To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes.

S.510 - Protecting Medicare and American Farmers from Sequester Cuts Act of 2021 HR 5376 Build Back Better Act HR 8702 & S 5007 - the Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 HR 8505 - to amend Title XVIII of the SS Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare Physician Fee Schedule, and for other purposes. HR 3502 - Protecting People from Surprise Medical Bills Act HR 3630 - to amend title XXVII of the Public Health Service Act HR 1384 - Medicare for All Act of 2019 HR 861 - End Surprise Billing Act of 2019 S 1266 - Protecting Patients from Surprise Medicare Bills Act S 1531 - Stopping the Outrageous Practice of Surprise Medical Act of 2019 S 1370 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 HR 345 - SMASH Act S 1213 - Consumer Health Insurance Protection Act of 2019 Protecting Access to Medicare Act Gene Patents HR4128 - Verifying Accurate Leading Edge IVCT Development (VALID) Act of 2021 Prostate Cancer Misdiagnosis Elimination Act Eliminate Kickbacks in Recovery Act (EDRA) Resident Physician Shortage Reduction Act of 2019, S 348, HR 1763 The Infrastructure Investments and Jobs Act

Client expense: $121,540 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 5376 Build Back Better Act HR 8702 & S 5007 - the Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 HR 8505 - to amend Title XVIII of the SS Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare Physician Fee Schedule, and for other purposes. HR 3502 - Protecting People from Surprise Medical Bills Act HR 3630 - to amend title XXVII of the Public Health Service Act HR 1384 - Medicare for All Act of 2019 HR 861 - End Surprise Billing Act of 2019 S 1266 - Protecting Patients from Surprise Medicare Bills Act S 1531 - Stopping the Outrageous Practice of Surprise Medical Act of 2019 S 1370 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 HR 345 - SMASH Act S 1213 - Consumer Health Insurance Protection Act of 2019 Protecting Access to Medicare Act Gene Patents HR4128 - Verifying Accurate Leading Edge IVCT Development (VALID) Act of 2021 Prostate Cancer Misdiagnosis Elimination Act Eliminate Kickbacks in Recovery Act (EDRA) Resident Physician Shortage Reduction Act of 2019, S 348, HR 1763 The Infrastructure Investments and Jobs Act

Client expense: $110,671 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 8702 & S 5007 - the Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 HR 8505 - to amend Title XVIII of the SS Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare Physician Fee Schedule, and for other purposes. HR 3502 - Protecting People from Surprise Medical Bills Act HR 3630 - to amend title XXVII of the Public Health Service Act HR 1384 - Medicare for All Act of 2019 HR 861 - End Surprise Billing Act of 2019 S 1266 - Protecting Patients from Surprise Medicare Bills Act S 1531 - Stopping the Outrageous Practice of Surprise Medical Act of 2019 S 1370 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 HR 345 - SMASH Act S 1213 - Consumer Health Insurance Protection Act of 2019 Protecting Access to Medicare Act Gene Patents HR4128 - Verifying Accurate Leading Edge IVCT Development (VALID) Act of 2021 Prostate Cancer Misdiagnosis Elimination Act Eliminate Kickbacks in Recovery Act (EDRA) Resident Physician Shortage Reduction Act of 2019, S 348, HR 1763 The Infrastructure Investments and Jobs Act Build Back Better Act

Client expense: $113,175 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 8702 & S 5007 - the Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 HR 8505 - to amend Title XVIII of the SS Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare Physician Fee Schedule, and for other purposes. HR 3502 - Protecting People from Surprise Medical Bills Act HR 3630 - to amend title XXVII of the Public Health Service Act HR 1384 - Medicare for All Act of 2019 HR 861 - End Surprise Billing Act of 2019 S 1266 - Protecting Patients from Surprise Medicare Bills Act S 1531 - Stopping the Outrageous Practice of Surprise Medical Act of 2019 S 1370 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 HR 345 - SMASH Act S 1213 - Consumer Health Insurance Protection Act of 2019 Protecting Access to Medicare Act Gene Patents VALID - Verifying Accurate Leading Edge IVCT Development Prostate Cancer Misdiagnosis Elimination Act Eliminate Kickbacks in Recovery Act (EDRA) Resident Physician Shortage Reduction Act of 2019, S 348, HR 1763

Client expense: $115,673 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 8702 & S 5007 - the Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 HR 8505 - to amend Title XVIII of the SS Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare Physician Fee Schedule, and for other purposes. HR 3502 - Protecting People from Surprise Medical Bills Act HR 3630 - to amend title XXVII of the Public Health Service Act HR 1384 - Medicare for All Act of 2019 HR 861 - End Surprise Billing Act of 2019 S 1266 - Protecting Patients from Surprise Medicare Bills Act S 1531 - Stopping the Outrageous Practice of Surprise Medical Act of 2019 S 1370 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 HR 345 - SMASH Act S 1213 - Consumer Health Insurance Protection Act of 2019 Protecting Access to Medicare Act Gene Patents VALID - Verifying Accurate Leading Edge IVCT Development Prostate Cancer Misdiagnosis Elimination Act Eliminate Kickbacks in Recovery Act (EDRA) Resident Physician Shortage Reduction Act of 2019, S 348, HR 1763

Client expense: $137,521 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare Reimbursement. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response to the outbreak. Monitoring and outreach on legislative activity related to the HEALS Act (S. 4317 - S. 4324). Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). House Draft, Department of Defense Appropriations Act, FY 2021. Senate Draft, Department of Defense Appropriations Act, FY 2021. H.R. 3, Lower Drug Costs Now Act of 2019. H.R.748, CARES Act (P.L. 116-136) and other legislation related to the policies in reaction to the national health crisis. H.R.7010, Paycheck Protection Program Flexibility Act of 2020 (P.L. 116-142). H.R. 1158, FY2020 Consolidated Appropriations Act (Defense, CJS, FSGG, Homeland Security). H.R. 1554, REDI Act. H.R. 2087, To amend title XVIII of the Social Security Act to require certain manufacturers to report drug pricing information with respect to drugs under the Medicare program, and for other purposes. H.R. 2279, Safe Step Act. H.R. 2693, To amend title XVIII of the Social Security Act to improve access to, and utilization of, bone mass measurement benefits under part B of the Medicare program by establishing a minimum payment amount under such part for bone mass measurement. H.R. 2781, Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness for Health Act of 2019. H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019. H.R. 4378, FY2020 Continuing Appropriations Resolution (P.L. 116-59). S. 64, Preserve Access to Affordable Generics and Biosimilars Act. S. 283, Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2019. S. 1391, Fair Accountability and Innovative Research Drug Pricing Act of 2019. S. 2543, Prescription Drug Pricing Reduction Act of 2019. S. 2546, Safe Step Act. H.R. 1763, Resident Physician Shortage Reduction Act. S. 348, Resident Physician Shortage Reduction Act. H.R. 6788, Workforce Resilience Act. S. 3599, Workforce Resilience Act. H.R. 5741, Strengthening Innovation in Medicare and Medicaid Act. H.R. 8505, To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 H.R. 6644/S. 3741, Health Care at Home Act H.R. 4932/S. 2741, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act H.R. 266, Paycheck Protection Program and Health Care Enhancement Act (P.L. 116-139). S. 4014, The Prioritized Paycheck Protection Program (P4) Act. S. 4116, A bill to extend the authority for commitments for the paycheck protection program and separate amounts authorized for other loans under section 7(a) of the Small Business Act, and for other purposes (P.L. 116-147). S.4775, Delivering Immediate Relief to America's Families, Schools and Small Businesses Act. H.R. 6800, The Heroes Act. H.R. 8337 - Continuing Appropriations Act, 2021 and Other Extensions Act (P.L. 116-159). P.L. 116-260, FY2021 Omnibus and COVID Relief and Response Act. H.R. 133: Consolidated Appropriations Act, 2021.

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare Reimbursement. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response to the outbreak. Monitoring and outreach on legislative activity related to the HEALS Act (S. 4317 - S. 4324). Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). House Draft, Department of Defense Appropriations Act, FY 2021. Senate Draft, Department of Defense Appropriations Act, FY 2021. H.R. 3, Lower Drug Costs Now Act of 2019. H.R.748, CARES Act (P.L. 116-136) and other legislation related to the policies in reaction to the national health crisis. H.R.7010, Paycheck Protection Program Flexibility Act of 2020 (P.L. 116-142). H.R. 1158, FY2020 Consolidated Appropriations Act (Defense, CJS, FSGG, Homeland Security). H.R. 1554, REDI Act. H.R. 2087, To amend title XVIII of the Social Security Act to require certain manufacturers to report drug pricing information with respect to drugs under the Medicare program, and for other purposes. H.R. 2279, Safe Step Act. H.R. 2693, To amend title XVIII of the Social Security Act to improve access to, and utilization of, bone mass measurement benefits under part B of the Medicare program by establishing a minimum payment amount under such part for bone mass measurement. H.R. 2781, Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness for Health Act of 2019. H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019. H.R. 4378, FY2020 Continuing Appropriations Resolution (P.L. 116-59). S. 64, Preserve Access to Affordable Generics and Biosimilars Act. S. 283, Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2019. S. 1391, Fair Accountability and Innovative Research Drug Pricing Act of 2019. S. 2543, Prescription Drug Pricing Reduction Act of 2019. S. 2546, Safe Step Act. H.R. 1763, Resident Physician Shortage Reduction Act. S. 348, Resident Physician Shortage Reduction Act. H.R. 6788, Workforce Resilience Act. S. 3599, Workforce Resilience Act. H.R. 5741, Strengthening Innovation in Medicare and Medicaid Act. H.R. 8505, To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 H.R. 6644/S. 3741, Health Care at Home Act H.R. 4932/S. 2741, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act H.R. 266, Paycheck Protection Program and Health Care Enhancement Act (P.L. 116-139). S. 4014, The Prioritized Paycheck Protection Program (P4) Act. S. 4116, A bill to extend the authority for commitments for the paycheck protection program and separate amounts authorized for other loans under section 7(a) of the Small Business Act, and for other purposes (P.L. 116-147). S.4775, Delivering Immediate Relief to America's Families, Schools and Small Businesses Act. H.R. 6800, The Heroes Act. H.R. 8337 - Continuing Appropriations Act, 2021 and Other Extensions Act (P.L. 116-159). P.L. 116-260, FY2021 Omnibus and COVID Relief and Response Act. H.R. 133: Consolidated Appropriations Act, 2021.

