The COVID-19 Hospital and Health Provider Loan Forgiveness Act of 2020

Bill # H.R. 652: Comprehensive Care for Seniors Act Bill # H.R. 1329: Medicaid Reentry Act. Partially lifts the Medicaid Inmate Exclusion Bill # H.R. 1763 and S348: Resident Physician Shortage Reduction Act of 2019. Create 15,000 new Medicare-supported residency slots by 2024 Bill # H.R. 2552: Protecting Local Access to Care for Everyone Act. Halts CMS' site neutrality policy Bill # H.R. 3022: Patient Access Protection Act.To protect hospitals from Medicaid DSH cuts Bill # H.R. 4932 and S2741: CONNECT for Health Act. Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act to expand access to telehealth services Bill #S. 296: Home Health Care Planning Improvement Act of 2019.Revises conditions of and limitations on Medicare payment for home health care services Bill HR7791 Makes improvements to the ACO program, including modifying risk adjustment and ensuring fair benchmarks, removes barriers to participation for rural ACOs, and further incentivizes participation in advanced alternative payment models Bill HR 7663 Protecting Access to Post-COVID-19 Telehealth Act To authorize the HHS Secretary to waive or modify application of Medicare requirements with respect to telehealth services during any emergency period Bill HR 7292 The COVID-19 Hospital Forgiveness Act To provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program Supply chain coordination and transparency in response to COVID-19.

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

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

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; Nursing and Allied Health Education payments; H.R. 133) Delay of Medicaid Disproportionate Share Hospital payment cuts (H.R. 133) Medicare sequestration (H.R. 133) Federal Medical Assistance Percentage increase (H.R. 133) Telehealth payment (all coronavirus relief packages - H.R. 6074, H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800, HEALS Act, S. 4775, H.R. 133; physician fee schedule rule) Medicare hospital accelerated payment program (H.R. 8337, 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, H.R. 133) 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) Waiver for Temporary Nurse Aides (H.R. 8874)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Funding for Disproportionate Share Hospitals (Medicaid DSH); Funding for Medicare graduate medical education (GME); Medicare site neutrality policies; Medicaid Financing Accountability Rule (MFAR) proposed rule; COVID-19 regulatory changes in general; Coronavirus Preparedness and Response Supplemental Appropriations (CPRSA) Act, The Consolidated Appropriations Act of 2021, the Families First Coronavirus Response Act (FFCRA), and the Coronavirus Aid, Relief and Economic Security (CARES) Act - issues impacting hospital financing, Medicaid DSH, telehealth expansion, Provider Relief Funds; H.R. 266/P.L. 116-139, the Paycheck Protection Program and Health Care Enhancement Act - provisions related to Public Health and Social Services Emergency Fund; increase in FMAP funding per COVID-10 PHE; support for reforms to CMS's Accelerated Advanced Payment Program; H.R. 7292 - The COVID-19 Hospital Forgiveness Act; support of telehealth policies, including for audio-only telehealth services.

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

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

Support for inclusion of funding and programs to help hospitals and health systems respond to COVID-19 pandemic, including health provisions in the Consolidated Appropriations Act of 2020 (H.R. 133) Support for legislation to continue expansion of telehealth services during and beyond COVID-19 pandemic Support for fair and accurate distribution of CARES Act Provider Relief Funds Support for the COVID-19 Hospital Forgiveness Act (H.R. 7292) Opposition to proposed Medicaid Fiscal Accountability Rule [CMS-2393-P] Support for Graduate Medical Education (GME) funding including the Resident Physician Shortage Reduction Act of 2019 (S. 348/H.R. 1763) and the Opioid Workforce Act of 2018 (H.R. 5818/S. 2843) and Advancing Medical Resident Training in Community Hospitals Act (H.R. 1358) Support for delay of impending Medicaid Disproportionate Share Hospital payment cuts and elimination of Medicare sequestration cuts Support for full protection of Critical Access Hospital payments including the Critical Access Hospital Relief Act of 2019 (H.R. 1041) Support for changes to Medicare Volume Decrease Adjustment calculation including the Access for Rural Communities Act (H.R. 3672) Support for Protecting Local Access to Care for Everyone Act (H.R. 2552) Support for Protecting Rural Access to Care Act (H.R. 8025)

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

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

Advocate for several Medicare & Medicaid provisions in the CARES Act (H.R. 748), including a delay of Medicare sequestration cuts, a delay of the Medicare Fiscal Accountability Rule and Medicaid disproportionate share hospital (DSH) cut relief. Support increased Federal Medical Assistance Percentages (FMAP) and FMAP flexibility at the state level in the Families First Coronavirus Response Act (H.R. 6201) and the CARES Act (H.R. 748). Discuss issues related to Medicare accelerated payments with Congressional staff. Discuss issues related to telehealth and HIT with Congressional staff. Discuss the HEROES Act (H.R. 6800) and other COVID-19 phase four response legislation with Congressional staff. Discuss Medicare Advance Payment forgiveness with Congressional staff, advocated for H.R. 7292 (support). Support a delay of Medicaid DSH reimbursement cuts in COVID-19 response package and a delay or repeal of the Medicaid Fiscal Accountability Regulation. Discuss increased Federal Medical Assistance Percentages (support) and increased funding for state and local governments (support) with Congressional staff.

Client expense: $250,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for several Medicare & Medicaid provisions in the CARES Act (H.R. 748), including a delay of Medicare sequestration cuts, a delay of the Medicare Fiscal Accountability Rule and Medicaid disproportionate share hospital (DSH) cut relief. Support increased Federal Medical Assistance Percentages (FMAP) and FMAP flexibility at the state level in the Families First Coronavirus Response Act (H.R. 6201) and the CARES Act (H.R. 748). Advocate for changes to indirect medical education payments to account for COVID-19 response efforts. Discuss issues related to Medicare accelerated payments with White House, HHS, CMS and Congressional staff. Advocate for continued Federal funding for New York States DSRIP program. Discuss Medicare and Medicaid issues with the CMS Administrator. Discuss COVID-19 response with White House staff and HHS leadership, including the HHS Secretary. Discuss GNYHA's legislative priorities with Congressional staff: a delay of cuts Medicaid DSH funding (support), site-neutral policies (oppose), 340B drug discount program (support), expanding federal graduate medical education programs (support), funding to address the opioid crisis (support), and the Affordable Care Act (support). Oppose several provisions in the White House's FY 2021 budget blueprint including cuts and changes to GME funding, site-neutral policies, changes to Medicare UCP and bad debt, Medicare post-acute care payments, wage index adjustments, and other Medicaid cuts. Educate Congressional staff and lawmakers on Medicare for All. Support graduate medical education funding through the Medicare program, including support for the Resident Physician Shortage Reduction Act (S. 348/H.R. 1763) and the Opioid Workforce Act (H.R. 3414/S. 2439). Discuss technical assistance regarding the Opioid Workforce Act (H.R. 3414/S. 2439) with committee staff. Discuss the Prescription Drug Pricing Reduction Act of 2019 (S. 2543) with Congressional staff and committee staff. Discuss New York State's Partnership for Patients initiative with CMS contract officers. Discuss GME rural training tracks and possible reforms with Congressional staff. Discuss the ET3 model with staff from CMMI. Discuss the Medicare GME program, including issues related to oversight and transparency, with congressional staff. Spoke with CMS to review Medicare DGME policy (42 CFR 413.75) on residency counting issues Discuss issues concerning DSH hospitals with the Executive Branch. Discuss Medicare and Medicaid issues with the CMS Administrator. Discuss Lower Drug Costs Now Act (H.R.3) with Congressional staff. Discuss issues related to telehealth and HIT with staff from CMS, the White House and Congressional staff. Discuss the HEROES Act (H.R. 6800) and other COVID-19 phase four response legislation with lawmakers, Congressional staff, HHS and the White House. Discuss disbursements from the Public Health and Social Services Emergency Fund with HHS, the White House, and Congressional staff and lawmakers. Discuss Medicare Advance Payment forgiveness with HHS and Congressional staff, advocated for H.R. 7292 (support). Discuss a range of other COVID-19 priorities with Congressional staff including ensuring Medicare advantage plans comply with increased COVID-19 Medicare payments (support), an add-on payment for COVID-19 care (support), and crisis pay for health care workers (support). Support a delay of Medicaid DSH reimbursement cuts in COVID-19 response package and a delay or repeal of the Medicaid Fiscal Accountability Regulation. Discuss increased Federal Medical Assistance Percentages (support) and increased funding for state and local governments (support) with Congressional staff. Discuss Medicare Rule on Physician Time Studies (42 CFR 415.60) with CMS. Discuss disclosure of patient information to the media with HHS. Discuss Medicare Rules regarding new teaching hospitals with CMS. Discuss alternate care site billing with CMS.

