Holding Providers Harmless From Medicare Cuts During COVID–19 Act of 2020

HR 4994/PL 113-185 Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (all sections) HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 3107 - Improving Seniors Timely Access to Care Act of 2019 (all sections) HR 266 - Paycheck Protection Program and Health Care Enforcement Act (all sections) HR 748 - Coronavirus Aid, Relief, and Economic Security (CARES) Act (all sections) HR 8600 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act (all sections) HR 8702 - Holding Providers Harmless from Medicare Cuts during COVID-19 Act of 2020 (all sections) HR 133/PL 116-260 - Consolidated Appropriations Act, 2021 (Division M - Coronavirus Response & Relief Supplemental Appropriations Act, 2021) HR 2455 - The Resetting the IMPACT Act (TRIA) of 2021 (all sections) S. 610 - Protecting Medicare and American Farmers from Sequester Acts Cut (all sections) HR 1887 - Rural Hospital Support Act (all sections) S. 4009 - Rural Hospital Support Act (all sections) HR 3173 - Improving Seniors Timely Access to Care Act (all sections)

Client expense: $428,000 · Firm income: Not reported

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

HR 4994/PL 113-185 Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (all sections) HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 3107 - Improving Seniors Timely Access to Care Act of 2019 (all sections) HR 266 - Paycheck Protection Program and Health Care Enforcement Act (all sections) HR 748 - Coronavirus Aid, Relief, and Economic Security (CARES) Act (all sections) HR 8600 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act (all sections) HR 8702 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (all sections) HR 133/PL 116-260 - Consolidated Appropriations Act, 2021 (Division M - Coronavirus Response & Relief Supplemental Appropriations Act, 2021) HR 2455 - The Resetting the IMPACT Act (TRIA) of 2021 (all sections) S. 610 - Protecting Medicare and American Farmers from Sequester Acts Cut (all sections) HR 1887 - Rural Hospital Support Act (all sections)

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

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

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 4994/PL 113-185 Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (all sections) HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) HR 3107 - Improving Seniors Timely Access to Care Act of 2019 (all sections) HR 266 - Paycheck Protection Program and Health Care Enforcement Act (all sections) HR 748 - Coronavirus Aid, Relief, and Economic Security (CARES) Act (all sections) HR 8600 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act (all sections) HR 8702 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (all sections) HR 133/PL 116-260 - Consolidated Appropriations Act, 2021 (Division M - Coronavirus Response & Relief Supplemental Appropriations Act, 2021) HR 2455 - The Resetting the IMPACT Act (TRIA) of 2021 (all sections) S. 610 - Protecting Medicare and American Farmers from Sequester Acts Cut (all sections) HR 1887 - Rural Hospital Support Act (all sections)

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

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

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 4994/PL 113-185 Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (all sections) HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 3417 - Beneficiary Education Tools, Telehealth, and Extenders (BETTER) Act of 2019 (Sec. 103. Medicare coverage of certain mental health telemedicine, HR 3107 - Improving Seniors Timely Access to Care Act of 2019 (all sections) HR 266 - Paycheck Protection Program and Health Care Enforcement Act (all sections) HR 748 - Coronavirus Aid, Relief, and Economic Security (CARES) Act (all sections) HR 8600 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act (all sections) HR 8702 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (all sections) HR 133/PL 116-260 - Consolidated Appropriations Act, 2021 (Division M - Coronavirus Response & Relief Supplemental Appropriations Act, 2021) HR 2455 - The Resetting the IMPACT Act (TRIA) of 2021 (all sections) S. 610 - Protecting Medicare and American Farmers from Sequester Acts Cut (all sections)

Client expense: $370,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), 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 4994/PL 113-185 Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (all sections) HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 3417 - Beneficiary Education Tools, Telehealth, and Extenders (BETTER) Act of 2019 (Sec. 103. Medicare coverage of certain mental health telemedicine, HR 3107 - Improving Seniors Timely Access to Care Act of 2019 (all sections) HR 266 - Paycheck Protection Program and Health Care Enforcement Act (all sections) HR 748 - Coronavirus Aid, Relief, and Economic Security (CARES) Act (all sections) HR 8600 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act (all sections) HR 8702 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (all sections) HR 133/PL 116-260 - Consolidated Appropriations Act, 2021 (Division M - Coronavirus Response & Relief Supplemental Appropriations Act, 2021) HR 2455 - The Resetting the IMPACT Act (TRIA) of 2021 (all sections