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare Reimbursement. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response to the outbreak. Monitoring and outreach on legislative activity related to the HEALS Act (S. 4317 - S. 4324). Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). House Draft, Department of Defense Appropriations Act, FY 2021. Senate Draft, Department of Defense Appropriations Act, FY 2021. H.R. 3, Lower Drug Costs Now Act of 2019. H.R.748, CARES Act (P.L. 116-136) and other legislation related to the policies in reaction to the national health crisis. H.R.7010, Paycheck Protection Program Flexibility Act of 2020 (P.L. 116-142). H.R. 1158, FY2020 Consolidated Appropriations Act (Defense, CJS, FSGG, Homeland Security). H.R. 1554, REDI Act. H.R. 2087, To amend title XVIII of the Social Security Act to require certain manufacturers to report drug pricing information with respect to drugs under the Medicare program, and for other purposes. H.R. 2279, Safe Step Act. H.R. 2693, To amend title XVIII of the Social Security Act to improve access to, and utilization of, bone mass measurement benefits under part B of the Medicare program by establishing a minimum payment amount under such part for bone mass measurement. H.R. 2781, Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness for Health Act of 2019. H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019. H.R. 4378, FY2020 Continuing Appropriations Resolution (P.L. 116-59). S. 64, Preserve Access to Affordable Generics and Biosimilars Act. S. 283, Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2019. S. 1391, Fair Accountability and Innovative Research Drug Pricing Act of 2019. S. 2543, Prescription Drug Pricing Reduction Act of 2019. S. 2546, Safe Step Act. H.R. 1763, Resident Physician Shortage Reduction Act. S. 348, Resident Physician Shortage Reduction Act. H.R. 6788, Workforce Resilience Act. S. 3599, Workforce Resilience Act. H.R. 5741, Strengthening Innovation in Medicare and Medicaid Act. H.R. 8505, To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 H.R. 6644/S. 3741, Health Care at Home Act H.R. 4932/S. 2741, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act H.R. 266, Paycheck Protection Program and Health Care Enhancement Act (P.L. 116-139). S. 4014, The Prioritized Paycheck Protection Program (P4) Act. S. 4116, A bill to extend the authority for commitments for the paycheck protection program and separate amounts authorized for other loans under section 7(a) of the Small Business Act, and for other purposes (P.L. 116-147). S.4775, Delivering Immediate Relief to America's Families, Schools and Small Businesses Act. H.R. 6800, The Heroes Act. H.R. 8337 - Continuing Appropriations Act, 2021 and Other Extensions Act (P.L. 116-159). P.L. 116-260, FY2021 Omnibus and COVID Relief and Response Act. H.R. 133: Consolidated Appropriations Act, 2021.

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

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 H.R. 8476 - TIKES Act -Blunt Rochester - telehealth coverage in Medicaid H.R. 8505 - To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule - Burgess - Medicare physician fee schedule H.R. 8525 - Expanded Genetic Screening Act of 2020 - Speier - Medicaid coverage of non-invasive prenatal genetic screening H.R. 8529 - Protecting Access to Affordable Medicines Act of 2020 - Butterfield - rebates under the Medicaid program for certain noninnovator multiple source drugs H.R. 8546 - Fair Drug Prices for Kids Act -Wild - Medicaid drug rebate program in CHIP H.R. 8558 - Comprehensive Breast Reconstruction Act of 2020 - Hastings - extends coverage of certain breast reconstructive services following mastectomy under the Medicare and Medicaid programs H.R. 8561 - Restoring Fairness to Medicaid Reimbursement Act of 2020 - Johnson - FMAP H.R. 8574 - PROTECT Long Term Care Facilities Act -Sherrill - long term care in COVID-19 H.R. 8586 - Medicaid Coverage for Addiction Recovery Expansion Act -Foster - Substance Use Disorder H.R. 8623 - SAVE for Seniors Act - Spanberger - Medicare coverage of COVID-19 vaccines H.R. 8624 - Protecting Access to Innovation During COVID-19 Act - Wenstrup - extension of pass-through status under the Medicare program H.R. 8702 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 -Bera - part B Medicare payments during COVID H.R. 8725 - HAPI Act - Soto - Medicaid Coverage of adult vaccines H.R. 8727 - Telehealth Modernization Act - Carter - Medicare telehealth payments H.R. 8755 - Expanded Telehealth Access Act -Sherrill - Medicare telehealth coverage H.R. 8756 - COVID Health Care Provider Assurance Act of 2020 - Riggleman - Medicare Part B payments during COVID-19 H.R. 8826 - The Resetting the Impact Act (TRIA) of 2020 - Sewell - amends the IMPACT Act of 2014 H.R. 8840 - Medicare Sequester COVID Moratorium Act - Schneider - extend temporary Medicare sequestration H.R. 8871 - COVID HCBS Relief Act of 2020 - Dingell - funding for state Medicaid programs HCBS H.R. 8934 - Community Integration Act of 2020 - Cartwright - Medicaid HCBS H.R. 8958 - Supporting Best Practices for Healthy Moms Act - Kelly - guidance for state Medicaid programs on maternal health H.R. 9002 - To amend title XIX of the Social Security Act to provide States an option to cover a children's program of all-inclusive coordinated care (ChiPACC) under Medicaid program - DeGette - Childrens health under Medicaid H.R. 9006 - To amend title XIX of the Social Security Act to provide for coverage under the Medicaid program under such title of routine patient costs associated with participation in certain clinical trials - Garcia - Medicaid coverage of clinical trials H.R. 9035 - Permanency for Audio-Only Telehealth Act - Smith - Audio only telehealth in Medicare 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 - Maternal Immunization Enhancement Act - Hassan - Medicaid and maternal health S. 4705 - Maternal Immunization Coverage Act - Cassidy - Medicaid coverage S. 4717 - Accelerating Kids Access to Care Act - Grassley - Medicaid enrollment S. 4742 - CLINICAL TREATMENT Act - Burr - Medicaid coverage S. 4825 - Ensuring Access to COVID-19 Vaccines for Seniors Act - Reed - Medicare coverage of COVID-19 vaccines S. 4840 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 -Roberts - audio-only risk adjustment in Medicare Advantage S. 4859 - Connected MOM Act - Cassidy - expanded coverage of remote physiologic devices and related services under Medicaid S. 4864 - HAPI Act - Brown - Medicaid coverage of adult vaccines S. 4944 - Equality in Medicare and Medicaid Treatment Act of 2020 - Booker - CMMI models for SDOH in Medicare/Medicaid S. 4949 - Supporting Best Practices for Healthy Moms Act - Toomey - guidance for state Medicaid programs on maternal health S. 4957 - COVID HCBS Relief Act of 2020 - Casey - funding for state Medicaid programs HCBS S. 5007 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 - Boozman - increase in Medicare part B payment S. 5044 - Bill to amend title XVIII of the SSA to establish requirement with respect to the use of prior authorization under the Medicare Advantage plans - Brown - Prior authorization S. 5077 - A bill to amend title XIX of the Social Security Act to adjust the limitations on Medicaid disproportionate share hospital payments - Cornyn - Medicaid DSH payments 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 removal of safe harbor protection for rebates; 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; issues related to changes to prior authorization regulations, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; issues related to health insurance tax for MA and Part D plans; implications of physician fee schedule on MA; 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 health plan models; 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: $2,400,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Council of Economic Advisers (CEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, Treasury, Dept of, White House Office

HR 6663, Truth in Health Care Marketing Act P.L. 111-148 Affordable Care Act, modifications: 1. Reducing regulatory/costly burdens on medical practices - relief from regulatory burdens 2. Preserving patient access to office ancillary testing services Meaningful Use/EHR program issues P.L. 113-54, Drug Quality & Security Act, all sections Medicare Advantage plan network adequacy Prior authorization utilization policies Medicare Part B Drug Price Issues Medicare Access and CHIP Reauthorization Act (P.L. 114-10) Implementation Issues Proposed Contact Lens Rule Modifications Medicare Physician Payment Issues Drug Pricing and Shortages Issues S. 2020, SEE MORE ACT Vision Research Funding Medical Surprise Billing Legislative proposals HR 3107, Improving Seniors' Timely Access to Care Act HR 3975, Contact Lens Prescription Verification Modernization Act S. 4613, Contact Lens Rule Modernization Act HR 2279/S.2546, Safe Step Act HR 4665, The Medicare Vision Act HR 3, Elijah Cummings Lower Drug Cost Now Act Coronavirus Pandemic Relief Measures HR 6365/S.3559 Immediate Relief for Rural Facilities and Providers Act HR 7059, Coronavirus Provider Protection Act HR 2620, Faster Treatments and Cures for Eye Diseases Act HR 7819, Eliminating the Provider Relief Fund Tax Penalties Act S. 4295, Public Health Emergency Pass-Through Payment Fairness Act HR 8624, Protecting Access to Innovation During COVID-19 Act S.4932, the Medicare Reimbursement Equity Act HR 8702/S. 5007, the Holding Providers Harmless From Medicare Cuts During COVID-19 Act HR 8505, a bill to waive budget neutrality requirements of the Medicare Physician Fee Schedule H.R. 8709, the Analyzing Kinetic Impact Projectiles (KIPs) Against Americans Act

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

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

Childrens Health Insurance Program (CHIP); Implementation of P.L. 114-10, Medicare Access and CHIP Reauthorization Act of 2015; Medicaid (general); Medicare (general); Telemedicine reimbursement (general); Medicare reimbursement (general); Health Care Reform (general); Medicaid DSH Payments (general); CY2021 Physician Fee Schedule E/M Global Codes; Medicaid Fiscal Accountability Regulation (general); Durable Medical Equipment (general); Maternal Mortality and Morbidity (general); COVID-19 Response (general) H.R. 4996, Helping MOMS Act; Extending Medicaid coverage to 12 months postpartum; H.R.8505, to amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes; H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020.

Client expense: $147,955 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Indian Health Service, Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), U.S. Agency for International Development (USAID), Veterans Affairs, Dept of (VA), White House Office

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

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

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

HR 133 Consolidate Appropriations Act of 2020:Oppose Medicare financial relief that excludes certain primary care service. HR 6149/S. 4088 - Kids Access to Primary Care Act/Ensuring Access to Primary Care for Women and Children Act: Increase Medicaid payment rates for primary care. HR 6837/S 3750: Medicare Accelerated and Advance Payments Improvement Act of 2020: Advanced payments to Medicare Part B providers. HR 7663/S 4230 - Expansion of telehealth; Protecting Access to Post-COVID-19 Telehealth Act: Expansion of telehealth services for primary care; coverage and payment parity during PHE. H.R. 8061- Community Immunity During COVID-19 Act: Support grants to increase the rates of recommended immunizations. HR 8337 - Continuing Appropriations Act 2021 and Other Extensions Act: Extension of THCGMEs, Medicare Accelerated Payments. HR 8505 - To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes: Support temporary waiver of Medicare budget neutrality to provide financial relief to physicians impacted by COVID-19. HR 8623/S 4864 - Securing Affordable Vaccines Equally (SAVE) for Seniors Act of 2020-Ensure Medicare and Medicaid coverage of COVID-19 vaccine and all recommended immunizations without cost-sharing. HR 8702 - Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020 : Oppose Medicare financial relief that excludes certain primary care services. P.L. 116-123 - CORONAVIRUS PREPAREDNESS AND RESPONSE SUPPLEMENTAL APPROPRIATIONS ACT, 2020: Ensure primary care physicians have adequate supplies, finances to serve their patients, are eligible for loans, payment for telehealth services. P.L. 116-136 - CARES Act: Ensure primary care physicians have adequate supplies, finances to serve their patients, are eligible for Small Business loans, payment for telehealth services. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No. - Medicare administrative flexibilities for physicians: Suspension of reporting requirements and administrative processes for Medicare physicians during PHE. No Bill No. - Issues related to increase immunization utilization/distribution: Efforts to support children and adults securing needed immunizations.