Client expense: $550,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), President of the U.S., SENATE, Small Business Administration (SBA), Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

Advocate for several Medicare & Medicaid provisions in the CARES Act (H.R. 748), including a delay of Medicare sequestration cuts, a delay of the Medicare Fiscal Accountability Rule and Medicaid disproportionate share hospital (DSH) cut relief. Support increased Federal Medical Assistance Percentages (FMAP) and FMAP flexibility at the state level in the Families First Coronavirus Response Act (H.R. 6201) and the CARES Act (H.R. 748). Advocate for federal childcare benefits for members of the health care workforce. Advocate for increasing borrowing limits on SBA loans and ensuring health care providers are eligible. Support direct funding for health care providers treating COVID-19 patients, including funding through the Hospital Preparedness Program. Support funding and efforts to ensure health care providers have access to essential materials, such as PPE, for COVID-19 response and readiness. Advocate for changes to indirect medical education payments to account for COVID-19 response efforts. Advocate for direct Federal funding for state and local governments during the COVID-19 crisis. Discuss the distribution methodology for the Public Health and Social Services Emergency Fund with the White House, HHS, CMS and Congressional staff. Discuss issues related to Medicare accelerated payments with White House, HHS, CMS and Congressional staff. Advocate for continued Federal funding for New York States DSRIP program. Discuss Medicare and Medicaid issues with the CMS Administrator. Discuss COVID-19 response with White House staff and HHS leadership, including the HHS Secretary. Discuss GNYHA's legislative priorities with Congressional staff: a delay of cuts to Medicaid DSH funding (support), site-neutral policies (oppose), 340B drug discount program (support), expanding federal graduate medical education programs (support), funding to address the opioid crisis (support), funding for hospital infrastructure (support), the Affordable Care Act (support), and liver allocation reforms (support). Discuss the need to reform the United States' liver allocation system with Congressional staff/members, HHS, HRSA, UNOS and OPTN. Oppose several provisions in the White House's FY 2021 budget blueprint including cuts and changes to GME funding, site-neutral policies, changes to Medicare UCP and bad debt, Medicare post-acute care payments, wage index adjustments, and other Medicaid cuts. Support for the Medical liability provisions in the budget. Educate Congressional staff and lawmakers on Medicare for All. Support graduate medical education funding through the Medicare program, including support for the Resident Physician Shortage Reduction Act (S. 348/H.R. 1763) and the Opioid Workforce Act (H.R. 3414/S. 2439). Discuss technical assistance regarding the Opioid Workforce Act (H.R. 3414/S. 2439) with committee staff. Discuss the Prescription Drug Pricing Reduction Act of 2019 (S. 2543) with Congressional staff and committee staff. Support surprise billing legislation reform and work with committee and Congressional staff on a range of issues. Discussed several bills including: Protecting People from Surprise Medical Bills Act (H.R. 3502), Lower Health Care Costs Act (S. 1895), No Surprises Act (H.R. 3630) and Consumer Protections Against Surprise Medical Bills Act of 2020 (H.R. 5826). Discussed the inclusion of surprise billing legislation in COVID-19 response legislation. Discuss New York State's Partnership for Patients initiative with CMS contract officers. Discuss GME rural training tracks and possible reforms with Congressional staff. Discuss the ET3 model with staff from CMMI. Discuss the Medicare GME program, including issues related to oversight and transparency, with congressional staff. Spoke with CMS to review Medicare DGME policy (42 CFR 413.75) on residency counting issues Discuss provisions in the CARES Act (H.R. 748) related to health care provider liability and immunity with Congressional and committee staff. Attend cybersecurity briefing related to foreign threats with FBI. Discuss issues concerning DSH hospitals with the Executive Branch. Discuss Medicare and Medicaid issues with the CMS Administrator. Discuss Lower Drug Costs Now Act (H.R.3) with Congressional staff. Discuss issues related to telehealth and HIT with staff from CMS, the White House and Congressional staff. Discuss drug shortages related to the COVID-19 crisis with Congressional and Administration staff. Coordinate with ASPR, the Department of Defense, FEMA and the FDA on COVID-19 response efforts. Discuss the HEROES Act (H.R. 6800) and other COVID-19 phase four response legislation with lawmakers, Congressional staff, HHS and the White House. Discuss disbursements from the Public Health and Social Services Emergency Fund with HHS, the White House, and Congressional staff and lawmakers. Discuss hospital infrastructure spending with Congressional staff, including in the Invest in America Act (H.R. 2). Discuss Medicare Advance Payment forgiveness with HHS and Congressional staff, advocated for H.R. 7292 (support). Discuss supply chain issues, including PPE and ventilators, with Congressional staff, HHS and White House. Discuss a range of other COVID-19 priorities with Congressional staff including ensuring Medicare advantage plans comply with increased COVID-19 Medicare payments (support), an add-on payment for COVID-19 care (support), and crisis pay for health care workers (support). Support a delay of Medicaid DSH reimbursement cuts in COVID-19 response package and a delay or repeal of the Medicaid Fiscal Accountability Regulation. Discuss increased Federal Medical Assistance Percentages (support) and increased funding for state and local governments (support) with Congressional staff. Discuss surprise billing legislation with White House staff. Discuss Medicare Rule on Physician Time Studies (42 CFR 415.60) with CMS. Discuss disclosure of patient information to the media with HHS. Discuss Medicare Rules regarding new teaching hospitals with CMS. Discuss alternate care site billing with CMS.

Client expense: $550,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), President of the U.S., SENATE, Small Business Administration (SBA), Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

Advance and accelerated payment program under Medicare, including efforts to reform the program as created by the CARES Act (H.R. 748, P.L. 116-136), including H.R. 7292.

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advance and accelerated payment program under Medicare, including efforts to reform the program as created by the CARES Act (H.R. 748, P.L. 116-136), including H.R. 7292.

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to hospital and related provider reimbursement, outpatient hospital payment restrictions, disproportionate share hospitals, graduate medical education, delivery system reforms, site neutrality payment policies, telehealth, surprise medical billing, and COVID-19 response; S.348/H.R.1763, Resident Physician Shortage Reduction Act of 2019; H.R.6074, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (P.L.116-123); H.R.6201, Families First Coronavirus Response Act (P.L.116-127); H.R.748, CARES Act (P.L.116-136); H.R.6800, The HEROES Act; H.R.7292, Hospital Pandemic Related Loan Forgiveness (To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program).