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

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

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 4994/PL 113-185 Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (all sections) HR 3298 - Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (all sections) HR 2797 - Patient Choice and Quality Care Act (all sections) S 1334 - Patient Choice and Quality Care Act (all sections) HR 1892 - Bipartisan Budget Act of 2018 (Sec. 51005. Extension of Blended Site-Neutral Payment Rate for Certain Long-Term Care Hospital Discharges; Temporary Adjustment to Site Neutral Payment Rates, Title III-Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care.) S. 594 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 1901 - Preserving Rehabilitation Innovation Centers Act of 2019 (all sections) HR 3417 - Beneficiary Education Tools, Telehealth, and Extenders (BETTER) Act of 2019 (Sec. 103. Medicare coverage of certain mental health telemedicine, HR 3107 - Improving Seniors Timely Access to Care Act of 2019 (all sections) HR 266 - Paycheck Protection Program and Health Care Enforcement Act (all sections) HR 748 - Coronavirus Aid, Relief, and Economic Security (CARES) Act (all sections) HR 8600 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act (all sections) HR 8702 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (all sections) HR 133/PL 116-260 - Consolidated Appropriations Act, 2021 (Division M - Coronavirus Response & Relief Supplemental Appropriations Act, 2021) HR 2455 - The Resetting the IMPACT Act (TRIA) of 2021 (all sections

Client expense: $590,000 · Firm income: Not reported

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

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

Medicare Access and CHIP Reauthorization Act (PL 114-10) S.2157, Rural Hospital Sustainability Act: CMMI payment model to rural hospitals H.R.1763, Resident Physician Shortage Reduction Act of 2019:residency positions eligible for graduate medical education payments H.R. 1384, Medicare for All Act of 2019: Medicare for All H.R. 4056, Medicare Audiologist Access and Services Act of 2019: audiology H.R. 5774, Combating Opioid Abuse for Care in Hospitals Act of 2018: Opioids H.R. 6, SUPPORT for Patients and Communities Act: Opioids H.R. 2550, Medicare Telehealth Parity Act of 2017 H.R. 676, Expanded and Improved Medicare for All Act: Medicare for All, payment H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020: payment H.R. 8756, COVID Health Care Provider Assurance Act of 2020: payment H.R. 315, Medicare Sequester COVID Moratorium Act: Medicare sequester, PAYGO Independent Payment Advisory Board (IPAB) Repeal Rural Anesthesiology: Rural Pass Through Out of Network/Out of Network Payment Historical Medicare payment undervaluation for anesthesiology services (33% problem) Anesthesia Conversion Factor Perioperative Surgical Home Model Bundled payments CMS 45 CFR Parts 147, 155, and 156, PPACA; Market Stabilization rule CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services 2017 Medicare Physician Fee Schedule Rule CMS decision to decrease values of interlaminar epidural injections CMS Value-Based purchasing CMS Medicare Data Final Rule Sunshine Act Implementation Conditions of Participation - Anesthesia services, opt-outs, supervision Physician Quality Reporting System, PPACA, Sec. 3007 Quality Modifier implementation IPAB cuts Graduate Medical Education Value-based modifier - PPACA Debt ceiling - Medicare sequestration QCDR - Qualified Clinical Data Registry CMS Meaningful Use Stage 3 Executive Order Promoting Healthcare Choice and Competition (Trumpcare) Ambulatory Surgery Center Critical Care and Anesthesia Services Payment Reform: Increase payments for anesthesia and critical care services for Medicare COVID patients Prescription Drug Management Programs: Evaluation and Monitoring codes & cuts Certified Anesthesiologist Assistants Public Option

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

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

Client expense: $370,000 · Firm income: Not reported

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

Support the "Amputation Reduction and Compassion Act" (HR 8615) which includes policies, including Medicare payment for arterial testing, to prevent amputations arising from peripheral artery disease. The Centers for Medicare & Medicaid Services issued its 2021 Medicare Physician Fee Schedule (PFS) final rule which finalized a 10.2% cut to the Medicare physician payment conversion factor. Advocated to prevent cuts to Medicare physician services from taking effect on Jan. 1, 2021, including support for the "Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020" (S 5007 and HR 8702).

Client expense: Not reported · Firm income: $10,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The 2021 Medicare Physician Fee Schedule final rule issued by the Centers for Medicare & Medicaid Services cut the Medicare conversion factor by 10.2 percent due to changes in evaluation and management codes. ASGE supported legislation to prevent the cuts from taking effect Jan. 1, 2020, including S. 5007 and H.R. 8702.