Client expense: $701,260 · Firm income: Not reported

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: Prior Authorization Requirements in Medicare and Medicaid Advantage -- H.R. 913 / S. 4742 - Medical Treatment Act: Coverage by Medicaid of clinical trials -- H.R. 133 - Consolidated Appropriations Act, 2021; H.R. 8702 / S. 5007 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020; H.R. 8505 - To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes: Medicare Evaluation and Management Visits - Addressing the impact of E/M services updates on the future of the conversion factor and the payments for other Medicare services; discussions of various policy change proposals to address the budget neutrality of these payment changes

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

-- H.R. 3107 - Improving Seniors' Timely Access to Care Act of 2019: Prior authorization requirements in Medicare and Medicaid Advantage -- H.R. 1763 / S. 348 - The Resident Physician Shortage Reduction Act of 2019: Graduate Medical Education -- H.R. 8505 - A bill to prevent pending Medicare payment cuts by waiving the budget neutrality requirements; H.R. 8702 / S. 5007 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020; H.R. 133 - Consolidated Appropriations Act, 2021: Medicare Evaluation and Management Visits: Addressing the impact of E/M services updates on the future of the conversion factor and the payments for the other Medicare services; discussions of various policy change proposals to address the budget neutrality of these payment changes

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

regulation and oversight of clinical laboratories, including laboratory developed test services and pharmacogenetic testing, the Diagnostic Accuracy and Innovation Act discussion draft and Verifying Accurate, Leading-edge IVCT Development Act discussion draft; reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, TRICARE coverage and reimbursement, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); narrowing the in-office ancillary services exception to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy; Medicare physician signature documentation requirements; National Diabetes Prevention Program; commercial laboratory surge capacity issues for response to pandemic/epidemic/public health crises, Anti-Kickback Law relating to clinical laboratories, surprise billing issues relating to clinical laboratory and ancillary providers. Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, FY2020; Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, FY2020; Medicare reimbursement of clinical laboratory services; SUPPORT for Patients and Communities Act (PL 115-271), H.R. 3584/S. 3049 Laboratory Access for Beneficiaries Act, H.R. 3630 No Surprises Act, S. 1895 Lower Health Care Costs Act, S. 1531 Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019, S. 1266 Protecting Patients from Surprise Medical Bills Act, H.R. 3502 Protecting People from Surprise Medical Bills Act, H.R. 861 End Surprise Billing Act of 2019, H.R. 2328 Reauthorizing and Extending Americas Community Health Act, H.R. 3107 Improving Seniors' Timely Access to Care Act of 2019, H.R. 2143 Promoting Integrity in Medicare Act of 2019, H.R. 269 Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019, S. 1379 Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019, H.R. 3055 Commerce, Justice, Science, Agriculture, Rural Development, Food and Drug Administration, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2020, H.R. 2740 Labor, Health and Human Services, Education, Defense, State, Foreign Operations, and Energy and Water Development Appropriations Act, 2020, H.R. 4378 Continuing Appropriations Act, 2020, and Health Extenders Act, H.R. 3055 Further Continuing Appropriations Act, 2020, and Further Health Extenders Act of 2019, H.R. 1158 Consolidated Appropriations Act, 2020, H.R. 1865 Further Consolidated Appropriations Act, 2020. COVID-19 Pandemic Crisis Response, including COVID-19 laboratory capacity and testing, PL 116-123 Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020, PL 116-127 Families First Coronavirus Response Act, PL 116-136 Coronavirus AID, Relief, and Economic Security Act (CARES Act/H.R. 748/S.3548), PL 116-139 Paycheck Protection Program and Health Care Enhancement Act, H.R.6800 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, H.R.6585 - Equitable Data Collection and Disclosure on COVID-19 Act, S.3850 - Equitable Data Collection and Disclosure on COVID-19 Act, S.4198 - A bill to require health plans to provide coverage for COVID-19 serology testing, H.R.7667 - Commerce, Justice, Science, and Related Agencies Appropriations Act, 2021, H.R.7610 - Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2021, H.R.7614 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2021, H.R.7615 - To provide a payroll tax credit for certain expenses associated with protecting employees from COVID-19, H.R.7658 - To provide a payroll tax credit for certain costs of providing employees with testing for COVID-19, S.4214 - A bill to provide a payroll tax credit for certain expenses associated with protecting employees from COVID-19, S.4198 - Affordable Coronavirus Testing Act, H.R. 925 - Updated Heroes Act, S.178 - Uighur Intervention and Global Humanitarian Unified Response Act of 2019, S.4318 - American Workers, Families, and Employers Assistance Act, S.4322 - Safely Back to School and Back to Work Act, S.4740 - Public Health Infrastructure Saves Lives Act, H.R.8337 - Continuing Appropriations Act, 2021 and Other Extensions Act, H.R.133 Consolidated Appropriations Act, 2021, H.R.8900 Further Continuing Appropriations Act, 2021, and Other Extensions Act, H.R.1520 Further Extension of Continuing Appropriations Act, 2021, H.R. 925 Updated Heroes Act, H.R.8496 SPEEDY COVID-19 Tests Act, S.4198 Affordable Coronavirus Testing Act, S.4740 Public Health Infrastructure Saves Lives Act, H.R.8505 To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes., H.R.8702 Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020.

Client expense: $450,946 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

regulation and oversight of clinical laboratories, including laboratory developed test services and pharmacogenetic testing, the Diagnostic Accuracy and Innovation Act discussion draft and Verifying Accurate, Leading-edge IVCT Development Act discussion draft; reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, TRICARE coverage and reimbursement, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); narrowing the in-office ancillary services exception to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy; Medicare physician signature documentation requirements; National Diabetes Prevention Program; commercial laboratory surge capacity issues for response to pandemic/epidemic/public health crises, Anti-Kickback Law relating to clinical laboratories, surprise billing issues relating to clinical laboratory and ancillary providers. Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, FY2020; Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, FY2020; Medicare reimbursement of clinical laboratory services; SUPPORT for Patients and Communities Act (PL 115-271), H.R. 3584/S. 3049 Laboratory Access for Beneficiaries Act, H.R. 3630 No Surprises Act, S. 1895 Lower Health Care Costs Act, S. 1531 Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019, S. 1266 Protecting Patients from Surprise Medical Bills Act, H.R. 3502 Protecting People from Surprise Medical Bills Act, H.R. 861 End Surprise Billing Act of 2019, H.R. 2328 Reauthorizing and Extending Americas Community Health Act, H.R. 3107 Improving Seniors' Timely Access to Care Act of 2019, H.R. 2143 Promoting Integrity in Medicare Act of 2019, H.R. 269 Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019, S. 1379 Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019, H.R. 3055 Commerce, Justice, Science, Agriculture, Rural Development, Food and Drug Administration, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2020, H.R. 2740 Labor, Health and Human Services, Education, Defense, State, Foreign Operations, and Energy and Water Development Appropriations Act, 2020, H.R. 4378 Continuing Appropriations Act, 2020, and Health Extenders Act, H.R. 3055 Further Continuing Appropriations Act, 2020, and Further Health Extenders Act of 2019, H.R. 1158 Consolidated Appropriations Act, 2020, H.R. 1865 Further Consolidated Appropriations Act, 2020. COVID-19 Pandemic Crisis Response, including COVID-19 laboratory capacity and testing, PL 116-123 Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020, PL 116-127 Families First Coronavirus Response Act, PL 116-136 Coronavirus AID, Relief, and Economic Security Act (CARES Act/H.R. 748/S.3548), PL 116-139 Paycheck Protection Program and Health Care Enhancement Act, H.R.6800 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, H.R.6585 - Equitable Data Collection and Disclosure on COVID-19 Act, S.3850 - Equitable Data Collection and Disclosure on COVID-19 Act, S.4198 - A bill to require health plans to provide coverage for COVID-19 serology testing, H.R.7667 - Commerce, Justice, Science, and Related Agencies Appropriations Act, 2021, H.R.7610 - Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2021, H.R.7614 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2021, H.R.7615 - To provide a payroll tax credit for certain expenses associated with protecting employees from COVID-19, H.R.7658 - To provide a payroll tax credit for certain costs of providing employees with testing for COVID-19, S.4214 - A bill to provide a payroll tax credit for certain expenses associated with protecting employees from COVID-19, S.4198 - Affordable Coronavirus Testing Act, H.R. 925 - Updated Heroes Act, S.178 - Uighur Intervention and Global Humanitarian Unified Response Act of 2019, S.4318 - American Workers, Families, and Employers Assistance Act, S.4322 - Safely Back to School and Back to Work Act, S.4740 - Public Health Infrastructure Saves Lives Act, H.R.8337 - Continuing Appropriations Act, 2021 and Other Extensions Act, H.R.133 Consolidated Appropriations Act, 2021, H.R.8900 Further Continuing Appropriations Act, 2021, and Other Extensions Act, H.R.1520 Further Extension of Continuing Appropriations Act, 2021, H.R. 925 Updated Heroes Act, H.R.8496 SPEEDY COVID-19 Tests Act, S.4198 Affordable Coronavirus Testing Act, S.4740 Public Health Infrastructure Saves Lives Act, H.R.8505 To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes., H.R.8702 Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020.

Client expense: $450,946 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

commercial laboratory surge capacity issues for response to pandemic/epidemic/public health crises; H.R. 269 Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019, S. 1379 Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019, COVID-19 Pandemic Crisis Response, including COVID-19 laboratory capacity and testing, PL 116-123 Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020, PL 116-127 Families First Coronavirus Response Act, PL 116-136 Coronavirus AID, Relief, and Economic Security Act (CARES Act/H.R. 748/S.3548), PL 116-139 Paycheck Protection Program and Health Care Enhancement Act, H.R.6800 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, H.R.6585 - Equitable Data Collection and Disclosure on COVID-19 Act, S.3850 - Equitable Data Collection and Disclosure on COVID-19 Act, S.4198 - A bill to require health plans to provide coverage for COVID-19 serology testing, H.R.7667 - Commerce, Justice, Science, and Related Agencies Appropriations Act, 2021, H.R.7610 - Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2021, H.R.7614 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2021H.R.7615 - To provide a payroll tax credit for certain expenses associated with protecting employees from COVID-19, H.R.7658 - To provide a payroll tax credit for certain costs of providing employees with testing for COVID-19, S.4214 - A bill to provide a payroll tax credit for certain expenses associated with protecting employees from COVID-19, S.4198 - Affordable Coronavirus Testing Act, H.R. 925 - Updated Heroes Act, S.178 - Uighur Intervention and Global Humanitarian Unified Response Act of 2019, S.4318 - American Workers, Families, and Employers Assistance Act, S.4322 - Safely Back to School and Back to Work Act, S.4740 - Public Health Infrastructure Saves Lives Act, H.R.8337 - Continuing Appropriations Act, 2021 and Other Extensions Act, H.R.133 Consolidated Appropriations Act, 2021, H.R.8900 Further Continuing Appropriations Act, 2021, and Other Extensions Act, H.R.1520 Further Extension of Continuing Appropriations Act, 2021, H.R. 925 Updated Heroes Act, H.R.8496 SPEEDY COVID-19 Tests Act, S.4198 Affordable Coronavirus Testing Act, S.4740 Public Health Infrastructure Saves Lives Act, H.R.8505 To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes., H.R.8702 Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020.