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

Government targets: HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

Issues related to hospital and other provider-related reimbursement, graduate medical education, value-based purchasing programs, post-acute care, inclusion of unique device identifiers on claims, telehealth, surprise medical billing, and COVID-19 response; S.348/H.R.1763, Resident Physician Shortage Reduction Act of 2019; H.R.6800, The HEROES Act; H.R.7292, Hospital Pandemic Related Loan Forgiveness (To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Paycheck Protection Program and Health Care Enhancement Act (H.R.266); CARES Act (H.R.748); Loan Forgiveness Bill (HR 7292); Healthcare Workforce Resilience Act (S. 3599); Medicare Area Wage Index - Imputed Rural Floor.

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Paycheck Protection Program and Health Care Enhancement Act (H.R.266); CARES Act (H.R.748); Loan Forgiveness Bill (HR 7292); Healthcare Workforce Resilience Act (S. 3599); Medicare Area Wage Index - Imputed Rural Floor.

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Paycheck Protection Program and Health Care Enhancement Act (H.R.266); CARES Act (H.R.748); Loan Forgiveness Bill (HR 7292); Healthcare Workforce Resilience Act (S. 3599); Medicare Area Wage Index - Imputed Rural Floor.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Paycheck Protection Program and Health Care Enhancement Act (H.R.266); CARES Act (H.R.748); Loan Forgiveness Bill (HR 7292); Healthcare Workforce Resilience Act (S. 3599); Medicare Area Wage Index - Imputed Rural Floor.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Paycheck Protection Program and Health Care Enhancement Act (H.R.266); CARES Act (H.R.748); Loan Forgiveness Bill (HR 7292); Healthcare Workforce Resilience Act (S. 3599); Medicare Area Wage Index - Imputed Rural Floor.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Paycheck Protection Program and Health Care Enhancement Act (H.R.266); CARES Act (H.R.748); Loan Forgiveness Bill (HR 7292); Healthcare Workforce Resilience Act (S. 3599); Medicare Area Wage Index - Imputed Rural Floor.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Bill # H.R. 652: Comprehensive Care for Seniors Act Bill # H.R. 1329: Medicaid Reentry Act. Partially lifts the Medicaid Inmate Exclusion Bill # H.R. 1763 and S348: Resident Physician Shortage Reduction Act of 2019. Create 15,000 new Medicare-supported residency slots by 2024 Bill # H.R. 2552: Protecting Local Access to Care for Everyone Act. Halts CMS' site neutrality policy Bill # H.R. 3022: Patient Access Protection Act.To protect hospitals from Medicaid DSH cuts Bill # H.R. 4932 and S2741: CONNECT for Health Act. Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act to expand access to telehealth services Bill #S. 296: Home Health Care Planning Improvement Act of 2019.Revises conditions of and limitations on Medicare payment for home health care services Bill HR7791 Makes improvements to the ACO program, including modifying risk adjustment and ensuring fair benchmarks, removes barriers to participation for rural ACOs, and further incentivizes participation in advanced alternative payment models Bill HR 7663 Protecting Access to Post-COVID-19 Telehealth Act To authorize the HHS Secretary to waive or modify application of Medicare requirements with respect to telehealth services during any emergency period Bill HR 7292 The COVID-19 Hospital Forgiveness Act To provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program Supply chain coordination and transparency in response to COVID-19.

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

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

Bill # H.R. 647 and S2080: Palliative Care and Hospice Education and Training Act. Establishes Palliative Care and Hospice Education Centers to increase access to palliative care Bill # H.R. 728: Title VIII Nursing Workforce Reauthorization Act.To amend title VIII of the Public Health Service Act to extend advanced education nursing grants to support clinical nurse specialist programs Bill # H.R. 1767 and S824: Excellence in Mental Health and Addiction Treatment Expansion Act. To increase the number of states that may conduct Medicaid demonstration programs to improve access to community mental health services Bill # H.R. 2062 and S1012: Overdose Prevention and Patient Safety Act.Amends the Public Health Service Act to protect the confidentiality of substance use disorder patient records Bill # H.R. 2431 and S2500: Mental Health Professionals Workforce Shortage Loan Repayment Act. Authorizes a loan repayment program for mental health professionals to relieve workforce shortages Bill #H.R. 2482 and S2074: Mainstreaming Addiction Treatment (MAT) Act. Loosens restrictions on doctors prescribing buprenorphine for addiction treatment Bill #H.R. 2895 and S948: Conrad State 30 and Physician Access Reauthorization Act. Reauthorizes the Conrad 30 program through FY 2021 Bill #H.R. 3165 and S1737: Mental Health Parity Compliance Act. To achieve complete implementation of the Mental Health Parity and Addiction Equity Act (federal parity law) Bill #H.R. 4004 and S2986: Social Determinants Accelerator Act. To direct the Secretary of Health and Human Services to establish an interagency council on social determinants of health Bill #H.R. 4468: Nursing Home Workforce Quality Act. To address the shortage of certified nursing assistants (CNAs) Bill #H.R. 4859: Protecting Older Americans from Social Isolation Act. To amend the Older Americans Act to reduce social isolation among older individuals Bill #H.R. 5242: Opioid Settlement Accountability Act. To ensure that opioid settlement funds are used to fight the opioid epidemic, including treatment, prevention, education and enforcement efforts. Bill # H.R. 945 and S286: Mental Health Access Improvement Act. To provide for the coverage of marriage and family therapist services and mental health counselor services under Medicare Bill # H.R. 986:Protecting Americans with Preexisting Conditions Act.To prevent the promotion of short-term, limited duration insurance plans and association health plans Bill #S1399:Title VIII Nursing Workforce Reauthorization Act.To amend title VIII of the Public Health Service Act to extend advanced education nursing grants to support clinical nurse specialist programs Bill #S1895 Lower Health Care Costs Act Bill # HR5640 and S3152:Data Mapping to Save Moms' Lives Act. To require the Federal Communications Commission to incorporate data on maternal health outcomes into its broadband health maps. Bill # S3374: Protecting Jessica Grubbs Legacy Act. Amends the Public Health Service Act to protect the confidentiality of substance use disorder patient records. Bill S3599 and HR6788 Healthcare Workforce Resilience Act to expand the number of immigrant visas available to nurses and physicians Bill # HR748 S3548: Coronavirus Aid, Relief, and Economic Security Act provides financial relief and resources to individuals, families, and businesses impacted by the COVID-19 public health emergency. Bill # 7010 Paycheck protection program flexibility Bill #HR7292 Advanced Accelerated Payment Program forgiveness Bill HR 7077 and S3877 Community Solutions for COVID-19 Act grants to reduce or eliminate disparities HR 8200 Ending health disparities during COVID-19 Bill HR7838 and S4160 To enable certain hospitals participating in 340B drug discount program prior to COVID-19 public health emergency to maintain eligibility

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

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

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

Funding for Disproportionate Share Hospitals (Medicaid DSH); Funding for Medicare graduate medical education (GME); Medicare site neutrality policies; Medicaid Financing Accountability Rule (MFAR) proposed rule; COVID-19 regulatory changes in general; Coronavirus Preparedness and Response Supplemental Appropriations (CPRSA) Act, the Families First Coronavirus Response Act (FFCRA), and the Coronavirus Aid, Relief, and Economic Security (CARES) Act - issues impacting hospital financing, Medicaid DSH, telehealth expansion; increase in FMAP funding per COVID-19 PHE; support for reforms to CMS's Accelerated Advanced Payment Program; H.R. 266/P.L. 116-139, the Paycheck Protection Program and Health Care Enhancement Act - provisions related to Public Health and Social Services Emergency Fund; H.R. 7292, The COVID-19 Hospital Forgiveness Act; issues concerning support of telehealth policies, including for audio-only telehealth services.