Client expense: Not reported · Firm income: $29,250

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

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H.R. 1959, Preserving Patient Access to Compounded Medications Act. Support H.R. 2077/S. 2546, Safe Step Act. Support H.R. 1035, Prescription Drug Price Transparency Act. Support H.R. 985, Fair Access for Safe and Timely Generics Act. Support S. 476, C-THRU Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act. Support H.R. 1034/S. 640, Phair Pricing Act. Support S. 657, Drug Price Transparency Act Support H.R. 938, BLOCKING Act Support H.R. 2375/S. 64, Preserve Access to Affordable Generics & Biosimilars Act Support H.R. 1499, Protecting Consumer Access to Generic Drugs Act Support H.R. 2296/S. 1391, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 2069, Stopping the Pharmaceutical Industry from Keeping drugs Expensive (SPIKE) Act. Support H.R. 2115, Public Disclosure of Drug Discounts Act Support H.R. 2376/S. 1227, Prescription Pricing for the People Act Support H.R. 1379/S. 560, Ensuring Lasting Smiles Act. Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Support pediatric subspecialty loan repayment in any reauthorization of the Title VII programs. Support S. 2443 Investment in Tomorrows Pediatric Health Care Workforce Act Support H.R. 1554, Resident Education Deferred Interest (REDI) Act. Advocate for the continued and increased funding of Community Health Centers. Lobby members of Congress to cosponsor H. Res. 323, which would support state, local, and community initiatives to encourage parents, teachers, camp counselors, and childcare professionals to take measures to prevent sunburns in the minors they care for, and would express the sense of the House of Representatives that state, local, and community entities should continue to support efforts to curb the incidences of skin cancer beginning with childhood skin protection. In the context of legislation to address surprise medical bills, advocate for an independent dispute resolution (IDR) process to resolve disputes between payers and physicians and against provisions that would set out-of-network reimbursement rates at a benchmark level. (H.R. 2328, H.R. 3502, S. 1531, S. 1895, H.R. 133) Support H.R. 4575, Improving Provider Directories Act, which would require group health plans and health insurance issuers offering group or individual health insurance coverage to establish a process to address inaccurate information listed in publicly accessible provider directories of such plans and issuers. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services. Support legislation to address drug shortages by providing additional authority to the Food and Drug Administration (FDA) to ensure a stable supply of medications (S. 2723, Mitigating Emergency Drug Shortages Act; H.R. 6080, Preventing Drug Shortages Act). Similar provisions to mitigate drug shortages included in CARES Act (H.R. 748, S. 3548). Request resources to provide personal protection equipment (PPE) and supplies and relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548). Support the Coronavirus Health Care Worker Wellness Act (H.R. 7255) to help promote mental health wellness among physicians and other health care workers during the Public Health Emergency. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package (H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act; S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule; H.R. 133, Consolidated Appropriations Act, 2021). Support H.R. 7233, the KEEP Telehealth Options Act. Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act

Client expense: $310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Oppose H.R. 2143, Promoting Integrity in Medicare Act (PIMA) of 2019. Advocate regarding possible changes to IOASE and Stark Law relative to implementation of Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110) Support H.R. 2282/S.966 Medicare Care Coordination Improvement Act of 2019 Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Advocate against a Medicare physician payment freeze beginning in January 2020 that was created under MACRA (P.L. 114-110) and the creation of the Quality Payment Program. Advocate expanding the period for reporting and returning overpayments beyond the 60 days statutorily required under audits by Recovery Audit Contractors (RACs). Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. Support H.R. 3302, Keep Physicians Serving Patients Act. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services Request relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548, H.R. 133) Extend moratorium of the Medicare sequester included in the CARES Act until end of COVID-19 public health emergency in H.R. 133, Consolidated Appropriations Act, 2021. Support H.R. 8840, the Medicare Sequester COVID Moratorium Act, which would extend relief from the Medicare sequester through end of the COVID 19 public health emergency (PHE). Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 7233) Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act Support S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act.

Client expense: $310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Oppose H.R. 2143, Promoting Integrity in Medicare Act (PIMA) of 2019. Advocate regarding possible changes to IOASE and Stark Law relative to implementation of Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110) Support H.R. 2282/S.966 Medicare Care Coordination Improvement Act of 2019 Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Advocate against a Medicare physician payment freeze beginning in January 2020 that was created under MACRA (P.L. 114-110) and the creation of the Quality Payment Program. Advocate expanding the period for reporting and returning overpayments beyond the 60 days statutorily required under audits by Recovery Audit Contractors (RACs). Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. Support H.R. 3302, Keep Physicians Serving Patients Act. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services Request relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548, H.R. 133) Extend moratorium of the Medicare sequester included in the CARES Act until end of COVID-19 public health emergency in H.R. 133, Consolidated Appropriations Act, 2021. Support H.R. 8840, the Medicare Sequester COVID Moratorium Act, which would extend relief from the Medicare sequester through end of the COVID 19 public health emergency (PHE). Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 7233) Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act Support S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act.