Client expense: $450,946 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); narrowing the in-office ancillary services exception to the federal self-referral statute to remove anatomic pathology, advanced diagnostic imaging, physical therapy, and radiation therapy; Medicare physician signature documentation requirements; Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, FY2020; Medicare reimbursement of clinical laboratory services; H.R. 3584/S. 3049 Laboratory Access for Beneficiaries Act, H.R. 3107 Improving Seniors' Timely Access to Care Act of 2019, H.R. 2143 Promoting Integrity in Medicare Act of 2019, H.R. 3055 Commerce, Justice, Science, Agriculture, Rural Development, Food and Drug Administration, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2020, H.R. 2740 Labor, Health and Human Services, Education, Defense, State, Foreign Operations, and Energy and Water Development Appropriations Act, 2020, H.R. 4378 Continuing Appropriations Act, 2020, and Health Extenders Act, H.R. 3055 Further Continuing Appropriations Act, 2020, and Further Health Extenders Act of 2019, H.R. 1158 Consolidated Appropriations Act, 2020, H.R. 1865 Further Consolidated Appropriations Act, 2020. COVID-19 Pandemic Crisis Response, including COVID-19 laboratory capacity and testing, PL 116-123 Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020, PL 116-127 Families First Coronavirus Response Act, PL 116-136 Coronavirus AID, Relief, and Economic Security Act (CARES Act/H.R. 748/S.3548), PL 116-139 Paycheck Protection Program and Health Care Enhancement Act, H.R.6800 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, H.R.6585 - Equitable Data Collection and Disclosure on COVID-19 Act, S.3850 - Equitable Data Collection and Disclosure on COVID-19 Act, S.4198 - A bill to require health plans to provide coverage for COVID-19 serology testing, H.R.7667 - Commerce, Justice, Science, and Related Agencies Appropriations Act, 2021, H.R.7610 - Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2021, H.R.7614 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2021, H.R.133 Consolidated Appropriations Act, 2021, H.R.8900 Further Continuing Appropriations Act, 2021, and Other Extensions Act, H.R.1520 Further Extension of Continuing Appropriations Act, 2021, H.R. 925 Updated Heroes Act, H.R.8496 SPEEDY COVID-19 Tests Act, S.4198 Affordable Coronavirus Testing Act, S.4740 Public Health Infrastructure Saves Lives Act, H.R.8505 To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes., H.R.8702 Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020.

Client expense: $450,946 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

surprise billing issues relating to clinical laboratory and ancillary providers, H.R. 3630 No Surprises Act, S. 1895 Lower Health Care Costs Act, S. 1531 Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019, S. 1266 Protecting Patients from Surprise Medical Bills Act, H.R. 3502 Protecting People from Surprise Medical Bills Act, H.R. 861 End Surprise Billing Act of 2019, H.R. 2328 Reauthorizing and Extending Americas Community Health Act, H.R. 3107 Improving Seniors' Timely Access to Care Act of 2019.COVID-19 Pandemic Crisis Response, including COVID-19 laboratory capacity and testing, PL 116-123 Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020, PL 116-127 Families First Coronavirus Response Act, PL 116-136 Coronavirus AID, Relief, and Economic Security Act (CARES Act/H.R. 748/S.3548), PL 116-139 Paycheck Protection Program and Health Care Enhancement Act, H.R.6800 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, H.R.6585 - Equitable Data Collection and Disclosure on COVID-19 Act, S.3850 - Equitable Data Collection and Disclosure on COVID-19 Act, S.4198 - A bill to require health plans to provide coverage for COVID-19 serology testing, H.R.7667 - Commerce, Justice, Science, and Related Agencies Appropriations Act, 2021, H.R.7610 - Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2021, H.R.7614 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2021, H.R.7615 - To provide a payroll tax credit for certain expenses associated with protecting employees from COVID-19, H.R.7658 - To provide a payroll tax credit for certain costs of providing employees with testing for COVID-19, S.4214 - A bill to provide a payroll tax credit for certain expenses associated with protecting employees from COVID-19, S.4198 - Affordable Coronavirus Testing Act, H.R. 925 - Updated Heroes Act, S.178 - Uighur Intervention and Global Humanitarian Unified Response Act of 2019, S.4318 - American Workers, Families, and Employers Assistance Act, S.4322 - Safely Back to School and Back to Work Act, S.4740 - Public Health Infrastructure Saves Lives Act, H.R.8337 - Continuing Appropriations Act, 2021 and Other Extensions Act, H.R.133 Consolidated Appropriations Act, 2021, H.R.8900 Further Continuing Appropriations Act, 2021, and Other Extensions Act, H.R.1520 Further Extension of Continuing Appropriations Act, 2021, H.R. 925 Updated Heroes Act, H.R.8496 SPEEDY COVID-19 Tests Act, S.4198 Affordable Coronavirus Testing Act, S.4740 Public Health Infrastructure Saves Lives Act, H.R.8505 To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes., H.R.8702 Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020.

Client expense: $450,946 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 8505 - To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes; H.R. 8702 / S. 5007 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020; H.R. 133 - Consolidated Appropriations Act, 2021: Addressing the impact of Evaluation and Management Services updates on the future of the conversion factor and the payments for other Medicare services; discussions of various policy change proposals to address the budget neutrality of these payment changes

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 4932, the Medicare Reimbursement Equity Act: legislation to require CMS to value the E/M portion of the global codes equal to the stand-alone E/M codes S. 5007, Holding Providers Harmless From Medicare Cuts During COVID-19 Act: legislation to prevent Medicare cuts 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. 8505, to waive Medicare's budget neutrality requirements when new office visit code values are implemented in 2021 H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act: legislation to prevent Medicare cuts H.R. 133, Consolidated Appropriations Act, 2021: COVID-19 relief, including additional financial support for physician practices, medical liability protections, suspending Medicares budget neutrality requirements, enhanced telemedicine, prior authorization relief, graduate medical education funds, ban on surprise medical bills

Client expense: $35,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 4932, the Medicare Reimbursement Equity Act: legislation to require CMS to value the E/M portion of the global codes equal to the stand-alone E/M codes S. 5007, Holding Providers Harmless From Medicare Cuts During COVID-19 Act: legislation to prevent Medicare cuts H.R. 133, Consolidated Appropriations Act, 2021: COVID-19 relief, including additional financial support for physician practices, medical liability protections, suspending Medicares budget neutrality requirements, enhanced telemedicine, prior authorization relief, graduate medical education funds, ban on surprise medical bills 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. 8505, to waive Medicare's budget neutrality requirements when new office visit code values are implemented in 2021 H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act: legislation to prevent Medicare cuts

Client expense: $35,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

No bill: Support inclusion of occupational therapy services via telehealth under Medicare Part B, Medicare Advantage and any demonstration programs such as telehealth within accountable care organizations. HR 3127/S 1725 - The Home Health Flexibility Act: Support the ability of occupational therapists to conduct the initial and comprehensive assessments for Medicare Home Health cases. No bill: Support for Congressional attention to the issue of falls related injuries and falls prevention. HR 4932/S 2741 - CONNECT for Health Act of 2019: Support expanded coverage for services provided to Medicare patients via telehealth, including occupational therapy and other therapy services. HR 1329 - Medicaid Reentry Act (mental health and Medicaid policy): Support passage S 1754/HR 3215 - The Disaster Relief Medicaid Act (DRMA): Support passage No bill: Support for Medicare payment for evidence-based programs, led by occupational therapists, that support caregivers for people with dementia. No bill: Support for Medicare payment for evidence-based programs, led by occupational therapists, to support aging in place. S 1202 - Independence At Home Act: support passage HR 7154 - Outpatient Therapy Modernization and Stabilization Act: Support passage. HR 6634 - Emergency COVID Telehealth Response Act: Support introduction and passage. S. 4375/HR 8727 - Telehealth Modernization Act: Advocate for provisions that would allow the Secretary of Health and Human Services to permanently add occupational therapy practitioners to the Medicare telehealth benefit. Support passage. Support various House and Senate proposals to extend and make permanent the Public Health Emergency provisions that enable occupational therapists to provide services to Medicare patients via telehealth. HR 8755-Expanded Telehealth Access Act: Support passage of bill that would allow occupational therapists and other therapists to provide services to Medicare Part B Patients via telehealth after public health emergency ends. S 4343/HR 8581-Triple A Study Bill: advocate to add occupational therapists to list of providers included in legislation mandating study of amputee healthcare. H.R. 133 - Consolidated Appropriations Act of 2021, Division CC Section 115: Advocate to permit occupational therapists to conduct the initial assessment visit and complete the comprehensive assessment with respect to certain rehabilitation services for home health agencies under the Medicare Part B program. HR 8702/S. 5007 - Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020; Division CC Section 113 of HR 133-Consolidated Appropriations Act, 2021; and HR 8505-a bill to provide a one year waiver of budget neutrality under the Medicare physician fee schedule: Advocate for changes to evaluation and management coding redistribution in Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2021 (CMS-1734-F). No bill: Advocated to pause Medicare sequestration for 2021.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3988: The Enhancing Preparedness Through Telehealth Act; all provisions. S. 2741/ H.R. 4932: CONNECT for Health Act; all provisions. S. 5007/ H.R. 8702: The Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 S. 5044/ H.R. 3107: Improving Seniors' Timely Access to Care Act; all provisions. H.R. 133: The Consolidated Appropriations Act, 2021, Division CC Health Care Extenders. H.R. 7391, The Protect Telehealth Access Act; all provisions. H.R. 7663: Protecting Access to Post-COVID-19 Telehealth Act; all provisions. H.R. 8505: To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes; all provisions. Supporting the implementation of CMSs final rule on Evaluation and Management (E/M) billing codes. Supporting policies to address the COVID-19 pandemic, including expanding telemedicine, support for physician practices, and regulatory relief. Supporting a permanent expansion of telehealth in Medicare, including eliminating on originating site and geographic restrictions. Supporting policies to address prescription drug costs, including supporting direct negotiation in Medicare, improving drug pricing transparency, extending negotiated Rx discounts to be passed through to patients cost-sharing requirements, and capping beneficiary out-of-pocket costs in Medicare Part D. Issues associated with Qualified Clinical Data Registry implementation, measures, and interoperability. Improvements to the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. Medicare coverage of oxygen therapy for cluster headaches. Advocating for reform to stark and anti-kickback laws to promote value-based payment arrangements. Opposing Most Favored Nation Model for Medicare Part B Drugs and Biologicals. Supporting extending moratorium on Medicare sequestration cuts.

