Stopping the Outrageous Practice of Surprise Medical Bills Act S. 1266 the Protecting Patients from Surprise Medical Bills Act S. 1497 the Health Care Price Check Act H.R.861the End Surprise Billing Act of 2019 S. 1688 - A bill to amend the Public Health Service Act to provide for the full disclosure of billing and service information to patients H.R. 3502 the Protecting People from Surprise Medical Bills Act H.R. 3630 No Surprises Act H.R. 2328 the Reauthorizing and Extending Americas Community Health Act S. 340/H.R. 965 CREATES Act H.R. 1499 Protecting Consumer Access to Generic Drugs Act H.R. 2375 Preserve Access to Affordable Generics and Biosimilars Act H.R. 2296 the More Efficient Tools to Realize Information for Consumers (METRIC) Act H.R. 2062 Overdose Prevention and Patient Safety Act H.R. 938 BLOCKING Act of 2019 (H.R. 938) H.R. 3439 To amend the Internal Revenue Code of 1986 and title XI of the Social Security Act to extend appropriations and transfers to the Patient-Centered Outcomes Research Trust Fund and to extend certain health insurance fees for such transfers, and for other purposes S. 1173/H.R. 776 Emergency Medical Services for Children Program Reauthorization Act of 2019 S. 1199 Poison Center Network Enhancement Act of 2019 H.R. 2781 the Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 H.R. 728 the Title VIII Nursing Workforce Reauthorization Act Hospital Star Ratings S. 586/H.R. 1041 Critical Access Hospital Relief Act of 2019 H.R. 1052 To amend title XVIII of the Social Security Act to provide for direct payment to physician assistants under the Medicare program for certain services furnished by such physician assistants. S. 895, Rural Hospital Regulatory Relief Act of 2019 S. 948/H.R. 2895 Conrad 30 and Physician Access Act H.R. 3429 the HEARTS and Rural Relief Act S. 348/H.R. 1763 Resident Physician Shortage Reduction Act of 2019 H.R. 2349/H.R. 3414 Opioid Workforce Act H.R. 3022 Patient Access Protection Act H.R. 1892 Bipartisan Budget Act of 2018 H.R. 6 SUPPORT for Patients and Communities Act H.R. 3417 Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act H.R.3253 Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019 S. 824/H.R. 1767 Excellence in Mental Health and Addiction Treatment Expansion Act Stark law reform Hospital outpatient payment policy Site neutral payment policy included in outpatient prospective payment system rule H.R.2552 Protecting Local Access to Care for Everyone Act of 2019 H.R. 3107 Improving Seniors Timely Access to Care Act H.R. 3436 Chronic Care Management Improvement Act Proposed AWI changes in inpatient prospective payment system proposed rule OPPS and physician fee schedule proposed rules NIH funding Title VII health professions education and training programs FY 2020 Appropriations bills H.R. 4378 - Continuing Appropriations Act, 2020, and Health Extenders Act of 2019 Public Charge proposed rule Submitted Comment Letters SUBJECT: CMS-1717-P, Medicare Program: Proposed Changes to Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Price Transparency of Hospital Standard Charges; Proposed Revisions of Organ Procurement Organizations Conditions of Coverage; Proposed Prior Authorization Process and Requirements for Certain Covered Outpatient Department Services; Potential Changes to the Laboratory Date of Service Policy; Proposed Changes to Grandfathered Childrens Hospitals-Within-Hospitals; Proposed Rule, Federal Register (Vol. 84, No.154), August 9, 2019 SUBJECT: CMS-5527-P, Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures; Proposed Rule, Federal Register (Vol. 84, No.138), July 18, 2019 SUBJECT: CMS-3347-P, Medicare and Medicaid Programs; Requirements for Long-Term Care Facilities: Regulatory Provisions to Promote Efficiency and Transparency, Federal Register (Vol. 84, No.138), July 18, 2019 SUBJECT: CMS-1711-P, Medicare and Medicaid Programs; CY 2020 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; Home Health Quality Reporting Requirements; and Home Infusion Therapy Requirements; Proposed Rule, Federal Register (Vol. 84, No.138), July 18, 2019 Subject: Proposed Rule: CMS 2406-P2/RIN 0938-AT41 Medicaid Program; Methods for Assuring Access to Covered Medicaid Services - Rescission (Vol. 84, No. 135, July 15, 2019) SUBJECT: CMS-6082-NC, Request for Information; Reducing Administrative Burden to put Patients over Paperwork; Federal Register (Vol. 84, No. 112), June 11, 2019

Rural hospital policies (S. 586/H.R. 1041, Critical Access Hospital Relief Act of 2019; H.R. 1052; S. 895, Rural Hospital Regulatory Relief Act of 2019; S. 948/H.R. 2895, Conrad 30 and Physician Access Act; H.R. 3429, the HEARTS and Rural Relief Act) Graduate Medical Education (GME) funding (S. 348/H.R. 1763, Resident Physician Shortage Reduction Act of 2019; H.R. 2349/H.R. 3414) Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 3417 Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act) Stark law reform Hospital outpatient payment policy Site neutral payment policy included in outpatient prospective payment system rule Improving Seniors Timely Access to Care Act (H.R. 3107) Chronic Care Management Improvement Act (H.R. 3436) Proposed AWI changes in inpatient prospective payment system proposed rule OPPS proposed rule Executive Order on Improving Price and Quality Transparency

Client expense: $220,000 · 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 policies (S. 586/H.R. 1041, Critical Access Hospital Relief Act of 2019; H.R. 1052; S. 895, Rural Hospital Regulatory Relief Act of 2019; S. 948/H.R. 2895, Conrad 30 and Physician Access Act; H.R. 3429, the HEARTS and Rural Relief Act) Graduate Medical Education (GME) funding (S. 348/H.R. 1763, Resident Physician Shortage Reduction Act of 2019; H.R. 2349/H.R. 3414 Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts (H.R. 3022, Patient Access Protection Act) Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 3417 Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act) Extending the Medicaid demonstration program for certified community behavioral health clinics (H.R.3253, Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019; S. 824/H.R. 1767, Excellence in Mental Health and Addiction Treatment Expansion Act) Stark law reform Hospital outpatient payment policy Site neutral payment policy included in outpatient prospective payment system rule (H.R.2552, Protecting Local Access to Care for Everyone Act of 2019) Improving Seniors Timely Access to Care Act (H.R. 3107) Chronic Care Management Improvement Act (H.R. 3436) Proposed AWI changes in inpatient prospective payment system proposed rule OPPS and physician fee schedule proposed rules

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

Medicare reimbursement and incident to billing, Medicare hospice restrictions, Medicare definition of PA services, transparency, healthcare competition, PA Direct Payment Act (S 596, HR 1052), Home Health Care Planning Improvement Act (S 296, HR 2150), Promoting Access to Diabetic Shoes Act (S 237, HR 808), the Mainstreaming Addiction Treatment Act (S 2074, HR 2482), Increasing Access to Quality Cardiac Rehabilitation Care Act (HR 3911), ACO Assignment Improvement Act (HR 900), PA Educational and Workforce Training Programs, surprise billing, Rural Health Clinic Modernization Act (S 1037 HR 2788), medical record documentation, issues related to federal PA workforce at the Departments of Veterans Affairs, Defense and Indian Health Services, requirements and restrictions related to federal DEA waivers to prescribe buprenorphine to treat opioid use disorder.

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

Medicare reimbursement including incident to billing; Medicare hospice restrictions; transparency; Veterans health care; opioid addiction treatment; S. 296/H.R. 2150- Home Healthcare Planning and Improvement Act; H.R. 808/S. 237 - promoting access to diabetic shoes; S. 596/H.R. 1052 - PA direct payment; H.R. 900 - ACO Assignment Improvement Act

Client expense: Not reported · Firm income: $60,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Medicare reimbursement and incident to billing, Medicare hospice restrictions, transparency, healthcare competition, PA Direct Payment Act (S 596, HR 1052), Home Health Care Planning Improvement Act (S 296, HR 2150), Promoting Access to Diabetic Shoes Act (S 237, HR 808), the Mainstreaming Addiction Treatment Act (HR 2482), Medicare implementation date for PAs to supervise cardiac and pulmonary rehab, ability for PAs to certify need for Medicare patients to receive cardiac and pulmonary rehab services, ACO Assignment Improvement Act (HR 900), PA Educational and Workforce Training Programs, surprise billing legislation, issues related to federal PA workforce at the Departments of Veterans Affairs, Defense and Indian Health Services, requirements and restrictions related to federal DEA waivers to prescribe buprenorphine to treat opioid use disorder.

Client expense: $180,000 · Firm income: Not reported

Rural hospital policies (S. 586/H.R. 1041, Critical Access Hospital Relief Act of 2019; H.R. 1052; S. 895, Rural Hospital Regulatory Relief Act of 2019; S. 948/H.R. 2895, Conrad 30 and Physician Access Act; H.R. 3429, the HEARTS and Rural Relief Act) Graduate Medical Education (GME) funding (S. 348/H.R. 1763, Resident Physician Shortage Reduction Act of 2019; H.R. 2349/H.R. 3414, Opioid Workforce Act) Extending the Medicaid demonstration program for certified community behavioral health clinics (H.R.3253, Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019; S. 824/H.R. 1767, Excellence in Mental Health and Addiction Treatment Expansion Act) Delay of Medicaid Disproportionate Share Hospital payment cuts (H.R. 3022, Patient Access Protection Act) Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 3417 Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act) Stark law reform Hospital outpatient payment policy Site neutral payment policy included in outpatient prospective payment system rule (H.R.2552, Protecting Local Access to Care for Everyone Act of 2019) H.R. 3107, Improving Seniors Timely Access to Care Act H.R. 3436, Chronic Care Management Improvement Act Proposed AWI changes in inpatient prospective payment system proposed rule

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

Rural hospital policies (S. 586/H.R. 1041, Critical Access Hospital Relief Act of 2019; H.R. 1052; S. 895, Rural Hospital Regulatory Relief Act of 2019; S. 948/H.R. 2895, Conrad 30 and Physician Access Act; H.R. 3429, the HEARTS and Rural Relief Act) Graduate Medical Education (GME) funding (S. 348/H.R. 1763, Resident Physician Shortage Reduction Act of 2019; H.R. 2349/H.R. 3414) Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts Stark law reform Hospital outpatient payment policy

Client expense: $190,000 · Firm income: Not reported

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

Medicare reimbursement including incident to billing; Medicare hospice restrictions; transparency; veterans health care; opioid addiction treatment; S. 296/H.R. 2150- Home Healthcare Planning and Improvement Act; H.R. 808/S. 237 - promoting access to diabetic shoes; S. 596/H.R. 1052 - PA direct payment; H.R. 900 - ACO Assignment Improvement Act

Client expense: Not reported · Firm income: $60,000

Rural hospital policies (S. 586/H.R. 1041, Critical Access Hospital Relief Act of 2019; H.R. 1052; S. 895, Rural Hospital Regulatory Relief Act of 2019) Graduate Medical Education (GME) funding (S. 348/H.R. 1763, Resident Physician Shortage Reduction Act of 2019) Delay of Medicaid Disproportionate Share Hospital payment cuts 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 rule

Client expense: $90,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 506 Hospital Competition Act of 2019 S. 131 Protect Medicaid Act H.R. 1384 Medicare for All Act of 2019 S. 1129 A bill to establish a Medicare-for-all national health insurance program H.R. 1041 Critical Access Hospital Relief Act of 2019 H.R. 1052 To amend title XVIII of the Social Security Act to provide for direct payment to physician assistants under the Medicare program for certain services furnished by such physician assistants H.R. 1425 State Health Care Premium Reduction Act H.R.1386 Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act H.R.1385 State Allowance for a Variety of Exchanges (SAVE) Act H.R. 269 Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 S. 895 Rural Hospital Regulatory Relief Act of 2019 H.R. 1767 Excellence in Mental Health and Addiction Treatment Expansion Act H.R. 1010 To provide that the rule entitled "Short-Term, Limited Duration Insurance" shall have no force or effect H.R. 1763 Resident Physician Shortage Reduction Act of 2019 S. 348 Resident Physician Shortage Reduction Act of 2019 OPTN Policy re: Equitable Distribution of Livers for Transplantation SUBJECT: Proposed Changes to Overall Hospital Quality Star Ratings Methodology (Submitted 3/29/2019) SUBJECT: RIN 2900-AQ46; Veterans Community Care Program; Proposed Rule, Federal Register (Vol. 84, No. 36), February 22, 2019 (Submitted 3/26/2019) SUBJECT: CMS-3367-NC, Accrediting Organizations Conflict of Interest and Consulting Services; Request for Information; Federal Register (Vol. 83, No. 244) December 20, 2018 (Submitted 2/19/2019) SUBJECT: Request for Information on Modifying HIPAA Rules to Improve Coordinated Care (RIN 0945- AA00), 83 Fed. Reg. 64302 (Dec. 14, 2018) (Submitted 2/12/2019) SUBJECT: Worksheet S-10 Data (Sent 1/31/2019) SUBJECT: Draft Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs (Submitted 1/28/2019) SUBJECT: Early Findings from the National Beta Test of Standardized Patient Assessment Data Elements (Submitted 1/15/2019) SUBJECT: Proposed Rule: CMS-2408-P. Medicaid Program; Medicaid and Childrens Health Insurance Program Managed Care (Submitted 1/14/2019

Medicare reimbursement and incident to billing, Medicare hospice restrictions, transparency, healthcare competition, PA Direct Payment Act (S 596, HR 1052), Home Health Care Planning Improvement Act (S 296, HR 2150), Promoting Access to Diabetic Shoes Act (S 237, HR 808), Medicare implementation date for PAs to supervise cardiac and pulmonary rehab, ability for PAs to certify need for Medicare patients to receive cardiac and pulmonary rehab services, ACO Assignment Improvement Act (HR 900), PA Educational and Workforce Training Programs, issues related to federal PA workforce at the Department of Veterans Affairs and Indian Health Services, requirements and restrictions related to federal DEA waivers to prescribe buprenorphine to treat opioid use disorder.

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), Indian Health Service, Natl Economic Council (NEC), SENATE, Veterans Affairs, Dept of (VA)