Client expense: $310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H.R. 1959, Preserving Patient Access to Compounded Medications Act. Support H.R. 2077/S. 2546, Safe Step Act. Support H.R. 1035, Prescription Drug Price Transparency Act. Support H.R. 985, Fair Access for Safe and Timely Generics Act. Support S. 476, C-THRU Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act. Support H.R. 1034/S. 640, Phair Pricing Act. Support S. 657, Drug Price Transparency Act Support H.R. 938, BLOCKING Act Support H.R. 2375/S. 64, Preserve Access to Affordable Generics & Biosimilars Act Support H.R. 1499, Protecting Consumer Access to Generic Drugs Act Support H.R. 2296/S. 1391, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 2069, Stopping the Pharmaceutical Industry from Keeping drugs Expensive (SPIKE) Act. Support H.R. 2115, Public Disclosure of Drug Discounts Act Support H.R. 2376/S. 1227, Prescription Pricing for the People Act Support H.R. 1379/S. 560, Ensuring Lasting Smiles Act. Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Support pediatric subspecialty loan repayment in any reauthorization of the Title VII programs. Support S. 2443 Investment in Tomorrows Pediatric Health Care Workforce Act Support H.R. 1554, Resident Education Deferred Interest (REDI) Act. Advocate for the continued and increased funding of Community Health Centers. Lobby members of Congress to cosponsor H. Res. 323, which would support state, local, and community initiatives to encourage parents, teachers, camp counselors, and childcare professionals to take measures to prevent sunburns in the minors they care for, and would express the sense of the House of Representatives that state, local, and community entities should continue to support efforts to curb the incidences of skin cancer beginning with childhood skin protection. In the context of legislation to address surprise medical bills, advocate for an independent dispute resolution (IDR) process to resolve disputes between payers and physicians and against provisions that would set out-of-network reimbursement rates at a benchmark level. (H.R. 2328, H.R. 3502, S. 1531, S. 1895, H.R. 133) Support H.R. 4575, Improving Provider Directories Act, which would require group health plans and health insurance issuers offering group or individual health insurance coverage to establish a process to address inaccurate information listed in publicly accessible provider directories of such plans and issuers. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services. Support legislation to address drug shortages by providing additional authority to the Food and Drug Administration (FDA) to ensure a stable supply of medications (S. 2723, Mitigating Emergency Drug Shortages Act; H.R. 6080, Preventing Drug Shortages Act). Similar provisions to mitigate drug shortages included in CARES Act (H.R. 748, S. 3548). Request resources to provide personal protection equipment (PPE) and supplies and relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548). Support the Coronavirus Health Care Worker Wellness Act (H.R. 7255) to help promote mental health wellness among physicians and other health care workers during the Public Health Emergency. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package (H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act; S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule; H.R. 133, Consolidated Appropriations Act, 2021). Support H.R. 7233, the KEEP Telehealth Options Act. Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act

Client expense: $310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Cuts to emergency department services. Support for HR. 8702 & S.5007.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposed cuts to total hip/knee arthroplasty. Support for relief from CY'21 Physician Fee Schedule Cuts; H.R. 8702 & S.5007. Issues related to services coming off of the inpatient only list. Development of alternative payment models. Maintaining patient access to total joint arthroplasty; especially high risk/medically complex patients.

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

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

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

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

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

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

H.R. 3: Lower Drug Costs Now Act of 2019 - Provisions related to prescription drug pricing, foreign reference pricing, Part D, manufacturer rebates, and other provisions H.R. 19: Lower Costs, More Cures Act of 2019 - Provisions related to prescription drug pricing, transparency, manufacturer rebates and other provisions H.R. 8624: Protecting Access to Innovation During COVID-19 Act - Provisions related to Medicare and prescription drug pricing H.R. 8702: Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 - Provisions related to Part B and physician reimbursement S. 1895: Lower Health Care Costs Act - Provisions related to prescription drug pricing, transparency and patent issues S. 2543: Prescription Drug Pricing Reduction Act of 2019 - Provisions related to prescription drug pricing, transparency, manufacturer rebates and other provisions S. 3129: Lower Costs, More Cures Act of 2019 - Provisions related to prescription drug pricing, transparency, manufacturer rebates and other provisions S. 4199: Prescription Drug Pricing Reduction Act of 2020 - Provisions related to prescription drug pricing, transparency, manufacturer rebates and other provisions S. 4274: Legalizing Drug Discounts for Seniors Act of 2020 - Provisions related to Part D and manufacturer rebates Department of Health and Human Services (HHS) drug policy issues and regulatory policy issues Part D policy issues including non-interference and rebates policy issues Part B reform including MedPAC recommendations and other policy issues and local coverage decisions Drug cost and pricing policy issues Transparency policy issues Alternative payment models policy issues Value-based purchasing arrangements policy issues Anti-Kickback Statute policy issues Center for Medicare and Medicaid Innovation (CMMI) policy issues Medicaid rebates and waiver policy issues Medicare prescription drug payments cards and related issues Medicare Part B policy issues relating to ASP reporting, payment for drugs with non-covered versions, and drug wastage rebates AMP cap policy issues Vial size policy issues Final Rule; Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2021; Notice Requirement for Non-Federal Governmental Plans (RIN 0938-AT98) Final Rule: Medicaid Program; Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability (TPL) Requirements (RIN 0938-AT82) Final Rule: Transparency in Coverage (RIN 0938-AU04) Interim Final Rule with comment period: Most Favored Nation (MFN) Model (RIN 0938-AT91) Final Rule: Fraud and Abuse; Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees (RIN 0936-AA08)

Client expense: $5,130,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE

Monitor issues related to healthcare costs, surprise billing, transparency; S. 1895, Lower Health Care Costs Act; S. 1531; Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019; H.R. 3630, No Surprises Act; H.R. 3502, Protecting People From Surprise Medical Bills Act; H.R. 861, End Surprise Billing Act of 2019; H.R. 1865, Consolidated Domestic and International Assistance Bill; H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act (Public Law 116-159); S. 4230, Telehealth Expansion Act of 2020; S. 3750/H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020; Issues related to evaluation and management (E&M) cuts contained in the CY2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule; Extension of the Medicare Sequester; H.R. 133, Consolidated Appropriations Act, 2021 (Public Law 116-260); H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (Medicaid rates as related to Medicare conversion factor)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Oppose H.R. 2143, Promoting Integrity in Medicare Act (PIMA) of 2019. Advocate regarding possible changes to IOASE and Stark Law relative to implementation of Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110) Support H.R. 2282/S.966 Medicare Care Coordination Improvement Act of 2019 Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Advocate against a Medicare physician payment freeze beginning in January 2020 that was created under MACRA (P.L. 114-110) and the creation of the Quality Payment Program. Advocate expanding the period for reporting and returning overpayments beyond the 60 days statutorily required under audits by Recovery Audit Contractors (RACs). Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. Support H.R. 3302, Keep Physicians Serving Patients Act. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services Request relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548, H.R. 133) Extend moratorium of the Medicare sequester included in the CARES Act until end of COVID-19 public health emergency in H.R. 133, Consolidated Appropriations Act, 2021. Support H.R. 8840, the Medicare Sequester COVID Moratorium Act, which would extend relief from the Medicare sequester through end of the COVID 19 public health emergency (PHE). Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 7233) Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act Support S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act.

Client expense: $310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H.R. 1959, Preserving Patient Access to Compounded Medications Act. Support H.R. 2077/S. 2546, Safe Step Act. Support H.R. 1035, Prescription Drug Price Transparency Act. Support H.R. 985, Fair Access for Safe and Timely Generics Act. Support S. 476, C-THRU Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act. Support H.R. 1034/S. 640, Phair Pricing Act. Support S. 657, Drug Price Transparency Act Support H.R. 938, BLOCKING Act Support H.R. 2375/S. 64, Preserve Access to Affordable Generics & Biosimilars Act Support H.R. 1499, Protecting Consumer Access to Generic Drugs Act Support H.R. 2296/S. 1391, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 2069, Stopping the Pharmaceutical Industry from Keeping drugs Expensive (SPIKE) Act. Support H.R. 2115, Public Disclosure of Drug Discounts Act Support H.R. 2376/S. 1227, Prescription Pricing for the People Act Support H.R. 1379/S. 560, Ensuring Lasting Smiles Act. Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Support pediatric subspecialty loan repayment in any reauthorization of the Title VII programs. Support S. 2443 Investment in Tomorrows Pediatric Health Care Workforce Act Support H.R. 1554, Resident Education Deferred Interest (REDI) Act. Advocate for the continued and increased funding of Community Health Centers. Lobby members of Congress to cosponsor H. Res. 323, which would support state, local, and community initiatives to encourage parents, teachers, camp counselors, and childcare professionals to take measures to prevent sunburns in the minors they care for, and would express the sense of the House of Representatives that state, local, and community entities should continue to support efforts to curb the incidences of skin cancer beginning with childhood skin protection. In the context of legislation to address surprise medical bills, advocate for an independent dispute resolution (IDR) process to resolve disputes between payers and physicians and against provisions that would set out-of-network reimbursement rates at a benchmark level. (H.R. 2328, H.R. 3502, S. 1531, S. 1895, H.R. 133) Support H.R. 4575, Improving Provider Directories Act, which would require group health plans and health insurance issuers offering group or individual health insurance coverage to establish a process to address inaccurate information listed in publicly accessible provider directories of such plans and issuers. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services. Support legislation to address drug shortages by providing additional authority to the Food and Drug Administration (FDA) to ensure a stable supply of medications (S. 2723, Mitigating Emergency Drug Shortages Act; H.R. 6080, Preventing Drug Shortages Act). Similar provisions to mitigate drug shortages included in CARES Act (H.R. 748, S. 3548). Request resources to provide personal protection equipment (PPE) and supplies and relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548). Support the Coronavirus Health Care Worker Wellness Act (H.R. 7255) to help promote mental health wellness among physicians and other health care workers during the Public Health Emergency. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package (H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act; S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule; H.R. 133, Consolidated Appropriations Act, 2021). Support H.R. 7233, the KEEP Telehealth Options Act. Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act

Client expense: $310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Oppose H.R. 2143, Promoting Integrity in Medicare Act (PIMA) of 2019. Advocate regarding possible changes to IOASE and Stark Law relative to implementation of Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110) Support H.R. 2282/S.966 Medicare Care Coordination Improvement Act of 2019 Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Advocate against a Medicare physician payment freeze beginning in January 2020 that was created under MACRA (P.L. 114-110) and the creation of the Quality Payment Program. Advocate expanding the period for reporting and returning overpayments beyond the 60 days statutorily required under audits by Recovery Audit Contractors (RACs). Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. Support H.R. 3302, Keep Physicians Serving Patients Act. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services Request relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548, H.R. 133) Extend moratorium of the Medicare sequester included in the CARES Act until end of COVID-19 public health emergency in H.R. 133, Consolidated Appropriations Act, 2021. Support H.R. 8840, the Medicare Sequester COVID Moratorium Act, which would extend relief from the Medicare sequester through end of the COVID 19 public health emergency (PHE). Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 7233) Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act Support S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act.

Client expense: $310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H.R. 1959, Preserving Patient Access to Compounded Medications Act. Support H.R. 2077/S. 2546, Safe Step Act. Support H.R. 1035, Prescription Drug Price Transparency Act. Support H.R. 985, Fair Access for Safe and Timely Generics Act. Support S. 476, C-THRU Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act. Support H.R. 1034/S. 640, Phair Pricing Act. Support S. 657, Drug Price Transparency Act Support H.R. 938, BLOCKING Act Support H.R. 2375/S. 64, Preserve Access to Affordable Generics & Biosimilars Act Support H.R. 1499, Protecting Consumer Access to Generic Drugs Act Support H.R. 2296/S. 1391, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 2069, Stopping the Pharmaceutical Industry from Keeping drugs Expensive (SPIKE) Act. Support H.R. 2115, Public Disclosure of Drug Discounts Act Support H.R. 2376/S. 1227, Prescription Pricing for the People Act Support H.R. 1379/S. 560, Ensuring Lasting Smiles Act. Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Support H.R. 3107, Improving Seniors Timely Access to Care Act Support pediatric subspecialty loan repayment in any reauthorization of the Title VII programs. Support S. 2443 Investment in Tomorrows Pediatric Health Care Workforce Act Support H.R. 1554, Resident Education Deferred Interest (REDI) Act. Advocate for the continued and increased funding of Community Health Centers. Lobby members of Congress to cosponsor H. Res. 323, which would support state, local, and community initiatives to encourage parents, teachers, camp counselors, and childcare professionals to take measures to prevent sunburns in the minors they care for, and would express the sense of the House of Representatives that state, local, and community entities should continue to support efforts to curb the incidences of skin cancer beginning with childhood skin protection. In the context of legislation to address surprise medical bills, advocate for an independent dispute resolution (IDR) process to resolve disputes between payers and physicians and against provisions that would set out-of-network reimbursement rates at a benchmark level. (H.R. 2328, H.R. 3502, S. 1531, S. 1895, H.R. 133) Support H.R. 4575, Improving Provider Directories Act, which would require group health plans and health insurance issuers offering group or individual health insurance coverage to establish a process to address inaccurate information listed in publicly accessible provider directories of such plans and issuers. Support the Creating Opportunities Now for Necessary and Effect Care Technologies (CONNECT) for Health Act of 2019 (S. 2741/H.R. 4932), which would increase access to telehealth services. Support legislation to address drug shortages by providing additional authority to the Food and Drug Administration (FDA) to ensure a stable supply of medications (S. 2723, Mitigating Emergency Drug Shortages Act; H.R. 6080, Preventing Drug Shortages Act). Similar provisions to mitigate drug shortages included in CARES Act (H.R. 748, S. 3548). Request resources to provide personal protection equipment (PPE) and supplies and relief from Medicare payment sequester and relief from penalties in Merit-based Incentive Payment System (MIPS) under MACRA in the CARES Act (H.R. 748, S. 3548). Support the Coronavirus Health Care Worker Wellness Act (H.R. 7255) to help promote mental health wellness among physicians and other health care workers during the Public Health Emergency. Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package (H.R. 8702/S. 5007, Holding Providers Harmless from Medicare Cuts During COVID-19 Act; S. 8505, a bill to provide a one-year waiver of budget neutrality adjustment under the Medicare Physician Fee Schedule; H.R. 133, Consolidated Appropriations Act, 2021). Support H.R. 7233, the KEEP Telehealth Options Act. Oppose H.R 884/S. 2772 the Medicare Mental Health Access Act

Client expense: $310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, 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

H.R. 3: Lower Drug Costs Now Act of 2019 - Provisions related to prescription drug pricing, foreign reference pricing, Part D, manufacturer rebates, and other provisions H.R. 19: Lower Costs, More Cures Act of 2019 - Provisions related to prescription drug pricing, transparency, manufacturer rebates and other provisions H.R. 8624: Protecting Access to Innovation During COVID-19 Act - Provisions related to Medicare and prescription drug pricing H.R. 8702: Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 - Provisions related to Part B and physician reimbursement S. 1895: Lower Health Care Costs Act - Provisions related to prescription drug pricing, transparency and patent issues S. 2543: Prescription Drug Pricing Reduction Act of 2019 - Provisions related to prescription drug pricing, transparency, manufacturer rebates and other provisions S. 3129: Lower Costs, More Cures Act of 2019 - Provisions related to prescription drug pricing, transparency, manufacturer rebates and other provisions S. 4199: Prescription Drug Pricing Reduction Act of 2020 - Provisions related to prescription drug pricing, transparency, manufacturer rebates and other provisions S. 4274: Legalizing Drug Discounts for Seniors Act of 2020 - Provisions related to Part D and manufacturer rebates Department of Health and Human Services (HHS) drug policy issues and regulatory policy issues Part D policy issues including non-interference and rebates policy issues Part B reform including MedPAC recommendations and other policy issues and local coverage decisions Drug cost and pricing policy issues Transparency policy issues Alternative payment models policy issues Value-based purchasing arrangements policy issues Anti-Kickback Statute policy issues Center for Medicare and Medicaid Innovation (CMMI) policy issues Medicaid rebates and waiver policy issues Medicare prescription drug payments cards and related issues ASP reporting policy issues AMP cap policy issues Vial size policy issues Non-covered drugs policy issues Drug wastage rebates policy issues Final Rule; Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2021; Notice Requirement for Non-Federal Governmental Plans (RIN 0938-AT98) Final Rule: Medicaid Program; Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based Purchasing (VBP) for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability (TPL) Requirements (RIN 0938-AT82) Final Rule: Transparency in Coverage (RIN 0938-AU04) Interim Final Rule with comment period: Most Favored Nation (MFN) Model (RIN 0938-AT91)/Executive Order Final Rule: Fraud and Abuse; Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees (RIN 0936-AA08)

Client expense: $750,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), SENATE, U.S. Trade Representative (USTR)

Monitor implementation of H.R. 1865, Further Consolidated Appropriations Act, 2020, (Public Law 116-94) and provisions related to policies regarding data collection from laboratories under the Protecting Access to Medicare Act (PAMA) S. 2246, Allergy Testing Access Act of 2019, and H.R. 2009, the Removing Barriers to Allergy Diagnostic Tests Act, and provisions relating to Medicare and Medicaid coverage of allergy diagnostic tests H.R. 1765, the Donald Payne Sr. Colorectal Cancer Detection Act H.R. 8702/S. 5007, the Holding Providers Harmless from Medicare Cuts During COVID-19 Act

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

Government targets: Centers For Disease Control & Prevention (CDC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE

Expressed support for the RISE Act (S.4286) (H.R. 5613) Expressed support for the TREAT Act (S.4421) Requested letters of support for NIOSH Total Worker Health Center grant proposal Expressed support for financial relief for physicians and other providers scheduled to receive cuts in the CMS 2021 Physician Fee Schedule (H.R. 8702) Expressed support for extension of Medicare sequestration relief Expressed support for flexibility in the use of resources from the CARES Act Provider Relief Fund Expressed support for Supporting Children with Disabilities During COVID-19 Act (H.R. 8523)