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

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

Medicare Access and CHIP Reauthorization Act of 2015 implementation, Medicare physician payment reform, MEDPAC, surgical global payments, ACA implementation, health care reform, health care quality improvement, physician workforce issues, comparative clinical effectiveness research, health information technology, EHR meaningful use, EHR data blocking, Patient-Centered Outcomes Research Institute, MEDCAC, Centers for Medicare & Medicaid Innovation, registry access to Medicare claims data, lung cancer screenings, Agency for Healthcare Research & Quality, graduate medical education, electronic cigarette and cigar regulation, PTAC, meaningful use, congenital heart disease funding, unique device identifiers, medical liability reform, COVID-19 pandemic, tobacco riders in appropriations bills, tobacco regulation in the FDA, price transparency, ECMO coding, Prohibit Smoking in VA Facilities Act (S.2106/HR3700) Resident Physician Shortage Reduction Act (S.348/HR1763), Congenital Heart Futures Reauthorization Act, surprise billing, prior authorization, Women and Lung Cancer Research and Preventive Services Act (S.1107/HR2222), T21 bills, Transcatheter aortic valve replacement (TAVR), Increasing Access to Quality Cardiac Rehabilitation Act (HR.3911), Smoke-Free Schools Act of 2019 (HR.4019/S.1832), Protection for Veterans Burn Pits Exposure Act (HR.4086), The Coronavirus Aid, Relief, and Economic Security Act (H.R.748), Coronavirus Provider Protection Act (H.R.7059), Resident Physician Shortage Reduction Act of 2019 (S. 348/H.R. 1763), Quit Because of COVID-19 Act (H.R.7286), Tobacco to 21 Act (S.1258/H.R.2411), The Local Chamber, Tourism, and 501(c)(6) Protection Act (H.R.6697), Immediate Relief for Rural Facilities and Providers Act (S.3559/H.R.6365), Reversing the Youth Tobacco Epidemic Act of 2019 (H.R.2339), Vaccines Act of 2019 (H.R.2862), Investment in Tomorrow's Pediatric Health Care Workforce Act (S.2443), Protecting People from Surprise Medical Bills Act (H.R.3502), Stopping Appealing Flavors in E-Cigarettes for Kids Act (H.R.1498), Resident Education Deferred Interest (REDI) Act (H.R.1554), Improving Access to Medicare Coverage Act (H.R.1682), Traditional Cigar Manufacturing and Small Business Jobs Preservation Act of 2019 (H.R.1854), Women & Lung Cancer Research & Preventive Services Act (H.R.2222), Prevent BLEEDing Act of 2019 (H.R.2550), Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act (H.R.2781), PCORI Reauthorization (H.R.3030), Improving Seniors Timely Access to Care Act (H.R.3107), Keep Physicians Serving Patients Act (H.R.3302), Stopping Appealing Flavors in E-Cigarettes for Kids Act (S.655), Improving Access to Medicare Coverage Act (S.753), Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (H.R. 8702/S.5007), Medicare Reimbursement Equity Act of 2020 (S.4932), To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes (H.R. 8505)

Client expense: $86,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged support for H.R. 8505, a bill to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule; Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases, along with GPC1X codes to go into effect. Administrative Tasks on Physicians and Patients: Congress should accelerate its efforts to reduce administrative burdens on clinicians and patients, including: streamlining the prior authorization process, better integrating clinical data into clinicians electronic health records (EHRs), and working with CMS in their effort to overhaul clinical documentation guidelines; Urged Congress to cosponsor and pass the Safe Step Act (H.R. 2279), to require health insurers to provide an exceptions process for any medication step therapy protocol based on clinical decision-making, medical necessity, and other patient needs. Prescription Drug Costs: The College advocated for greater transparency in drug pricing, the elimination of anti-competitive industry practices that create barriers to generics coming to market, the importance of accounting for value in payment and coverage for prescriptions, and providing authority to the federal government to negotiate drug discounts under the Medicare Part D program. Specifically, the College urged Congress to pass the Medicare Prescription Drug Price Negotiation Act of 2019 (H.R. 275/S. 62), which allows the Secretary of Health and Human Services to negotiate covered Part D drug prices on behalf of Medicare beneficiaries, and the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2019, (H.R. 965/S. 340), which would improve patient access to alternative low-cost prescription drugs and biological products by preventing prescription drug manufacturers from misusing the FDAs Risk Evaluation and Mitigation Strategies (REMS) process to make it difficult for competing generics to be brought to the market. Also urged that Congress pass the Reforming Evergreening and Manipulation that Extends Drug Years, REMEDY Act (S. 1209), to aid in the approval of more generic drug applications by the FDA and therefore improve patient access to those medications. Also urged that Congress pass the Prescription Drug STAR Act (H.R. 2113), and the Fair Accountability and Innovative Research (FAIR) Drug Pricing Act (H.R. 2296/S. 1391), to promote greater drug pricing transparency; Expressed appreciation to the House speaker for introduction of H.R. 3, the Lower Drug Costs Now Act, noting encouragement for its provisions to empower the Secretary of Health and Human Services (HHS) to negotiate with drug companies for lower prices and to cap out-of-pocket costs for seniors enrolled in the Medicare Part D program. Commented to the FDA on its prescription drug reimportation proposed rule noting that while the College is generally supportive of drug importation as laid out in the proposed rule as a means to control the cost of prescription drugs, the FDA must guarantee that the design and implementation of the rule includes numerous measures and safeguards to ensure patient safety. By limiting the origin of imported drugs to Canadian-certified and FDA-approved and registered drugs and entities, the College believes the proposed rule meets the required U.S. standards to assure high-quality drugs and patient safety. Any final drug importation system must also be one that is a closed system and has a tightly controlled and documented supply chain to assure authenticity and avoid degradation of the drug. Workforce, Medical and Health Services Research, Public Health Initiatives: Congress should ensure funding in FY 2021 for federal programs/initiatives designed to support primary care including Title VII Health Professions grants and the National Health Service Corps (NHSC). Equally important is the need to fund essential health services and medical research by the Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health (NIH) and public health programs supported by the Centers for Disease Control and Prevention (CDC). Firearms-Related Injury and Death: The College advocated for lawmakers to pass measures to strengthen the criminal background check system, ban assault weapons and high capacity magazines, prevent the unlawful transfer of firearms to those who cannot legally purchase them, and remove restrictions on, and provide dedicated funding for, research by federal agencies on prevention of firearms-related injuries and death. Specifically, the College urged passage of the Bipartisan Background Checks Act of 2019 (H.R. 8), which would strengthen the accuracy and reporting of the National Instant Criminal Background Check System (NICS) as well as expand Brady background checks to cover all firearm sales, including unlicensed firearms sellers currently not required to use background checks, and the Gun Violence Prevention Research Act (H.R. 674/S. 184), which would authorize funding for the Centers for Disease Control and Prevention (CDC) to study firearms safety and gun violence prevention. Also urged Congress to pass the Violence Against Women (VAWA) Reauthorization Act of 2019 (H.R. 1585), to provide protections for domestic violence victims by restricting access to firearms by those deemed a threat to them. Also urged Congress to pass the Assault Weapons Ban of 2019 (S. 66/H.R. 1296), to ban the sale of semi-automatic weapons and high capacity magazines. Immigration: The College advocated against family separation at the U.S. border. Specifically, the College urged support for H.R. 541 - the Keep Families Together Act, which would help ensure that children are not separated from their parents when families unlawfully cross over the border into the United States and would ensure that the Department of Homeland Security would not be able to implement the zero tolerance policy that separated families at the border last summer; urged congressional oversight of family separation policies. Also urged that Congress pass H.R. 6, the Dream and Promise Act of 2019, which would provide a pathway to U.S. citizenship for undocumented children who came to the United States due to the action of their parents, also known as Dreamers. Expressed concern to the U.S. Department of Homeland Security with the recent U.S. Citizenship and Immigration Service (USCIS) policy change to no longer accept or adjudicate non-military deferred action requests including those for individuals with serious medical conditions; Urged USCIS to reverse this decision immediately and resume consideration of deferred action requests for medical reasons; Opposed the proposed rule, U.S. Immigration and Customs Enforcement (ICE) Establishing a Fixed Time Period of Admission and an Extension of Stay Procedure for Nonimmigrant Academic Students, Exchange Visitors, and Representatives of Foreign Information Media. This rule would change the process to extend