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), SENATE

H.R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 - DelBene - prior authorization in Medicare Advantage H.R. 3925 - Reducing Barriers to Substance Use Treatment Act - Tonko - Opioids H.R. 3935 - Protecting Patients Transportation to Care Act - Carter - Medicaid coverage for transportation H.R. 4453 - Protecting Seniors from Health Care Fraud Act of 2019 - Ruiz -Distributing information to Medicare beneficiaries to prevent fraud H.R. 4529 - Promoting Access to Broadband Act of 2019 - Maloney - Medicaid H.R. 4583 - Medicare Extra Rx Higher Eligibility Limits in Part D Act of 2019 - Schneider - prescription drug affordability H.R. 4620 - More Help for Seniors Act of 2019 - Rose - expand eligibility for low-income subsidies under part D of the Medicare program H.R. 4621 - Collecting and Analyzing Resources Integral and Necessary for Guidance for Social Determinants Act of 2019 - Blunt Rochester - best practices re social determinants of health H.R. 4629 - Star Rating for Biosimilars Act - Tonko - biosimilars H.R. 4632 - Better Transparency in Information for Medicare Beneficiaries Act of 2019 - Kind - provides consumers information regarding premiums under LIS benchmark plans H.R. 4671 - Helping Seniors Afford Health Care Act - Kim - Medicare affordability and low income beneficiaries H.R. 4996 - Helping Medicaid Offer Maternity Services Act of 2020 - Kelly - extend Medicaid coverage post-partum H.R. 5006 - Expanding Access to Inpatient Mental Health Act - Emmer - Medicaid coverage for SUD/mental health for institutionalized H.R. 5201 - Telemental Health Expansion Act of 2019 - Matsui - Medicare coverage of mental telehealth H.R. 5232 - Road to Recovery Act - Fitzpatrick - Medicaid and CHIP SUD treatment H.R. 5693 - Primary Health Services Enhancement Act - Kind - Medicare rural health H.R. 5808 - Save Rural Communities Act of 2020 - Arrington - rural emergency medical access services under Medicare H.R. 5833 - To amend title XVIII of the Social Security Act to permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain - Latta - Medicare coverage in telehealth H.R. 5882 - GENE Therapy Payment Act - Schrader - value based care H.R. 6098 - To amend title XXI of the Social Security Act to allow States to expand income eligibility standards under the Children's Health Insurance Program -Barragan - CHIP eligibility H.R. 6151 - CARING for Kids Act - Fineknauer - CHIP H.R. 6179 - Increasing Access to Biosimilars Act of 2020 - Cardenas - payments to providers of biosimilars under Medicare H.R. 6209 - Reducing Unnecessary Senior Hospitalizations Act of 2020 or the RUSH Act of 2020 -Kuster - Medicare coverage for certain services in hospital emergency departments H.R. 6244 - To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Children's Health Insurance Program - Kelly - Medicaid coverage of COVID-19 related visits and testing H.R. 6263 - To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19 -Sarbanes - Medicare coverage of COVID-19 related visits and testing H.R. 6273 - Protecting Vulnerable Americans in Times of Crisis Act of 2020 - Butterfield - FMAP H.R. 6311 - Care for COVID-19 Act - Ruiz - COVID-19 cost sharing H.R. 6336 - Increasing Hospital Capacity to Fight the Coronavirus Act of 2020 - Bishop - Medicare and Medicaid payments during COVID-19 emergency H.R. 6462 - Emergency Medicaid for Coronavirus Treatment Act - Gallego - Medicaid coverage H.R. 6511 - Ensuring Vaccination and Treatment Affordability Act - Pappas - COVID H.R. 6521 - To prohibit the Secretary of Health and Human Services from taking certain actions with respect to Medicaid supplemental payments reporting requirements, and for other purposes - Diaz Barragan - Medicaid, delays implementation of MFAR H.R. 6538 - Modernized Medicine Act - Kennedy - Medicaid, Telehealth H.R. 6539 - Coronavirus Medicaid Response Act - Lee - FMAP H.R. 6572 - To direct the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, to carry out a national campaign to increase awareness and knowledge of COVID-19. -Bilirakis - COVID H.R. 6583 - To amend title XVIII of the Social Security Act to establish a risk corridor program for Medicare Advantage plans during the COVID-19 emergency, and for other purposes. - Houlahan - COVID H.R. 6616 - Stronger Medicaid Response to the COVID-19 Pandemic Act -Cardenas - COVID H.R. 6640 - Medicare Advantage COVID Treatment Act - Mucarsel-Powell - COVID H.R. 6658 - Insular Area Medicaid Coronavirus Recovery Act - Sablan - FMAP H.R. 6727 - To hold Medicare beneficiaries harmless for specified COVID-19 treatment services furnished under part A or part B of the Medicare program - Schrier - COVID H.R. 6744 - Computer and Internet Equity Act - Davis - internet access for Lifeline program H.R. 6753 - Save Rural Hospitals Act of 2020 - Finkenauer - Medicare hospital payments H.R. 6792 - Improving Telehealth for Underserved Communities Act of 2020 - Smith - telehealth H.R. 6797 - CHIPPER Act - Wild - CHIP, COVID H.R. 6837 - Medicare Accelerated and Advance Payments Improvement Act of 2020 -Schneider - COVID H.R. 7154 - Outpatient Therapy Modernization and Stabilization Act -Boyle - outpatient therapy services H.R. 7187 - HEALTH Act of 2020 -Thompson -Smith - telehealth H.R. 7292 - To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program. - Kaptur - advance payments H.R. 7338 - To amend title XVIII of the Social Security Act to permit the Secretary of Health and Human Services to waive requirements relating to the furnishing of telehealth services under the Medicare program, and for other purposes. - Cheney - Telehealth H.R. 7391 - To amend title XVIII of the Social Security Act to remove certain geographic and originating site restrictions on the furnishing of telehealth services under the Medicare program - Sherrill- Telehealth H.R. 7606 - MFAR Transparency Act - Williams - report on impact of MFAR to Congress H.R. 7627 - MORE Savings Act - Dean - Medicare access to opioid treatment and MAT H.R. 7663 - Protecting Access to Post-COVID-19 Telehealth Act of 2020 - Thompson - waive or modify application of Medicare requirements with respect to telehealth during PHE H.R. 7791 - Value in Health Care Act of 2020 - Welch - Medicare shared savings program and alternative payment arrangements H.R. 7877 - Lowering Drug Costs for Seniors Act of 2020 - Katko - Medicare Part D costs H.R. 7892 - Medicaid Expansion During Crisis Act - Coleman - extend eligibility period for Medicaid enrollment application H.R. 8177 - Renal Anemia Innovation Support and Expansion Act - OHalleran - Medicare prescription drug coverage for chronic kidney disease H.R. 8218 - Rural Ambulance Reimbursement Fairness Act - Gianforte - Medicare payment for rural ambulance services H.R. 8254 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Blumenauer - integrated care for Medicare beneficiaries with ESRD H.R. 8427 - To provide for certain reports on enrollment in the Lifeline program, and for other purposes - Luria - Lifeline program S. 2846 - Protecting Patients Transportation to Care Act - Isakson - Medicaid coverage of transportation S. 2911 - Seniors Prescription Drug Relief Act of 2019 - Cassidy - Part D smoothing S. 3013 - Encouraging Innovative Benefit Design to Lower Costs for Seniors Act - Crapo - offer additional prescription drugs under Part D S. 3220 - Ensuring Access to Direct Support Professionals Act - Portman - Medicaid coverage in acute care hospitals S. 3238 - Preventive Home Visit Act - King - preventative home visits S. 3277 - HCBS Infrastructure Improvement Act - Casey - access to community based services S. 3353 - Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020 - Cassidy - Medicare coverage of kidney transplant services S. 3384 - Lowering Prescription Drug Prices for America's Seniors and Families Act of 2020 - McSally - Medicare Part D drug pricing negotiation S. 3399 - FCHIP Extension Act - Tester - rural health S. 3442 - Care for COVID-19 Act - Booker - COVID-19 cost sharing S. 3443 - Improving Coverage and Care for Mothers Act - Casey - Medicaid coverage for all pregnant and postpartum women S. 3447 - RUSH Act of 2020 - Thune - Medicare coverage for certain services in hospital emergency departments S. 3466 - ACCESS for Biosimilars Act of 2020 - McSally - eliminates cost sharing for biosimilar biological products furnished under part B of the Medicare program S. 3615 - Rural Community Hospital Demonstration Extension Act of 2020 - Murkowski - rural community hospital demonstration program S. 3665 - Save Rural Hospitals Act of 2020 - Alexander - Medicare hospital payments S. 3750 - Medicare Accelerated and Advance Payments Improvement Act of 2020 - Shaheen - COVID S. 3881 - CHIPPER Act - Casey - CHIP, COVID S. 3998 - HEALTH Act of 2020 - Hyde-Smith - telehealth S. 3999 - Mental and Behavioral Health Connectivity Act - King - Mental Health S. 4108 - A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns - Casey - FMAP S. 4151 - SOS: Sustaining Outpatient Services Act - Hoeven - Medicare OPPS coverage S. 4230 - Telehealth Expansion Act of 2020 - Wyden - Telehealth mental health services in Medicare S. 4274 - Legalizing Drug Discounts for Seniors Act of 2020 - Paul - exclude discounts for covered part D drugs from the anti-kickback prohibition S. 4295 - Public Health Emergency Pass-Through Payment Fairness Act of 2020 - Paul - access to drugs and devices under Medicare S. 4358 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Bennet - Medicaid coverage for vaccines and treatment for COVID-19 for uninsured without cost-sharing S. 4375 - Telehealth Modernization Act - Alexander - make permanent Medicare telehealth flexibilities S. 4423 - COVID-19 Hospice Respite Care Relief Act of 2020 - Brown - Medicare hospice care S. 4448 - Fair Drug Prices for Kids Act - Warner - extend Medicaid drug rebate program to CHIP S. 4574 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Young - integrated care for Medicare beneficiaries with ESRD S. 4690 - A bill to increase vaccination rates among pregnant women enrolled in Medicaid or CHIP, and for other purposes - Hassan - Medicaid and maternal health S. 4705 - A bill to amend title XIX requiring coverage under Medicaid of vaccines for pregnant women - Cassidy - Medicaid coverage S. 4717 - A bill to amend title XIX of the Social Security Act to streamline enrollment of certain Medicaid providers across State lines, and for other purposes - Grassley - Medicaid enrollment S. 4742 - A bill to amend title XIX of the Social Security Act to promote access to life-saving therapies for Medicaid enrollees by ensuring coverage of routine patient costs for items and services furnished in connection with participation in qualifying clinical trials, and for other purposes - Burr - Medicaid coverage Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2021 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in and public option; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2022 Rate Notice; Executive Orders relating to international pricing, Part D rebates, insulin costs, and importation; issues related to MLTSS; issues related to proposed changes to removal of safe harbor protection for rebates (proposed rule); issues relating to COVID-19, including testing; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) and the Bipartisan Budget Act of 2018 changes to the Part D coverage gap; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; issues relating to prescription drug price blueprint; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.