Client expense: $110,852 · Firm income: Not reported

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

Medicare physician payment; new/alternative payment models; Medicare coverage, including coverage policies pertaining to transcatheter mitral valve repair, hospital payment of cardiovascular services; access to Medicare claims data; physician and hospital quality; electronic health record incentive program; clinical data registries; health care quality; medical imaging and prior authorization, including HR 3107; the Stark Law and the in-office ancillary services exception, including the Medicare Care Coordination Improvement Act (HR 2282/S 966); Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; access to and supervision of Cardiac and Pulmonary Rehabilitation (HR 3911/S 2842); graduate medical education policy including HR 1763/S 348, Resident Physician Shortage Reduction Act of 2019; end of life care; oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy, Medicaid coverage and eligibility, Medicare Part B Home Infusion Services Temporary Transitional Payment Act; Affordable Care Act repeal/replace/reform efforts; Ways and Means Committee Medicare extenders policy/legislation; paclitaxel mortality signal in PAD patients; cardiac CT payment; COVID-19 and the coronavirus, including HR 6074, the Coronavirus Preparedness and Response Supplemental Appropriations Act, HR 6201, the Families First Coronavirus Response Act and HR 748, the Coronavirus Aid, Relief, and Economic Security Act; Protecting Access to Post-COVID-19 Telehealth Act (HR 7663); Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (H.R. 8702/S. 5007)

Client expense: $540,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), 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), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

Medicare Part A, B and D AMP Cap H.R 3 S.2543 - Prescription Drug Pricing Reduction Act of 2019 H.R. 1046/S.377 - Medicare Negotiation and Competitive Licensing Act of 2019 Innovative pharmaceuticals (including cell, gene and radioligand therapies), Biosimilars and Generics Drug Pricing Outcomes Based Contracts/value based arrangements Medicaid H.R.275 - Medicare Prescription Drug Price Negotiation Act of 2019 H.R.448 - Medicare Drug Price Negotiation Act H.R.19 - Lower Costs, More Cures Act of 2019 H.R.107 - To amend title XIX of the Social Security Act to sunset the limit on the maximum rebate amount for single source drugs and innovator multiple source drugs H.R.4455 - BIOSIM Act H.R.4619 - Pharmaceutical Rebates for Excessive Pricing Above Inflation Act HR. 3772 - The Medicare Diagnostic Radiopharmaceutical Payment Equity Act of 2019 HR. 4597 - Acting to Cancel Copays and Ensure Substantial Savings for Biosimilars Act of 2019 S.3466 - ACCESS for Biosimilars Act of 2020 HR. 6179 - Increasing Access to Biosimilars Act of 2020 HR. 4629 - Star Rating for Biosimilars Act S. 3129 - Lower Costs, More Cures Act of 2019 S. 3384 - Lowering Prescription Drug Prices for America's Seniors and Families Act of 2020 S. 3457 - Preserving Patient Access to Home Infusion Act H.R.5741 - Strengthening Innovation in Medicare and Medicaid Act Department of Health and Human Services (HHS) drug policy issues and regulatory policy issues Transparency policy issues Center for Medicare and Medicaid Innovation (CMMI) policy issues ANPRM; Medicare Program; International Pricing Index Model for Medicare Part B Drugs (CMS-5528-ANPRM) Removal of Safe Harbor Protection for Rebates to Plans or PBMs Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection (RIN 0936-AA08) Proposed Rule; Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2021; Notice Requirement for Non-Federal Governmental Plans (CMS-9916-P) Reimbursement for cell therapy products S. 3353/H.R. 5534 - Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act Patient Cost-Sharing and Smoothing S. 4134 - Increasing Access to Biosimilars Act of 2020 S. 102 - Prescription Drug Price Relief Act of 2019 CMS Proposed Rule: Medicaid Program; Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value-Based Purchasing (VBP) or Drugs Covered in Medicaid, Revising Medicaid Rebate and Third Party Liability (TPL) Requirements (CMS-2482-P) H.R. 8624 - Protecting Access to Innovation During COVID-19 Act H.R. 8702 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 S. 1895 - Lower Health Care Costs Act S. 4199 - Prescription Drug Pricing Reduction Act of 2020 S. 4274 - Legalizing Drug Discounts for Seniors Act of 2020 Anti-Kickback Statute policy issues Center for Medicare and Medicaid Innovation (CMMI) policy issues Medicaid rebates and waiver policy issues Medicare prescription drug payments cards and related issues ASP reporting policy issues Non-covered drugs policy issues Drug wastage rebates policy issues

Client expense: $660,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Trade Representative (USTR), 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