the period of authorized stay in the United States for certain categories of nonimmigrants by eliminating the long-standing "duration of status and replacing it with a specific end date. The College urged the Department of Homeland Security to exclude physicians in the Department of States (DOS) Exchange Visitor Program in J-1 visa status from this rule change because it will otherwise disrupt the training of thousands of physicians - physicians who already have been thoroughly vetted, already are serving on our nations health care teams, and already are carefully monitored during their time in the U.S. Graduate Medical Education: Urged that Congress support medical education training and debt relief for primary care physicians and other specialties facing shortages by passing the Resident Physician Shortage Reduction Act of 2019 (S. 348, H.R. 1763), to lift the GME caps as needed to permit training an adequate number of primary care physicians, including internal medicine specialists, and physicians in other specialties facing shortages; passing the Resident Education Deferred Interest Act (H.R. 1554), to save physicians in residency programs thousands of dollars in interest on their loans and help incentivize the opening of practices in underserved areas; pass legislation to combine DGME and IME into a single, more functional payment program, and broaden the GME financing structure to include all payers; support funding for GME/IME and programs within the Veterans Health Administration that provide graduate medical education to ensure that physicians are adequately trained with the skills needed to treat an aging population. Urged Congress to pass the Opioid Workforce Act of 2019 (H.R. 3414), which would provide Medicare support for an additional 1,000 graduate medical education (GME) positions over five years in hospitals that have, or are in the process of establishing, accredited residency programs in addiction medicine, addiction psychiatry, or pain medicine. Urged Congress to pass S. 1203 and H.R. 2441, the What You Can Do For Your Country Act, which would improve and reform the Public Service Loan Forgiveness (PSLF) Program. Vaccines: Urged Congress to pass the Vaccines Act (HR 2862), which would provide federal funding for vaccine hesitancy surveillance at the Centers for Disease Control and Prevention (CDC), and outline a national public messaging campaign informed by this research to help improve vaccination rates; Supported H.R. 592, recognizing the anniversary of the eradication of smallpox and the importance of vaccination in the United States and worldwide; Urged the U.S. Department of Homeland Security (DHS) to reconsider its decision to not vaccinate families in the custody of U.S. Customs and Border Protection (CBP) against influenza (flu). Urged Congress to support payments for vaccines, as finalized by CMS, and set for implementation on Jan. 1, 2021. Surprise Medical Billing: Urged Congress to pass legislation that would protect patients from surprise out-of-network medical bills in both emergency and non-emergency settings that includes the following principles: hold patients harmless from surprise medical bills for out-of-network services, address narrow insurance networks, abandon efforts to establish an in-network median rate for services in these settings and instead opt for an independent dispute resolution process to determine payment. Appropriations: Urged Congress to fund Title VII, Section 747, Primary Care Training and Enhancement (PCTE) at $71 million for fiscal year 2021; Fund the Agency for Health Care Research and Quality (AHRQ) at $460 million for fiscal year 2021; Fund the National Health Service Corps (NHSC) at $830 million for fiscal year 2021; Fund the Title X Family Planning Program at $400 million for fiscal year 2021 and include language to remove barriers to care that interfere with the patient-physician relationship; Fund Research on Prevention of Firearms-related Injuries and Deaths at $50 million for Fiscal Year 2021; Fund the National Institutes of Health (NIH) at $44.7 billion for fiscal year 2021; Fund the Centers for Disease Control and Prevention (CDC) at $8.3 billion for fiscal year 2021; Urged the House and Senate Armed Services Committees to support provisions in any final FY2021 National Defense Authorization Act to prevent cuts to the Military Health Service and the military medical workforce without requiring appropriate congressional oversight and review. Physician Fee Schedule: Commented to CMS and to Congress to fully implement payment increases for all evaluation and management codes, as finalized by CMS, and as scheduled for implementation on Jan. 1, 2021. Reduce the documentation burden for E/M services by allowing choice of medical decision making or time, and work to develop additional clarity and guidance on acceptable documentation to operationalize these important proposals; examination room desktop computers should be counted as a direct medical equipment cost; care management should be promoted by increasing the values of services like Transitional Care Management (TCM) and Chronic Care Management and implementing Principle Care Management (PCM) codes; require additional survey and review for any requests to increase non-outpatient E/M or other services; work with the physician community prior to finalizing any policy affecting eligibility to participate in the Medicare program; Urged congressional committees of jurisdiction to support: Higher physician work relative value units (RVUs) for new and established office visit codes, leading to increased payments for them, Reduced documentation requirements for office visit codes, which enables physicians to select and document for each visit based on medical decision-making or total time, Expanded and improved payment for care management services. Urged Congress to support waiving budget neutrality, applicable to the calendar year 2021 physician fee schedule. COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Urged the administration to explore regulatory and other actions that would make COVID-19 testing free-of-charge to patients covered by both public and private insurance plans, including ACA-compliant plans offered through the insurance exchanges, and to waive co-pays and deductibles for patients seeing physicians for symptoms that may be indicative of COVID-19 or who are hospitalized for treatment. Urged CMS to utilize a national disaster recovery program that would pay doctors 110% of Medicare rates for caring for uninsured patients who have been infected with SARS-CoV-2. Expressed support to Congress and the administration for the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged HHS and Congress to make a targeted allocation out of the Provider Relief Fund (PRF) to support primary care physicians and their practices, sufficient to keep their doors open, by offsetting lost revenue from the COVID-19 pandemic, similar to the targeted allocation for rural hospitals; Urged support for the Student Loan Forgiveness for Frontline Health Workers Act, H.R. 6720, introduced May 5, 2020 by Representative Carolyn B. Maloney (D-NY) which would eliminate graduate school debt for healthcare workers, including physicians and medical students, who are providing direct patient care in response to the COVID-19 pandemic; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. This extension-either continued by CMS or mandated by Congress-should last at least through the end of 2021, or until such a time when effective vaccines and treatments are widely available, with an option to extend it even further, or consider making permanent, based on the experience and learnings of patients and physicians who are utilizing these visits. Urged Congress to support a targeted allocation from the Provider Relief Fund specifically for primary care services. Priorities for New Administration: Urged the incoming Biden Administration to identify and appoint physicians to health care leadership positions within your Administration. Implement approval, distribution, and funding of a safe and effective COVID-19 vaccine based on recommendations from the Advisory Committee on Immunization Practices (ACIP). Provide support to physicians and other frontline health care workers, including ensuring access and distribution of personal protective equipment (PPE) to health care workers. Fund COVID-19 testing and contact tracing efforts. Reverse regulations that allow the sale of extended short-term, limited duration plans, association health plans. Take action to defend the Affordable Care Act from any litigation, including California v. Texas, that would undermine coverage and patient protections. Expand premium tax credits and cost-sharing reductions. Establish a federal public option to inject competition into the health insurance marketplace. Expand Medicaid eligibility and oppose expansion waivers that limit benefits and apply high cost sharing. Permanently increase payment for Medicaid primary care services to the level of Medicare. Restore the Deferred Action for Childhood Arrivals, consistent with a recent ruling from a federal judge, and identify executive actions that can be taken to ensure that it is not vulnerable to being eliminated in the future. Pursue executive actions to preserve the principles of patient autonomy regarding reproductive decision-making rights. Reverse the Title X gag rule and restore funding to family planning clinics. Establish universal access to at least six weeks of paid family and medical leave that is flexible to accommodate care for a diverse array of family structures, including updating the Family Medical and Leave Act to include grandparents or in-laws. Re-introduce and pass the George Floyd Act and other legislation focused on eliminating racism and police violence. Rejoin the Paris Agreement.

Client expense: $241,204 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS)

Considerations for Medicare reimbursement of physician evaluation and management services involving primary and cognitive care and domiciliary sites of service. Coronavirus Response and Relief Supplemental Appropriations Act, 2021 (H.R. 133). To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule (H.R. 8505). Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (H.R. 8702/S. 5007).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged support for H.R. 8505, a bill to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule; Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases, along with GPC1X codes to go into effect. Administrative Tasks on Physicians and Patients: Congress should accelerate its efforts to reduce administrative burdens on clinicians and patients, including: streamlining the prior authorization process, better integrating clinical data into clinicians electronic health records (EHRs), and working with CMS in their effort to overhaul clinical documentation guidelines; Urged Congress to cosponsor and pass the Safe Step Act (H.R. 2279), to require health insurers to provide an exceptions process for any medication step therapy protocol based on clinical decision-making, medical necessity, and other patient needs. Prescription Drug Costs: The College advocated for greater transparency in drug pricing, the elimination of anti-competitive industry practices that create barriers to generics coming to market, the importance of accounting for value in payment and coverage for prescriptions, and providing authority to the federal government to negotiate drug discounts under the Medicare Part D program. Specifically, the College urged Congress to pass the Medicare Prescription Drug Price Negotiation Act of 2019 (H.R. 275/S. 62), which allows the Secretary of Health and Human Services to negotiate covered Part D drug prices on behalf of Medicare beneficiaries, and the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2019, (H.R. 965/S. 340), which would improve patient access to alternative low-cost prescription drugs and biological products by preventing prescription drug manufacturers from misusing the FDAs Risk Evaluation and Mitigation Strategies (REMS) process to make it difficult for competing generics to be brought to the market. Also urged that Congress pass the Reforming Evergreening and Manipulation that Extends Drug Years, REMEDY Act (S. 1209), to aid in the approval of more generic drug applications by the FDA and therefore improve patient access to those medications. Also urged that Congress pass the Prescription Drug STAR Act (H.R. 2113), and the Fair Accountability and Innovative Research (FAIR) Drug Pricing Act (H.R. 2296/S. 1391), to promote greater drug pricing transparency; Expressed appreciation to the House speaker for introduction of H.R. 3, the Lower Drug Costs Now Act, noting encouragement for its provisions to empower the Secretary of Health and Human Services (HHS) to negotiate with drug companies for lower prices and to cap out-of-pocket costs for seniors enrolled in the Medicare Part D program. Commented to the FDA on its prescription drug reimportation proposed rule noting that while the College is generally supportive of drug importation as laid out in the proposed rule as a means to control the cost of prescription drugs, the FDA must guarantee that the design and implementation of the rule includes numerous measures and safeguards to ensure patient safety. By limiting the origin of imported drugs to Canadian-certified and FDA-approved and registered drugs and entities, the College believes the proposed rule meets the required U.S. standards to assure high-quality drugs and patient safety. Any final drug importation system must also be one that is a closed system and has a tightly controlled and documented supply chain to assure authenticity and avoid degradation of the drug. Workforce, Medical and Health Services Research, Public Health Initiatives: Congress should ensure funding in FY 2021 for federal programs/initiatives designed to support primary care including Title VII Health Professions grants and the National Health Service Corps (NHSC). Equally important is the need to fund essential health services and medical research by the Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health (NIH) and public health programs supported by the Centers for Disease Control and Prevention (CDC). Firearms-Related Injury and Death: The College advocated for lawmakers to pass measures to strengthen the criminal background check system, ban assault weapons and high capacity magazines, prevent the unlawful transfer of firearms to those who cannot legally purchase them, and remove restrictions on, and provide dedicated funding for, research by federal agencies on prevention of firearms-related injuries and death. Specifically, the College urged passage of the Bipartisan Background Checks Act of 2019 (H.R. 8), which would strengthen the accuracy and reporting of the National Instant Criminal Background Check System (NICS) as well as expand Brady background checks to cover all firearm sales, including unlicensed firearms sellers currently not required to use background checks, and the Gun Violence Prevention Research Act (H.R. 674/S. 184), which would authorize funding for the Centers for Disease Control and Prevention (CDC) to study firearms safety and gun violence prevention. Also urged Congress to pass the Violence Against Women (VAWA) Reauthorization Act of 2019 (H.R. 1585), to provide protections for domestic violence victims by restricting access to firearms by those deemed a threat to them. Also urged Congress to pass the Assault Weapons Ban of 2019 (S. 66/H.R. 1296), to ban the sale of semi-automatic weapons and high capacity magazines. Immigration: The College advocated against family separation at the U.S. border. Specifically, the College urged support for H.R. 541 - the Keep Families Together Act, which would help ensure that children are not separated from their parents when families unlawfully cross over the border into the United States and would ensure that the Department of Homeland Security would not be able to implement the zero tolerance policy that separated families at the border last summer; urged congressional oversight of family separation policies. Also urged that Congress pass H.R. 6, the Dream and Promise Act of 2019, which would provide a pathway to U.S. citizenship for undocumented children who came to the United States due to the action of their parents, also known as Dreamers. Expressed concern to the U.S. Department of Homeland Security with the recent U.S. Citizenship and Immigration Service (USCIS) policy change to no longer accept or adjudicate non-military deferred action requests including those for individuals with serious medical conditions; Urged USCIS to reverse this decision immediately and resume consideration of deferred action requests for medical reasons; Opposed the proposed rule, U.S. Immigration and Customs Enforcement (ICE) Establishing a Fixed Time Period of Admission and an Extension of Stay Procedure for Nonimmigrant Academic Students, Exchange Visitors, and Representatives of Foreign Information Media. This rule would change the process to extend the period of authorized stay in the United States for certain categories of nonimmigrants by eliminating the long-standing "duration of status and replacing it with a specific end date. The College urged the Department of Homeland Security to exclude physicians in the Department of States (DOS) Exchange Visitor Program in J-1 visa status from this rule change because it will otherwise disrupt the training of thousands of physicians - physicians who already have been thoroughly vetted, already are serving on our nations health care teams, and already are carefully monitored during their time in the U.S. Graduate Medical Education: Urged that Congress support medical education training and debt relief for primary care physicians and other specialties facing shortages by passing the Resident Physician Shortage Reduction Act of 2019 (S. 348, H.R. 1763), to lift the GME caps as needed to permit training an adequate number of primary care physicians, including internal medicine specialists, and physicians in other specialties facing shortages; passing the Resident Education Deferred Interest Act (H.R. 1554), to save physicians in residency programs thousands of dollars in interest on their loans and help incentivize the opening of practices in underserved areas; pass legislation to combine DGME and IME into a single, more functional payment program, and broaden the GME financing structure to include all payers; support funding for GME/IME and programs within the Veterans Health Administration that provide graduate medical education to ensure that physicians are adequately trained with the skills needed to treat an aging population. Urged Congress to pass the Opioid Workforce Act of 2019 (H.R. 3414), which would provide Medicare support for an additional 1,000 graduate medical education (GME) positions over five years in hospitals that have, or are in the process of establishing, accredited residency programs in addiction medicine, addiction psychiatry, or pain medicine. Urged Congress to pass S. 1203 and H.R. 2441, the What You Can Do For Your Country Act, which would improve and reform the Public Service Loan Forgiveness (PSLF) Program. Vaccines: Urged Congress to pass the Vaccines Act (HR 2862), which would provide federal funding for vaccine hesitancy surveillance at the Centers for Disease Control and Prevention (CDC), and outline a national public messaging campaign informed by this research to help improve vaccination rates; Supported H.R. 592, recognizing the anniversary of the eradication of smallpox and the importance of vaccination in the United States and worldwide; Urged the U.S. Department of Homeland Security (DHS) to reconsider its decision to not vaccinate families in the custody of U.S. Customs and Border Protection (CBP) against influenza (flu). Urged Congress to support payments for vaccines, as finalized by CMS, and set for implementation on Jan. 1, 2021. Surprise Medical Billing: Urged Congress to pass legislation that would protect patients from surprise out-of-network medical bills in both emergency and non-emergency settings that includes the following principles: hold patients harmless from surprise medical bills for out-of-network services, address narrow insurance networks, abandon efforts to establish an in-network median rate for services in these settings and instead opt for an independent dispute resolution process to determine payment. Appropriations: Urged Congress to fund Title VII, Section 747, Primary Care Training and Enhancement (PCTE) at $71 million for fiscal year 2021; Fund the Agency for Health Care Research and Quality (AHRQ) at $460 million for fiscal year 2021; Fund the National Health Service Corps (NHSC) at $830 million for fiscal year 2021; Fund the Title X Family Planning Program at $400 million for fiscal year 2021 and include language to remove barriers to care that interfere with the patient-physician relationship; Fund Research on Prevention of Firearms-related Injuries and Deaths at $50 million for Fiscal Year 2021; Fund the National Institutes of Health (NIH) at $44.7 billion for fiscal year 2021; Fund the Centers for Disease Control and Prevention (CDC) at $8.3 billion for fiscal year 2021; Urged the House and Senate Armed Services Committees to support provisions in any final FY2021 National Defense Authorization Act to prevent cuts to the Military Health Service and the military medical workforce without requiring appropriate congressional oversight and review. Physician Fee Schedule: Commented to CMS and to Congress to fully implement payment increases for all evaluation and management codes, as finalized by CMS, and as scheduled for implementation on Jan. 1, 2021. Reduce the documentation burden for E/M services by allowing choice of medical decision making or time, and work to develop additional clarity and guidance on acceptable documentation to operationalize these important proposals; examination room desktop computers should be counted as a direct medical equipment cost; care management should be promoted by increasing the values of services like Transitional Care Management (TCM) and Chronic Care Management and implementing Principle Care Management (PCM) codes; require additional survey and review for any requests to increase non-outpatient E/M or other services; work with the physician community prior to finalizing any policy affecting eligibility to participate in the Medicare program; Urged congressional committees of jurisdiction to support: Higher physician work relative value units (RVUs) for new and established office visit codes, leading to increased payments for them, Reduced documentation requirements for office visit codes, which enables physicians to select and document for each visit based on medical decision-making or total time, Expanded and improved payment for care management services. Urged Congress to support waiving budget neutrality, applicable to the calendar year 2021 physician fee schedule. COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Urged the administration to explore regulatory and other actions that would make COVID-19 testing free-of-charge to patients covered by both public and private insurance plans, including ACA-compliant plans offered through the insurance exchanges, and to waive co-pays and deductibles for patients seeing physicians for symptoms that may be indicative of COVID-19 or who are hospitalized for treatment. Urged CMS to utilize a national disaster recovery program that would pay doctors 110% of Medicare rates for caring for uninsured patients who have been infected with SARS-CoV-2. Expressed support to Congress and the administration for the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged HHS and Congress to make a targeted allocation out of the Provider Relief Fund (PRF) to support primary care physicians and their practices, sufficient to keep their doors open, by offsetting lost revenue from the COVID-19 pandemic, similar to the targeted allocation for rural hospitals; Urged support for the Student Loan Forgiveness for Frontline Health Workers Act, H.R. 6720, introduced May 5, 2020 by Representative Carolyn B. Maloney (D-NY) which would eliminate graduate school debt for healthcare workers, including physicians and medical students, who are providing direct patient care in response to the COVID-19 pandemic; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. This extension-either continued by CMS or mandated by Congress-should last at least through the end of 2021, or until such a time when effective vaccines and treatments are widely available, with an option to extend it even further, or consider making permanent, based on the experience and learnings of patients and physicians who are utilizing these visits. Urged Congress to support a targeted allocation from the Provider Relief Fund specifically for primary care services. Priorities for New Administration: Urged the incoming Biden Administration to identify and appoint physicians to health care leadership positions within your Administration. Implement approval, distribution, and funding of a safe and effective COVID-19 vaccine based on recommendations from the Advisory Committee on Immunization Practices (ACIP). Provide support to physicians and other frontline health care workers, including ensuring access and distribution of personal protective equipment (PPE) to health care workers. Fund COVID-19 testing and contact tracing efforts. Reverse regulations that allow the sale of extended short-term, limited duration plans, association health plans. Take action to defend the Affordable Care Act from any litigation, including California v. Texas, that would undermine coverage and patient protections. Expand premium tax credits and cost-sharing reductions. Establish a federal public option to inject competition into the health insurance marketplace. Expand Medicaid eligibility and oppose expansion waivers that limit benefits and apply high cost sharing. Permanently increase payment for Medicaid primary care services to the level of Medicare. Restore the Deferred Action for Childhood Arrivals, consistent with a recent ruling from a federal judge, and identify executive actions that can be taken to ensure that it is not vulnerable to being eliminated in the future. Pursue executive actions to preserve the principles of patient autonomy regarding reproductive decision-making rights. Reverse the Title X gag rule and restore funding to family planning clinics. Establish universal access to at least six weeks of paid family and medical leave that is flexible to accommodate care for a diverse array of family structures, including updating the Family Medical and Leave Act to include grandparents or in-laws. Re-introduce and pass the George Floyd Act and other legislation focused on eliminating racism and police violence. Rejoin the Paris Agreement.

Client expense: $91,236 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS)

Medicare coverage and reimbursement for therapy services and rehabilitation telehealth services including H.R. 7154, the Outpatient Therapy Modernization and Stabilization Act; Policies impacting the U.S. response to the COVID-19 pandemic including H.R. 604, the Coronavirus Preparedness and Response Supplemental Appropriations Act, Public Law No. 116-123; H.R. 6201, Families First Coronavirus Response Act, Public Law No. 116-127; H.R. 748, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), Public Law No. 116-136; and H.R. 6800, the Health and Economic Recovery Omnibus Emergency Solutions Act (HEROES Act). Medicare payment reform for post acute care services. Matters affecting bundled payments and value-based reimbursement; Implementation of physician fee schedule for CY 2020. Legislation to waive the budget neutrality requirement for E/M codes under the CY 2021 physician fee schedule including H.R. 8505. S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020; H.R. 8702, Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020. H.R. 133, Consolidated Appropriations Act, 2021, Pub. L. No. 116-260.

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

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

CARES Act funding H.R. 748 "Coronavirus Aid, Relief, and Economic Security Act" H.R. 133 - United States-Mexico Economic Partnership Act [Consolidated Appropriations Act, 2021] HR 8505 - "To amend title XVII of the Social Security Act....." (Medicare physician fee schedule) HR 8702 - "Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020" (Medicare physician fee schedule)

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

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

HR 8505 - "To amend title XVII of the Social Security Act....." (Medicare physician fee schedule) HR 8702 - "Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020" (Medicare physician fee schedule)

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

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

H.R. 7614 Labor, HHS and Education Appropriations (NIH) CARES Act H.R. 748 "Coronavirus Aid, Relief, and Economic Security Act" H.R. 133 - United States-Mexico Economic Partnership Act [Consolidated Appropriations Act, 2021] HR 8505 - "To amend title XVII of the Social Security Act....." (Medicare physician fee schedule) HR 8702 - "Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020" (Medicare physician fee schedule)

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

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

DMEPOS payment and coverage Medicare Part B reimbursement Extension of telehealth flexibilities H.R.7154 - Outpatient Therapy Modernization and Stabilization Act H.R. 8702/S. 5007 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 H.R.8505 - To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes.

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

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

HR 8505 - Medicare Physician Fee Schedule (MPFS) budget neutrality HR 8702 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 HR 2282 and S. 966 - The Medicare Care Coordination Improvement Act - To amend title XVIII of the Social Security Act to modernize the physician self-referral prohibitions to promote care coordination in the merit-based incentive payment system and to facilitate physician practice participation in alternative payment models under the Medicare program, and for other purposes S. 348 - Resident Physician Shortage Reduction Act, to provide Medicare funding for additional residency training slots H.R. 1763 - Resident Physician Shortage Reduction Act, to provide Medicare funding for additional residency training slots HR 3107 - Improving Seniors' Timely Access to Care Act - streamlining prior authorization proccess in Medicare Advantage space

Client expense: $32,898 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare policies related to access to and payment for post-acute care services, including the "Improving Seniors' Timely Access to Care Act of 2019 (H.R. 3107)", the "Coronavirus Preparedness and Response Supplemental (H.R. 6074)", the "Families First Coronavirus Response Act (H.R. 6201)", the "Coronavirus Aid, Relief and Economic Security Act (H.R. 748)", the "Health and Economic Recovery Omnibus Emergency Solutions Act (H.R. 6800, H.R 8406)", the "Paycheck Protection Program and Health Care Enhancement Act (H.R. 266)", the "Medicare Accelerated and Advance Payment Improvement Act (S. 3750, H.R. 6837)", the "Continuing Appropriations Act, 2021 and Other Extensions Act (H.R. 8337)", the "American Workers, Families and Employer Assistance Act (S.4318)", the "Further Continuing Appropriations Act, 2021 and Other Extensions Act (H.R. 8900)", the Further Additional Continuing Appropriations Act, 2021 (H.J. Res. 107)", the "Extension of Continuing Appropriations Act, 2021 (H.J.Res 110)", the Consolidated Appropriations Act, 2021 (H.R. 133)", the "Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020 (H.R. 8702, S. 5007)", H.R. 8505 related to Medicare outpatient payments and the "Resetting the IMPACT Act of 2020 (H.R. 8826)".

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare, Medicaid, private insurance and other health care policies that impact patient access to hospital and physician care, including the "Resident Physician Shortage Reduction Act of 2019 (S. 348, H.R. 1763)", the "Lower Health Care Costs Act (S. 1895)", the "Opioid Workforce Act (H.R. 3414, S. 2892)", the "Ban Surprise Bill Act (H.R. 5800)", the "Consumer Protections Against Surprise Medical Bills Act (H.R. 5826)", the "Coronavirus Preparedness and Response Supplemental (H.R. 6074)", the "Families First Coronavirus Response Act (H.R. 6201)", the "Coronavirus Aid, Relief and Economic Security Act (H.R. 748)", the "Health and Economic Recovery Omnibus Emergency Solutions Act (H.R. 6800 and H.R 8406)", the "Paycheck Protection Program and Health Care Enhancement Act (H.R. 266)", the "Medicare Accelerated and Advance Payment Improvement Act (S. 3750, H.R. 6837)", the "Continuing Appropriations Act, 2021 and Other Extensions Act (H.R. 8337)", the "American Workers, Families and Employer Assistance Act (S.4318)", the "States Achieve Medicaid Expansion Act of 2019 (S.585)", the "Further Continuing Appropriations Act, 2021 and Other Extensions Act (H.R. 8900)", the Further Additional Continuing Appropriations Act, 2021 (H.J. Res. 107)", the "Extension of Continuing Appropriations Act, 2021 (H.J.Res 110)", the Consolidated Appropriations Act, 2021 (H.R. 133)", the "Medical Education for a Diverse America Act (H.R. 5432)", the "Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (H.R. 8702, S. 5007)", and H.R. 8505 related to Medicare physician payment.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues: Telehealth: Advocated for extension of Medicare telehealth waivers under 1834m of the Social Security Act Surprise medical bills: advocated for independent dispute resolution improvements in No Surprises Act such as exclusion of federal payer rates from consideration APMs: advocated for freeze in qualifying participant thresholds and extension of APM bonus in Value Act; advocated for delay and improvements to radiation oncology model to administration ACOs: advocated to administration to delay or rescind proposals for quality reporting changes in 2021 Provider relief fund: advocated for improvements to reporting requirements and for distributions to group practices in front of administration and congress MIPS: advocated to administration for reductions in reporting burden for 2021 Accelerated advance payment program: advocated to congress to include improved repayment terms in federal legislative package Medicare sequestration: advocated for a delay in the sequestration cuts through the end of the COVID-19 public health emergency Medicare payment cuts: advocated against cuts to Medicare reimbursement slated for Jan. 1, 2021 related to the E/M increases Appropriate Use Criteria (AUC) program: advocated for a delayed start to the program National Patient Identifier: advocated for the development of a national approach to matching patient records Medicare Document Requirement Lookup Service policy: advocated in support of real time transactions; applicability to all payers Medicare administrative simplification policy: advocated for development of new attachment standards; improved prior authorization processes; enhanced enforcement Application Programming Interface prior authorization standards: advocated for applicability to a wider group of federally-controlled payers; reduced time for payers to respond to practices with authorization determinations Interoperability and information blocking policy: advocated against additional administrative burden for physician practices; delay in enforcement for information blocking requirements until after the COVID-19 public health emergency Bills: HR 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions HR 8505, To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes, all provisions HR 133, Consolidated Appropriations Act, 2021, provisions relating to Medicare reimbursement cuts, sequestration cut delay, surprise medical billing, radiation oncology model delay, and APM qualifying participant threshold freeze H.R.7898 - To amend the Health Information Technology for Economic and Clinical Health Act to require the Secretary of Health and Human Services to consider certain recognized security practices of covered entities and business associates when making certain determinations, and for other purposes

Client expense: $387,000 · Firm income: Not reported

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

Issues: Telehealth: Advocated for extension of Medicare telehealth waivers under 1834m of the Social Security Act Surprise medical bills: advocated for independent dispute resolution improvements in No Surprises Act such as exclusion of federal payer rates from consideration APMs: advocated for freeze in qualifying participant thresholds and extension of APM bonus in Value Act; advocated for delay and improvements to radiation oncology model to administration ACOs: advocated to administration to delay or rescind proposals for quality reporting changes in 2021 Provider relief fund: advocated for improvements to reporting requirements and for distributions to group practices in front of administration and congress MIPS: advocated to administration for reductions in reporting burden for 2021 Accelerated advance payment program: advocated to congress to include improved repayment terms in federal legislative package Medicare sequestration: advocated for a delay in the sequestration cuts through the end of the COVID-19 public health emergency Medicare payment cuts: advocated against cuts to Medicare reimbursement slated for Jan. 1, 2021 related to the E/M increases Appropriate Use Criteria (AUC) program: advocated for a delayed start to the program National Patient Identifier: advocated for the development of a national approach to matching patient records Medicare Document Requirement Lookup Service policy: advocated in support of real time transactions; applicability to all payers Medicare administrative simplification policy: advocated for development of new attachment standards; improved prior authorization processes; enhanced enforcement Application Programming Interface prior authorization standards: advocated for applicability to a wider group of federally-controlled payers; reduced time for payers to respond to practices with authorization determinations Interoperability and information blocking policy: advocated against additional administrative burden for physician practices; delay in enforcement for information blocking requirements until after the COVID-19 public health emergency Bills: HR 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions HR 8505, To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes, all provisions HR 133, Consolidated Appropriations Act, 2021, provisions relating to Medicare reimbursement cuts, sequestration cut delay, surprise medical billing, radiation oncology model delay, and APM qualifying participant threshold freeze H.R.7898 - To amend the Health Information Technology for Economic and Clinical Health Act to require the Secretary of Health and Human Services to consider certain recognized security practices of covered entities and business associates when making certain determinations, and for other purposes

Client expense: $387,000 · Firm income: Not reported

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare Reimbursement. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response to the outbreak. CARES Act and other legislation related to the policies in reaction to the national health crisis. H.R. 7010, The Paycheck Protection Program Flexibility Act. House Draft, Department of Defense Appropriations Act, FY 2021. Senate Draft, Department of Defense Appropriations Act, FY 2021. H.R. 3, Lower Drug Costs Now Act of 2019. Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.R. 1158, FY2020 Consolidated Appropriations Act (Defense, CJS, FSGG, Homeland Security). H.R. 1554, REDI Act. H.R. 2087, To amend title XVIII of the Social Security Act to require certain manufacturers to report drug pricing information with respect to drugs under the Medicare program, and for other purposes. H.R. 2279, Safe Step Act. H.R. 2693, To amend title XVIII of the Social Security Act to improve access to, and utilization of, bone mass measurement benefits under part B of the Medicare program by establishing a minimum payment amount under such part for bone mass measurement. H.R. 2781, Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness for Health Act of 2019. H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019. H.R. 4378, FY2020 Continuing Appropriations Resolution (P.L. 116-59). S. 64, Preserve Access to Affordable Generics and Biosimilars Act. S. 283, Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2019. S. 1391, Fair Accountability and Innovative Research Drug Pricing Act of 2019. S. 2543, Prescription Drug Pricing Reduction Act of 2019. S. 2546, Safe Step Act. H.R. 1763, Resident Physician Shortage Reduction Act. S. 348, Resident Physician Shortage Reduction Act. H.R. 6788, Workforce Resilience Act. S. 3599, Workforce Resilience Act. H.R. 5741, Strengthening Innovation in Medicare and Medicaid Act. H.R.8505, To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes H.R. 6644/S. 3741, Health Care at Home Act H.R. 4932/S. 2741, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health 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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare Reimbursement. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response to the outbreak. CARES Act and other legislation related to the policies in reaction to the national health crisis. H.R. 7010, The Paycheck Protection Program Flexibility Act. House Draft, Department of Defense Appropriations Act, FY 2021. Senate Draft, Department of Defense Appropriations Act, FY 2021. H.R. 3, Lower Drug Costs Now Act of 2019. Monitor implementation of the Patient Protection and Affordable Care Act (P.L. 111-148). Monitor implementation of Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). Monitor implementation of 21st Century Cures Act (P.L. 114-255). H.R. 1158, FY2020 Consolidated Appropriations Act (Defense, CJS, FSGG, Homeland Security). H.R. 1554, REDI Act. H.R. 2087, To amend title XVIII of the Social Security Act to require certain manufacturers to report drug pricing information with respect to drugs under the Medicare program, and for other purposes. H.R. 2279, Safe Step Act. H.R. 2693, To amend title XVIII of the Social Security Act to improve access to, and utilization of, bone mass measurement benefits under part B of the Medicare program by establishing a minimum payment amount under such part for bone mass measurement. H.R. 2781, Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness for Health Act of 2019. H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019. H.R. 4378, FY2020 Continuing Appropriations Resolution (P.L. 116-59). S. 64, Preserve Access to Affordable Generics and Biosimilars Act. S. 283, Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2019. S. 1391, Fair Accountability and Innovative Research Drug Pricing Act of 2019. S. 2543, Prescription Drug Pricing Reduction Act of 2019. S. 2546, Safe Step Act. H.R. 1763, Resident Physician Shortage Reduction Act. S. 348, Resident Physician Shortage Reduction Act. H.R. 6788, Workforce Resilience Act. S. 3599, Workforce Resilience Act. H.R. 5741, Strengthening Innovation in Medicare and Medicaid Act. H.R.8505, To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes H.R. 6644/S. 3741, Health Care at Home Act H.R. 4932/S. 2741, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health 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