Client expense: $2,230,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

H.R. 1763, The Resident Physician Shortage Reduction Act of 2019. H.R. 7292, Covid-19 Hospital and Health Provider Loan Forgiveness Act of 2020, all provisions.

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

Funding for Disproportionate Share Hospitals (Medicaid DSH); Funding for Medicare graduate medical education (GME); Medicare site neutrality policies; Medicaid Financing Accountability Rule (MFAR) proposed rule; COVID-19 regulatory changes in general; Coronavirus Preparedness and Response Supplemental Appropriations (CPRSA) Act, the Families First Coronavirus Response Act (FFCRA), and the Coronavirus Aid, Relief and Economic Security (CARES) Act - issues impacting hospital financing, Medicaid DSH, telehealth expansion; H.R. 266/P.L. 116-139, the Paycheck Protection Program and Health Care Enhancement Act - provisions related to Public Health and Social Services Emergency Fund; increase in FMAP funding per COVID-10 PHE; support for reforms to CMS's Accelerated Advanced Payment Program; H.R. 7292 - The COVID-19 Hospital Forgiveness Act; support of telehealth policies, including for audio-only telehealth services.

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

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

Legislation related to health care reform and creation of a health care reform commission. Advance and accelerated payment program under Medicare, including efforts to reform the program as created by the CARES Act (H.R. 748, P.L. 116-136), including H.R. 7292.

Client expense: Not reported · Firm income: $11,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation related to health care reform and creation of a health care reform commission. Advance and accelerated payment program under Medicare, including efforts to reform the program as created by the CARES Act (H.R. 748, P.L. 116-136), including H.R. 7292.

Client expense: Not reported · Firm income: $11,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for inclusion of funding and programs to help hospitals and health systems respond to COVID-19 pandemic in Health and Economic Recovery Omnibus Emergency Solutions Act or the HEROES Act (H.R. 6800) Support for healthcare provisions in Continuing Appropriations Act, 2021 and Other Extensions Act (H.R. 8319) Support for legislation to continue expansion of telehealth services during and beyond COVID-19 pandemic Support for fair and accurate distribution of CARES Act Provider Relief Funds Support for the COVID-19 Hospital Forgiveness Act (H.R. 7292) Opposition to proposed Medicaid Fiscal Accountability Rule [CMS-2393-P] Support for Graduate Medical Education (GME) funding including the Resident Physician Shortage Reduction Act of 2019 (S. 348/H.R. 1763) and the Opioid Workforce Act of 2018 (H.R. 5818/S. 2843) and Advancing Medical Resident Training in Community Hospitals Act (H.R. 1358) Support for delay of impending Medicaid Disproportionate Share Hospital payment cuts Support for full protection of Critical Access Hospital payments including the Critical Access Hospital Relief Act of 2019 (H.R. 1041) Support for changes to Medicare Volume Decrease Adjustment calculation including the Access for Rural Communities Act (H.R. 3672) Support for Protecting Local Access to Care for Everyone Act (H.R. 2552) Support for Protecting Rural Access to Care Act (H.R. 8025)

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

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

Issues related to hospital and related provider reimbursement, outpatient hospital payment restrictions, disproportionate share hospitals, graduate medical education, delivery system reforms, site neutrality payment policies, telehealth, surprise medical billing, and COVID-19 response; S.348/H.R.1763, Resident Physician Shortage Reduction Act of 2019; H.R.6074, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (P.L.116-123); H.R.6201, Families First Coronavirus Response Act (P.L.116-127); H.R.748, CARES Act (P.L.116-136); H.R.6800, The HEROES Act; H.R.7292, Hospital Pandemic Related Loan Forgiveness (To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program).

