BETTER Act of 2019

Site Neutrality. Graduate Medical Education Funding. H.R.3417 - Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R. 1865 - Further Consolidated Appropriations Act, 2020

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE

Site Neutrality. Graduate Medical Education Funding. H.R.3417 - Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R. 1865 - Further Consolidated Appropriations Act, 2020 H.R. 6074 - Coronavirus Preparedness and Response Supplemental Appropriations Act IMPLEMENTATION H.R. 266, Paycheck Protection Program and Health Care Enhancement Act H.R. 6800, HEROES Act H.R. 600 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Health, Economic Assistance, Liability Protection and Schools (HEALS) Act Delivering Immediate Relief to America's Families, Schools and Small Business Act (Senate Amendment No. 2652 to the House Amendment S. 178)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE

Site Neutrality. Graduate Medical Education Funding. H.R.3417 - Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R. 266, Paycheck Protection Program and Health Care Enhancement Act H.R. 6800, HEROES Act H.R. 600 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Health, Economic Assistance, Liability Protection and Schools (HEALS) Act Delivering Immediate Relief to America's Families, Schools and Small Business Act (Senate Amendment No. 2652 to the House Amendment S. 178) H.R. 133 - Consolidated Appropriations Act, 2021

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE

S. 3001 Toomey, regarding Medicare and Medicaid program extensions HR 4932, Thompson regarding telehealth in the Medicare program S. 2741 Schatz, regarding telehealth in the Medicare program HR 1839, the Medicaid Services Investment and Accountability Act HR 3253, The Empowering Beneficiaries, Ensuring Access and Strengthening Accountability Act (regarding Medicaid) HR 2131 and S. 1114, regarding the Medicare Advantage benchmark cap HR 3107, regarding the use of preauthorization in the Medicare Advantage program HR 3417 the Beneficiary Education Tools, Telehealth and Extenders Reauthorization Act (regarding Medicare) Legislation and regulation regarding the Medicare Advantage program HR 1839, regarding multiple Medicaid program changes, including the Medicaid Drug Rebate program. HR 1046 and S. 377, regarding Medicare Part D and requirements for HHS to negotiate drug prices HR 1781 Regarding MedPAC and MACPAC access to drug pricing and rebate data.

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

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

Graduate Medical Education Affordable Care Act Teaching Health Centers Re-authorization - S.192, S.304, S.1191, HR2815, HR4378 Continuing Appropriations Act 2020 Health Extenders Act of 2019 Primary Care Exception Under Teaching Physician Regulation Rural Graduate Medical Education Regulations & sub-regulatory issues re: Teaching Physician Regulation HR 1358 Advancing Resident Training in Community Hospitals Act of 2019; HR3417 The Rural Physician Workforce Production Act of 2019 S.289, draft legislation in House S.348/HR 1763 Resident Physician Shortage Reduction Act of 2019 Draft legislation regarding GME cap flexibility (rep Raul Ruiz) HR748 CARES Act HR6074 Coronavirus Preparedness & Response Supplemental Appropriations Act 2020 HR6201 - Families First Coronavirus Response Act Draft COVID-19 package #4; Health, Economic Assistance, Liabilities protections, and Schools (HEALS) Act S.4775 Delivering Immediate Relief to America's Families, Schools, and Small Business Act; HR6800, HEROES Act CMS waivers RE: COVID-19 public health emergency Annual physicians fee schedule for 2021

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), President of the U.S., SENATE, Veterans Affairs, Dept of (VA)

H.R.451-Dont Break Up the T-Band Act of 2020 H.R.1301-Mental Health Telemedicine Expansion Act H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.4932-Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2019 S.2741-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019

Client expense: $340,838 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.861-End Surprise Billing Act of 2019 H.R.1301-Mental Health Telemedicine Expansion Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.3935-Protecting Patients Transportation to Care Act H.R.8505-To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes H.R.8702-Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019 S.5007-Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020

Client expense: $340,838 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Price transparency, out-of-network reimbursement of emergency medical services, surprise medical bills Opioids, pain management Federal funding for Substance Use Disorder treatments Drug Shortages H.R.451-Dont Break Up the T-Band Act of 2020 H.R.501-Poison Center Network Enhancement Act of 2019 H.R.861-End Surprise Billing Act of 2019 H.R.925-The Heroes Act H.R.1301-Mental Health Telemedicine Expansion Act H.R.1309-Workplace Violence Prevention for Health Care and Social Service Workers Act H.R.1418-Competitive Health Insurance Reform Act of 2019 H.R.1554-Resident Education Deferred Interest (REDI) Act H.R.1646-Helping Emergency Responders Overcome (HERO) Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.1767-Excellence in Mental Health and Addiction Treatment Expansion Act H.R.2281-Easy Medication Access and Treatment (MAT) for Opioid Addiction Act H.R.2328-Reauthorizing and Extending Americas Community Health Act H.R.2464-End the Cycle of Violence Act of 2019 H.R.2482-Mainstreaming Addiction Treatment Act of 2019 H.R.2519-Improving Mental Health Access from the Emergency Department Act of 2019 H.R.2550-Prevent Blood Loss with Emergency Equipment Devices Act of 2019 H.R.2569-Comprehensive Addiction Resources Emergency Act of 2019 H.R.3107-Improving Seniors Timely Access to Care Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.3502-Protecting People From Surprise Medical Bills Act H.R.3630-No Surprises Act H.R.3935-Protecting Patients Transportation to Care Act H.R.3984-Health Care Safety Net Enhancement Act of 2019 H.R.4194-National Suicide Hotline Designation Act of 2019 H.R.4861-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 H.R.4932-Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2019 H.R.5619-Suicide Prevention Act H.R.5727-Research Empirical Solutions to End Ambulance Reversals from Closed Hospitals (RESEARCH) Act of 2020 H.R.5800-Ban Surprise Billing Act H.R.5826-Consumer Protections Against Surprise Medical Bills Act of 2020 H.R.5855-Bipartisan Solution to Cyclical Violence Act of 2020 H.R.6663-Truth in Healthcare Marketing Act of 2020 H.R.6800-Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act H.R.6910-Emergency Room Hero and Patient Safety Act H.R.6930-Manufacturing API, Drugs, and Excipients (MADE) in America Act of 2020 H.R.7059-Coronavirus Provider Protection Act H.R.7255-Coronavirus Health Care Worker Wellness Act of 2020 H.R.7574-Strengthening Americas Strategic National Stockpile Act of 2020 H.R.7819-Eliminating the Provider Relief Fund Tax Penalties Act of 2020 H.R.8094-Dr. Lorna Breen Health Care Provider Protection Act H.R.8441-Frontlines Heroes Act H.R.8505-To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes H.R.8702-Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 S.289-Rural Physician Workforce Production Act of 2019 S.299-Geriatrics Workforce Improvement Act S.350-Competitive Health Insurance Reform Act of 2019 S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019 S.824-Excellence in Mental Health and Addiction Treatment Expansion Act S.851-Workplace Violence Prevention for Health Care and Social Service Workers Act S.1199-Poison Center Network Enhancement Act of 2019 S.1266-Protecting Patients from Surprise Medical Bills Act S.1334-Improving Mental Health Access from the Emergency Department S.1350-Good Samaritan Health Professionals Act of 2019 S.1365-Comprehensive Addiction Resources Emergency Act of 2019 S.1531-Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 S.1895-Lower Health Care Costs Act S.2074-Mainstreaming Addiction Treatment Act of 2019 S.2661-National Suicide Hotline Designation Act of 2020 S.2741-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 S.3006-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 S.3143-Magnet Injury Prevention Act S.3198-Suicide Prevention Act S.3346-Prevent Blood Loss with Emergency Equipment Devices Act of 2020 S.4349-Dr. Lorna Breen Health Care Provider Protection Act S.5007-Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020

Client expense: $340,838 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.861-End Surprise Billing Act of 2019 H.R.1301-Mental Health Telemedicine Expansion Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.3935-Protecting Patients Transportation to Care Act S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019

Client expense: $391,824 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Price transparency, out-of-network reimbursement of emergency medical services, surprise medical bills Opioids, pain management Federal funding for Substance Use Disorder treatments Drug Shortages H.R.451-Dont Break Up the T-Band Act of 2020 H.R.501-Poison Center Network Enhancement Act of 2019 H.R.861-End Surprise Billing Act of 2019 H.R.925-The Heroes Act H.R.1301-Mental Health Telemedicine Expansion Act H.R.1309-Workplace Violence Prevention for Health Care and Social Service Workers Act H.R.1418-Competitive Health Insurance Reform Act of 2019 H.R.1554-Resident Education Deferred Interest (REDI) Act H.R.1646-Helping Emergency Responders Overcome (HERO) Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.1767-Excellence in Mental Health and Addiction Treatment Expansion Act H.R.2281-Easy Medication Access and Treatment (MAT) for Opioid Addiction Act H.R.2328-Reauthorizing and Extending Americas Community Health Act H.R.2464-End the Cycle of Violence Act of 2019 H.R.2482-Mainstreaming Addiction Treatment Act of 2019 H.R.2519-Improving Mental Health Access from the Emergency Department Act of 2019 H.R.2550-Prevent Blood Loss with Emergency Equipment Devices Act of 2019 H.R.2569-Comprehensive Addiction Resources Emergency Act of 2019 H.R.3107-Improving Seniors Timely Access to Care Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.3502-Protecting People From Surprise Medical Bills Act H.R.3630-No Surprises Act H.R.3935-Protecting Patients Transportation to Care Act H.R.3984-Health Care Safety Net Enhancement Act of 2019 H.R.4194-National Suicide Hotline Designation Act of 2019 H.R.4861-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 H.R.4932-Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2019 H.R.5619-Suicide Prevention Act H.R.5727-Research Empirical Solutions to End Ambulance Reversals from Closed Hospitals (RESEARCH) Act of 2020 H.R.5800-Ban Surprise Billing Act H.R.5826-Consumer Protections Against Surprise Medical Bills Act of 2020 H.R.5855-Bipartisan Solution to Cyclical Violence Act of 2020 H.R.6663-Truth in Healthcare Marketing Act of 2020 H.R.6800-Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act H.R.6910-Emergency Room Hero and Patient Safety Act H.R.6930-Manufacturing API, Drugs, and Excipients (MADE) in America Act of 2020 H.R.7059-Coronavirus Provider Protection Act H.R.7255-Coronavirus Health Care Worker Wellness Act of 2020 H.R.7574-Strengthening Americas Strategic National Stockpile Act of 2020 H.R.7819-Eliminating the Provider Relief Fund Tax Penalties Act of 2020 H.R.8094-Dr. Lorna Breen Health Care Provider Protection Act S.289-Rural Physician Workforce Production Act of 2019 S.299-Geriatrics Workforce Improvement Act S.350-Competitive Health Insurance Reform Act of 2019 S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019 S.824-Excellence in Mental Health and Addiction Treatment Expansion Act S.851-Workplace Violence Prevention for Health Care and Social Service Workers Act S.1199-Poison Center Network Enhancement Act of 2019 S.1266-Protecting Patients from Surprise Medical Bills Act S.1334-Improving Mental Health Access from the Emergency Department S.1350-Good Samaritan Health Professionals Act of 2019 S.1365-Comprehensive Addiction Resources Emergency Act of 2019 S.1531-Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 S.1895-Lower Health Care Costs Act S.2074-Mainstreaming Addiction Treatment Act of 2019 S.2661-National Suicide Hotline Designation Act of 2020 S.2741-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 S.3006-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 S.3143-Magnet Injury Prevention Act S.3198-Suicide Prevention Act S.3346-Prevent Blood Loss with Emergency Equipment Devices Act of 2020 S.4349-Dr. Lorna Breen Health Care Provider Protection Act

Client expense: $391,824 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.451-Dont Break Up the T-Band Act of 2020 H.R.1301-Mental Health Telemedicine Expansion Act H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.4932-Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2019 S.2741-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019

Client expense: $391,824 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 8840, Medicare Sequester COVID Moratorium Act, all provisions H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions S. 5007, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions H.R. 7154, Outpatient Therapy Modernization and Stabilization Act, all provisions H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, all provisions S. 5044, Improving Seniors Timely Access to Care Act of 2020y, all provisions H.R. 8727, Telehealth Modernization Act, all provisions S. 4375, Telehealth Modernization Act, all provisions H.R. 7663, Protecting Access to Post-COVID-19 Telehealth Act of 2020, all provisions H.R. 7391, Protect Telehealth Access Act of 2020, all provisions H.R. 1301, Mental Health Telemedicine Expansion Act, all provisions H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019, all provisions H.R. 5201, Telemental Health Expansion Act of 2020, provisions relating to 1834(m) of the Social Security Act; geographic and originating sites H.R. 7233, Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020, all provisions H.R. 5172, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, All provisions S. 3067, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, All provisions H.R. 3414, Opioid Workforce Act of 2019, all provisions H.R. 7791, Value in Health Care Act of 2020, provisions relating to qualifying APM physician thresholds H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020, all provisions S. 3750, Medicare Accelerated and Advance Payments Improvement Act, all provisions H.R. 8505, To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes, all provisions H.R. 884, Medicare Mental Health Access Act, all provisions H.R. 945, Mental Health Access Improvement Act of 2019, all provisions H.R. 6744, Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2020, all provisions H.R. 4004, Social Determinants Accelerator Act of 2019, all provisions H.R. 4932, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions S. 2741, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions H.R. 5534, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020, all provisions S. 3353, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, provisions related to PBM and prescription drug price transparency H.R. 19, Lower Costs, More Cures Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2020, all provisions H.R. 6090, Physician Shortage GME Cap Flex Act of 2020, all provisions H.R. 6142, Black Maternal Health Momnibus Act of 2020, all provisions Medicare program: P.L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) implementation/Accountable Care Organizations/APM thresholds Medicare program: Patient Protection and Affordable Care Act (PPACA)/Prior authorization provider and patient burdens/patient electronic access to health information Medicare program: P.L. 113-93 Protecting Access to Medicare Act (PAMA)/Imaging appropriate use criteria/Radiation Oncology APM Medicare program: FY 2021 Inpatient Rehab Facility Prospective Payment System (IRF PPS)/scope of practice issues Medicare program: CY 2021 physician fee schedule/E&M services/Budget neutrality/Part B/Sequester Medicare program: Alternative payment models (APMs) Medicare program: Merit-based Incentive Payment System (MIPS)/cost/quality/interoperability/hardship exemption Medicare program: Regulatory relief/Advanced APMs, prior authorization, and utilization management Medicare program: Shared Savings Program Medicare program: Quality Payment Program/prior authorization/electronic funds transfer Medicare program: Surprise medical billing Medicare program: Medicare-For-All Medicare program: Electronic Health Records (EHR) Certification Medicare program: 21st Century Cures Act Medicare program: Quality payment program/physician burdens Medicare program: National Coverage determination/validated home blood pressure monitors Medicare program: Health IT/physician burden Medicare program: Drug pricing Medicare program: Most favored nation drug pricing Medicare program: Provider compliance/regulatory relief Medicare program: Provider Enrollment, Chain and Ownership (PECOS) enrollment/revalidation Medicare and Medicaid programs: 21st Century Cures Act/health data and privacy Medicaid program: CMS proposed regulation Medicaid Program Medicaid program: FMAP increases Medicaid program: Interoperability

Client expense: $3,870,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, Veterans Affairs, Dept of (VA), White House Office

Discussions on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussions about the work of Aligning for Health to address social determinants of health; Support HR 1041 / S 586,Critical Access Hospital Relief Act of 2019, a bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services; Support S 895, Rural Hospital Regulatory Relief Act of 2019, a bill to provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals; Support S 948,Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities, and for other purposes; Discussions in support of the Rural Emergency Medical Center Act (REACH) Act; Support for extension of the Rural Community Hospital Demonstration Program; Support for extension of the Frontier Community Health Integration Project Demonstration program; Discuss changes with House and Senate committees to Section 8122 of the SUPPORT for Patients and Communities Act; Letter of support to Energy and Commerce Committee for the hearing on legislation to strengthen our health care system and ACA market stability; Support HR 1781/ S 801, Payment Commission Data Act of 2019, a bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information; Support S 551 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 or the REFUND Act of 2019, a bill to amend title XVIII of the Social Security Act to require manufacturers of certain single-dose vial drugs payable under part B of the Medicare program to provide rebates with respect to amounts of such drugs discarded, and for other purposes; Support S 824/ HR 1767, Excellence in Mental Health and Addiction Treatment Expansion Act, a bill to increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services; Statement submitted to Senate Finance Committee on the implementation of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support HR 2552Protecting Local Access to Care for Everyone Act of 2019 or the PLACE Act of 2019, a bill to direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program; Support HR 3022, Patient Access Protection Act, a bill to amend title XIX of the Social Security Act to repeal the reductions in Medicaid DSH allotments, and for other purposes; Letter of support to the Ways and Means Committee in support of legislation to improve the quality of an access to services for Medicare beneficiaries, help train the physician workforce and reduce administrative burden on rural hospitals; Support HR 3431, HEARTS and Rural Relief Act, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2021; Support HR 3417,Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 or the BETTER Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for patient improvements and rural and quality improvements under the Medicare program; Oppose HR 1384, Medicare for All Act of 2019, a bill to establish an improved Medicare for All national health insurance program; Oppose S 1129, Medicare for All Act of 2019, a bill to establish a Medicare-for-all national health insurance program; Letter to House Committee on Ways and Means for the hearing on Pathways to Universal Health Coverage addressing concerns with Medicare for All and believe that the variety of proposals that often are used interchangeably under that name are not the solution; Oppose HR 2452, Medicare for America Act of 2019, a bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans; Letter to House Committee on Budget for the hearing on the Congressional Budget Offices (CBO) Key Design Components and Considerations for Establishing a Single-Payer Health Care System addressing concerns with Medicare for All; Oppose S 1261/ HR 2463, Choose Medicare Act, a bill to provide for the establishment of Medicare part E public health plans, and for other purposes; Oppose S 981/ HR 2000Medicare-X Choice Act of 2019A bill to establish a public health plan; Oppose S 1033/ HR 2085, CHOICE Act, a bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Oppose S 470, Medicare at 50 Act, a bill to amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare; Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes; Submitted Statement to the House Committee on Rules for the Hearing Medicare for All Act of 2019; Comment on provisions of HR 2328,Reauthorizing and Extending Americas Community Health (REACH) Act, support for the Medicaid disproportionate share hospital(DSH) program provisions included in Title III; comments on Title IV, which contains provisions of the No Surprises Act and concern with the legislations approach to determining reimbursement for out-of-network providers; Support HR 3107 Seniors Timely Access to Care Act of 2019, this legislation would establish requirements for the use of prior authorization under Medicare Advantage plans; Meeting with the Senate finance committee to discuss changes to drug bill; Meeting with CMS to discuss changes to prior authorization; Meeting with Department of Labor to discuss issues with ERISA health plans; Met with CMS staff on rural hospital issues; Regulatory burden related to new CMS guidance on documenting Crossover bad debt; Sent a Comment letter to CMS on a final rule on program integrity enhancements to the provider enrollment process for Medicare, Medicaid and Children's Health Insurance Programs; Oppose S. 2860 Patient Access to Higher Quality Health Care Act of 2019, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 4996, Helping MOMS Act of 2019, a bill amend title XIX of the Social Security Act to provide for a State option under the Medicaid program to provide for and extend continuous coverage for certain individuals, and for other purposes; Addressing hospital concerns about HR 3 Lower Drug Costs Now Act, a bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes; Sent comment letter requesting that CMS withdraw the proposed regulation related to Medicaid Program: Medicaid Fiscal Accountability Regulation ( MFAR) financing and supplemental payments. Given that the proposal would severely curtail the availability of health care services to millions of individuals and because many of its provisions are not legally permissible; Discussion with CMS for rural hospitals and critical access hospitals about the Medicare accelerated payment program, which is intended to provide necessary funds to providers, including rural hospitals and critical access hospitals, when there is a disruption in claims submission and/or claims processing; Submitted comments on CMSs proposed rule on Medicare Advantage and Part D prescription drug program for Contract Years 2021 and 2022. The letter focuses on several proposals addressing network adequacy; Letter sent to HHS, CDC, CMS, and SAMHSA requesting specialized guidance and assistance for providers who care for patients with behavioral health disorders; Support resetting the Improving Medicare Post- Acute Care Transformation (IMPACT) Act of 2014 in the next COVID-19 relief package. The IMPACT Acts implementation is behind schedule and does not take into account extensive payment reforms already underway in each post-acute care setting; Letter urging HHS to release substantial additional emergency funds to all hospitals in an expedited manner. This second wave of funding to all hospitals, targeted relief is necessary for hospitals in hot spots, hospitals with a high percentage of payments under Medicare Advantage, hospitals caring for high numbers of Medicaid patients, and rural hospitals; Support HR 6693 Critical Access Hospital Expansion Act of 2020, a bill to amend title XVIII of the Social Security Act to allow States to certify certain hospitals as necessary providers for purposes of designating such hospitals as critical access hospitals under the Medicare program; Support HR 6753/ S 3615 Rural Community Hospital Demonstration Extension Act of 2020, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the rural community hospital demonstration program; Letter urging CMS to use its authority to extend to LTCHs the existing 20% hospital add-on payment for Medicare beneficiaries diagnosed with COVID-19; Letter to CMS urging the agency to temporarily extend certain waivers and make others permanent beyond the COVID-19 public health emergency to allow hospitals to provide better and more cost effective care to their patients and communities; Sent comment letter to CMS about our concerns with the timeline proposed for implementation as well as the potential for penalties for noncompliance within this timeline on the Medicare Program: Electronic Prescribing of Controlled Substances; Sent comment letter on the FY 2021 Inpatient PPS proposed rule addressing CMS proposals related to payer-specific negotiated rate data collection, Medicare DSH payments, CAR T, bad debt, MS-DRG classifications, and quality programs, among other topics. Letter requesting that the CMS delay the implementation of the Appropriate Use Criteria for Advanced Diagnostic Imaging Services program to allow providers the opportunity to implement and test operational changes and acquire the education necessary to achieve compliance with the program; Sent comments to the CMS on the agencys long-term care hospital prospective payment system proposed policy changes and fiscal year 2021 rates; Letter to CMS asking for a delay in the start of repayments associated with the Medicare Accelerated and Advance Payment (AAP) Programs; Letter urging the CMS to continue its suspension of medical review activities throughout the ongoing COVID-19 public health emergency; Letter urging CMS to allow periodic interim payment (PIP) hospitals to carry out their accelerated payment repayment at cost settlement, as was initially communicated by the agency and also request that the agency make alternative repayment approaches available, such as direct payments to the Medicare Administrative Contractor (MAC), for all hospitals; Comment letter on CY 2021 Home Health Prospective Payment System Rate Update proposed rule. While we continue to support the PDGM objective of increasing HH PPS payment accuracy, we remain concerned that CY 2020s large behavioral offset, 4.36%, was implemented on a prospective basis; Letter urging the CMS to withdraw the condition of participation (CoP) that hospitals report daily COVID-19 data and request that CMS immediately release detailed interpretive guidance so hospitals can take the necessary steps to come into compliance; Urged CMS to withdraw its Medicaid fiscal accountability proposed rule from its regulatory agenda because it would "severely curtail the availability of health care services to millions of individuals" and "many of its provisions are not legally permissible;" Submitted comment letter that disagree with CMS interim APC assignments of COVID-19 vaccine administration services to these New Technology APCs because they are inconsistent with longstanding CMS policy; Submitted comments responding to a CMS request for information on regulatory relief to support economic recovery urging the agency to take additional action to remove certain regulatory barriers standing in the way of efficiency and innovation, thus allowing hospitals to provide better and more cost-effective care to our patients and communities. In order to achieve these objectives, we ask the agency to temporarily extend certain waivers and make others permanent beyond the duration of the COVID-19 public health emergency; Urged a delay implementation of CMS price transparency rule and also asked the Biden Transition team for enforcement discretion with the rule; Letter urging Congress to include in the year-end legislation an extension of the congressionally-enacted moratorium on the application of the Medicare sequester cuts into 2021 and through the duration of the public health emergency (PHE); Letter urging Congress to continue to support the movement to value by ensuring that clinicians in advanced alternative payment models (APMs) continue to receive incentives established under the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support S 5044, The Improving Seniors Timely Access to Care Act of 2020, a bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans; Submitted a comment letter, urging CMS not to finalize proposals that would allow states to create a new type of direct enrollment marketplace in lieu of Healthcare.gov or a state-based marketplace. In addition, we do not support the codification in regulation of previous Section 1332 guidance that could allow states to pursue alternative approaches to coverage that would result in coverage losses; Support efforts to protect patients from surprise medical bills by including the No Surprises Act as part of the year-end legislative package; Submitted COVID-19 snapshot report for Congress to better understand the needs of hospitals and health systems during the public health emergency, which combines important data points with news articles and testimonials from the field to reiterate the dire circumstances hospitals and health systems face, and highlight why additional relief is necessary; Submitted comments in response to HRSAs proposal to include additional counties as eligible to receive Federal Office of Rural Health Policy (FORHP) grants, encouraged the agency to use a definition of rural that is inclusive and flexible, in order to broaden opportunities for providers in rural communities and urged HRSA to increase rural grant opportunities.

Client expense: $4,460,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Issue: Support repeal or a delay in the implementation of the Medicaid disproportionate share hospital (DSH) cuts Issue: Educate Congress on concerns related to potentially burdensome Medicaid supplemental payment reporting proposals Issue: Educate Congress on the negative impact of the proposed Medicaid Fiscal Accountability Regulation (MFAR) and urge the administration to withdraw or delay the proposal Issue: ACA Medicaid expansion. Maintain commitment to match State spending on medical care for Medicaid beneficiaries without limits, caps, or block grants. Maintain and enforce network adequacy requirements and mandate sufficient payments to providers. S. 1343, Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (MOMMIES) Act Issue: Support expansion of Medicaid and CHIP coverage for postpartum women from current 90 days to 1 year. S. 585, States Achieve Medicaid Expansion (SAME) Act of 2019 Issue: Support legislation to allow states that expanded Medicaid after 2014 to receive the same full federal matching funds as states that previously expanded Medicaid under the Affordable Care Act H.R. 1763 / S. 348, Resident Physician Shortage Reduction Act of 2019 Issue: Support additional Medicare funding for graduate medical education H.R. 3414 / H.R. 2439, Opioid Workforce Act Issue: Support additional Medicare funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs S. 289, Rural Physician Workforce Production Act of 2019 Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals H.R. 8892, Rural-Urban Physician Workforce Act of 2020 Issue: Support improvements to Rural Training Track programs. H.R.1358, Advancing Medical Resident Training in Community Hospitals Act of 2019 H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act Issue: Support Medicare Graduate Medical Education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issue: Oppose reduction of Medicare GME/IME payments Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose Medicare hospital cuts Issue: Oppose overly burdensome Medicaid GME transparency language. Issue: Support technical correction to increase access to physician services in rural communities by allowing teaching hospitals to count resident time spent in critical access hospitals for purposes of Medicare GME payments. H.R. 5432, Medical Education for a Diverse America Act Issue: Ensure that time medical residents spend in unconscious bias training is counted toward the determination of FTE for Medicare GME Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives H.R. 3107, Improving Seniors Timely Access to Care Act of 2019 Issue: Support protecting patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency Issue: Modify CMS Hospital Compare Star Ratings to allow stakeholders time to work together to address concerns with methodology. Support inclusion of sociodemographic status as part of quality programs HHS Rebate Rule Medicare Part D benefit re-design Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) S. 1343, Maximizing Outcomes for Moms through Medicaid Improvement and Enhancements of Services (MOMMIES) Act H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2020 Issue: Support expansion of Medicaid coverage for postpartum women. H.R. 8702 Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020 Issue: Support relief for providers from pending evaluation and management cuts included in the CY 2021 Physician Fee Schedule (PSF) rule. H.R. 8840 Medicare Sequester COVID Moratorium Act Issue: Support extension of Medicare sequester. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support making permanent the CMS policy allowing teaching physicians to provide supervision via real-time, interactive audio/video technology to meet resident supervision requirements. Issue: Support making permanent the interim final rule that allows hospitals that unknowingly trigger their Medicare GME caps and per resident amounts to not have that happen and instead retain the ability to build a new resident cap / PRA so long as the cap / PRA is not above a minimum amount. Issue: Support CMS introducing new regulations to make permanent the interim final rule that ensures teaching hospitals that increased their number of inpatient beds to accommodate the surge in patients during the public health emergency to not have their Indirect Medical Education (IME) payments reduced by CMS. Issue: Oppose CMS hospital price transparency rule. Issue: Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Oppose Hospital co-location draft guidance. Issue: Oppose finalizing proposed rule for Medicare Coverage of Innovative Technology (MCIT) and definition of reasonable and necessary. Issue: Oppose enforcement of linking Medicare Conditions of Participation (CoP) compliance with requiring that hospitals report 38 COVID-19 related measures. Issue: Support continuation of the 3-Day Skilled Nursing Facility (SNF) Stay waiver after the conclusion of the COVID-19 public health emergency. Issue: Oppose finalizing prior authorization policy in CY 2020 for certain HOPD services and in CY 2021 to include new service categories. Issue: Oppose efforts to remove five exclusion criteria that would allow over 270 new procedures to be performed in ASC settings in CY 2021. Issue: Oppose the elimination of the Inpatient Only List over a three-year period Issue: Oppose policy of incorporating revenue distinctions into the Medicare Shared Savings Program.

Client expense: $1,035,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), Office of the Vice President of the United States, SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

H.R. 803 / S. 988, Improving Transparency and Accuracy in Medicare Part D Drug Spending Act; H.R. 1034 / S. 640, Phair Pricing Act of 2019; H.R. 1035, Prescription Drug Price Transparency Act, S. 475, Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act, S. 476, Reducing Existing Costs Associated with Pharmaceuticals for Seniors (RxCAP) Act; H.R. 107, To amend title XIX of the Social Security Act to sunset the limit on the maximum rebate amount for single source drugs and innovator multiple source drugs; H.R.448 / S. 99, Medicare Drug Price Negotiation Act; H.R. 275, Medicare Prescription Drug Price Negotiation Act of 2019; H.R. 1346, Medicare Buy-In and Health Care Stabilization Act of 2019; H.R. 366, Insulin Access for All Act of 2019; S. 62, Empowering Medicare Seniors to Negotiate Drug Prices Act of 2019; S. 205 / H.R. 937, Right Rebate Act of 2019; H.R. 1046 / S. 377, Medicare Negotiation and Competitive Licensing Act of 2019; H.R. 1781 / S. 801, the Payment Commission Data Act of 2019; H.R. 2113, Prescription Drug Sunshine, Transparency, Accountability and Reporting (STAR) Act of 2019; H.R. 2115, To amend title XI of the Social Security Act to provide greater transparency of discounts provided by drug manufacturers; Proposed rule, "Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses, CMS-4180-P"; Proposed rule, "Fraud and Abuse; Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees, OIG-0936-P"; Proposed rule, Medicaid Program; Medicaid and Childrens Health Insurance Plan (CHIP) Managed Care - CMS-2408-P; H.R. 1323, Rural Hospital Frontier Fairness Act; S. 551, REFUND Act of 2019; S. 691, Medicare Extra Rx HELP Act of 2019; S. 773, Telehealth Innovation and Improvement Act of 2019; S. 814, Expanding Access to Diabetes Self-Management Training Act of 2019; H.R. 1384 / S. 1129, Medicare for All Act of 2019; H.R. 3417, The Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019; H.R. 3408, Shop Rx Act of 2019; S. 1384, Prescription Drug Rebate Reform Act of 2019; H.R. 2113, Prescription Drug STAR Act; H.R. 2115, Public Disclosure of Drug Discounts Act S. 2447, the Phair Relief Act; S. 2771, the Protecting Home Oxygen and Medical Equipment Act of 2019; S. 1861 / H.R. 3924, the Streamlining Part D Appeals Process Act; H.R. 4946, the Ensuring Seniors Access to Local Pharmacies Act of 2019; H.R. 5281, the Drug Price Transparency in Medicaid Act of 2019; H.R. 5442, the Lowest Price for Patients Act; Report language for H.R.1865, the Further Consolidated Appropriations Act; Pharmacist Provider Status draft legislation

Client expense: $330,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, Small Business Administration (SBA), Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

FDA/CMS Breakthrough Pathway - Legislation to harmonize CMS Reimbursement with FDA Approval to speed products' market introduction House/Senate Implementation of Comprehensive Addiction & Recovery Act (CARA) Law to address the National Opioid epidemic. Specifically, Advocacy for FDA approved alternative treatments for Chronic Pain Public Law 115-271 SUPPORT for Patients and Communities Act - Specifically, advocacy for FDA approved alternative treatments for Chronic Pain, and medical device's role in the opioid epidemic. HR 3417 Better Act - Modifications to legislation to streamline access to medical device interventions by employing telehealth 2020 proposed OPPS rule - Telehealth and C-APC changes for Interspinous Decompression Labor HHS bill HR 1865 - Advocacy for C-APC changes HR 5833 to Amend Title XVIII of the Social Security Act - Allows psychological evaluation required for preauthorization for certain interventional pain therapies to be conducted via telehealth Public Law 116-136 Coronavirus Aid Relief & Economic Security (CARES) Act - Legislation to support businesses of all sizes, cash support for citizens, and monetary relief for health care providers & hospitals, telehealth expansion. Specifically, advocacy for funding to help health providers offset expenses and lost revenue related to the pandemic; medical device shortages reporting for public health emergencies, grants for COVID-19 medical countermeasures; and air transport provisions to maintain medical device supply chain. Coronavirus Response and Relief Supplemental Appropriations Act, 2021, (CRRSA) Public Law 116-260: Emergency waiver to increase the frequency of application review of CMS's New Tech Add-on Payment program during the Public Health Emergency 2021 Proposed CMS OPPS Rule - Requesting that CMS not finalized new prior authorization requirements in Medicare Part A. 2021 Proposed Physician Fee Schedule - Adding telehealth services approved for use during the Public Health Emergency to the list of permanently authorized telehealth services S4473/HR7956 Critical Medical Infrastructure Right to Repair Act of 2020 - To allow non-manufacturer repair technicians to maintain and repair essential medical equipment during the COVID-19 pandemic, and temporarily suspend restrictions. 2021 CMS Final Rule "Medicare Coverage of Innovative Technology and Definition of Reasonable and Necessary"- advocacy for a new, voluntary Medicare Coverage of Innovative Technology (MCIT) pathway that provides four years of national Medicare coverage for Breakthrough-designated technologies, beginning on the date of FDA market authorization.

Client expense: $380,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

H.R. 3417; Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019; provisions related to disproportionate Share Hospital Funding H.R. 266; Paycheck Protection and Health Care Enhancement Act; provisions related to provider relief H.R. 6800; The Heroes Act; provisions related to Medicare Accelerated Advance Payments

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H. Res. 480, Acknowledging the racial disparities in diagnosing and treating mental health among youth in communities of color H.R. 1554, the Resident Education Deferred Interest Act H.R. 1763 / S. 348, the Resident Physician Shortage Reduction Act of 2019 H.R. 2734 / S. 1448, the Safer Prescribing of Controlled Substances Act H.R. 3180/ S. 1770, the RISE from Trauma Act H.R. 3239/ S. 2135, the Humanitarian Standards for Individuals in Customs and Border Protection Custody Act H.R. 3253, the Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act H.R. 3417, BETTER Act of 2019 H.R. 4194/S. 2661, the National Suicide Hotline Designation Act of 2019 H.R. 4309, the Barriers to Suicide Act H.R. 4327, the Enhancing Mental Health and Suicide Prevention Through Campus Planning Act H.R. 4861/ S. 3006, the Effective Suicide Screening and Assessment in the Emergency Department Act H.R. 4932 / S. 2741, the CONNECT for Health Act H.R. 4995, the Maternal Health Quality Improvement Act of 2019 H.R. 4996, the Helping Medicaid Offer Maternity Services Act of 2019 H.R. 5201, the Telemental Health Expansion Act of 2019 H.R. 5473, the Enhance Access to Support Essential Behavioral Health Services Act H.R.5469/ S.4388, the Pursuing Equity in Mental Health Act of 2019 H.R.5575, the Primary and Behavioral Health Care Access Act of 2020 Out of network billing legislation S. 1227, the Prescription Pricing for the People Act of 2019 S. 2443, the Investment in Tomorrow's Pediatric Health Care Workforce Act S. 824, the Excellence in Mental Health and Addiction Treatment Expansion Act S.1659, the Ensuring Childrens Access to Specialty Care Act of 2019 Title III Sec. 305 Timely Bills to Patients within the Lower Health Care Costs Act of 2019 (S. 1895) Cures 2.0 Title X Family Planning Program Administration Rule Efforts related to psychiatric bed shortages. H.R. 6074, the Coronavirus Preparedness and Response Supplemental Appropriations Act H.R. 6201, the Families First Coronavirus Response Act H.R. 4996, the Helping Medicaid Offer Maternity Services (MOMS) Act, and Senate efforts. S. 311, the Born-Alive Abortion Survivors Protection Act S. 3275, the Pain-Capable Unborn Child Protection Act H.R. 4056 and S. 2446, the Medicare Audiologist Access and Services Act of 2019 H.R. 5575, the Primary and Behavioral Health Care Access Act Telehealth provisions as related to Covid-19. H.R. 6644, the Health Care at Home Act Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 and related Medicare and Medicaid payment updates. Emergency financial relief and stability funding for 501(c)(6) tax-exempt medical and dental trade associations impacted by the pandemic H.R. 7078, the Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act of 2020 (EDOT Act of 2020) H.R. 7255, the Coronavirus Health Care Worker Wellness Act of 2020 S. 3919, the Military Suicide Prevention in the 21st Century Act H.R. 7608, the Legislative Vehicle for the Fiscal 2021 Four-Bill Appropriations Package H.R. 7539, the Strengthening Behavioral Health Parity Act H.R. 4564, the Suicide Prevention Lifeline Improvement Act of 2019 H.R. 5619/ S. 3198, the Suicide Prevention Act H.R. 4585, the Campaign to Prevent Suicide Act H.R. 1646/ S. 3244, the Helping Emergency Responders Overcome (HERO) Act of 2019 H.R. 2519/ S. 1334, the Improving Mental Health Access from the Emergency Department Act of 2019 H.R. 7147, the Creating Resources to Improve Situations of Inherent Severity Act (CRISIS Act) H.R. 7159/S. 4282, the Crisis Care Improvement and Suicide Prevention Act of 2020 H.R. 7689, the Improving Data Collection for Adverse Childhood Experiences Act H.R. 8094/S. 4349, the Dr. Lorna Breen Health Care Provider Protection Act H.R. 6561/S. 4440, the Improving Social Determinants of Health Act H.R. 7511/ S. 4211, the Facilitating Reforms that Offer Necessary Telehealth in Every Rural (FRONTIER) Community Act H.R. 884 / S. 2772, the Medicare Mental Health Access Act H.R. 3935, the Protecting Patients Transportation to Care Act H.R. 4564, the Suicide Prevention Lifeline Improvement Act of 2020 S. Res. 738, Recognizing suicide as a serious public health problem and expressing support for the designation of September as National Suicide Prevention Month S. 4113, the Broadband Reform and Investment to Drive Growth in the Economy Act of 2020 (BRIDGE Act) H.R. 7859, the Strengthening Behavioral Health Supports for Schools Act S. 4421, the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act H.R. 8141, the Strengthening Mental Health Supports for BIPOC Communities Act HR 7510, the Assimilating Health and Equity Assessments into Decision-making Act of 2020 or AHEAD Act H.R. 5469/S.4388, the Mental Health Equity Act of 2020 H.R. 7059, the Coronavirus Provider Protection Act, S. 3792, the Tele-Mental Health Improvement Act of 2020. HR 6810 to provide COBRA subsidies for unemployed and furloughed individuals during COVID H.R. 7593/S. 4103, the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act H.R. 6645, the Mental Health Research Act H.R. 5201, the Telemental Health Expansion Act of 2019 H.R. 6561/S. 3595, the Ensuring Understanding for COVID-19 to Protect Public Health Act S. 4524, the Quit Because of COVID-19 Act S. 4486, the Achieving Thorough Transparency & Accessibility for Information Navigation (ATTAIN) on Mental Health Act H.R. 6800/H.R. 8406, the HEROES Act S. 4230, the Telehealth Expansion Act of 2020 H.R. 7391, the Protect Telehealth Access Act of 2020 H.R. 7760, To make a supplemental appropriation for the COVID-19 Telehealth Program of the Federal Communications Commission for the fiscal year ending September 30, 2020 H.R.8067, the Addressing COVID-19 Health Disparities Act H.R. 2862, the VACCINES Act of 2019 (G6 letter for internal purposes) Efforts related to Collaborative Care Model S. 3197, the Improving Access to Health Care in Rural and Underserved Areas Act H.R. 6139, the COVID-19 Health Care Worker Protection Act of 2020 H.Res. 908 (S.Res. 580) Condemning all forms of Anti-Asian Sentiment as related to COVID-19 H.R. 6585, the Equitable Data Collection and Disclosure on COVID-19 Act H.R. 7078, the EDOT Act of 2020 HR 7077, the Community Solutions for COVID-19 Act H.R. 7780, the Virtual Community Support Act of 2020 H. R. 8016, the Peer Assisted Relief Through Empathetic Resources and Supports (PARTNERS) Act H. R. 8206, the Promoting Effective and Empowering Recovery Services in Medicare Act of 2020 (PEERS Medicare Act of 2020) 2021 Centers for Medicare and Medicaid Services (CMS), Medicare Physician Fee Schedule (MPFS) Final Rule, E/M (H.R. 8702; H.R. 8505; S. 4932) H.R. 9035, the Permanency for Audio Only Telehealth Act H.R. 7663, Protecting Access to Post-COVID-19 Telehealth Act of 2020 H.R. 8283/S. 4421 TREAT Act H.R. 2482/S. 2074 Mainstreaming Addiction Treatment Act of 2019 Misuse of race data within clinical algorithms.

Client expense: $238,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of the Vice President of the United States, SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 8840, Medicare Sequester COVID Moratorium Act, all provisions H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions S. 5007, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions H.R. 7154, Outpatient Therapy Modernization and Stabilization Act, all provisions H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, all provisions S. 5044, Improving Seniors Timely Access to Care Act of 2020y, all provisions H.R. 8727, Telehealth Modernization Act, all provisions S. 4375, Telehealth Modernization Act, all provisions H.R. 7663, Protecting Access to Post-COVID-19 Telehealth Act of 2020, all provisions H.R. 7391, Protect Telehealth Access Act of 2020, all provisions H.R. 1301, Mental Health Telemedicine Expansion Act, all provisions H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019, all provisions H.R. 5201, Telemental Health Expansion Act of 2020, provisions relating to 1834(m) of the Social Security Act; geographic and originating sites H.R. 7233, Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020, all provisions H.R. 5172, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, All provisions S. 3067, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, All provisions H.R. 3414, Opioid Workforce Act of 2019, all provisions H.R. 7791, Value in Health Care Act of 2020, provisions relating to qualifying APM physician thresholds H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020, all provisions S. 3750, Medicare Accelerated and Advance Payments Improvement Act, all provisions H.R. 8505, To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes, all provisions H.R. 884, Medicare Mental Health Access Act, all provisions H.R. 945, Mental Health Access Improvement Act of 2019, all provisions H.R. 6744, Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2020, all provisions H.R. 4004, Social Determinants Accelerator Act of 2019, all provisions H.R. 4932, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions S. 2741, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions H.R. 5534, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020, all provisions S. 3353, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, provisions related to PBM and prescription drug price transparency H.R. 19, Lower Costs, More Cures Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2020, all provisions H.R. 6090, Physician Shortage GME Cap Flex Act of 2020, all provisions H.R. 6142, Black Maternal Health Momnibus Act of 2020, all provisions Medicare program: P.L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) implementation/Accountable Care Organizations/APM thresholds Medicare program: Patient Protection and Affordable Care Act (PPACA)/Prior authorization provider and patient burdens/patient electronic access to health information Medicare program: P.L. 113-93 Protecting Access to Medicare Act (PAMA)/Imaging appropriate use criteria/Radiation Oncology APM Medicare program: FY 2021 Inpatient Rehab Facility Prospective Payment System (IRF PPS)/scope of practice issues Medicare program: CY 2021 physician fee schedule/E&M services/Budget neutrality/Part B/Sequester Medicare program: Alternative payment models (APMs) Medicare program: Merit-based Incentive Payment System (MIPS)/cost/quality/interoperability/hardship exemption Medicare program: Regulatory relief/Advanced APMs, prior authorization, and utilization management Medicare program: Shared Savings Program Medicare program: Quality Payment Program/prior authorization/electronic funds transfer Medicare program: Surprise medical billing Medicare program: Medicare-For-All Medicare program: Electronic Health Records (EHR) Certification Medicare program: 21st Century Cures Act Medicare program: Quality payment program/physician burdens Medicare program: National Coverage determination/validated home blood pressure monitors Medicare program: Health IT/physician burden Medicare program: Drug pricing Medicare program: Most favored nation drug pricing Medicare program: Provider compliance/regulatory relief Medicare program: Provider Enrollment, Chain and Ownership (PECOS) enrollment/revalidation Medicare and Medicaid programs: 21st Century Cures Act/health data and privacy Medicaid program: CMS proposed regulation Medicaid Program Medicaid program: FMAP increases Medicaid program: Interoperability

Client expense: $4,170,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, Veterans Affairs, Dept of (VA), White House Office

Urged Congress to extend the moratorium on looming automatic 2% cuts (sequestration) in the Medicare program and $4 billion cuts in the Medicaid Disproportionate Share Hospital (DSH) program the duration of the public health emergency and at least until the end of 2021 to ensure providers have the resources to continue to care for patients and communities during this pandemic. Urged Congress to include language in the Continuing Resolution (CR) that eliminates the Medicaid Disproportionate Share Hospital (DSH) reductions slated to begin on December 1 of this year. Urged the House to support H.R. 2477, the Beneficiary Enrollment Notification an Eligibility Simplification (BENES) Act of 2019 which would modernize and simplify the Medicare Part B enrollment process as recommended by the Medicare Payment Advisory Commission (MedPAC). Urged the House to support H.R. 3935, the Protecting Patients Transportation to Care Act which would amend the Medicaid statute to include non-emergency medical transportation (NEMT) in the list of mandatory Medicaid benefits by codifying current Medicaid NEMT regulations. Urged the House to support H.R. 5201, the Tele-Mental Health Expansion Act of 2019 would permanently include a patients home as an eligible originating site for mental health services delivered via telehealth in the Medicare program. Urged Congress to increase the FMAP for Medicaid by 5.8 percent for a total increase of 12 percent to ensure states capacity to provide access to care though Medicaid in then next round of financial relief. Urged HHS to ensure that a proportional amount of the remaining Public Health and Social Services Emergency Fund (PHSSEF) and any additional relief funding appropriated by Congress, is provided quickly to ALL Medicaid providers and health professionals impacted by the COVID-19 pandemic. Urged the House to support the H.R. 826, Expressing disapproval of the Trump administrations harmful actions towards Medicaid. This resolution seeks to reverse the recent guidance from the Centers for Medicare and Medicaid Services (CMS) titled Healthy Adult Opportunity, which would essentially cap or block grant funding for certain populations. CMS-2393-P Medicaid Program; Medicaid Fiscal Accountability Regulation; Proposed Rule (84 Federal Register 63722, November 18, 2019) - Urged CMS not to finalize the proposed MFAR. The proposed rule could force states to reduce the size of their Medicaid programs by covering fewer beneficiaries, restricting health care services or reducing provider payment rates. Urged the House to support H.R. 3, the Lower Drug Costs Act Now of 2019, which includes proposals to lower the costs of prescription drugs through Medicare negotiation authority and also includes new Medicare protections and additional coverage. Urged the House to support H.R. 4650, the Medicare Dental Act of 2019, which would add a dental benefit to Medicare Part B. Urged the House to support H.R. 4665, the Medicare Vision Act of 2019, which would a vision benefit to Medicare Part B. Urged the House to support H.R. 4618, the Medicare Hearing Act of 2019, which would add a hearing benefit to Part B including hearing aids. 2393-P - Request for Extension of Comment Period for Medicaid Program; Medicaid Fiscal Accountability Regulation, 84 Fed. Reg. 63722 (November 18, 2019) - Urged CMS to extend the comment period on the proposed rule for at least 60 days, until March 17, 2020, to ensure that states and other stakeholders have sufficient time to provide CMS with the information it needs to make sound policy decisions. Territories Health Care Improvement Act (HR 3631) - Urged the Senate to adopt new funding levels for Medicaid in the Territories to address outdated funding mechanisms and matching rates. Urged the House and Senate to delay FY2020 funding cuts to Medicaid disproportionate share hospitals. Beneficiary Education Tools, Telehealth, and Extenders Re-authorization Act of 2019 (H.R. 3417) - Supported expanding mental and behavioral health telemedicine services to Medicare beneficiaries. Patient Centered Outcomes Research Institute (H.R. 3439) - Supported extending the legislation to provide research on substance use disorders, mental health, and maternal morbidity and mortality. The HEARTS and Rural Relief Act (H.R. 3429) - Supported extending the rural and critical access hospital moratorium for two years on direct supervision requirements for outpatient therapeutic services. Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019 (H.R. 3253) - Supported extending Medicaid demonstration programs to improve person-centered health care across the continuum of care. Maternal Health Quality Improvement Act (H.R. 4995) and Helping Medicaid Offer Maternity Services Act of (H.R. 4996) - Urged the Senate to pass both to help to eliminate preventable pregnancy-related deaths and improve maternal health outcomes. Reauthorizing and Extending America's Community Health (REACH) Act (H.R. 2328) - Opposed a statutory payment rate. Supported elimination of DSH funding cuts for FY 2020 and 2021. Supported permanent Medicaid funding in the United States territories. Supported demonstrations for Medicare beneficiaries that promote enrollment, education, and outreach.

Client expense: $196,341 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Natl Institutes of Health (NIH), Office of the Vice President of the United States, President of the U.S., SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of

Issues related to Graduate Medical Education (GME), including the Advancing Medical Training in Community Hospitals Act (H.R. 1358) and the Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 (H.R. 3417).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Graduate Medical Education (GME), including the Advancing Medical Training in Community Hospitals Act (H.R. 1358) and the Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 (H.R. 3417).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 7659 Re: ensuring parity for Audio Only Telehealth (Sewell) S. 3001 Toomey, regarding Medicare and Medicaid program extensions HR 4932, Thompson regarding telehealth in the Medicare program S. 2741 Schatz, regarding telehealth in the Medicare program HR 1839, the Medicaid Services Investment and Accountability Act HR 3253, The Empowering Beneficiaries, Ensuring Access and Strengthening Accountability Act (regarding Medicaid) HR 2131 and S. 1114, regarding the Medicare Advantage benchmark cap HR 3107, regarding the use of preauthorization in the Medicare Advantage program HR 3417 the Beneficiary Education Tools, Telehealth and Extenders Reauthorization Act (regarding Medicare) Legislation and regulation regarding the Medicare Advantage program HR 1839, regarding multiple Medicaid program changes, including the Medicaid Drug Rebate program. HR 1046 and S. 377, regarding Medicare Part D and requirements for HHS to negotiate drug prices HR 1781 Regarding MedPAC and MACPAC access to drug pricing and rebate data.

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

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

COVID-19 issues related to COVID-19 health care legislative and regulatory implementation and funding issues, including inpatient rehab hospitals (IRFs), Families First Coronavirus Response Act (H.R. 6201), Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (H.R. 6074), and the CARES Act (S. 3548/H.R. 748), Consolidated Appropriations Act, 2021 (H.R. 133).; Unified post-acute care payment system; Medicare Advantage and Prior Authorization including H.R.3107; Site neutral payment issues; Medical necessity to post-acute care reform; The Preserving rehabilitation Innovation Centers Act of 2019 (S.594, H.R. 1901); Implementation of IMPACT Act of 2014 (P.L. 113-185); Implementation of H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015; Comprehensive Care for Joint Replacement(CCJR) Model; Medicare Advantage and managed care related issues; Value based purchasing issues, Recovery Audit Contractor issues, prior authorization, PPS excluded hospitals operation of excluded units, 3-hour rule, 60% rule, LTCH exempt unit issue; Preserving Rehabilitation Innovation Centers Act (H.R.1901/S.594); Improving Seniors Timely Access to Care Act (H.R.3107); The BETTER Act (H.R.3417); The Resetting The Impact Act (TRIA) (H.R. 8826); Implementation of the Continuing Care Hospital.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, White House Office

COVID-19 health care legislative and regulatory implementation and funding issues, including issues related to inpatient rehab hospitals (IRFs), Families First Coronavirus Response Act (H.R. 6201), Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (H.R. 6074), and the CARES Act (S. 3548/H.R. 748), Consolidated Appropriations Act, 2021 (H.R. 133); Unified post-acute care payment system; Medicare Advantage and Prior Authorization including H.R.3107; Site neutral payment issues; Medical necessity to post-acute care reform; The Preserving rehabilitation Innovation Centers Act of 2019 (S.594, H.R. 1901); Implementation of IMPACT Act of 2014 (P.L. 113-185); Implementation of H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015; Comprehensive Care for Joint Replacement(CCJR) Model; Medicare Advantage and managed care related issues; Value based purchasing issues, Recovery Audit Contractor issues, prior authorization, PPS excluded hospitals operation of excluded units, 3-hour rule, 60% rule, LTCH exempt unit issue; Preserving Rehabilitation Innovation Centers Act (H.R.1901/S.594); Improving Seniors Timely Access to Care Act (H.R.3107; The BETTER Act (H.R.3417); The Resetting The Impact Act (TRIA) (H.R. 8826); implementation of the Continuing Care Hospital.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, White House Office

Medicare Advantage. Rebate Rule. Prescription Drug Pricing. Medicare expansions and Medicare for all. Medicare Part D reform. H.R.3417 - Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

Support S.299 - Geriatrics Workforce Improvement Act Support H.R.2781 - Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness for Health Act of 2019 Support H.R.728 - Title VIII Nursing Workforce Re-authorization Act of 2019 Support H.R.2035 - Lifespan Respite Care Reauthorization Act of 2019 Support S. 4423COVID-19 Hospice Respite Care Relief Act of 2020 Support H.R.3398 - Pathways to Health Careers Act Support H.R.3417 - Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 Support S.2080/H.R. 647 - Palliative Care and Hospice Education and Training Act Support H.R.4397 - Direct Creation, Advancement, and Retention of Employment Opportunity Act Support S. 4840Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 H.R 8322/S.4423 COVID-19 Hospice Respite Care Relief Act of 2020 H.R. 8114 Emergency Support for Nursing Homes and Elder Justice Reform Act of 2020 H.R 7663 Protecting Access to Post-COVID-19 Telehealth Act of 2020

Client expense: $31,167 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2772, H.R. 884: Medicare Mental Health Access Act. H.R. 1301: The Mental Health Telemedicine Expansion Act H.R.1839: Medicaid Services Investment and Accountability Act of 2019 H.R. 1530, S. 595: Treat & Reduce Obesity H.R. 1329: Medicaid Reentry Act H.R. 3417: Beneficiary Education Tools Telehealth Extender Reauthorization Act of 2019 H.R. 5575: Primary Care and Behavioral Health Access Act H/S bill is under HCR S.3999: Mental and Behavioral Health Connectivity Act H.R. 6644, S. 3741: Health Care at Home Act H.R. 5201: Telemental Health Expansion Act H.R. 7663: Protecting Access to Post Covid-19 Telehealth Act H.R.4996: Helping MOMS Act of 2020 SF H.R.7539: Strengthening Behavioral Health Parity Act H.R. 9035: Permanency for Audio-Only Telehealth Act H,R, 8702, S. 5007: Holding Providers Harmless From Medicare Cuts During COVID-19 Act H.R. 8840: Medicare Sequester COVID Moratorium Act S. 4013, H.R. 7593: TREATS Act

Client expense: $216,000 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), SENATE

Site Neutrality. Graduate Medical Education Funding. H.R.3417 - Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R. 266, Paycheck Protection Program and Health Care Enhancement Act H.R. 6800, HEROES Act H.R. 600 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Health, Economic Assistance, Liability Protection and Schools (HEALS) Act Delivering Immediate Relief to America's Families, Schools and Small Business Act (Senate Amendment No. 2652 to the House Amendment S. 178) H.R. 133 - Consolidated Appropriations Act, 2021

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE

H.R. 1614 A bill to amend the Controlled Substances Act to establish additional registration requirements for prescribers of opioids, and for other purposes; John S. McCain Opioid Addiction Prevention Act S. 724 A bill to amend the Controlled Substances Act to establish additional registration requirements for prescribers of opioids, and for other purposes; John S. McCain Opioid Addiction Prevention Act S.340 CREATES Act of 2019 H.R. 985 FAST Generics Act of 2019 S.640 Phair Pricing Act of 2019 S. 97 Affordable and Safe Prescription Drug Importation Act S. 61 Safe and Affordable Drugs from Canada Act of 2019 H.R. 1034 Phair Pricing Act of 2019 H.R. 965 CREATES Act of 2019 H.R. 1478 Affordable Insulin Act of 2019 H.R. 447 Affordable and Safe Prescription Drug Importation Act H.R. 1499 Protecting Consumer Access to Generic Drugs Act H.R. 3417 The Beneficiary Education Tools, Telehealth, and Extenders Re-authorization Act of 2019 H.R. 2296 Fair Accountability and Innovative Research Drug Pricing (FAIR Drug Pricing) Act of 2019 H.R. 1607 Fairness to Pet Owners Act H.R. 3379 Priced Relief, Innovation, and Competition for Essential Drugs (PRICED) Act H.R. 478 Safe and Affordable Drugs from Canada Act of 2019 H.R. 3 Lower Drug Costs Now Act of 2019 H.R. 275 Medicare Prescription Drug Price Negotiation Act of 2019 H.R. 448 Medicare Drug Price Negotiation Act H.R. 1046 Medicare Negotiation and Competitive Licensing Act of 2019 H.R. 5304 PBM Transparency in Prescription Drug Costs Act H.R. 5172 NOPAIN Act S. 2543 Prescription Drug Pricing Reduction Act of 2019 S. Rept. 116-120 Prescription Drug Pricing Reduction Act of 2019 S. 2247 Phair Relief Act of 2019 S. 3070 Preventing Pill Mills Through Data Sharing Act H.R. 3055 Further Continuing Appropriations Act, 2020, and Further Health Extenders Act of 2019 H.R. 19 Lower Costs, More Cures Act on 2019 S. 3129 Lower Costs, More Cures Act on 2019 H.R. 748 Coronavirus Aid, Relief, and Economic Security Act or the CARES Act H.R. 6573 Help our Heroes Access Medicine Act of 2020 H.R. 6557 MAIL Act S. 3979 A bill to amend title 10, United States Code, to authorize the Secretary of Defense to temporarily waive cost-sharing amounts under the TRICARE pharmacy benefits program during certain declared emergencies. H.R.6395 - William M. (Mac) Thornberry National Defense Authorization Act for Fiscal Year 2021 H.R. 4806 DEBAR Act of 2019 H.R. 3878 Block, Report, and Suspend Suspicious Shipments Act of 2019 H.R. 4812 Ensuring Compliance Against Drug Diversion Act H.R. 4814 Suspicious Order Identification Act of 2019 H.R. 8061 Community Immunity During COVID-19 Act S. 3548 The CARES Act H.R. 6800 The HEROES Act

Client expense: $280,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 4994/PL 113-185 Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (all sections) HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 807 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) S 253 - Medicare Access to Rehabilitation Services Act of 2017 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 3417 - Beneficiary Education Tools, Telehealth, and Extenders (BETTER) Act of 2019 (Sec. 103. Medicare coverage of certain mental health telemedicine, Sec. 204. Improving measurements under the skilled nursing value-based purchasing program under the Medicare program) HR 3107 - Improving Seniors Timely Access to Care Act of 2019 (all sections) HR 266 - Paycheck Protection Program and Health Care Enforcement Act (all sections) HR 748 - Coronavirus Aid, Relief, and Economic Security (CARES) Act (all sections) HR 7154 - Outpatient Therapy Modernization and Stabilization Act (all sections) HR 8600 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act (all sections) HR 8702 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (all sections) HR 8826 - The Resetting the Impact Act (TRIA) of 2020 (all sections) HR 133/PL 116-260 - Consolidated Appropriations Act, 2021 (Division M - Coronavirus Response & Relief Supplemental Appropriations Act, 2021)

Client expense: $720,300 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) National Defense Authorization Act of 2018 (H.R. 2810) S. AMDT. 621 (H.R. 2810)--Authorization of Physical Therapist Assistants and Occupational Therapy Assistants to Provide Services Under the TRICARE Program Trusted Exchange Framework and Common Agreement (TEFCA) CONNECT for Health Act of 2017 (H.R. 2556/S. 1016) The Laboratory Access for Beneficiaries (LAB) Act of 2019 (H.R. 3584) The Ensuring Access to Quality Complex Rehabilitation Technology Act of 2019 (H.R. 2408) The Protecting Access to Wheelchairs Act of 2019 (H.R. 2293) The Protecting Beneficiary Access to Complex Rehab Technology Act of 2019 (S. 1223) The Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019 (H.R.3417) The Creating Opportunities Now and Effective Care Technologies (CONNECT) Act of 2019 (S.2741) The Safeguarding Medicare Access to Respiratory Therapy (SMART) Act of 2019 (H.R.4945) The Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020(H.R.6074) The Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020 (S.3548) The Outpatient Therapy Modernization and Stabilization Act (H.R.7154) The Nursing Home COVID-19 Protection and Prevention Act (S.3768) The Infection Control Training and Support Act (H.R.7254) The Consolidated Appropriations Act of 2021 (PL 116-260) The Holding Providers Harmless from Medicare Cuts during COVID-19 Act of 2020 (H.R. 8702/S.5007)

Client expense: $39,516 · Firm income: Not reported

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

IPPS, OPPS and other regulations impacting hospitals. P.L. 116-260/H.R. 133 - Consolidated Appropriations Act of 2021 - Issues related to the fight against COVID-19 including issues of vaccine distribution, testing policies and procedures and support of the nation's health care system, patients, families and their care providers. H.R. 8319 - Continuing Appropriation Act 2021 - Ensuring that "health extenders" are addressed. H.R. 8406 - The HEROES Act (modified) - Issues related to ensuring that hospitals are able to support patients with the full battery of services needed during the COVID-19 pandemic. Senate HEALS Act - Issues related to ensuring that hospitals are able to support patients with the full battery of services needed during the COVID-19 pandemic. H.R. 6800 - The HEROES Act - Issues related to support for patients, providers and hospitals fighting against COVID-19. Issues related to the care of displaced nursing home residents covered by Medicare and Medicaid in area hospitals. H.R. 6074 - Coronavirus Preparedness and Response Supplemental Appropriation Act of 2020- IMPLEMENTATION - Issues related to ensuring that not-for-profit hospitals, providers and hospital systems are able to best prevent, test, diagnose and treat the outbreak of COVID-19. H.R. 6201 - Families First Coronavirus Response Act - IMPLEMENTATION - Issues related to ensuring that not-for-profit hospitals, providers and hospital systems are able to best prevent, test, diagnose and treat the outbreak of COVID-19. H.R. 748 - The CARES Act - IMPLEMENTATION - Issues related to support not-for-profit hospitals to best respond to the COVID-19 pandemic. H.R. 5473 - EASE Behavioral Health Services Act - IMPLEMENTATION - Issues related to increasing the use of telemedicine to support people with behavioral health concerns. H.R. 3417 - The Beneficiary Education Tools Telehealth Extender Reauthorization Act of 2019 - support for policies that allow for increased GME slots for underserved areas and increased utilization of telemedicine in Medicare. S. 1895 - Lower Health Costs Act of 2019 - Issues related to addressing the practice of surprise billing in private health care. Issues related to increasing GME slots for hospitals in communities with growing populations. Issues related to the promotion of the Medicaid DSH program. Issues related to advancing behavioral health services for children and other underserved populations.

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

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

IPPS, OPPS and other regulations impacting hospitals. P.L. 116-260/H.R. 133 - Consolidated Appropriations Act of 2021 - Issues related to the fight against COVID-19 including issues of vaccine distribution, testing policies and procedures and support of the nation's health care system, patients, families and their care providers. H.R. 8319 - Continuing Appropriation Act 2021 - Ensuring that "health extenders" are addressed. H.R. 8406 - The HEROES Act (modified) - Issues related to ensuring that hospitals are able to support patients with the full battery of services needed during the COVID-19 pandemic. Senate HEALS Act - Issues related to ensuring that hospitals are able to support patients with the full battery of services needed during the COVID-19 pandemic. H.R. 6800 - The HEROES Act - Issues related to support for patients, providers and hospitals fighting against COVID-19. H.R. 6074 - Coronavirus Preparedness and Response Supplemental Appropriation Act of 2020- IMPLEMENTATION - Issues related to ensuring that not-for-profit hospitals, providers and hospital systems are able to best prevent, test, diagnose and treat the outbreak of COVID-19. H.R. 6201 - Families First Coronavirus Response Act - IMPLEMENTATION - Issues related to ensuring that not-for-profit hospitals, providers and hospital systems are able to best prevent, test, diagnose and treat the outbreak of COVID-19. H.R. 748 - The CARES Act - IMPLEMENTATION- Issues related to support not-for-profit hospitals to best respond to the COVID-19 pandemic. H.R. 5473 - EASE Behavioral Services Act - Issues related to increasing the use of telemedicine for behavioral health services in Medicare. H.R. 1839- The Medicaid Service,Investments and Accountability Act of 2019 - Policies related to caring for children with multiple complex conditions. H.R. 3417 - The Beneficiary Education Tools Telehealth Extender Reauthorization Act of 2019 - support for policies that allow for increased GME slots for underserved areas and increased utilization of telemedicine in Medicare. S. 1895 - Lower Health Costs Act of 2019 - Issues related to addressing the practice of surprise billing in private health care. Issues related to supporting the 340(b) program to ensure the best care possible for low income Americans. Issues related to increasing GME slots for hospitals in communities with growing populations. Issues related to the promotion of the Medicaid DSH program. Issues related to advancing behavioral health services for children and other underserved populations.

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

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

Monitored Congressional Proposals concerning health price transparency. H.R. 1384 - "Medicare For All Act of 2019", S.1129 - "A bill to establish a Medicare-for-all national health insurance program" - Oppose legislation to impose single payer health care delivery. H.R. 2085/ S.1033 "Consumer Health Options and Insurance Competition Enhancement Act (CHOICE) Act", H.R. 2000/S.981 - "Medicare-X Choice Act of 2019" - Oppose legislation to impose a Medicare public option. H.R. 728/S.1399 - "Title VIII Nursing Workforce Re-authorization Act of 2019" - Support legislation to provide loan repayment for nurses to practice in any care setting. S. 1895 - "Lower Health Care Costs Act" - Support protecting patients from surprise billing and oppose government rate setting. Advocated for appropriate transparency and contracting flexibility. S.1531 "Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019", H.R. 3630 "No Surprises Act", H.R. 3502 "Protecting People From Surprise Medical Bills Act", H.R. 5800 Ban Surprise Billing Act, H.R. 5826 "Consumer Protections Against Surprise Medical Bills Act of 2020" - Advocate to protect patients from surprise billing and oppose government rate setting. H.R. 2328 "Community Health Investment, Modernization, and Excellence Act of 2019", H.R. 748 "Coronavirus Aid, Relief, and Economic Security Act" - Support re-authorization of National Quality Forum. H.R. 3417 "Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019" - Supported legislation. H.R. 748 Coronavirus Aid, Relief, and Economic Security (CARES) Act, H.R. 6837/ S. 3750 "Medicare Accelerated and Advance Payments Improvement Act of 2020", H.R. 266 "Paycheck Protection Program and Health Care Enhancement Act" - Advocated in support of funding and programs for hospitals and post-acute care providers to respond to COVID-19 H.R. 6800 "Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act" - Support expanded access and affordability of COBRA and other health insurance options H.R. 6365/ S. 3559 "Immediate Relief for Rural Facilities and Providers Act of 2020" - Support expansion of access to telehealth programs for tax paying rural hospitals H.R. 7059 "Coronavirus Provider Protection Act" - Evaluated and advocated for improvements to legislation Liability Protections - Develop proposal to protect hospitals, healthcare professionals and facilities from liability due to COVID-19 Provider Relief Fund Taxability - Support technical corrections to Provider Relief Fund to ensure funds received are not taxable

Client expense: $650,000 · Firm income: Not reported

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

General Issues - Maintaining the 340B drug pricing program; all provisions General Issues - Medicare Hospital Outpatient Prospective Payment System (OPPS) CY 2019; provisions related to cuts to hospital outpatient departments CMS-1716-P - FY2020 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Physician Fee Schedule Proposed Rule H.R. 3417 - Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act; all provisions S. 2543Prescription Drug Pricing Reduction Act of 2019; all provisions H.R. 3Lower Drug Costs Now Act of 2019; all provisions H.R. 3630 - No Surprises Act; provisions related to eliminate surprise billing H.R. 3502 - Protecting People from Surprise Medical Bills Act; provisions related to eliminate surprise billing S. 1531Stopping the Outrageous Practice of Surprise Medical Bills Act of 2019; provisions related to eliminate surprise billing S. 348/H.R. 1763 - Resident Physician Shortage Reduction Act of 2019; all provisions

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

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

The Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753) National Defense Authorization Act of 2018 (H.R. 2810) S. AMDT. 621 (H.R. 2810)--Authorization of Physical Therapist Assistants and Occupational Therapy Assistants to Provide Services Under the TRICARE Program Trusted Exchange Framework and Common Agreement (TEFCA) CONNECT for Health Act of 2017 (H.R. 2556/S. 1016) The Laboratory Access for Beneficiaries (LAB) Act of 2019 (H.R. 3584) The Ensuring Access to Quality Complex Rehabilitation Technology Act of 2019 (H.R. 2408) The Protecting Access to Wheelchairs Act of 2019 (H.R. 2293) The Protecting Beneficiary Access to Complex Rehab Technology Act of 2019 (S. 1223) The Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019 (H.R.3417) The Creating Opportunities Now and Effective Care Technologies (CONNECT) Act of 2019 (S.2741) The Safeguarding Medicare Access to Respiratory Therapy (SMART) Act of 2019 (H.R.4945) The Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020(H.R.6074) The Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020 (S.3548) The Outpatient Therapy Modernization and Stabilization Act (H.R.7154) The Nursing Home COVID-19 Protection and Prevention Act (S.3768) The Infection Control Training and Support Act (H.R.7254)

Client expense: $39,516 · Firm income: Not reported

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

Issue: Support repeal or a delay in the implementation of the Medicaid disproportionate share hospital (DSH) cuts Issue: Educate Congress on concerns related to potentially burdensome Medicaid supplemental payment reporting proposals Issue: Educate Congress on the negative impact of the proposed Medicaid Fiscal Accountability Regulation (MFAR) and urge the administration to withdraw or delay the proposal Issue: ACA Medicaid expansion. Maintain commitment to match State spending on medical care for Medicaid beneficiaries without limits, caps, or block grants. Maintain and enforce network adequacy requirements and mandate sufficient payments to providers. S. 1343, Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (MOMMIES) Act Issue: Support expansion of Medicaid and CHIP coverage for postpartum women from current 90 days to 1 year. H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2020 Issue: Support expansion of Medicaid coverage for postpartum women. S. 585, States Achieve Medicaid Expansion (SAME) Act of 2019 Issue: Support legislation to allow states that expanded Medicaid after 2014 to receive the same full federal matching funds as states that previously expanded Medicaid under the Affordable Care Act H.R. 1763, S. 348, Resident Physician Shortage Reduction Act of 2019 Issue: Support additional Medicare funding for graduate medical education H.R. 3414, H.R. 2439, Opioid Workforce Act Issue: Support additional Medicare funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issue: Oppose reduction of Medicare GME/IME payments Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. S. 289, Rural Physician Workforce Production Act of 2019 Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals H.R.1358, Advancing Medical Resident Training in Community Hospitals Act of 2019 H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act Issue: Support Medicare Graduate Medical Education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose Medicare hospital cuts Issue: Oppose overly burdensome Medicaid GME transparency language. Issue: Support technical correction to increase access to physician services in rural communities by allowing teaching hospitals to count resident time spent in critical access hospitals for purposes of Medicare GME payments. H.R. 5432, Medical Education for a Diverse America Act Issue: Ensure that time medical residents spend in unconscious bias training is counted toward the determination of FTE for Medicare GME Issue: Educate Congress on role of academic medicine as it relates to price disclosure initiatives H.R. 3107, Improving Seniors Timely Access to Care Act of 2019 Issue: Support protecting patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency Issue: Modify CMS Hospital Compare Star Ratings to allow stakeholders time to work together to address concerns with methodology. Support inclusion of sociodemographic status as part of quality programs HHS Rebate Rule Medicare Part D benefit re-design Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Issue: Support nominees for MedPAC

Client expense: $1,095,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), Office of the Vice President of the United States, SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Medicaid Fiscal Accountability Regulation Rural hospital policies; HHS Rural Action Plan 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; H.R. 748, CARES Act; H.R.8337, Continuing Appropriations Act, 2021 and Other Extensions Act) Medicare sequestration (H.R. 748, CARES Act) Federal Medical Assistance Percentage increase (H.R. 6201, Families First Coronavirus Response Act; H.R. 748, CARES Act; H.R. 6800; S. 4108, Coronavirus Medicaid Response 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; all coronavirus relief packages - H.R. 6074, H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800, HEALS Act, S. 4775; physician fee schedule proposed rule Medicare hospital accelerated payment program (coronavirus relief packages-H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800, HEALS Act, S. 4775; H.R. 6837/S. 3750, Medicare Accelerated and Advance Payments Improvement Act; H.R. 7292, COVID-19 Hospital and Health Provider Loan Forgiveness Act of 2020) Post-acute care flexibilities (coronavirus relief packages - H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800, HEALS Act, S. 4775) Stark law reform Site neutral payment policy included in outpatient prospective payment system rule (H.R.2552, Protecting Local Access to Care for Everyone Act of 2019) OPPS and physician fee schedule rules Interim Final Rule establishing a Medicare Condition of Participation for COVID-19 Data Reporting (Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments (CLIA), and Patient Protection and Affordable Care Act; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Discussions on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussions about the work of Aligning for Health to address social determinants of health; Support HR 1041 / S 586,Critical Access Hospital Relief Act of 2019, a bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services; Support S 895, Rural Hospital Regulatory Relief Act of 2019, a bill to provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals; Support S 948,Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities, and for other purposes; Discussions in support of the Rural Emergency Medical Center Act (REACH) Act; Support for extension of the Rural Community Hospital Demonstration Program; Support for extension of the Frontier Community Health Integration Project Demonstration program; Discuss changes with House and Senate committees to Section 8122 of the SUPPORT for Patients and Communities Act; Letter of support to Energy and Commerce Committee for the hearing on legislation to strengthen our health care system and ACA market stability; Support HR 1781/ S 801, Payment Commission Data Act of 2019, a bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information; Support S 551 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 or the REFUND Act of 2019, a bill to amend title XVIII of the Social Security Act to require manufacturers of certain single-dose vial drugs payable under part B of the Medicare program to provide rebates with respect to amounts of such drugs discarded, and for other purposes; Support S 824/ HR 1767, Excellence in Mental Health and Addiction Treatment Expansion Act, a bill to increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services; Statement submitted to Senate Finance Committee on the implementation of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support HR 2552Protecting Local Access to Care for Everyone Act of 2019 or the PLACE Act of 2019, a bill to direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program; Support HR 3022, Patient Access Protection Act, a bill to amend title XIX of the Social Security Act to repeal the reductions in Medicaid DSH allotments, and for other purposes; Letter of support to the Ways and Means Committee in support of legislation to improve the quality of an access to services for Medicare beneficiaries, help train the physician workforce and reduce administrative burden on rural hospitals; Support HR 3431, HEARTS and Rural Relief Act, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2021; Support HR 3417,Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 or the BETTER Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for patient improvements and rural and quality improvements under the Medicare program; Oppose HR 1384, Medicare for All Act of 2019, a bill to establish an improved Medicare for All national health insurance program; Oppose S 1129, Medicare for All Act of 2019, a bill to establish a Medicare-for-all national health insurance program; Letter to House Committee on Ways and Means for the hearing on Pathways to Universal Health Coverage addressing concerns with Medicare for All and believe that the variety of proposals that often are used interchangeably under that name are not the solution; Oppose HR 2452, Medicare for America Act of 2019, a bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans; Letter to House Committee on Budget for the hearing on the Congressional Budget Offices (CBO) Key Design Components and Considerations for Establishing a Single-Payer Health Care System addressing concerns with Medicare for All; Oppose S 1261/ HR 2463, Choose Medicare Act, a bill to provide for the establishment of Medicare part E public health plans, and for other purposes; Oppose S 981/ HR 2000Medicare-X Choice Act of 2019A bill to establish a public health plan; Oppose S 1033/ HR 2085, CHOICE Act, a bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Oppose S 470, Medicare at 50 Act, a bill to amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare; Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes; Submitted Statement to the House Committee on Rules for the Hearing Medicare for All Act of 2019; Comment on provisions of HR 2328,Reauthorizing and Extending Americas Community Health (REACH) Act, support for the Medicaid disproportionate share hospital(DSH) program provisions included in Title III; comments on Title IV, which contains provisions of the No Surprises Act and concern with the legislations approach to determining reimbursement for out-of-network providers; Support HR 3107 Seniors Timely Access to Care Act of 2019, this legislation would establish requirements for the use of prior authorization under Medicare Advantage plans; Meeting with the Senate finance committee to discuss changes to drug bill; Meeting with CMS to discuss changes to prior authorization; Meeting with Department of Labor to discuss issues with ERISA health plans; Met with CMS staff on rural hospital issues; Regulatory burden related to new CMS guidance on documenting Crossover bad debt; Sent a Comment letter to CMS on a final rule on program integrity enhancements to the provider enrollment process for Medicare, Medicaid and Children's Health Insurance Programs; Oppose S. 2860 Patient Access to Higher Quality Health Care Act of 2019, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 4996, Helping MOMS Act of 2019, a bill amend title XIX of the Social Security Act to provide for a State option under the Medicaid program to provide for and extend continuous coverage for certain individuals, and for other purposes; Addressing hospital concerns about HR 3 Lower Drug Costs Now Act, a bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes; Sent comment letter requesting that CMS withdraw the proposed regulation related to Medicaid Program: Medicaid Fiscal Accountability Regulation ( MFAR) financing and supplemental payments. Given that the proposal would severely curtail the availability of health care services to millions of individuals and because many of its provisions are not legally permissible; Discussion with CMS for rural hospitals and critical access hospitals about the Medicare accelerated payment program, which is intended to provide necessary funds to providers, including rural hospitals and critical access hospitals, when there is a disruption in claims submission and/or claims processing; Submitted comments on CMSs proposed rule on Medicare Advantage and Part D prescription drug program for Contract Years 2021 and 2022. The letter focuses on several proposals addressing network adequacy; Letter sent to HHS, CDC, CMS, and SAMHSA requesting specialized guidance and assistance for providers who care for patients with behavioral health disorders; Support resetting the Improving Medicare Post- Acute Care Transformation (IMPACT) Act of 2014 in the next COVID-19 relief package. The IMPACT Acts implementation is behind schedule and does not take into account extensive payment reforms already underway in each post-acute care setting; Letter urging HHS to release substantial additional emergency funds to all hospitals in an expedited manner. This second wave of funding to all hospitals, targeted relief is necessary for hospitals in hot spots, hospitals with a high percentage of payments under Medicare Advantage, hospitals caring for high numbers of Medicaid patients, and rural hospitals; Support HR 6693 Critical Access Hospital Expansion Act of 2020, a bill to amend title XVIII of the Social Security Act to allow States to certify certain hospitals as necessary providers for purposes of designating such hospitals as critical access hospitals under the Medicare program; Support HR 6753/ S 3615 Rural Community Hospital Demonstration Extension Act of 2020, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the rural community hospital demonstration program; Letter urging CMS to use its authority to extend to LTCHs the existing 20% hospital add-on payment for Medicare beneficiaries diagnosed with COVID-19; Letter to CMS urging the agency to temporarily extend certain waivers and make others permanent beyond the COVID-19 public health emergency to allow hospitals to provide better and more cost effective care to their patients and communities; Sent comment letter to CMS about our concerns with the timeline proposed for implementation as well as the potential for penalties for noncompliance within this timeline on the Medicare Program: Electronic Prescribing of Controlled Substances; Sent comment letter on the FY 2021 Inpatient PPS proposed rule addressing CMS proposals related to payer-specific negotiated rate data collection, Medicare DSH payments, CAR T, bad debt, MS-DRG classifications, and quality programs, among other topics. Letter requesting that the CMS delay the implementation of the Appropriate Use Criteria for Advanced Diagnostic Imaging Services program to allow providers the opportunity to implement and test operational changes and acquire the education necessary to achieve compliance with the program; Sent comments to the CMS on the agencys long-term care hospital prospective payment system proposed policy changes and fiscal year 2021 rates; Letter to CMS asking for a delay in the start of repayments associated with the Medicare Accelerated and Advance Payment (AAP) Programs; Letter urging the CMS to continue its suspension of medical review activities throughout the ongoing COVID-19 public health emergency; Letter urging CMS to allow periodic interim payment (PIP) hospitals to carry out their accelerated payment repayment at cost settlement, as was initially communicated by the agency and also request that the agency make alternative repayment approaches available, such as direct payments to the Medicare Administrative Contractor (MAC), for all hospitals; Comment letter on CY 2021 Home Health Prospective Payment System Rate Update proposed rule. While we continue to support the PDGM objective of increasing HH PPS payment accuracy, we remain concerned that CY 2020s large behavioral offset, 4.36%, was implemented on a prospective basis; Letter urging the CMS to withdraw the condition of participation (CoP) that hospitals report daily COVID-19 data and request that CMS immediately release detailed interpretive guidance so hospitals can take the necessary steps to come into compliance; Urged CMS to withdraw its Medicaid fiscal accountability proposed rule from its regulatory agenda because it would "severely curtail the availability of health care services to millions of individuals" and "many of its provisions are not legally permissible."

Client expense: $4,860,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Urged Congress to include language in the Continuing Resolution (CR) that eliminates the Medicaid Disproportionate Share Hospital (DSH) reductions slated to begin on December 1 of this year. Urged the House to support H.R. 2477, the Beneficiary Enrollment Notification an Eligibility Simplification (BENES) Act of 2019 which would modernize and simplify the Medicare Part B enrollment process as recommended by the Medicare Payment Advisory Commission (MedPAC). Urged the House to support H.R. 3935, the Protecting Patients Transportation to Care Act which would amend the Medicaid statute to include non-emergency medical transportation (NEMT) in the list of mandatory Medicaid benefits by codifying current Medicaid NEMT regulations. Urged the House to support H.R. 5201, the Tele-Mental Health Expansion Act of 2019 would permanently include a patients home as an eligible originating site for mental health services delivered via telehealth in the Medicare program. Urged Congress to increase the FMAP for Medicaid by 5.8 percent for a total increase of 12 percent to ensure states capacity to provide access to care though Medicaid in then next round of financial relief. Urged HHS to ensure that a proportional amount of the remaining Public Health and Social Services Emergency Fund (PHSSEF) and any additional relief funding appropriated by Congress, is provided quickly to ALL Medicaid providers and health professionals impacted by the COVID-19 pandemic. Urged the House to support the H.R. 826, Expressing disapproval of the Trump administrations harmful actions towards Medicaid. This resolution seeks to reverse the recent guidance from the Centers for Medicare and Medicaid Services (CMS) titled Healthy Adult Opportunity, which would essentially cap or block grant funding for certain populations. CMS-2393-P Medicaid Program; Medicaid Fiscal Accountability Regulation; Proposed Rule (84 Federal Register 63722, November 18, 2019) - Urged CMS not to finalize the proposed MFAR. The proposed rule could force states to reduce the size of their Medicaid programs by covering fewer beneficiaries, restricting health care services or reducing provider payment rates. Urged the House to support H.R. 3, the Lower Drug Costs Act Now of 2019, which includes proposals to lower the costs of prescription drugs through Medicare negotiation authority and also includes new Medicare protections and additional coverage. Urged the House to support H.R. 4650, the Medicare Dental Act of 2019, which would add a dental benefit to Medicare Part B. Urged the House to support H.R. 4665, the Medicare Vision Act of 2019, which would a vision benefit to Medicare Part B. Urged the House to support H.R. 4618, the Medicare Hearing Act of 2019, which would add a hearing benefit to Part B including hearing aids. 2393-P - Request for Extension of Comment Period for Medicaid Program; Medicaid Fiscal Accountability Regulation, 84 Fed. Reg. 63722 (November 18, 2019) - Urged CMS to extend the comment period on the proposed rule for at least 60 days, until March 17, 2020, to ensure that states and other stakeholders have sufficient time to provide CMS with the information it needs to make sound policy decisions. Territories Health Care Improvement Act (HR 3631) - Urged the Senate to adopt new funding levels for Medicaid in the Territories to address outdated funding mechanisms and matching rates. Urged the House and Senate to delay FY2020 funding cuts to Medicaid disproportionate share hospitals. Beneficiary Education Tools, Telehealth, and Extenders Re-authorization Act of 2019 (H.R. 3417) - Supported expanding mental and behavioral health telemedicine services to Medicare beneficiaries. Patient Centered Outcomes Research Institute (H.R. 3439) - Supported extending the legislation to provide research on substance use disorders, mental health, and maternal morbidity and mortality. The HEARTS and Rural Relief Act (H.R. 3429) - Supported extending the rural and critical access hospital moratorium for two years on direct supervision requirements for outpatient therapeutic services. Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019 (H.R. 3253) - Supported extending Medicaid demonstration programs to improve person-centered health care across the continuum of care. Maternal Health Quality Improvement Act (H.R. 4995) and Helping Medicaid Offer Maternity Services Act of (H.R. 4996) - Urged the Senate to pass both to help to eliminate preventable pregnancy-related deaths and improve maternal health outcomes. Reauthorizing and Extending America's Community Health (REACH) Act (H.R. 2328) - Opposed a statutory payment rate. Supported elimination of DSH funding cuts for FY 2020 and 2021. Supported permanent Medicaid funding in the United States territories. Supported demonstrations for Medicare beneficiaries that promote enrollment, education, and outreach.

Client expense: $181,961 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Natl Institutes of Health (NIH), Office of the Vice President of the United States, President of the U.S., SENATE, Securities & Exchange Commission (SEC), Treasury, Dept of

FDA/CMS Breakthrough Pathway - Legislation to harmonize CMS Reimbursement with FDA Approval to speed products' market introduction House/Senate Implementation of Comprehensive Addiction & Recovery Act (CARA) Law to address the National Opioid epidemic. Specifically, Advocacy for FDA approved alternative treatments for Chronic Pain Public Law 115-271 SUPPORT for Patients and Communities Act - Specifically, advocacy for FDA approved alternative treatments for Chronic Pain, and medical device's role in the opioid epidemic. HR 3417 Better Act - Modifications to legislation to streamline access to medical device interventions by employing telehealth 2020 proposed OPPS rule - Telehealth and C-APC changes for Interspinous Decompression Labor HHS bill HR 1865 - Advocacy for C-APC changes HR 5833 to Amend Title XVIII of the Social Security Act - Allows psychological evaluation required for preauthorization for certain interventional pain therapies to be conducted via telehealth Public Law 116-136 Coronavirus Aid Relief & Economic Security (CARES) Act - Legislation to support businesses of all sizes, cash support for citizens, and monetary relief for health care providers & hospitals, telehealth expansion. Specifically, advocacy for funding to help health providers offset expenses and lost revenue related to the pandemic; medical device shortages reporting for public health emergencies, grants for COVID-19 medical countermeasures; and air transport provisions to maintain medical device supply chain. Yet-to-be released COVID Stimulus Bill (House & Senate): Emergency waiver to increase the frequency of application review of CMS's New Tech Add-on Payment program during the Public Health Emergency 2021 Proposed CMS OPPS Rule - Requesting that CMS not finalized new prior authorization requirements in Medicare Part A. 2021 Proposed Physician Fee Schedule - Adding telehealth services approved for use during the Public Health Emergency to the list of permanently authorized telehealth services S4473/HR7956 Critical Medical Infrastructure Right to Repair Act of 2020 - To allow non-manufacturer repair technicians to maintain and repair essential medical equipment during the COVID-19 pandemic, and temporarily suspend restrictions.

Client expense: $380,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

H.R. 5201, Telemental Health Expansion Act of 2019, provisions relating to 1834(m) of the Social Security Act; geographic and originating sites H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019, all provisions H.R. 7391, Protect Telehealth Access Act of 2020, all provisions H.R. 7233, KEEP Telehealth Options Act of 2020, all provisions H.R. 7663, Protecting Access to Post-COVID-19 Telehealth Act of 2020, all provisions S. 4375, Telehealth Modernization Act, all provisions H.R. 1301, Mental Health Telemedicine Expansion Act, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, all provisions H.R. 19, Lower Costs, More Cures Act of 2019, all provisions H.R. 3414, Opioid Workforce Act of 2019, all provisions H.R. 7791, Value in Health Care Act of 2020, all provisions H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019, all provisions H.R. 6379, Take Responsibility for Workers and Families Act, provisions related to Medicare and Medicaid H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020, all provisions S. 3750, Medicare Accelerated and Advance Payments Improvement Act of 2020, all provisions H.R. 7154, Outpatient Therapy Modernization and Stabilization Act, all provisions H.R. 6585, Equitable Data Collection and Disclosure on COVID-19 Act, all provisions H.R. 884, Medicare Mental Health Access Act, all provisions S. 2772, Medicare Mental Health Access Act, all provisions H.R. 945, Mental Health Access Improvement Act of 2019, all provisions H.R. 1763, Resident Physician Shortage Reduction Act of 2019, all provisions H.R. 6774, Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2020, all provisions H.R. 4004, Social Determinants Accelerator Act of 2019, all provisions H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2020, all provisions H.R. 6090, Physician Shortage GME Cap Flex Act of 2020, all provisions H.R. 913, CLINICAL TREATMENT Act, all provisions H.R. 4932, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions S, 2741, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions Medicare program: P.L. 113-93 Protecting Access to Medicare Act (PAMA), provisions relating to imaging appropriate use criteria Medicare program: Sequester exemption Medicare program: Laboratory developed tests for COVID-19/coverage Medicare program: Medicare for All Medicare program: CY 2021 Medicare Physician Fee Schedule/E&M/Budget Neutrality Medicare program: Inpatient Rehab Facility/Prospective Payment System (IRF/PPS)/Scope issues Medicare program: Public Health Emergency/Scope and licensure waivers sunset Medicare program: Medicare Advanced Payment Program improvements Medicare program: Regulatory Relief/Advanced Alternative Payment Models (APMs)/Prior authorization and utilization management Medicare program: Merit-based Incentive Payment System (MIPS)/Quality/cost/improvement activity/interoperability Medicare program: Program integrity Medicare program: Interoperability and data blocking Medicare program: Quality Payment Program/physician burdens Medicare program: Health IT physician burdens Medicare program: Open Payments Medicare program: PECOS Enrollment/Revalidation Medicare program: Graduate Medical Education/cap flexibility Medicare program: Diabetes Prevention Program Medicare program: MACRA/Alternative Payment Model (APM) bonus payments Medicare program: MACRA/radiation oncology payments Medicare program: Accelerated and Advance Payment Program/physician relief Medicare and Medicaid programs: Medicare Provider Relief Fund extension Medicare and Medicaid programs: 21st Century Cures Act/health data and privacy Medicare and Medicaid program: Electronic health record (EHR) certification Medicare and Medicaid programs: P.L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Medicare and Medicaid programs: Accountable Care Organizations Medicare and Medicaid programs: Telehealth waivers Medicare and Medicaid programs: Qualifying APM Physician Thresholds Medicare and Medicaid programs: Opioid use disorder Medicare and Medicaid programs: Validated home blood pressure monitors/coverage Medicaid program: Federal Medical Assistance Percentages (FMAP) increases Medicaid program: Georgia's Section 1332 waiver

Client expense: $4,260,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Natl Institutes of Health (NIH), Office of Natl Drug Control Policy (NDCP), President of the U.S., SENATE, State, Dept of (DOS), U.S. Immigration & Customs Enforcement (ICE), Veterans Affairs, Dept of (VA), White House Office

General Issues - Maintaining the 340B drug pricing program; all provisions General Issues - Medicare Hospital Outpatient Prospective Payment System (OPPS) CY 2019; provisions related to cuts to hospital outpatient departments CMS-1716-P - FY2020 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Physician Fee Schedule Proposed Rule H.R. 3417 - Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act; all provisions S. 2543Prescription Drug Pricing Reduction Act of 2019; all provisions H.R. 3Lower Drug Costs Now Act of 2019; all provisions H.R. 3630 - No Surprises Act; provisions related to eliminate surprise billing H.R. 3502 - Protecting People from Surprise Medical Bills Act; provisions related to eliminate surprise billing S. 1531Stopping the Outrageous Practice of Surprise Medical Bills Act of 2019; provisions related to eliminate surprise billing S. 348/H.R. 1763 - Resident Physician Shortage Reduction Act of 2019; all provisions

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

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

Issues related to Graduate Medical Education (GME), including the Advancing Medical Training in Community Hospitals Act (H.R. 1358) and the Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 (H.R. 3417).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE