Medicare Audiologist Access and Services Act of 2019

Coalition letter to the Centers for Medicare and Medicaid Services (CMS) urging the retraction or postponement of the requirement that the Qualified Clinical Data Registries (QCDRs) perform mandatory randomized audits for the MIPS Improvement Activities and Promoting Interoperability categories prior to CMS data submission. Coalition letter addressed to Seema Verma, CMS Administrator, urging the Agency to reconsider the stand-alone Medicare Appropriate Use Criteria Program for advanced diagnostic imaging for its necessity and value as it is void of integration with patient quality, and outcomes and satisfaction metrics. Coalition letter addressed to Representatives Ami Bera, M.D., Larry Bucshon, M.D., Brendan Boyle, George Holding, Raul Ruiz, Phil Roe, Abby Finkenauer, and Roger Marshall, M.D. thanking them for the introduction of H.R. 8702 the "Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020" which would provide two years of Medicare payment updates. Letter addressed to Representatives Ami Bera, M.D., Larry Bucshon, M.D., Brendan Boyle, George Holding, Raul Ruiz, Phil Roe, Abby Finkenauer, and Roger Marshall, M.D. thanking them for the introduction of H.R. 8702 the "Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020" which would provide two years of Medicare payment updates. Coalition letter address to Seema Verma, CMS Administrator, urging the immediate implementation of and payment for Current Procedural Terminology code 99072 to compensate practices for the additional supplies and new staff activities required to provide safe patient care during the COVID-19 public health emergency. Letter addressed to House Speaker Nancy Pelosi, House Minority Leader Kevin McCarthy, Senate Majority Leader Mitch McConnell, and Senate Minority Leader Charles Schumer urging amendments to the proposed "No Surprises Act" to resolve potential negative impacts on physicians. Coalition letter addressed to Senator Charles Grassley, Senator Ron Wyden, Representatives Richard Neal, Kevin Brady, Frank Pallone, and Greg Walden urging Congress to pass a statutory delay of the Appropriate Use Criteria Program originally established in the 2014 Protecting Access to Medicare Act to allow for a thorough re-examination of the program. S. 4317, the Safeguarding Americas Frontline Employees To Offer Work Opportunities Required to Kickstart the Economy (SAFE TO WORK) Act: COVID-19-related medical liability protections. H.R. 133, Consolidated Appropriations Act, 2021. No bill: Compromise legislation to provide protections for health insurance consumers from surprise medical bills. H.R. 3107, the "Improving Senior Timely Access to Care Act," to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes, all provisions. H.R. 4056 and S. 2446, the "Medicare Audiologist Access and Services Act" all provisions. H.R. 3502, the "Protecting People from Surprise Medical Bills Act," all provisions. S. 1531, the "STOP Surprise Medical Bills Act," to amend the Public Health Service Act to provide protections to health insurance consumers from surprise billing, all provisions. S. 1895, the "Lower Health Care Costs Act," to lower health care costs, all provisions. H.R. 3630, the "No Surprises Act," to protect health care consumers from surprise billing practices, and for other purposes, all provisions. Issues pertaining to scope of practice legislation; in general. Issues related to hearing healthcare; in general. Issues pertaining to health information technology and electronic health records; in general. Issues pertaining to the COVID-19 pandemic, in general.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Coalition letter to the Centers for Medicare and Medicaid Services (CMS) urging the retraction or postponement of the requirement that Qualified Clinical Data Registries (QCDRs) perform mandatory randomized audits for the MIPS Improvement Activities and Promoting Interoperability categories prior to CMS data submission. Coalition letter addressed to Senator Joe Manchin urging the inclusion of S. 4317, the "Safeguarding America's Frontline Employees to Offer Work Opportunities Required to Kickstart the Economy Act", in any COVID-19 relief packages. S. 4317 would provide liability protections to healthcare workers and facilities. Coalition letter addressed to Seema Verma, CMS Administrator, urging the Agency to reconsider the stand-alone Medicare Appropriate Use Criteria Program for advanced diagnostic imaging for its necessity and value. Letter to the House Minority Leader, Kevin McCarthy urging appointment of Congressman Michael Burgess as Ranking Member on the House Energy and Commerce Committee. Coalition letter addressed to Representatives Ami Bera, M.D., Larry Bucshon, M.D., Brendan Boyle, George Holding, Raul Ruiz, Phil Roe, Abby Finkenauer, and Roger Marshall, M.D. thanking them for the introduction of H.R. 8702 the "Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020" which would provide two years of Medicare payment updates. Letter addressed to Representatives Ami Bera, M.D., Larry Bucshon, M.D., Brendan Boyle, George Holding, Raul Ruiz, Phil Roe, Abby Finkenauer, and Roger Marshall, M.D. thanking them for introducing H.R. 8702 the "Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020" which would provide two years of Medicare payment updates. Coalition letter addressed to Seema Verma, CMS Administrator, urging the immediate implementation of and payment for Current Procedural Terminology code 99072 to compensate practices for the additional supplies and new staff activities required to provide safe patient care during the COVID-19 public health emergency. Letter addressed to House Speaker Nancy Pelosi, House Minority Leader Kevin McCarthy, Senate Majority Leader Mitch McConnell, and Senate Minority Leader Charles Schumer urging amendments to the proposed "No Surprises Act" to resolve potential negative impacts on physicians. Coalition letter addressed to Stephen Hahn, Commissioner of the Food and Drug Administration, urging the prohibition of menthol as a characterizing flavor in cigarettes. Coalition letter addressed to Senator Charles Grassley, Senator Ron Wyden, Representatives Richard Neal, Kevin Brady, Frank Pallone, and Greg Walden urging Congress to pass a statutory delay of the Appropriate Use Criteria Program originally established in the 2014 Protecting Access to Medicare Act to allow for a thorough re-examination of the program. S. 4317, the Safeguarding Americas Frontline Employees To Offer Work Opportunities Required to Kickstart the Economy (SAFE TO WORK) Act: COVID-19-related medical liability protections. H.R. 133, Consolidated Appropriations Act, 2021. No bill: Compromise legislation to provide protections for health insurance consumers from surprise medical bills. H.R. 663, the "Truth in Healthcare Marketing Act of 2020," all provisions. H.R. 7059, the Coronavirus Provider Protection Act," all provisions. H.R. 4056 and S. 2446, the "Medicare Audiologist Access and Services Act" all provisions. H.R. 3502, the "Protecting People from Surprise Medical Bills Act," all provisions. S. 1531, the "STOP Surprise Medical Bills Act," to amend the Public Health Service Act to provide protections to health insurance consumers from surprise billing, all provisions. S. 1895, the "Lower Health Care Costs Act," to lower health care costs, all provisions. H.R. 3630, the "No Surprises Act," to protect health care consumers from surprise billing practices, and for other purposes, all provisions. Issues pertaining to scope of practice legislation; in general. Issues related to hearing healthcare; in general. Issues pertaining to health information technology and electronic health records; in general. Federal "Truth in Advertising" Legislation; in general. Issues pertaining to Graduate Medical Education; in general. Issues pertaining to the COVID-19 pandemic, in general. Issues pertaining to healthcare liability reform, in general.

Medicare Access and CHIP Reauthorization Act (PL 114-10) S.2157, Rural Hospital Sustainability Act: CMMI payment model to rural hospitals H.R.1763, Resident Physician Shortage Reduction Act of 2019:residency positions eligible for graduate medical education payments H.R. 1384, Medicare for All Act of 2019: Medicare for All H.R. 4056, Medicare Audiologist Access and Services Act of 2019: audiology H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act of 2018: Opioids H.R. 6, SUPPORT for Patients and Communities Act: Opioids H.R. 2550, Medicare Telehealth Parity Act of 2017 H.R. 676, Expanded and Improved Medicare for All Act: Medicare for All, payment H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020: payment H.R. 8756, COVID Health Care Provider Assurance Act of 2020: payment Independent Payment Advisory Board (IPAB) Repeal Rural Anesthesiology: Rural Pass Through Out of Network/Out of Network Payment Historical Medicare payment undervaluation for anesthesiology services (33% problem) Anesthesia Conversion Factor Perioperative Surgical Home Model Bundled payments CMS 45 CFR Parts 147, 155, and 156, PPACA; Market Stabilization rule CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services 2017 Medicare Physician Fee Schedule Rule CMS decision to decrease values of interlaminar epidural injections CMS Value-Based purchasing CMS Medicare Data Final Rule Sunshine Act Implementation Conditions of Participation - Anesthesia services, opt-outs, supervision Physician Quality Reporting System, PPACA, Sec. 3007 Quality Modifier implementation IPAB cuts Graduate Medical Education Value-based modifier - PPACA Debt ceiling - Medicare sequestration QCDR - Qualified Clinical Data Registry CMS Meaningful Use Stage 3 Executive Order Promoting Healthcare Choice and Competition (Trumpcare) Ambulatory Surgery Center Critical Care and Anesthesia Services Payment Reform: Increase payments for anesthesia and critical care services for Medicare COVID patients Prescription Drug Management Programs: Evaluation and Monitoring codes & cuts Certified Anesthesiologist Assistants Public Option

H.R. 4056 and S. 2446-- bills that would amend Medicare to provide expanded beneficiary access to audiologist services and reduced barriers for patients through increased access and expanded coverage of audiologist services. S.785--This Veteran's Mental Health Bill includes a section on the provision of hearing services in the VA

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Coalition letter addressed to the Administrator for the Centers for Medicare and Medicaid Services urging CMS to sunset waivers involving scope of practice and licensure when the COVID public health emergency concludes. Coalition letter addressed to Speaker Nancy Pelosi, Leader Kevin McCarthy, Majority Leader Mitch McConnell, and Ranking Member Charles Schumer asking that unanticipated medical bills be addressed separately from any upcoming COVID-19 relief legislation. Coalition letter addressed to Chairman Frank Pallone, Ranking Member Greg Walden, Chairman Richard Neal, Ranking Member Kevin Brady, Chairman Chuck Grassley and Ranking Member Ron Wyden urging opposition to H.R. 884 / S. 2772, the Medicare Mental Health Access Act, which would decrease the overall access and quality of care for Medicare beneficiaries by inappropriately allowing psychologists to provide services well beyond their education and training. H.R. 663, the "Truth in Healthcare Marketing Act of 2020," all provisions. H.R. 7059, the Coronavirus Provider Protection Act," all provisions. H.R. 4056 and S. 2446, the "Medicare Audiologist Access and Services Act" all provisions. H.R. 3502, the "Protecting People from Surprise Medical Bills Act," all provisions. S. 1531, the "STOP Surprise Medical Bills Act," to amend the Public Health Service Act to provide protections to health insurance consumers from surprise billing, all provisions. S. 1895, the "Lower Health Care Costs Act," to lower health care costs, all provisions. H.R. 3630, the "No Surprises Act," to protect health care consumers from surprise billing practices, and for other purposes, all provisions. Issues pertaining to scope of practice legislation; in general. Issues related to hearing healthcare; in general. Issues pertaining to health information technology and electronic health records; in general. Federal "Truth in Advertising" Legislation; in general. Issues pertaining to Language Equality and Acquisition for Deaf Kids (LEAD-K) and parent choice; in general. Issues pertaining to the Early Detection and Intervention (EHDI) program, in general. Issues pertaining to surprise out of network bills, in general. Issues pertaining to Graduate Medical Education; in general. Issues pertaining to the COVID-19 pandemic, in general. Issues pertaining to healthcare liability reform, in general.

Coalition letter addressed to the Administrator for the Centers for Medicare and Medicaid Services urging CMS to sunset waivers involving scope of practice and licensure when the COVID public health emergency concludes. Coalition letter addressed to Speaker Nancy Pelosi, Leader Kevin McCarthy, Majority Leader Mitch McConnell, and Ranking Member Charles Schumer asking that unanticipated medical bills be addressed separately from any upcoming COVID-19 relief legislation. Coalition letter addressed to Chairman Frank Pallone, Ranking Member Greg Walden, Chairman Richard Neal, Ranking Member Kevin Brady, Chairman Chuck Grassley and Ranking Member Ron Wyden urging opposition to H.R. 884 / S. 2772, the Medicare Mental Health Access Act, which would decrease the overall access and quality of care for Medicare beneficiaries by inappropriately allowing psychologists to provide services well beyond their education and training. H.R. 3107, the "Improving Senior Timely Access to Care Act," to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes, all provisions. H.R. 4056 and S. 2446, the "Medicare Audiologist Access and Services Act" all provisions. H.R. 3502, the "Protecting People from Surprise Medical Bills Act," all provisions. S. 1531, the "STOP Surprise Medical Bills Act," to amend the Public Health Service Act to provide protections to health insurance consumers from surprise billing, all provisions. S. 1895, the "Lower Health Care Costs Act," to lower health care costs, all provisions. H.R. 3630, the "No Surprises Act," to protect health care consumers from surprise billing practices, and for other purposes, all provisions. Issues pertaining to scope of practice legislation; in general. Issues related to hearing healthcare; in general. Issues pertaining to health information technology and electronic health records; in general. Issues pertaining to the Early Detection and Intervention (EHDI) program, in general. Issues pertaining to surprise out of network bills, in general. Issues pertaining to the COVID-19 pandemic, in general.

H.R. 4056/S.2446- Medicare Audiologist Access and Services Act of 2019 H.R. 4618- Medicare Hearing Act of 2019 H.R. 6654- Emergency COVID Telehealth Response Act H.R. 7233- KEEP Telehealth Options Act of 2020 Various issues related to CMS Actions surrounding: Medicare supervision requirements audits of medical records and claims for Part A and B services code development and reimbursement of personal protective equipment Quality reporting under MIPS Implementation of the IMPACT Act Medicare physician fee schedule Prospective payments systems Demonstration projects/episodic payment models Accountable Care Organizations Federally-facilitated marketplace Medicare Advantage Reimbursement of telehealth services COVID-19 emergency telepractice coverage of Medicare, Medicare Advantage and Medicaid Medicare telehealth coverage under Part A and B Essential and Non-essential personnel designation CARES Act (P.L.116-136) Provision and payment for Part A therapy Various issues related to implementation of ACA Various issues related to Medicaid in schools

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

Medicare Access and CHIP Reauthorization Act (PL 114-10) S.2157, Rural Hospital Sustainability Act: CMMI payment model to rural hospitals H.R.1763, Resident Physician Shortage Reduction Act of 2019:residency positions eligible for graduate medical education payments H.R. 1384, Medicare for All Act of 2019: Medicare for All H.R. 4056, Medicare Audiologist Access and Services Act of 2019: audiology H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act of 2018: Opioids H.R. 6, SUPPORT for Patients and Communities Act: Opioids H.R. 2550, Medicare Telehealth Parity Act of 2017 H.R. 676 Expanded and Improved Medicare for All Act: Medicare for All, payment Independent Payment Advisory Board (IPAB) Repeal Rural Anesthesiology: Rural Pass Through Department of Labor Health and Human Services funding - out of network payment Out of Network/Out of Network Payment Historical Medicare payment undervaluation for anesthesiology services (33% problem) Anesthesia Conversion Factor Perioperative Surgical Home Model Bundled payments CMS 45 CFR Parts 147, 155, and 156, PPACA; Market Stabilization rule CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services 2017 Medicare Physician Fee Schedule Rule CMS decision to decrease values of interlaminar epidural injections CMS Value-Based purchasing CMS Medicare Data Final Rule Sunshine Act Implementation Conditions of Participation - Anesthesia services, opt-outs, supervision Physician Quality Reporting System, PPACA, Sec. 3007 Quality Modifier implementation IPAB cuts Graduate Medical Education Value-based modifier - PPACA Debt ceiling - Medicare sequestration QCDR - Qualified Clinical Data Registry CMS Meaningful Use Stage 3 Executive Order Promoting Healthcare Choice and Competition (Trumpcare) Ambulatory Surgery Center Critical Care and Anesthesia Services Payment Reform: Increase payments for anesthesia and critical care services for Medicare COVID patients Prescription Drug Management Programs: Evaluation and Monitoring codes & cuts Certified Anesthesiologist Assistants Public Option

H. Res. 480, Acknowledging the racial disparities in diagnosing and treating mental health among youth in communities of color H.R. 1109, the Mental Health Services for Students Act of 2019 H.R. 1554, the Resident Education Deferred Interest Act H.R. 1763 / S. 348, the Resident Physician Shortage Reduction Act of 2019 H.R. 2279/ S. 2546, the Safe Step Act H.R. 2482/ S. 2074, the Mainstreaming Addiction Treatment 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. 3414/ S. 2892, the Opioid Workforce 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. 5, the Equality Act 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, 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. 748, the Coronavirus Aid, Relief and Economic Security (CARES) Act H.R. 2895/ S. 948, the Conrad State 30 and Physician Access Reauthorization 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 H.R. 748, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), including the Payroll Protection Program (PPP), the Public Health and Social Services Emergency Fund, and more. 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 Recommendations on confidential mental health records sharing. H.R. 7539, the Strengthening Behavioral Health Parity Act H.R. 4564, the Suicide Prevention Lifeline Improvement Act of 2019 H.R. 5619, the Suicide Prevention Act H.R. 4585, the Campaign to Prevent Suicide Act H.R. 1646, the Helping Emergency Responders Overcome (HERO) Act of 2019 H.R. 2519, 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 21st Century Cures Act, RE: Opioid State Targeted Response Grants 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. 1763, the Resident Physician Shortage Reduction Act of 2019 S. 2661, the National Suicide Hotline Designation Act of 2020 (Sen. Gardner - Energy and Commerce) 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. 7539, the Strengthening Behavioral Health Parity 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 H.R. 7663, the Protecting Access to Post-COVID-19 Telehealth Act of 2020 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 S. 4441, the Crisis Assistance Helping Out On The Streets (CAHOOTS) Act

H.R. 4056 and S. 2446-- bills that would amend Medicare to provide expanded beneficiary access to audiologist services and reduced barriers for patients through increased access and expanded coverage of audiologist services. HR 3637 --The Allied Health Workforce Diversity Act of 2019. This bill would authorize the HHS Secretary to issue grants to increase educational opportunities for eligible students in the professions of audiology, speech-language pathology, occupational therapy and physical therapy The Emergency COVID-19 Telehealth Response Act. This bill would allow certain allied healthcare professionals to provide telehealth services under Medicare during the COVID-19 health emergency H.R. 5485--Ally's Act. This bill would require private insurers to cover implantable hearing devices S.785--This Veteran's Mental Health Bill includes a section on the provision of hearing services in the VA

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Support for H.R. 4056, the Medicare Audiologist Access and Services Act, to allow Medicare beneficiaries to receive direct access to diagnostic and therapeutic services of audiologists. Request to CMS to encourage use of regulatory flexibility to recognize audiologists as eligible providers of telehealth services.

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), 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. 1109, the Mental Health Services for Students Act of 2019 H.R. 1554, the Resident Education Deferred Interest Act H.R. 1763 / S. 348, the Resident Physician Shortage Reduction Act of 2019 H.R. 2062 / S. 1012 (42 CFR Part 2) H.R. 2279/ S. 2546, the Safe Step Act H.R. 2482/ S. 2074, the Mainstreaming Addiction Treatment Act of 2019 H.R. 2734 / S. 1448, the Safer Prescribing of Controlled Substances Act H.R. 2862, the VACCINES Act of 2019 H.R. 3, Lower Drug Costs Now Act of 2019 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. 3414/ S. 2892, the Opioid Workforce 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. 5, the Equality Act 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, 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 Suggestions related to addressing mental health in rural communities. 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. 748, the Coronavirus Aid, Relief and Economic Security (CARES) Act H.R. 2895, S. 948, the Conrad State 30 and Physician Access Reauthorization 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 H.R. 748, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), including the Payroll Protection Program (PPP), the Public Health and Social Services Emergency Fund, the provider fund (for MH funding), and more. 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, Military Suicide Prevention in the 21st Century Act H.R. 7608, Legislative Vehicle for the Fiscal 2021 Four-Bill Appropriations Package H.R. 6788/S. 3599, Healthcare Workforce Resilience Act Recommendations on confidential mental health records sharing. H.R. 4564, the Suicide Prevention Lifeline Improvement Act of 2019 H.R. 5619, the Suicide Prevention Act H.R. 4585, the Campaign to Prevent Suicide Act H.R. 1646, the Helping Emergency Responders Overcome (HERO) Act of 2019 H.R.884/S. 2772, the Medicare Mental Health Access Act H.R. 2519, 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, the Crisis Care Improvement and Suicide Prevention Act of 2020 21st Century Cures Act, RE: Opioid State Targeted Response Grants S.4088, the Ensuring Access to Primary Care for Women & Children Act H.R. 6159, the KIDS Access to Primary Care Act S. 3741, the Health Care at Home Act S. 3792, the Tele-mental Health Improvement Act H.R. 6697, the Local Chamber, Tourism, and 501(c)(6) Protection Act

Coalition letter addressed to the Secretary of the U.S. Department of Health and Human Services urging HHS to provide one month of revenue to each physician, nurse practitioner, and physician assistant enrolled in Medicare or Medicaid to account for financial losses and non-reimbursable expenses. Coalition letter addressed to House Speaker Pelosi, House Minority Leader McCarthy, Senate Majority Leader McConnell, and Senate Minority Leader Schumer urging support for physicians by including provisions such as student loan relief, medical liability protections, supply chain support and others in a future COVID-19 legislative package. Coalition letter addressed to Quality Measurement and Value-Based Incentives Group urging CMS to encourage clinicians and groups to report under the Merit-Based Incentive Payment System using Qualified Clinical Data Registries. Coalition letter addressed to House Speaker Pelosi, House Minority Leader McCarthy, Senate Majority Leader McConnell, and Senate Minority Leader Schumer asking to preserve viability of physician practices by including certain provisions in any upcoming COVID-19 legislation. Coalition letter addressed to the Administrator of the Center for Medicare & Medicaid Services stating opposition to expanding the scope of services NPPs furnish in IRFs, and urging CMS to uphold the role of the rehabilitation physician in delivering and overseeing care for patients in IRF settings. Coalition letter addressed to Representatives Diana DeGette and Fred Upton requesting to include in any upcoming COVID-19 legislation language guaranteeing clinical data registries access to Medicare claims data for quality improvement, patient safety, and research purposes, all of which are necessary to build an evidence-based shift to value-based care. H.R. 4056 and S. 2446, the "Medicare Audiologist Access and Services Act," all provisions. H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, section 602. H.R. 3502, the Protecting People from Surprise Medical Bills Act, all provisions. S.1531, the STOP Surprise Medical Bills Act, To amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing, all provisions. S. 1895, the Lower Health Care Costs Act, to lower health care costs, all provisions. H.R.3630, the No Surprises Act, to protect health care consumers from surprise billing practices, and for other purposes, all provisions. Issues pertaining to scope of practice legislation; in general. Issues related to hearing healthcare; in general. Issues pertaining to health information technology and electronic health records; in general. Issues pertaining to the Early Detection and Intervention (EHDI) program, in general. Issues pertaining to surprise out of network bills, in general. Issues pertaining to the COVID-19 pandemic, in general.

Coalition letter addressed to the Secretary of the U.S. Department of Health and Human Services urging HHS to provide one month of revenue to each physician, nurse practitioner, and physician assistant enrolled in Medicare or Medicaid to account for financial losses and non-reimbursable expenses. Coalition letter addressed to House Speaker Pelosi, House Minority Leader McCarthy, Senate Majority Leader McConnell, and Senate Minority Leader Schumer urging support for physicians by including provisions such as student loan relief, medical liability protections, supply chain support and others in a future COVID-19 legislative package. Coalition letter addressed to Quality Measurement and Value-Based Incentives Group urging CMS to encourage clinicians and groups to report under the Merit-Based Incentive Payment System using Qualified Clinical Data Registries. Coalition letter addressed to House Speaker Pelosi, House Minority Leader McCarthy, Senate Majority Leader McConnell, and Senate Minority Leader Schumer asking to preserve viability of physician practices by including certain provisions in any upcoming COVID-19 legislation. Coalition letter addressed to House Speaker Pelosi, House Minority Leader McCarthy, Senate Majority Leader McConnell, and Senate Minority Leader Schumer urging Congress to include language from H.R. 7059, the Coronavirus Provider Protection Act that would provide liability protections for physicians in the next COVID-19 legislative package. Coalition letter addressed to Rep. Phil Roe, M.D. and Lou Correa thanking them for introduction and expressing support for H.R. 7059, the Coronavirus Provider Protection Act. Coalition letter addressed to the Administrator of the Center for Medicare & Medicaid Services stating opposition to expanding the scope of services NPPs furnish in IRFs, and urging CMS to uphold the role of the rehabilitation physician in delivering and overseeing care for patients in IRF settings. Coalition letter addressed to Representatives Diana DeGette and Fred Upton requesting to include in any upcoming COVID-19 legislation language guaranteeing clinical data registries access to Medicare claims data for quality improvement, patient safety, and research purposes, all of which are necessary to build an evidence-based shift to value-based care. H.R. 4056 and S. 2446, the "Medicare Audiologist Access and Services Act," all provisions. H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, section 602. H.R. 3502, the Protecting People from Surprise Medical Bills Act, all provisions. S.1531, the STOP Surprise Medical Bills Act, To amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing, all provisions. S. 1895, the Lower Health Care Costs Act, to lower health care costs, all provisions. H.R.3630, the No Surprises Act, to protect health care consumers from surprise billing practices, and for other purposes, all provisions. H.R. 663, the Truth in Healthcare Marketing Act of 2020, all provisions. H.R. 7059, the "Coronavirus Provider Protection Act," all provisions. Issues pertaining to the COVID-19 pandemic, in general. Issues related to hearing healthcare; in general. Issues pertaining to health information technology and electronic health records; in general. Issues pertaining to the Early Detection and Intervention (EHDI) program, in general. Issues pertaining to scope of practice legislation; in general. Federal "Truth in Advertising" Legislation; in general. Issues pertaining to Language Equality and Acquisition for Deaf Kids (LEAD-K) and parent choice; in general. Issues pertaining to surprise out of network bills, in general. Issues pertaining to Graduate Medical Education; in general. Issues pertaining to healthcare liability reform, in general.

H.R. 4056/S.2446- Medicare Audiologist Access and Services Act of 2019 H.R. 4618- Medicare Hearing Act of 2019 H.R. 6654- Emergency COVID Telehealth Response Act H.R. 7233- KEEP Telehealth Options Act of 2020 Various issues related to CMS Actions surrounding: Medicare supervision requirements therapy cap and the institution of a manual review process audits of medical records and claims for Part A and B services standards for functionality of speech generating devices Quality reporting under MIPS Implementation of the IMPACT Act Medicare physician fee schedule Prospective payments systems Demonstration projects/episodic payment models Accountable Care Organizations Federally-facilitated marketplace Medicare Advantage Reimbursement of telehealth services COVID-19 emergency telepractice coverage of Medicare, Medicare Advantage and Medicaid Medicare telehealth coverage under Part A and B Essential and Non-essential personnel designation CARES Act (P.L.116-136) Provision and payment for Part A therapy Various issues related to implementation of ACA Various issues related to Medicaid in schools

Client expense: $200,000 · Firm income: Not reported

Medicare Access and CHIP Reauthorization Act (PL 114-10) S.2157, Rural Hospital Sustainability Act: CMMI payment model to rural hospitals H.R.1763, Resident Physician Shortage Reduction Act of 2019:residency positions eligible for graduate medical education payments H.R. 1384, Medicare for All Act of 2019: Medicare for All H.R. 4056, Medicare Audiologist Access and Services Act of 2019: audiology H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act of 2018: Opioids H.R. 6, SUPPORT for Patients and Communities Act: Opioids H.R. 2550, Medicare Telehealth Parity Act of 2017 H.R. 676 Expanded and Improved Medicare for All Act: Medicare for All, payment Independent Payment Advisory Board (IPAB) Repeal Rural Anesthesiology: Rural Pass Through Department of Labor Health and Human Services funding - out of network payment Out of Network/Out of Network Payment Historical Medicare payment undervaluation for anesthesiology services (33% problem) Anesthesia Conversion Factor Perioperative Surgical Home Model Bundled payments CMS 45 CFR Parts 147, 155, and 156, PPACA; Market Stabilization rule CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services 2017 Medicare Physician Fee Schedule Rule CMS decision to decrease values of interlaminar epidural injections CMS Value-Based purchasing CMS Medicare Data Final Rule Sunshine Act Implementation Conditions of Participation - Anesthesia services, opt-outs, supervision Physician Quality Reporting System, PPACA, Sec. 3007 Quality Modifier implementation IPAB cuts Graduate Medical Education Value-based modifier - PPACA Debt ceiling - Medicare sequestration QCDR - Qualified Clinical Data Registry CMS Meaningful Use Stage 3 Executive Order Promoting Healthcare Choice and Competition (Trumpcare) Ambulatory Surgery Center Increase payments for anesthesia and critical care services for Medicare COVID patients

H.R. 4056 and S. 2446-- bills that would amend Medicare to provide expanded beneficiary access to audiologist services and reduced barriers for patients through increased access and expanded coverage of audiologist services. HR 3637 --The Allied Health Workforce Diversity Act of 2019. This bill would authorize the HHS Secretary to issue grants to increase educational opportunities for eligible students in the professions of audiology, speech-language pathology, occupational therapy and physical therapy The Emergency COVID-19 Telehealth Response Act. This bill would allow certain allied healthcare professionals to provide telehealth services under Medicare during the COVID-19 health emergency H.R. 5485--Ally's Act. This bill would require private insurers to cover implantable hearing devices

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

Government targets: Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Support for H.R. 4056, the Medicare Audiologist Access and Services Act, to allow Medicare beneficiaries to receive direct access to diagnostic and therapeutic services of audiologists. Support for revision of evaluation and management code structure changes to minimize impact of code changes on providers, like audiologists, who cannot bill evaluation and management codes. Support for Relative Value Update Committee relative value unit (RVUs) recommendations for audiology codes including aural rehabilitation and computerized dynamic posturography.

Client expense: Not reported · Firm income: Not reported

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

Coalition letter addressed to the Chairman and Ranking Members of the House Energy and Commerce and Ways and Means Committees urging opposition to H.R. 4056, the Medicare Audiologist Access and Services Act." Coalition letter addressed to the Majority and Minority Leaders as well as the Chairman and Ranking Member of the Senate Finance Committee regarding opposition to S. 2446, the Medicare Audiologist Access and Services Act. Coalition letter addressed to House Speaker Pelosi, House Minority Leader McCarthy, Senate Majority Leader McConnell, and Senate Minority Leader Schumer urging support for physicians by including provisions that would protect physicians on the frontline, support existing resources, ensure access to necessary care and protect physician practices in COVID-19 relief legislation. Coalition letter addressed to Senators Michael Bennet and John Barrasso expressing support for S. 3449 the Immediate Relief for Rural Facilities and Providers Act" and urge inclusion in a COVID-19 relief package. Coalition letter addressed to House Speaker Pelosi, House Minority Leader McCarthy, Senate Majority Leader McConnell, and Senate Minority Leader Schumer urging support for physicians through tax relief, no-interest loans, direct payments, payment for virtual visits including phone calls, and other measures. H.R. 4056 and S. 2446, the "Medicare Audiologist Access and Services Act," all provisions. H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, section 602. S.1350, Good Samaritan Health Professionals Act, A bill to amend the Public Health Service Act to limit the liability of health care professionals who volunteer to provide health care services in response to a disaster, all provisions. H.R. 3502, the Protecting People from Surprise Medical Bills Act, all provisions. S.1531, the STOP Surprise Medical Bills Act, To amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing, all provisions. S. 1895, the Lower Health Care Costs Act, to lower health care costs, all provisions. H.R.3630, the No Surprises Act, to protect health care consumers from surprise billing practices, and for other purposes, all provisions. Issues pertaining to Graduate Medical Education; in general. Issues pertaining to the COVID-19 pandemic, in general. Issues pertaining to scope of practice legislation; in general. Issues related to hearing healthcare; in general. Issues pertaining to health information technology and electronic health records; in general. Issues pertaining to Language Equality and Acquisition for Deaf Kids (LEAD-K) and parent choice; in general. Issues pertaining to the Early Detection and Intervention (EHDI) program, in general. Federal "Truth in Advertising" Legislation; in general.

Coalition letter to the Secretary of the U.S. Department of Health and Human Services regarding CMS MIPS quality measure selection and removal policy as finalized in the 2020 Physician Fee Schedule/Quality Payment Program (QPP) Final Rule. The letter recommended policies in order to strengthen and make the MIPS program more meaningful. Coalition letter to the Administrator of the Centers for Medicare & Medicaid Services regarding CMS' request for information on scope of practice of health care professionals. Letter to the Administrator of the Centers for Medicare & Medicaid Services regarding the President's Executive Order #13890 on protecting and improving Medicare for our nation's seniors on supervision requirements for physician assistants. Coalition letter addressed to the Chairman and Ranking Members of the House Energy and Commerce and Ways and Means Committees urging opposition to H.R. 4056, the Medicare Audiologist Access and Services Act. Coalition letter to addressed to the Minority and Minority Leaders as well as the Chairman and Ranking Member of the Senate Finance Committee regarding opposition to S. 2446, the Medicare Audiologist Access and Services Act. Coalition letter addressed to House Speaker Pelosi, House Minority Leader McCarthy, Senate Majority Leader McConnell, and Senate Minority Leader Schumer urging support for physicians by including provisions that would protect physicians on the frontline, support existing resources, ensure access to necessary care and protect physician practices in COVID-19 relief legislation. Coalition letter addressed to Senators Michael Bennet and John Barrasso expressing support for "the Immediate Relief for Rural Facilities and Providers Act" and urge inclusion in a COVID-19 relief package. Coalition letter addressed to House Speaker Pelosi, House Minority Leader McCarthy, Senate Majority Leader McConnell, and Senate Minority Leader Schumer urging support for physicians by through tax relief, no-interest loans, direct payments, payment for virtual visits including phone calls, and other measures. H.R.3107, the Improving Seniors Timely Access to Care Act, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes, all provisions. H.R. 4056 and S. 2446, the "Medicare Audiologist Access and Services Act," all provisions. H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, section 602. H.R. 3502, the Protecting People from Surprise Medical Bills Act, all provisions. S.1531, the STOP Surprise Medical Bills Act, To amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing, all provisions. S. 1895, the Lower Health Care Costs Act, to lower health care costs, all provisions. H.R.3630, the No Surprises Act, to protect health care consumers from surprise billing practices, and for other purposes, all provisions. Issues pertaining to the COVID-19 pandemic, in general. Issues related to hearing healthcare; in general. Issues pertaining to health information technology and electronic health records; in general. Issues pertaining to the Early Detection and Intervention (EHDI) program, in general. Issues pertaining to scope of practice legislation; in general.

S. 348, Resident Physician Shortage Reduction Act, to provide Medicare funding for additional residency training slots S. 2446, Medicare Audiologist Access and Services Act, to provide audiologists with unlimited direct access to Medicare patients without a physician referral H.R.748 - CARES Act, financial relief for physician practices H.R. 1763, Resident Physician Shortage Reduction Act, to provide Medicare funding for additional residency training slots H.R.3107, Improving Seniors Timely Access to Care Act, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes H.R. 4056, Medicare Audiologist Access and Services Act, to provide audiologists with unlimited direct access to Medicare patients without a physician referral H.R.6074 - Coronavirus Preparedness and Response Supplemental Appropriations Act, financial relief for physician practices H.R.6201 - Families First Coronavirus Response Act, financial relief for physician practices No bill: Repealing/modifying Medicare's Appropriate Use Criteria Program for Advanced Diagnostic Imaging No bill: Suspend Medicares budget neutrality requirements when new office visit code values are implemented in 2021 No bill: COVID-19 relief, including additional financial support for physician practices, medical liability protections, suspending Medicares budget neutrality requirements, enhanced telemedicine, prior authorization relief

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

S. 348, Resident Physician Shortage Reduction Act, to provide Medicare funding for additional residency training slots S. 2446, Medicare Audiologist Access and Services Act, to provide audiologists with unlimited direct access to Medicare patients without a physician referral H.R.748 - CARES Act, financial relief for physician practices H.R. 1763, Resident Physician Shortage Reduction Act, to provide Medicare funding for additional residency training slots H.R.3107, Improving Seniors Timely Access to Care Act, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes H.R. 4056, Medicare Audiologist Access and Services Act, to provide audiologists with unlimited direct access to Medicare patients without a physician referral H.R.6074 - Coronavirus Preparedness and Response Supplemental Appropriations Act, financial relief for physician practices H.R.6201 - Families First Coronavirus Response Act, financial relief for physician practices No bill: Repealing/modifying Medicare's Appropriate Use Criteria Program for Advanced Diagnostic Imaging No bill: Suspend Medicares budget neutrality requirements when new office visit code values are implemented in 2021 No bill: COVID-19 relief, including additional financial support for physician practices, medical liability protections, suspending Medicares budget neutrality requirements, enhanced telemedicine, prior authorization relief

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

H.R. 4056/S.2446- Medicare Audiologist Access and Services Act of 2019 H.R. 4618- Medicare Hearing Act of 2019 Various issues related to CMS Actions surrounding: Medicare supervision requirements therapy cap and the institution of a manual review process audits of medical records and claims for Part A and B services standards for functionality of speech generating devices Quality reporting under MIPS Implementation of the IMPACT Act Medicare physician fee schedule Prospective payments systems Demonstration projects/episodic payment models Accountable Care Organizations Federally-facilitated marketplace Medicare Advantage Reimbursement of telehealth services COVID-19 emergency telepractice coverage of Medicare, Medicare Advantage and Medicaid Medicare telehealth coverage under Part A and B Essential and Non-essential personnel designation CARES Act (P.L.116-136) Provision and payment for Part A therapy Various issues related to implementation of ACA Various issues related to Medicaid in schools

Client expense: $300,000 · Firm income: Not reported

H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, provisions relating to price transparency, value, and prior authorizations H. R. 3107, Improving Seniors' Timely Access to Care 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. 6090, Physician Shortage GME Cap Flex Act of 2020, all provisions S. 348, Resident Physician Shortage Reduction Act of 2019, 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 2019, all provisions H.R. 3414, Opioid Workforce Act of 2019, all provisions H.R. 19, Lower Costs, More Cures Act of 2019, all provisions H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2019, all provisions H.R. 4056, Medicare Audiologist Access and Services Act of 2019, all provisions Medicare program: COVID-19 Pandemic Medicare program: Regulatory Relief/Advanced Alternative Payment Models (APMs)/Stark modernization/prior authorization/utilization management Medicare program: Physician-focused APMs Medicare program: ASCOs Patient-Centered Oncology Payment model Medicare program: Merit-based Incentive Payment System (MIPS)/cost, quality, promoting interoperability Medicare program: 2020 Physician Fee schedule/Quality Payment Program/Inflation increase Medicare program: Payment and delivery reform/misvalued codes/PTAC Medicare program: Medicare for All Medicare program: Interoperability and Data blocking Medicare program: Privacy legislation/administrative simplification/COVID-19 Medicare program: Appropriate Use Criteria/advanced diagnostic imaging/COVID-19 Medicare program: Diabetes prevention Medicare program: Health IT burden Medicare program: Evaluation and Management (E&M)/2021 Budget neutrality Medicare program: 2020 measure removal and testing policy Medicare program: Pharmacy Benefits Manager (PBM)/Rx Drug Pricing Transparency Medicare program: Open Payments Medicare program: PECOS Enrollment/Revalidation Medicare program: Scope of Practice Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA) implementation/physician payments/Accountable Care Organizations Medicare and Medicaid programs: MACRA cost measure development Medicare and Medicaid programs: Telehealth/remote psychologic monitoring/telephone E&M Medicare and Medicaid programs: Opioids Medicare and Medicaid programs: Defense Production Act (DPA)

Medicare Access and CHIP Reauthorization Act (PL 114-10) H.R. 1384, Medicare for All Act of 2019: Medicare for All H.R. 4056, Medicare Audiologist Access and Services Act of 2019: audiology H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act of 2018: Opioids H.R. 6, SUPPORT for Patients and Communities Act: Opioids H.R. 2550, Medicare Telehealth Parity Act of 2017 H.R. 676 Expanded and Improved Medicare for All Act: Medicare for All, payment Independent Payment Advisory Board (IPAB) Repeal Rural Anesthesiology: Rural Pass Through Department of Labor Health and Human Services funding - out of network payment Out of Network/Out of Network Payment Historical Medicare payment undervaluation for anesthesiology services (33% problem) Anesthesia Conversion Factor Perioperative Surgical Home Model Bundled payments CMS 45 CFR Parts 147, 155, and 156, PPACA; Market Stabilization rule CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services 2017 Medicare Physician Fee Schedule Rule CMS decision to decrease values of interlaminar epidural injections CMS Value-Based purchasing CMS Medicare Data Final Rule Sunshine Act Implementation Conditions of Participation - Anesthesia services, opt-outs, supervision Physician Quality Reporting System, PPACA, Sec. 3007 Quality Modifier implementation IPAB cuts Graduate Medical Education Value-based modifier - PPACA Debt ceiling - Medicare sequestration QCDR - Qualified Clinical Data Registry CMS Meaningful Use Stage 3 Executive Order Promoting Healthcare Choice and Competition (Trumpcare) Ambulatory Surgery Center

Client expense: $340,000 · Firm income: Not reported

H. Res. 480, Acknowledging the racial disparities in diagnosing and treating mental health among youth in communities of color H.R. 1109, the Mental Health Services for Students Act of 2019 H.R. 1554, the Resident Education Deferred Interest Act H.R. 1763 / S. 348, the Resident Physician Shortage Reduction Act of 2019 H.R. 2062 / S. 1012 (42 CFR Part 2) and S. 3374, the Protecting Jessica Grubb's Legacy Act H.R. 2279/ S. 2546, the Safe Step Act H.R. 2482/ S. 2074, the Mainstreaming Addiction Treatment Act of 2019 H.R. 2734 / S. 1448, the Safer Prescribing of Controlled Substances Act H.R. 2862, the VACCINES Act of 2019 H.R. 3, Lower Drug Costs Now Act of 2019 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. 3414/ S. 2892, the Opioid Workforce 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. 5, the Equality Act 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, 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 Suggestions related to addressing mental health in rural communities. 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. 748, the Coronavirus Aid, Relief and Economic Security (CARES) Act H.R. 2895, S. 948, the Conrad State 30 and Physician Access Reauthorization 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 H.R. 6143, the MOMS Matter Act H.R. 1309, the Workplace Violence Prevention for Health Care and Social Service Workers Act

Medicare reform; HR2276; S. 2575 audiology patient choice act; H.R. 4056/S. 2446 - The Medicare Audiologist Access and Services Act of 2019

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

Medicare reform; HR2276; S. 2575 audiology patient choice act; H.R. 4056/S. 2446 - The Medicare Audiologist Access and Services Act of 2019

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

Support for H.R. 4056, the Medicare Audiologist Access and Services Act, to allow Medicare beneficiaries to receive direct access to diagnostic and therapeutic services of audiologists.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES

Medicare Access and CHIP Reauthorization Act (PL 114-10) H.R. 1384, Medicare for All Act of 2019: Medicare for All H.R. 4056, Medicare Audiologist Access and Services Act of 2019: audiology H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act of 2018: Opioids H.R. 6, SUPPORT for Patients and Communities Act: Opioids H.R. 2550, Medicare Telehealth Parity Act of 2017 H.R. 676 Expanded and Improved Medicare for All Act: Medicare for All, payment Independent Payment Advisory Board (IPAB) Repeal Rural Anesthesiology: Rural Pass Through Department of Labor Health and Human Services funding - out of network payment Out of Network/Out of Network Payment Historical Medicare payment undervaluation for anesthesiology services (33% problem) Anesthesia Conversion Factor Perioperative Surgical Home Model Bundled payments CMS 45 CFR Parts 147, 155, and 156, PPACA; Market Stabilization rule CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services 2017 Medicare Physician Fee Schedule Rule CMS decision to decrease values of interlaminar epidural injections CMS Value-Based purchasing CMS Medicare Data Final Rule Sunshine Act Implementation Conditions of Participation - Anesthesia services, opt-outs, supervision Physician Quality Reporting System, PPACA, Sec. 3007 Quality Modifier implementation IPAB cuts Graduate Medical Education Value-based modifier - PPACA Debt ceiling - Medicare sequestration QCDR - Qualified Clinical Data Registry CMS Meaningful Use Stage 3 Executive Order Promoting Healthcare Choice and Competition (Trumpcare)

Client expense: $300,000 · Firm income: Not reported

H.R. 4056/S.2446- Medicare Audiologist Access and Services Act of 2019 H.R. 4618- Medicare Hearing Act of 2019 Various issues related to CMS Actions surrounding: Medicare supervision requirements therapy cap and the institution of a manual review process audits of medical records and claims for Part A and B services standards for functionality of speech generating devices Quality reporting under MIPS Implementation of the IMPACT Act Medicare physician fee schedule Prospective payments systems Demonstration projects/episodic payment models Accountable Care Organizations Federally-facilitated marketplace Medicare Advantage Reimbursement of telehealth services Provision and payment for Part A therapy Various issues related to implementation of ACA Various issues related to Medicaid in schools

Client expense: $230,000 · Firm income: Not reported

H.R. 4056 and S. 2446-- bills that would amend Medicare to provide expanded beneficiary access to audiologist services and reduced barriers for patients through increased access and expanded coverage of audiologist services. HR 3637 --The Allied Health Workforce Diversity Act of 2019. This bill would authorize the HHS Secretary to issue grants to increase educational opportunities for eligible students in the professions of audiology, speech-language pathology, occupational therapy and physical therapy HR 4618--The Medicare Hearing Act of 2019. This bill would add a hearing aid benefit to the Medicare program

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

Government targets: Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Coalition letter addressed to the Speaker and Republican Leader of the House of Representatives regarding the need for a legislative solution to protect patients from surprise medical bills without the use of rate-setting provisions seen in current bills like H.R. 2328 that would further shift marketplace leverage to health insurers at the expense of providers. Coalition letter addressed to the Senate Majority and Minority Leader regarding the need for a legislative solution to protect patients from surprise medical bills without the use of rate-setting provisions seen in current bills like S. 1895 that would further shift marketplace leverage to health insurers at the expense of providers. Coalition letter addressed to Secretary Azar at HHS regarding concerns with a vague provision in an October 3, 2019 Executive Order entitled, "Protecting and Improving Medicare for our Nation's Seniors", that potentially could require HHS to eliminate or weaken current Medicare supervision requirements of nonphysician professionals, a critical safeguard for patient safety. Coalition letter addressed to CMS expressing concerns about requirements for pre-submission audits by QCDRs and QRs of the Improvement Activities (IA) and Promoting Interoperability (PI) categories of MIPS. Coalition letter addressed to CMS expressing concerns about QCDRs and measure testing requirements. Issues related to hearing healthcare; in general. Issues pertaining to health information technology and electronic health records; in general. Issues pertaining to the Early Detection and Intervention (EHDI) program, in general. Issues pertaining to scope of practice legislation; in general, including H.R. 3, H.R. 4056, and S. 2446. Issues pertaining to surprise out of network bills, in general.

Coalition letter addressed to the Speaker and Republican Leader of the House of Representatives regarding the need for a legislative solution to protect patients from surprise medical bills without the use of rate-setting provisions seen in current bills like H.R. 2328 that would further shift marketplace leverage to health insurers at the expense of providers. Coalition letter addressed to the Senate Majority and Minority Leader regarding the need for a legislative solution to protect patients from surprise medical bills without the use of rate-setting provisions seen in current bills like S. 1895 that would further shift marketplace leverage to health insurers at the expense of providers. Coalition letter addressed to Secretary Azar at HHS regarding concerns with a vague provision in an October 3, 2019 Executive Order entitled, "Protecting and Improving Medicare for our Nation's Seniors", that potentially could require HHS to eliminate or weaken current Medicare supervision requirements of nonphysician professionals, a critical safeguard for patient safety. Issues related to hearing healthcare; in general. Issues pertaining to health information technology and electronic health records; in general. Federal "Truth in Advertising" Legislation; in general. Issues pertaining to Language Equality and Acquisition for Deaf Kids (LEAD-K) and parent choice; in general. Issues pertaining to the Early Detection and Intervention (EHDI) program, in general. Issues pertaining to scope of practice legislation; in general, including H.R. 3, H.R. 4056, and S. 2446. Issues pertaining to surprise out of network bills, in general. Issues pertaining to Graduate Medical Education; in general.

Client expense: $220,000 · Firm income: Not reported

H.R. 4056 and S. 2446-- bills that would amend Medicare to provide expanded beneficiary access to audiologist services and reduced barriers for patients through increased access and expanded coverage of audiologist services. HR 3637 --The Allied Health Workforce Diversity Act of 2019. This bill would authorize the HHS Secretary to issue grants to increase educational opportunities for eligible students in the professions of audiology, speech-language pathology, occupational therapy and physical therapy

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

Government targets: Federal Communications Commission (FCC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

HR 4056/S.2446- Medicare Audiologist Access and Services Act of 2019 Various issues related to CMS Actions surrounding: Medicare supervision requirements therapy cap and the institution of a manual review process audits of medical records and claims for Part A and B services standards for functionality of speech generating devices Quality reporting under MIPS Implementation of the IMPACT Act Medicare physician fee schedule Prospective payments systems Demonstration projects/episodic payment models Accountable Care Organizations Federally-facilitated marketplace Medicare Advantage Reimbursement of telehealth services Provision and payment for Part A therapy Various issues related to implementation of ACA Various issues related to Medicaid in schools

Client expense: $230,000 · Firm income: Not reported