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

Government targets: HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

Issues related to hospital and other provider-related reimbursement, graduate medical education, value-based purchasing programs, post-acute care, inclusion of unique device identifiers on claims, telehealth, surprise medical billing, and COVID-19 response; S.348/H.R.1763, Resident Physician Shortage Reduction Act of 2019; H.R.6800, The HEROES Act; H.R.7292, Hospital Pandemic Related Loan Forgiveness (To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Any COVID-19 stimulus bill(s), package(s), or provision(s) passed after 10/16/2020 impacting hospitals and health systems, including: Forgiveness for Medicare accelerated payments; Additional money and reporting requirements for the Provider Relief Fund; Support for front-line caregivers; Liability protections for front-line medical providers and facilities; and Maintaining health benefits for individuals and families and increasing coverage options for the uninsured. Expansion of resources for testing, tracing, and vaccine development. S.B. 3548, THE CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY ACT. Any provision(s) supporting hospitals and veterans health care; vaccines, therapeutics, diagnostics, and other preparedness needs; healthcare professionals and patients who are fighting the coronavirus on the front lines. H.R. 7292 THE COVID-19 HOSPITAL AND HEALTH PROVIDER LOAN FORGIVENESS ACT OF 2020. Any provision(s) in favor of forgiveness of certain payments for hospitals. H.R. 8472 IMPACT AID CORONAVIRUS RELIEF ACT. Any provision(s) supporting hospitals and health systems and relief/funds for hospitals. H.R. 6800 THE HEROES ACT. Any provision(s) supporting relief for hospitals and providers. S. 4116 Any provision(s) supporting funds for hospitals. Any provision(s) extending the loan application period. The HEALS Act- Health, Economic Assistance, Liability Protection, and Schools act. Any bill(s) or provision(s) advocating for more PPE and supplies for healthcare workers, hospitals, and health systems during the COVID-19 pandemic. Any requirement(s) for hospitals to collect and report COVID-19 data. Any bill(s) or provision(s) urging the delay of CMSs hospital transparency rule requiring hospitals to publicly disclose negotiated rates with commercial health plans. Any provision(s) on the CMS hospital inpatient prospective payment system proposed rule for fiscal year 2021. Any provision(s) on the CMS hospital outpatient prospective payment system/ ambulatory surgical center proposed rule reducing payment rates received by hospitals. Any bill(s) or provision(s) addressing surprise medical billing proposals harmful to patients and hospitals/health systems. Any bill(s) or provision(s) enabling or making it easier for providers to use telemedicine to increase access for patients. Any provision(s) concerning CMSs Medicaid Fiscal Accountability Proposed Rule, with hospitals urging the proposed rule be withdrawn.

Client expense: $57,250 · Firm income: Not reported

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

Any COVID-19 stimulus bill(s), package(s), or provision(s) impacting hospitals and health systems, including: Forgiveness for Medicare accelerated payments; Additional money and reporting requirements for the Provider Relief Fund; Support for front-line caregivers; Liability protections for front-line medical providers and facilities; and Maintaining health benefits for individuals and families and increasing coverage options for the uninsured. Expansion of resources for testing, tracing, and vaccine development. S.B. 3548, THE CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY ACT. Any provision(s) supporting hospitals and veterans health care; vaccines, therapeutics, diagnostics, and other preparedness needs; healthcare professionals and patients who are fighting the coronavirus on the front lines. H.R. 7292 THE COVID-19 HOSPITAL AND HEALTH PROVIDER LOAN FORGIVENESS ACT OF 2020. Any provision(s) in favor of forgiveness of certain payments for hospitals. H.R. 8472 IMPACT AID CORONAVIRUS RELIEF ACT. Any provision(s) supporting hospitals and health systems and relief/funds for hospitals. H.R. 6800 THE HEROES ACT. Any provision(s) supporting relief for hospitals and providers. S. 4116 Any provision(s) supporting funds for hospitals. Any provision(s) extending the loan application period. The HEALS Act- Health, Economic Assistance, Liability Protection, and Schools act. Any bill(s) or provision(s) advocating for more PPE and supplies for healthcare workers, hospitals, and health systems during the COVID-19 pandemic. Any requirement(s) for hospitals to collect and report COVID-19 data. Any bill(s) or provision(s) urging the delay of CMSs hospital transparency rule requiring hospitals to publicly disclose negotiated rates with commercial health plans. Any provision(s) on the CMS hospital inpatient prospective payment system proposed rule for fiscal year 2021. Any provision(s) on the CMS hospital outpatient prospective payment system/ ambulatory surgical center proposed rule reducing payment rates received by hospitals. Any bill(s), provision(s), or action(s) impacting the 340B Drug Discount Program and hospitals and health systems ability to provide access to these drugs for patients. Any bill(s) or provision(s) addressing high drug prices. Any bill(s) or provision(s) addressing surprise medical billing proposals harmful to patients and hospitals/health systems. Any bill(s) or provision(s) enabling or making it easier for providers to use telemedicine to increase access for patients. Any provision(s) concerning CMSs Medicaid Fiscal Accountability Proposed Rule, with hospitals urging the proposed rule be withdrawn.

Client expense: $57,250 · Firm income: Not reported

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

Medicaid Fiscal Accountability Regulation Rural hospital policies 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) 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) Medicare hospital accelerated payment program (coronavirus relief packages-H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800; 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) 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

Client expense: $250,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Loan Forgiveness Bill (HR 7292); Healthcare Workforce Resilience Act (S. 3599); Medicare Area Wage Index - Imputed Rural Floor; Provider Relief Fund; Hospital Preparedness Program, Telehealth.

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

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

Advocate for several Medicare & Medicaid provisions in the CARES Act (H.R. 748), including a delay of Medicare sequestration cuts, a delay of the Medicare Fiscal Accountability Rule and Medicaid disproportionate share hospital (DSH) cut relief. Support increased Federal Medical Assistance Percentages (FMAP) and FMAP flexibility at the state level in the Families First Coronavirus Response Act (H.R. 6201) and the CARES Act (H.R. 748). Advocate for changes to indirect medical education payments to account for COVID-19 response efforts. Discuss issues related to Medicare accelerated payments with White House, HHS, CMS and Congressional staff. Advocate for continued Federal funding for New York States DSRIP program. Discuss Medicare and Medicaid issues with the CMS Administrator. Discuss COVID-19 response with White House staff and HHS leadership, including the HHS Secretary. Discuss GNYHA's legislative priorities with Congressional staff: a delay of cuts Medicaid DSH funding (support), site-neutral policies (oppose), 340B drug discount program (support), expanding federal graduate medical education programs (support), funding to address the opioid crisis (support), and the Affordable Care Act (support). Oppose several provisions in the White House's FY 2021 budget blueprint including cuts and changes to GME funding, site-neutral policies, changes to Medicare UCP and bad debt, Medicare post-acute care payments, wage index adjustments, and other Medicaid cuts. Educate Congressional staff and lawmakers on Medicare for All. Support graduate medical education funding through the Medicare program, including support for the Resident Physician Shortage Reduction Act (S. 348/H.R. 1763) and the Opioid Workforce Act (H.R. 3414/S. 2439). Discuss technical assistance regarding the Opioid Workforce Act (H.R. 3414/S. 2439) with committee staff. Discuss the Prescription Drug Pricing Reduction Act of 2019 (S. 2543) with Congressional staff and committee staff. Discuss New York State's Partnership for Patients initiative with CMS contract officers. Discuss GME rural training tracks and possible reforms with Congressional staff. Discuss the ET3 model with staff from CMMI. Discuss the Medicare GME program, including issues related to oversight and transparency, with congressional staff. Spoke with CMS to review Medicare DGME policy (42 CFR 413.75) on residency counting issues Discuss issues concerning DSH hospitals with the Executive Branch. Discuss Medicare and Medicaid issues with the CMS Administrator. Discuss Lower Drug Costs Now Act (H.R.3) with Congressional staff. Discuss issues related to telehealth and HIT with staff from CMS, the White House and Congressional staff. Discuss the HEROES Act (H.R. 6800) and other COVID-19 phase four response legislation with lawmakers, Congressional staff, HHS and the White House. Discuss disbursements from the Public Health and Social Services Emergency Fund with HHS, the White House, and Congressional staff and lawmakers. Discuss Medicare Advance Payment forgiveness with HHS and Congressional staff, advocated for H.R. 7292 (support). Discuss a range of other COVID-19 priorities with Congressional staff including ensuring Medicare advantage plans comply with increased COVID-19 Medicare payments (support), an add-on payment for COVID-19 care (support), and crisis pay for health care workers (support). Support a delay of Medicaid DSH reimbursement cuts in COVID-19 response package and a delay or repeal of the Medicaid Fiscal Accountability Regulation. Discuss increased Federal Medical Assistance Percentages (support) and increased funding for state and local governments (support) with Congressional staff. Discuss Medicare Rule on Physician Time Studies (42 CFR 415.60) with CMS. Discuss disclosure of patient information to the media with HHS. Discuss Medicare Rules regarding new teaching hospitals with CMS. Discuss alternate care site billing with CMS.

Client expense: $550,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), President of the U.S., SENATE, Small Business Administration (SBA), Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

Advocate for several Medicare & Medicaid provisions in the CARES Act (H.R. 748), including a delay of Medicare sequestration cuts, a delay of the Medicare Fiscal Accountability Rule and Medicaid disproportionate share hospital (DSH) cut relief. Support increased Federal Medical Assistance Percentages (FMAP) and FMAP flexibility at the state level in the Families First Coronavirus Response Act (H.R. 6201) and the CARES Act (H.R. 748). Advocate for federal childcare benefits for members of the health care workforce. Advocate for increasing borrowing limits on SBA loans and ensuring health care providers are eligible. Support direct funding for health care providers treating COVID-19 patients, including funding through the Hospital Preparedness Program. Support funding and efforts to ensure health care providers have access to essential materials, such as PPE, for COVID-19 response and readiness. Advocate for changes to indirect medical education payments to account for COVID-19 response efforts. Advocate for direct Federal funding for state and local governments during the COVID-19 crisis. Discuss the distribution methodology for the Public Health and Social Services Emergency Fund with the White House, HHS, CMS and Congressional staff. Discuss issues related to Medicare accelerated payments with White House, HHS, CMS and Congressional staff. Advocate for continued Federal funding for New York States DSRIP program. Discuss Medicare and Medicaid issues with the CMS Administrator. Discuss COVID-19 response with White House staff and HHS leadership, including the HHS Secretary. Discuss GNYHA's legislative priorities with Congressional staff: a delay of cuts to Medicaid DSH funding (support), site-neutral policies (oppose), 340B drug discount program (support), expanding federal graduate medical education programs (support), funding to address the opioid crisis (support), funding for hospital infrastructure (support), the Affordable Care Act (support), and liver allocation reforms (support). Discuss the need to reform the United States' liver allocation system with Congressional staff/members, HHS, HRSA, UNOS and OPTN. Oppose several provisions in the White House's FY 2021 budget blueprint including cuts and changes to GME funding, site-neutral policies, changes to Medicare UCP and bad debt, Medicare post-acute care payments, wage index adjustments, and other Medicaid cuts. Support for the Medical liability provisions in the budget. Educate Congressional staff and lawmakers on Medicare for All. Support graduate medical education funding through the Medicare program, including support for the Resident Physician Shortage Reduction Act (S. 348/H.R. 1763) and the Opioid Workforce Act (H.R. 3414/S. 2439). Discuss technical assistance regarding the Opioid Workforce Act (H.R. 3414/S. 2439) with committee staff. Discuss the Prescription Drug Pricing Reduction Act of 2019 (S. 2543) with Congressional staff and committee staff. Support surprise billing legislation reform and work with committee and Congressional staff on a range of issues. Discussed several bills including: Protecting People from Surprise Medical Bills Act (H.R. 3502), Lower Health Care Costs Act (S. 1895), No Surprises Act (H.R. 3630) and Consumer Protections Against Surprise Medical Bills Act of 2020 (H.R. 5826). Discussed the inclusion of surprise billing legislation in COVID-19 response legislation. Discuss New York State's Partnership for Patients initiative with CMS contract officers. Discuss GME rural training tracks and possible reforms with Congressional staff. Discuss the ET3 model with staff from CMMI. Discuss the Medicare GME program, including issues related to oversight and transparency, with congressional staff. Spoke with CMS to review Medicare DGME policy (42 CFR 413.75) on residency counting issues Discuss provisions in the CARES Act (H.R. 748) related to health care provider liability and immunity with Congressional and committee staff. Attend cybersecurity briefing related to foreign threats with FBI. Discuss issues concerning DSH hospitals with the Executive Branch. Discuss Medicare and Medicaid issues with the CMS Administrator. Discuss Lower Drug Costs Now Act (H.R.3) with Congressional staff. Discuss issues related to telehealth and HIT with staff from CMS, the White House and Congressional staff. Discuss drug shortages related to the COVID-19 crisis with Congressional and Administration staff. Coordinate with ASPR, the Department of Defense, FEMA and the FDA on COVID-19 response efforts. Discuss the HEROES Act (H.R. 6800) and other COVID-19 phase four response legislation with lawmakers, Congressional staff, HHS and the White House. Discuss disbursements from the Public Health and Social Services Emergency Fund with HHS, the White House, and Congressional staff and lawmakers. Discuss hospital infrastructure spending with Congressional staff, including in the Invest in America Act (H.R. 2). Discuss Medicare Advance Payment forgiveness with HHS and Congressional staff, advocated for H.R. 7292 (support). Discuss supply chain issues, including PPE and ventilators, with Congressional staff, HHS and White House. Discuss a range of other COVID-19 priorities with Congressional staff including ensuring Medicare advantage plans comply with increased COVID-19 Medicare payments (support), an add-on payment for COVID-19 care (support), and crisis pay for health care workers (support). Support a delay of Medicaid DSH reimbursement cuts in COVID-19 response package and a delay or repeal of the Medicaid Fiscal Accountability Regulation. Discuss increased Federal Medical Assistance Percentages (support) and increased funding for state and local governments (support) with Congressional staff. Discuss surprise billing legislation with White House staff. Discuss Medicare Rule on Physician Time Studies (42 CFR 415.60) with CMS. Discuss disclosure of patient information to the media with HHS. Discuss Medicare Rules regarding new teaching hospitals with CMS. Discuss alternate care site billing with CMS.

Client expense: $550,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Defense, Dept of (DOD), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), President of the U.S., SENATE, Small Business Administration (SBA), Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

HR 748 CARES Act Safety Net Hospital Grants 340B Contract Pharmacy Pricing HR 7292 Loan Forgiveness

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Paycheck Protection Program and Health Care Enhancement Act (H.R.266); CARES Act (H.R.748); Loan Forgiveness Bill (HR 7292); Healthcare Workforce Resilience Act (S. 3599); Medicare Area Wage Index - Imputed Rural Floor.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 266, Paycheck Protection Program and Health Care Enhancement Act - funding for hospitals H.R. 6800, the HEROES Act - funding for hospitals, no-cost extensions for expiring RF1/UF1 grants, revision of loan terms for the Medicare Accelerated Payment Program In general, funding for hospitals impacted by COVID and no-cost extensions for expiring RF1/UF1 grants, revision of loan terms for the Medicare Accelerated Payment Program. Congressional support letters for CDC BOLD Public Health CEnter of Excellence for Dementia Caregiving grant application Gathering information about funding to build COVID testing capacity at hospitals. H.R.7292 - To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program.

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

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

Medicare Advantage; Medicaid Expansion; Medicare Data Sharing; Privacy; Medicare Prescription Drug Pricing; CMS; Generic drugs (CREATES); MACRA; Drug approval; Provider funding; Coronavirus Medicaid Response; Rate Notice and Call Letter; Prior Authorizations, COVID-19 Test Without Cost-Sharing. H.R. 3107 - 116th Congress (2019-2020) Improving Seniors' Timely Access to Care Act of 2019 Sponsor: Rep. Suzan DelBene (D-WA), Rep. Mike Kelly (R-PA), Roger Marshal (R-KS) and Ami Bera (D-CA) H.R. 5833 - 116th Congress - Second Session To amend title XVIII of the Social Security Act to permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain. Sponsor: Rep. Bob Latta (R-OK-05) H.R. 6179 - 116th Congress - Second Session Increasing Access to Biosimilars Act of 2020 Sponsor: Rep. Tony Cardenas (D-CA-29) H.R. 6218 - 116th Congress - Second Session Preserving Patient Access to Home INfusion Act Sponsor: Rep. Eliot Engel (D-NY-16) H.R. 6214 - 116th Congress - Second Session To amend title XVIII of the Social Security Act to provide for coverage of testing for COVID-19 at no cost sharing under the Medicare Advantage program. Sponsor: Rep. Ron Kind (D-WI-03) H.R. 6484 - 116th Congress - Second Session Care for COVID-19 Act 2.0 Sponsor: Rep. Raul Ruiz (D-CA-36) H.R. 6674 - 116th Congress - Second Session Medicare Crisis Program Act of 2020 Sponsor: Rep. Pramila Hayapal. (D-WA-07) H.R. 6739 - 116th Congress - Second Session Ensuring Seniors' Access to COVID Treatments Act Sponsor: Rep. Sean Casten (D-IL-06) H.R. 7062 - 116th Congress - Second Session Affordable Insulin for the COVID-19 Emergency Act Sponsor: Rep. Maxine Waters (D-CA-43) H.R. 6583 - 116th Congress - Second Session To amend title XVIII of the Social Security Act to establish a risk corridor program for Medicare Advantage plans during the COVID-19 emergency, and for other purposes. Sponsor: Rep. Chrissy Houlahan (D-PA-06) H.R. 6640 - 116th Congress - Second Session Medicare Advantage COVID Treatment Act Sponsor: Rep. Debbie Mucarsel-Powell (D-FL-26) H.R. 6837 - 116th Congress - Second Session Medicare Accelerated and Advance Payments IMprovement Act of 2020 Sponsor: Rep. Brad Schneider (D-IL-10) H.R. 7292 - 116th Congress - Second Session To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program. Sponsor: Repm. Marcy Kaptur (D-OH-09) H.R. 7323 - 116th Congress - Second Session Medicare Mental Health Inpatient Equity Act of 2019 Sponsor: Rep. Paul Tonko (D-NY-20) H.R. 7338 - 116th Congress - Second Session To amend title XVIII of the Social Security Act to permit the Secretary of Health and Human Services to waive requirements relating to the furnishing of telehealth services under the Medicare program, and for other purposes. Sponsor: Rep. Liz Cheney (R-WY-At-Large) H.R. 5883 - 116th Congress - Second Session Generating Effective and Novel Evidence for Therapy Payment Act Sponsor: Rep. Kurt Schrader (D-OR-05) H.R. 6649 - 116th Congress - Second Session Lower Drug Costs for Seniors During COVID-19 Act of 2020 Sponsor: Rep. Jan Schakowsky (D-IL-09)

Client expense: Not reported · Firm income: Not reported

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

Funding for Disproportionate Share Hospitals (Medicaid DSH); Funding for Medicare graduate medical education (GME); Medicare site neutrality policies; Medicaid Financing Accountability Rule (MFAR) proposed rule; COVID-19 regulatory changes in general; Coronavirus Preparedness and Response Supplemental Appropriations (CPRSA) Act, the Families First Coronavirus Response Act (FFCRA), and the Coronavirus Aid, Relief, and Economic Security (CARES) Act - issues impacting hospital financing, Medicaid DSH, telehealth expansion; increase in FMAP funding per COVID-19 PHE; support for reforms to CMS's Accelerated Advanced Payment Program; H.R. 266/P.L. 116-139, the Paycheck Protection Program and Health Care Enhancement Act - provisions related to Public Health and Social Services Emergency Fund; H.R. 7292, The COVID-19 Hospital Forgiveness Act.

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), SENATE

Funding for Disproportionate Share Hospitals (Medicaid DSH); Funding for Medicare graduate medical education (GME); Medicare site neutrality policies; Medicaid Financing Accountability Rule (MFAR) proposed rule; COVID-19 regulatory changes in general; Coronavirus Preparedness and Response Supplemental Appropriations (CPRSA) Act, the Families First Coronavirus Response Act (FFCRA), and the Coronavirus Aid, Relief and Economic Security (CARES) Act - issues impacting hospital financing, Medicaid DSH, telehealth expansion; H.R. 266/P.L. 116-139, the Paycheck Protection Program and Health Care Enhancement Act - provisions related to Public Health and Social Services Emergency Fund; increase in FMAP funding per COVID-10 PHE; support for reforms to CMS's Accelerated Advanced Payment Program; H.R. 7292 - The COVID-19 Hospital Forgiveness Act.

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

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

CARES Act (H.R. 748); Paycheck Protection Program and Health Care Enhancement Act (H.R. 266); To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program (H.R. 7292); relief for ASCs related to COVID-19 pandemic outbreak.

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

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

General Medicaid/Medicare issues; Issues related to surprise billing; HR 7292 COVID-19 Hospital Forgiveness

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

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

Legislation related to a health care reform and creation of a health care reform commission. Advance and accelerated payment program under Medicare, including efforts to reform the program as created by the CARES Act (H.R. 748, P.L. 116-136), including H.R. 7292.

Client expense: Not reported · Firm income: $11,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation related to a health care reform and creation of a health care reform commission. Advance and accelerated payment program under Medicare, including efforts to reform the program as created by the CARES Act (H.R. 748, P.L. 116-136), including H.R. 7292.

Client expense: Not reported · Firm income: $11,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE