TIKES Act

Issue: Support policies to close the Medicaid coverage gap, including through 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. Issue: Support programs and funds for safety-net providers. Educate Congress about the impact of Section 203 of the Consolidated Appropriations Act, 2021 and its changes to the Medicaid DSH cap calculation methodology on academic medical centers. P.L. 117-328, Consolidated Appropriations Act, 2023 Division FF Issue: Support increased Medicare funding for graduate medical education, including 200 new Medicare-supported GME slots included in the Consolidated Appropriations Act, 2023. H.R. 2256 / S. 834, Resident Physician Shortage Reduction Act of 2021 H.R. 5376, Build Back Better Act Issue: Support increased Medicare funding for graduate medical education S. 1438 Opioid Workforce Act H.R. 3441 Substance Use Disorder Workforce Act Issue: Support targeted Medicare funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs S.1893 / H.R. 8508, Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals Issue: Provide feedback to CMS on its proposed distribution of the 1,000 new GME slots authorized be the Consolidated Appropriations Act, 2021 as described in the 2022 Inpatient Prospective Payment System (IPPS) proposed rule. Support CMS adopting alternative 2 with modifications to allow for more than 1.0 FTE per hospital. Support policy to ensure each qualifying hospital that applies for CAA, 2021 GME positions would receive at least 1 (or a fraction of 1) of the positions before any qualifying hospital receives more than 1 of such positions 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 establishing nationality-based restrictions on medical residencies supported by Medicare Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose Medicare hospital, physician, and provider cuts. H.R. 8850, Fair Access In Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. 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. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives H.R.3173 / S.3018, Improving Seniors Timely Access to Care Act Issue: 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. Draft Medicare Part D benefit re-design legislation Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support expansion of Medicaid and CHIP coverage during the postpartum period. S. 610, Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 315, Medicare Sequester COVID Moratorium Act S. 748, Medicare Sequester Relief Act H.R. 1868, To prevent across-the-board direct spending cuts, and for other purposes. Issue: Support extension of Medicare sequester moratorium. P.L. 117-328, Consolidated Appropriations Act, 2023 Issue: Support clearing the PAYGO scorecard to avoid another Medicare sequester due to the use of reconciliation to pass the American Rescue Plan Act. Issue: Oppose use of extended Medicare sequester and repurposing of unused Provider Relief Fund. P.L. 117-328, Consolidated Appropriations Act, 2023 Division FF H.R.8800, Supporting Medicare Providers Act of 2022 Issue: Support a 4.42% increase in the Medicare physician fee schedule that Congress provided in the Consolidated Appropriations Act, 2021 to avoid payment cuts due to budget neutrality requirements. 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 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: Oppose aspects of 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 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 policy of incorporating revenue distinctions into the Medicare Shared Savings Program. P.L. 117-328, Consolidated Appropriations Act, 2023 Division FF Issue: Support permanent extension of Medicare telehealth waivers, including removing patient location restrictions and rural site requirements, allowing payment for audio-only services, and reimbursing providers for telehealth services as services delivered in-person. Support 2 year or permanent extension of the waivers. P.L. 117-328, Consolidated Appropriations Act, 2023 Division FF H.R. 7053 / S. 3792, Hospital Inpatient Services Modernization Act Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support permanent extension of current Covid telehealth flexibilities HR 1332, the Telehealth Modernization Act Issue: Support efforts to expand patient access to telehealth HR 1397, the Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP Issue: Support efforts to improve access to childrens mental health care H.R. 4040 Advancing Telehealth Beyond COVID-19 Act of 2021 Issue: Support extension of COVID-19 telehealth waivers for two years beyond the end of the COVID-19 public health emergency. H.R. 7961 - Safety from Violence for Healthcare Employees Act (SAVE Act)Issue: Support funding for hospital-based violence intervention programs and community violence interventions Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support expanded Medicare reimbursement for integrated behavioral health Medicare payment codes. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). S. 2061 Telemental Health Care Access Act Issue: Support policy to remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create IME payments for outpatient services while remaining budget neutral. Issue: Support efforts to reverse cuts in Medicare OPPS reimbursements to hospitals for drugs acquired under the 340B program. H.R. 4547, Value in Health Care Act Issue: Support changes to alternative payment models (APMs) to increase participation in value-based health programs and promote quality care and improved health outcomes. P.L. 117-328, Consolidated Appropriations Act, 2023 Issue: Support extension of alternative payment model (APM) bonus. H.R. 3746, Accountable Care in Rural America Act Issue: Support improving the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location. H.R. 4970, Rural Medical Residency Expansion Act of 2021 Issue: Support providing funds for rural teaching hospitals to expand their residency programs. Issue: Support efforts to investigate nurse-staffing agencies conduct during the COVID-19 pandemic.

Client expense: $876,000 · 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), SENATE, White House Office

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act S 2691- Strengthening the Vaccines for Children Program Act of 2021 HR 2347- Strengthening the Vaccines for Children Program Act of 2021 HR 7236 Strengthen Kids' Mental Health Now Act HR 8295 Labor HHS FY23 Appropriations HR 6833 Continuing Appropriations Act of 2023 S 4747 Investing in Kids Mental Health Now Act S 4472 Health Care Capacity for Pediatric Mental Health HR 2617 Consolidated Appropriations Act of 2023 General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

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

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act S 2691- Strengthening the Vaccines for Children Program Act of 2021 HR 2347- Strengthening the Vaccines for Children Program Act of 2021 HR 7236 Strengthen Kids' Mental Health Now Act HR 8295 Labor HHS FY23 Appropriations HR 6833 Continuing Appropriations Act of 2023 S 4747 Investing in Kids Mental Health Now Act S 4472 Health Care Capacity for Pediatric Mental Health HR 2617 Consolidated Appropriations Act of 2023 General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

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

Safe Step Act (H.R.2163/S. 464); Telehealth Improvement for Kids' Essential Services Act "TIKES Act",(H.R. 1397/S. 1798); National Triple-Negative Breast Cancer Day (H.R.185); March 2021 as National Colorectal Cancer Awareness Month (H.R. 209); Improving Senior's Timely Access to Care Act (H.R. 3173);Lymphedema Treatment Act. (H.R. 3630/S. 1315) Waiting for reintroduction: Palliative Care Hospice Education & Treatment Act ("PCHETA"); Cancer Drug Parity Act;

Client expense: $217,224 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE, White House Office

H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd - Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital 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 2023 policy and technical regulation for MA and Part D; issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2023 Rate Notice; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; issues related to specialty infant formula; issues related to the Inflation Reduction Act passage and implementation; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to Managed Long Term Services and Supports (MLTSS); issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; 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 or legislation, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; 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 value based payment 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; 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; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); issues relating to potential Medicare mental health parity requirements; 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 Affordable Care Act (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; 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; 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. *Add MACPAC to Agency List.

Issues regarding childrens health care coverage and access to care under Medicaid, CHIP, the Exchanges, and private insurance Issues related to implementation of aspects of childrens health coverage under Medicaid, CHIP, the Exchanges, and private insurance Issues regarding the implementation of the ACE Kids Act S.1544/H.R. 3089 - Accelerating Kids Access to Care Act H.R. 7076/S. 3864, the Supporting Childrens Mental Health Care Access Act H.R. 7236 Strengthen Kids Mental Health Now Act S. 4472 Health Care Capacity for Pediatric Mental Health Act Issues regarding childrens health included in Build Back Better Act/reconciliation H.R. 4934, the Childrens Mental Health Infrastructure Act, H.R. 4944, the Helping Kids Cope Act, S.1902, the Behavioral Health Crisis Services Expansion Act Issues regarding childrens mental health, the national emergency in childrens mental health, and the Surgeon General Advisory on youth mental health. Issue regarding Medicaid supplemental payments HR. 3753/S. 1962 - Parity Implementation Act S.2762/H.R. 5131, the Pediatric Access to Critical Healthcare (PATCH) Act, and issues regarding pediatric health care infrastructure and capacity Issues regarding the importance of Medicaid to military and veteran families FY 2022 and FY 2023 Senate and House Labor-HHS appropriations provisions - Children's Hospitals Graduate Medical Education (CHGME) program funding Issues regarding Children's Hospitals Graduate Medical Education (CHGME) program reauthorization appropriations Issues related to 340B Drug Pricing Program, prescription drug pricing, drug shortages, and pharmaceutical supply chain, including H.R. 4390, the PROTECT 340B Act of 2021 Issues related to Provider Relief Funding Issues related to pediatric workforce Issues regarding the passage and implementation of COVID-19 relief packages, increased FMAP funding, and the impact of COVID-19 on childrens hospitals, the pediatric supply chain, and pediatric residency programs Issues regarding COVID-19 vaccination efforts for children Issues regarding surprise billing bad debt, and price transparency in health care H.R. 1397 - Telehealth Improvement for Kids Essential Services (TIKES) Act and broader telehealth policies Mental health funding provided in Consolidated Appropriations Act and ARPA Issues regarding the Public Health Emergency Issues regarding 340B drug program and other drug issues H.R. 7691, Safety from Violence for Healthcare Employees (SAVE) Act H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022 S.4170, The Mental Health Reform Reauthorization Act of 2022 Issues regarding infant formula shortage Issues regarding food security and nutrition Issues regarding medical device shortages Issues regarding climate change S. 4747, Investing in Kids Mental Health Now Act

Issues regarding childrens health care coverage and access to care under Medicaid and CHIP. Issues related to eligibility and enrollment, access to care and payment in response to CMS RFI on Medicaid and CHIP Issues related to implementation of aspects of childrens health coverage under Medicaid and CHIP, including unwinding of the Public Health Emergency. Issues regarding childrens health included in Build Back Better Act/reconciliation Issue regarding Medicaid supplemental payments Issues regarding the implementation of the ACE Kids Act S.1544/H.R. 3089 - Accelerating Kids Access to Care Act Issues regarding the importance of Medicaid to military and veteran families Issue regarding the passage and implementation of COVID-19 relief packages, increased FMAP funding, and the impact of COVID-19 on childrens hospitals, the pediatric supply chain, and pediatric residency programs. Issues related to pediatric telehealth, including H.R. 1397 - Telehealth Improvement for Kids Essential Services (TIKES) Act H.R. 7236, Strengthen Kids Mental Health Now Act S. 4747, Investing in Kids Mental Health Now Act

Client expense: $565,000 · Firm income: Not reported

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act S 2691- Strengthening the Vaccines for Children Program Act of 2021 HR 2347- Strengthening the Vaccines for Children Program Act of 2021 HR 7236 Strengthen Kids' Mental Health Now Act HR 8295 Labor HHS FY23 Appropriations HR 6833 Continuing Appropriations Act of 2023 S 4747 Investing in Kids Mental Health Now Act S 4472 Health Care Capacity for Pediatric Mental Health General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

Client expense: $37,000 · Firm income: Not reported

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act S 2691- Strengthening the Vaccines for Children Program Act of 2021 HR 2347- Strengthening the Vaccines for Children Program Act of 2021 HR 7236 Strengthen Kids' Mental Health Now Act HR 8295 Labor HHS FY23 Appropriations HR 6833 Continuing Appropriations Act of 2023 S 4747 Investing in Kids Mental Health Now Act S 4472 Health Care Capacity for Pediatric Mental Health General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

Client expense: $37,000 · Firm income: Not reported

Issue: Support policies to close the Medicaid coverage gap, including through 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. Issue: Support programs and funds for safety-net providers. Educate Congress about the impact of Section 203 of the Consolidated Appropriations Act, 2021 and its changes to the Medicaid DSH cap calculation methodology on academic medical centers. Support legislative efforts to address concerns. H.R. 2256 / S. 834, Resident Physician Shortage Reduction Act of 2021 Issue: Support increased Medicare funding for graduate medical education S. 1438 Opioid Workforce Act H.R. 3441 Substance Use Disorder Workforce Act Issue: Support targeted Medicare funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs S.1893 / H.R. 8508, Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals Issue: Provide feedback to CMS on its proposed distribution of the 1,000 new GME slots authorized be the Consolidated Appropriations Act, 2021 as described in the 2022 Inpatient Prospective Payment System (IPPS) proposed rule. Support CMS adopting alternative 2 with modifications to allow for more than 1.0 FTE per hospital. 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 establishing nationality-based restrictions on medical residencies supported by Medicare Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose Medicare hospital cuts. H.R. 8850 Fair Access In Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. 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. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives H.R.3173 / S.3018, Improving Seniors Timely Access to Care Act Issue: 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. Draft Medicare Part D benefit re-design legislation Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Issue: Support expansion of Medicaid and CHIP coverage for postpartum women. S. 610 Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 315 Medicare Sequester COVID Moratorium Act S. 748 Medicare Sequester Relief Act H.R. 1868 To prevent across-the-board direct spending cuts, and for other purposes. Issue: Support extension of Medicare sequester moratorium. Issue: Support clearing the PAYGO scorecard to avoid another Medicare sequester due to the use of reconciliation to pass the American Rescue Plan Act. Issue: Oppose use of extended Medicare sequester and repurposing of unused Provider Relief Fund. H.R.8800 - Supporting Medicare Providers Act of 2022 Issue: Support a 4.42% increase in the Medicare physician fee schedule that Congress provided in the Consolidated Appropriations Act, 2021 to avoid payment cuts due to budget neutrality requirements. 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 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: Oppose aspects of 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 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 policy of incorporating revenue distinctions into the Medicare Shared Savings Program. Issue: Support permanent extension of Medicare telehealth waivers, including removing patient location restrictions and rural site requirements, allowing payment for audio-only services, and reimbursing providers for telehealth services as services delivered in-person. Support 2 year or permanent extension of the waivers. H.R. 7053 / S. 3792, Hospital Inpatient Services Modernization Act Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support permanent extension of current Covid telehealth flexibilities HR 1332, the Telehealth Modernization Act Issue: Support efforts to expand patient access to telehealth HR 1397, the Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP Issue: Support efforts to improve access to childrens mental health care H.R. 4040 Advancing Telehealth Beyond COVID-19 Act of 2021 Issue: Support extension of COVID-19 telehealth waivers for two years beyond the end of the COVID-19 public health emergency. Issue: Support funding for hospital-based violence intervention programs and community violence interventions S. 2061 Telemental Health Care Access Act Issue: Support policy to remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services H.R. 3173/Sr. 3018 Improving Seniors Timely Access to Care Act of 2022 Issue: Support policy that would implement an electronic prior authorization program in Medicare Advantage that would simplify processes and save time for both providers and patients. Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create IME payments for outpatient services while remaining budget neutral. Issue: Support efforts to reverse cuts in Medicare OPPS reimbursements to hospitals for drugs acquired under the 340B program. Draft Value in Health Care Act Issue: Support changes to alternative payment models (APMs) to increase participation in value-based health programs and promote quality care and improved health outcomes. H.R. 3746 Accountable Care in Rural America Act Issue: Support improving the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location. H.R. 4970 Rural Medical Residency Expansion Act of 2021 Issue: Support providing funds for rural teaching hospitals to expand their residency programs. Issue: Support efforts to investigate nurse-staffing agencies conduct during the COVID-19 pandemic.

Safe Step Act (H.R.2163/S. 464); Telehealth Improvement for Kids' Essential Services Act "TIKES Act",(H.R. 1397/S. 1798); National Triple-Negative Breast Cancer Day (H.R.185); March 2021 as National Colorectal Cancer Awareness Month (H.R. 209); Improving Senior's Timely Access to Care Act (H.R. 3173);Lymphedema Treatment Act. (H.R. 3630/S. 1315) Waiting for reintroduction: Palliative Care Hospice Education & Treatment Act ("PCHETA"); Cancer Drug Parity Act;

Client expense: $78,913 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE, White House Office

Issue: Support policies to close the Medicaid coverage gap, including through 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. Issue: Support programs and funds for safety-net providers. Educate Congress about the impact of Section 203 of the Consolidated Appropriations Act, 2021 and its changes to the Medicaid DSH cap calculation methodology on academic medical centers. Support legislative efforts to address concerns. H.R. 2256 / S. 834, Resident Physician Shortage Reduction Act of 2021 Issue: Support increased Medicare funding for graduate medical education S. 1438 Opioid Workforce Act H.R. 3441 Substance Use Disorder Workforce Act Issue: Support targeted Medicare funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs S.1893, Draft House bill Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals H.R. 5376, Build Back Better Act Issue: Support additional Medicare funding for graduate medical education slots. Support efforts to increase physician workforce diversification through novel, targeted scholarship programs. Support protection of the 340B Drug Pricing Program in the budget reconciliation package. Support for 12-months continuous coverage for children on Medicaid and CHIP. Support extending the enhanced ACA marketplace subsidies and addressing the Medicaid coverage gap . Support extending life of Medicare Hospital Insurance Trust Fund. Issue: Provide feedback to CMS on its proposed distribution of the 1,000 new GME slots authorized be the Consolidated Appropriations Act, 2021 as described in the 2022 Inpatient Prospective Payment System (IPPS) proposed rule. Support CMS adopting alternative 2 with modifications to allow for more than 1.0 FTE per hospital. 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 establishing nationality-based restrictions on medical residencies supported by Medicare Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose Medicare hospital cuts . Issue: Oppose overly burdensome Medicaid GME transparency language. Issue: Oppose policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. 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. Issue: Educate Congress on Consolidated Appropriations Act, 2021 (CAA Sec. 203) changes to the Medicaid shortfall calculations and the potential impact on Medicaid DSH payments Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives H.R.3173 / S.3018, Improving Seniors Timely Access to Care Act Issue: 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. Draft Medicare Part D benefit re-design legislation Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Issue: Support expansion of Medicaid and CHIP coverage for postpartum women. S. 610 Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 315 Medicare Sequester COVID Moratorium Act S. 748 Medicare Sequester Relief Act H.R. 1868 To prevent across-the-board direct spending cuts, and for other purposes. Issue: Support extension of Medicare sequester moratorium. Issue: Support clearing the PAYGO scorecard to avoid another Medicare sequester due to the use of reconciliation to pass the American Rescue Plan Act. Issue: Oppose use of extended Medicare sequester and repurposing of unused Provider Relief Fund. Issue: Support congressional extension of 3.75% temporary increase in the Medicare physician fee schedule that Congress provided in the Consolidated Appropriations Act, 2021 to avoid payment cuts due to budget neutrality requirements. 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 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: Oppose aspects of 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 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 policy of incorporating revenue distinctions into the Medicare Shared Savings Program. Issue: Support permanent extension of Medicare telehealth waivers, including removing patient location restrictions and rural site requirements, allowing payment for audio-only services, and reimbursing providers for telehealth services as services delivered in-person. Support 2 year or permanent extension of the waivers. H.R. 7053 / S. 3792, Hospital Inpatient Services Modernization Act Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support permanent extension of current Covid telehealth flexibilities HR 1332, the Telehealth Modernization Act Issue: Support efforts to expand patient access to telehealth HR 1397, the Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP Issue: Support efforts to improve access to childrens mental health care Issue: Support funding for hospital-based violence intervention programs and community violence interventions S. 2061 Telemental Health Care Access Act Issue: Support policy to remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create IME payments for outpatient services while remaining budget neutral. Issue: Support efforts to reverse cuts in Medicare OPPS reimbursements to hospitals for drugs acquired under the 340B program. Draft Value in Health Care Act Issue: Support changes to alternative payment models (APMs) to increase participation in value-based health programs and promote quality care and improved health outcomes. H.R. 3746 Accountable Care in Rural America Act Issue: Support improving the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location. H.R. 4970 Rural Medical Residency Expansion Act of 2021 Issue: Support providing funds for rural teaching hospitals to expand their residency programs. Issue: Support efforts to investigate nurse-staffing agencies conduct during the COVID-19 pandemic.

Issues regarding childrens health care coverage and access to care under Medicaid and CHIP. Issues related to eligibility and enrollment, access to care and payment in response to CMS RFI on Medicaid and CHIP Issues related to implementation of aspects of childrens health coverage under Medicaid and CHIP, including unwinding of the Public Health Emergency. Issues regarding childrens health included in Build Back Better Act/reconciliation Issue regarding Medicaid supplemental payments Issues regarding the implementation of the ACE Kids Act S.1544/H.R. 3089 - Accelerating Kids Access to Care Act Issues regarding the importance of Medicaid to military and veteran families Issue regarding the passage and implementation of COVID-19 relief packages, increased FMAP funding, and the impact of COVID-19 on childrens hospitals, the pediatric supply chain, and pediatric residency programs. Issues related to pediatric telehealth, including H.R. 1397 - Telehealth Improvement for Kids Essential Services (TIKES) Act H.R. 7236, Strengthen Kids Mental Health Now Act

Client expense: $770,000 · Firm income: Not reported

Issues regarding childrens health care coverage and access to care under Medicaid, CHIP, the Exchanges, and private insurance Issues related to implementation of aspects of childrens health coverage under Medicaid, CHIP, the Exchanges, and private insurance Issues regarding the implementation of the ACE Kids Act S.1544/H.R. 3089 - Accelerating Kids Access to Care Act H.R. 7076/S. 3864, the Supporting Childrens Mental Health Care Access Act H.R. 7249/S. 2686, the Anna Westin Legacy Act S. 3663 Kids Online Safety Act H.R. 7236 Strengthen Kids Mental Health Now Act S. 4472 Health Care Capacity for Pediatric Mental Health Act Issues regarding childrens health included in Build Back Better Act/reconciliation H.R. 4934, the Childrens Mental Health Infrastructure Act, H.R. 4944, the Helping Kids Cope Act, S.1902, the Behavioral Health Crisis Services Expansion Act, H.R. 5772, Brycen Gray and Ben Price COVID-19 Neurological Impact Act, H.R. 5703, the Post-Disaster Mental Health Response Act, Issues regarding childrens mental health, the national emergency in childrens mental health, and the Surgeon General Advisory on youth mental health. Issue regarding Medicaid supplemental payments HR. 3753/S. 1962 - Parity Implementation Act S.2762/H.R. 5131, the Pediatric Access to Critical Healthcare (PATCH) Act, and issues regarding pediatric health care infrastructure and capacity Issues regarding the importance of Medicaid to military and veteran families FY 2022 and FY 2023 Senate and House Labor-HHS appropriations provisions - Children's Hospitals Graduate Medical Education (CHGME) program funding Issues regarding Children's Hospitals Graduate Medical Education (CHGME) program reauthorization appropriations Issues related to 340B Drug Pricing Program, prescription drug pricing, drug shortages, and pharmaceutical supply chain, including H.R. 4390, the PROTECT 340B Act of 2021 Issues related to Provider Relief Funding Issues related to pediatric workforce Issues regarding the passage and implementation of COVID-19 relief packages, increased FMAP funding, and the impact of COVID-19 on childrens hospitals, the pediatric supply chain, and pediatric residency programs Issues regarding COVID-19 vaccination efforts for children Issues regarding surprise billing in health care H.R. 1397 - Telehealth Improvement for Kids Essential Services (TIKES) Act and broader telehealth policies Mental health funding provided in Consolidated Appropriations Act and ARPA Issues regarding the Public Health Emergency Issues regarding 340B drug program and other drug issues H.R. 3467, Improving Data Collection for Adverse Childhood Experiences Act H.R. 7691, Safety from Violence for Healthcare Employees (SAVE) Act H.R. 7255, the Garrett Lee Smith Memorial Reauthorization Act H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022 S.4170, The Mental Health Reform Reauthorization Act of 2022 Issues regarding infant formula shortage Issues regarding medical device shortages Issues regarding climate change HR 623, the Gabriella Miller Kids First Research Act 2.0

H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd - Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital 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 2023 policy and technical regulation for MA and Part D; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2023 Rate Notice; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; 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, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; 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 or legislation, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; 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 value based payment 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; 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; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); issues relating to potential Medicare mental health parity requirements; 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 Affordable Care Act (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; 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.

Medicaid and Social Determinants of Health (SDOH) legislation (proposal under development related to social determinants of health) S. 1798 and H.R.1397, Telehealth Improvement for Kids' Essential Services Act or the TIKES Act (provisions of the TIKES Act were included in the Bipartisan Safer Communities Act (P.L.# 117-159)) H.R. 7236, Strengthen Kids Mental Health Now Act of 2022 S.2112 and H.R.4036, Enhance Access to Support Essential Behavioral Health Services (EASE) Act S. 3389 and H.R. 6216, Sickle Cell Disease Comprehensive Care Act Senate Finance Committee's Youth Mental Health Discussion Draft

Client expense: $174,436 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act S 2691- Strengthening the Vaccines for Children Program Act of 2021 HR 2347- Strengthening the Vaccines for Children Program Act of 2021 HR 7236 Strengthen Kids' Mental Health Now Act HR 8295 Labor HHS FY23 Appropriations General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

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

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

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act S 2691- Strengthening the Vaccines for Children Program Act of 2021 HR 2347- Strengthening the Vaccines for Children Program Act of 2021 HR 7236 Strengthen Kids' Mental Health Now Act HR 8295 Labor HHS FY23 Appropriations General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

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

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

Safe Step Act (H.R.2163/S. 464); Telehealth Improvement for Kids' Essential Services Act "TIKES Act",(H.R. 1397/S. 1798); National Triple-Negative Breast Cancer Day (H.R.185); March 2021 as National Colorectal Cancer Awareness Month (H.R. 209); Improving Senior's Timely Access to Care Act (H.R. 3173);Lymphedema Treatment Act. (H.R. 3630/S. 1315) Waiting for reintroduction: Palliative Care Hospice Education & Treatment Act ("PCHETA"); Cancer Drug Parity Act;

Client expense: $96,545 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE, White House Office

H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd -- Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital 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 2023 policy and technical regulation for MA and Part D; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2023 Rate Notice; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; 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, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; 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; 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 value based payment 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; 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; issues relating to MACRA, including implications for MA and Part D plans; 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 Affordable Care Act (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; 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.

Medicaid and Social Determinants of Health (SDOH) legislation (proposal under development related to social determinants of health) S. 1798 and H.R.1397, TIKES Act H.R. 7236 Strengthen Kids Mental Health Now Act of 2022 S.2112 and H.R.4036, The Enhance Access to Support Essential Behavioral Health Services (EASE) Act

Client expense: $186,520 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issue: Support policies to close the Medicaid coverage gap, including through 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. H.R. 2256 / S. 834, Resident Physician Shortage Reduction Act of 2021 Issue: Support increased Medicare funding for graduate medical education S. 1438 Opioid Workforce Act H.R. 3441 Substance Use Disorder Workforce Act Issue: Support targeted Medicare funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs S.1893, Draft House bill Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals H.R. 5376, Build Back Better Act Issue: Support additional Medicare funding for graduate medical education slots. Support efforts to increase physician workforce diversification through novel, targeted scholarship programs. Support protection of the 340B Drug Pricing Program in the budget reconciliation package. Support for 12-months continuous coverage for children on Medicaid and CHIP. Support extending the enhanced ACA market place subsidies and addressing the Medicaid coverage gap. Issue: Provide feedback to CMS on its proposed distribution of the 1,000 new GME slots authorized be the Consolidated Appropriations Act, 2021 as described in the 2022 Inpatient Prospective Payment System (IPPS) proposed rule. Support CMS adopting alternative 2 with modifications to allow for more than 1.0 FTE per hospital. 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: Oppose policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. 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. Issue: Educate Congress on Consolidated Appropriations Act, 2021 (CAA Sec. 203) changes to the Medicaid shortfall calculations and the potential impact on Medicaid DSH payments Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives H.R.3173 / S.3018, Improving Seniors Timely Access to Care Act Issue: 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. Medicare Part D benefit re-design Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Issue: Support expansion of Medicaid and CHIP coverage for postpartum women. S. 610 Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 315 Medicare Sequester COVID Moratorium Act S. 748 Medicare Sequester Relief Act H.R. 1868 To prevent across-the-board direct spending cuts, and for other purposes. Issue: Support extension of Medicare sequester moratorium. Issue: Support clearing the PAYGO scorecard to avoid another Medicare sequester due to the use of reconciliation to pass the American Rescue Plan Act. Issue: Oppose use of extended Medicare sequester and repurposing of unused Provider Relief Fund. Issue: Support congressional extension of 3.75% temporary increase in the Medicare physician fee schedule that Congress provided in the Consolidated Appropriations Act, 2021 to avoid payment cuts due to budget neutrality requirements. 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 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: Oppose aspects of 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 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 policy of incorporating revenue distinctions into the Medicare Shared Savings Program. Issue: Support permanent extension of Medicare telehealth waivers, including removing patient location restrictions and rural site requirements, allowing payment for audio-only services, and reimbursing providers for telehealth services as services delivered in-person. Support 2 year or permanent extension of the waivers. H.R. 7053 / S. 3792, Hospital Inpatient Services Modernization Act Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support permanent extension of current Covid telehealth flexibilities HR 1332, the Telehealth Modernization Act Issue: Support efforts to expand patient access to telehealth HR 1397, the Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP Issue: Support efforts to improve access to childrens mental health care Issue: Support funding for hospital-based violence intervention programs and community violence interventions S. 2061 Telemental Health Care Access Act Issue: Support policy to remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create IME payments for outpatient services while remaining budget neutral. Issue: Support efforts to reverse cuts in Medicare OPPS reimbursements to hospitals for drugs acquired under the 340B program. Draft Value in Health Care Act Issue: Support changes to alternative payment models (APMs) to increase participation in value-based health programs and promote quality care and improved health outcomes. H.R. 3746 Accountable Care in Rural America Act Issue: Support improving the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location. H.R. 4970 Rural Medical Residency Expansion Act of 2021 Issue: Support providing funds for rural teaching hospitals to expand their residency programs. Issue: Support efforts to investigate nurse-staffing agencies conduct during the COVID-19 pandemic.

Issues regarding childrens health care coverage and access to care under Medicaid and CHIP. Issues related to eligibility and enrollment, access to care and payment in response to CMS RFI on Medicaid and CHIP Issues related to implementation of aspects of childrens health coverage under Medicaid and CHIP, including unwinding of the Public Health Emergency. Issues regarding childrens health included in Build Back Better Act Issue regarding Medicaid supplemental payments Issues regarding the implementation of the ACE Kids Act S.1544/H.R. 3089 - Accelerating Kids Access to Care Act Issues regarding the importance of Medicaid to military and veteran families Issue regarding the passage and implementation of COVID-19 relief packages, increased FMAP funding, and the impact of COVID-19 on childrens hospitals, the pediatric supply chain, and pediatric residency programs. H.R. 1397 - Telehealth Improvement for Kids Essential Services (TIKES) Act

Client expense: $1,120,000 · Firm income: Not reported

Issues regarding childrens health care coverage and access to care under Medicaid, CHIP, the Exchanges, and private insurance Issues related to implementation of aspects of childrens health coverage under Medicaid, CHIP, the Exchanges, and private insurance Issues regarding the implementation of the ACE Kids Act S.1544/H.R. 3089 - Accelerating Kids Access to Care Act Issues regarding childrens health included in Build Back Better Act H.R. 4934, the Childrens Mental Health Infrastructure Act, H.R. 4944, the Helping Kids Cope Act, S.1902, the Behavioral Health Crisis Services Expansion Act, H.R. 5772, Brycen Gray and Ben Price COVID-19 Neurological Impact Act, H.R. 5703, the Post-Disaster Mental Health Response Act, HR. 3753/S. 1962 - Parity Implementation Act S. 3698 /H.R. 1545 Crisis Counseling Act Issues regarding the crisis continuum of care for children and childrens needs related to implantation of the 988 Suicide lifeline. Issues regarding childrens mental health, the national emergency in childrens mental health, and the Surgeon General Advisory on youth mental health. Issue regarding Medicaid supplemental payments Issues regarding the importance of Medicaid to military and veteran families Issues regarding Children's Hospitals Graduate Medical Education (CHGME) program Issues related to 340B Drug Pricing Program, prescription drug pricing, drug shortages, and pharmaceutical supply chain, including H.R. 4390, the PROTECT 340B Act of 2021 Issues related to Provider Relief Funding Issues related to pediatric workforce Issues regarding the passage and implementation of COVID-19 relief packages, increased FMAP funding, and the impact of COVID-19 on childrens hospitals, the pediatric supply chain, and pediatric residency programs Issues regarding COVID-19 vaccination efforts for children Issues regarding surprise billing in health care H.R. 1397 - Telehealth Improvement for Kids Essential Services (TIKES) Act and broader telehealth policies Mental health funding provided in Consolidated Appropriations Act and ARPA Issues regarding the Public Health Emergency Issues regarding 340B drug program and other drug issues

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act S 2691- Strengthening the Vaccines for Children Program Act of 2021 HR 2347- Strengthening the Vaccines for Children Program Act of 2021 HR 7236 Strengthen Kids' Mental Health Now Act General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

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

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

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act S 2691- Strengthening the Vaccines for Children Program Act of 2021 HR 2347- Strengthening the Vaccines for Children Program Act of 2021 HR 7236 Strengthen Kids' Mental Health Now Act General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

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

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

Medicaid and Social Determinants of Health (SDOH) legislation. S. 1798/H.R. 1397 - TIKES Act. H.R. 3894 - CARING for Social Determinants Act of 2021. S. 2112/H.R. 4036 - The Enhance Access to Support Essential Behavior Health Services (EASE) Act.

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

Safe Step Act (H.R.2163/S. 464); Telehealth Improvement for Kids' Essential Services Act "TIKES Act",(H.R. 1397/S. 1798); National Triple-Negative Breast Cancer Day (H.R.185); March 2021 as National Colorectal Cancer Awareness Month (H.R. 209); Improving Senior's Timely Access to Care Act (H.R. 3173);Lymphedema Treatment Act. (H.R. 3630/S. 1315) Waiting for reintroduction: Palliative Care Hospice Education & Treatment Act ("PCHETA"); Cancer Drug Parity Act;

Client expense: $82,014 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE, White House Office

Medicaid program reforms, including telemedicine Implementation of health care reform Section 340B Drug Pricing program Healthcare disparities issues generally Drug pricing reforms generally Implementation of electronic health records regulations generally Telemedicine policy generally, including FCC COVID-19 Telehealth Program Juvenile mental and behavioral health legislation generally Asthma prevention issues generally H.R. 623 (Gabriella Miller Kids First Research Act 2.0), all provisions H.R. 708 and S. 168 (TREAT Act), all provisions H.R. 1397 and S. 1798 (Telehealth Improvement for Kids Essential Services (TIKES) Act), all provisions H.R. 3089 and S. 1544 (Accelerating Kids Access to Care Act), all provisions H.R. 3773 and S. 1357 (Pediatricians Accelerate Childhood Therapies (PACT) Act), all provisions H.R. 4943 (Children's Mental Health Infrastructure Act of 2021), all provisions H.R. 4944 (Helping Kids Cope Act of 2021), all provisions H.R. 5131 and S. 2762 (Pediatric Access to Critical Healthcare (PATCH) Act), all provisions H.R. 3894 (CARING for Social Determinants Act of 2021), all provisions H.R. 5414 and S. 2689 (Ensuring Medicaid Continuity for Children in Foster Care Act of 2021), all provisions H.R. 959 (Black Maternal Health Momnibus Act of 2021), all provisions H.R. 5585 (Advanced Research Project Agency-Health Act), all provisions Draft 21st Century Cures Act 2.0, regarding regulation of new biomedical products and technologies Neonatal health generally

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

Issue: Support policies to close the Medicaid coverage gap, including through 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. H.R. 2256 / S. 834, Resident Physician Shortage Reduction Act of 2021 Issue: Support increased Medicare funding for graduate medical education S. 1438 Opioid Workforce Act H.R. 3441 Substance Use Disorder Workforce Act Issue: Support targeted Medicare funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs S.1893, Draft House bill Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals H.R. 5376, Build Back Better Act Issue: Support additional Medicare funding for graduate medical education slots. Issue: Support efforts to increase physician workforce diversification through novel, targeted scholarship programs. Issue: Support protection of the 340B Drug Pricing Program in the budget reconciliation package Issue: Support for 12-months continuous coverage for children on Medicaid and CHIP Issue: Support extending the enhanced ACA market place subsidies and addressing the Medicaid coverage gap Rural-Urban Physician Workforce Act Issue: Support improvements to Rural Training Track programs. Issue: Provide feedback to CMS on its proposed distribution of the 1,000 new GME slots authorized be the Consolidated Appropriations Act, 2021 as described in the 2022 Inpatient Prospective Payment System (IPPS) proposed rule. Support CMS adopting alternative 2 with modifications to allow for more than 1.0 FTE per hospital. 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. Issue: Educate Congress on Consolidted Appropriations Act, 2021 (CAA Sec. 203) changes to the Medicaid shortfall calculations and the potential impact on Medicaid DSH payments Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives Draft, Improving Seniors Timely Access to Care Act Issue: Support protecting patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency Issue: Modify CMS Hospital Compare Star Ratings to allow stakeholders time to work together to address concerns with methodology. Support inclusion of sociodemographic status as part of quality programs HHS Rebate Rule Medicare Part D benefit re-design Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Issue: Support expansion of Medicaid and CHIP coverage for postpartum women. S. 610 Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 315 Medicare Sequester COVID Moratorium Act S. 748 Medicare Sequester Relief Act H.R. 1868 To prevent across-the-board direct spending cuts, and for other purposes. Issue: Support extension of Medicare sequester moratorium. Issue: Support clearing the PAYGO scorecard to avoid another Medicare sequester due to the use of reconciliation to pass the American Rescue Plan Act. Issue: Oppose use of extended Medicare sequester and repurposing of unused Provider Relief Fund as a financing mechanism for bipartisan infrastructure package. Issue: Support congressional extension of 3.75% temporary increase in the Medicare physician fee schedule that Congress provided in the Consolidated Appropriations Act, 2021 to avoid payment cuts due to budget neutrality requirements. 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: 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 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 policy of incorporating revenue distinctions into the Medicare Shared Savings Program. Issue: Support permanent extension of Medicare telehealth waivers, including removing patient location restrictions and rural site requirements, allowing payment for audio-only services, and reimbursing providers for telehealth services as services delivered in-person. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support permanent extension of current Covid telehealth flexibilities HR 1332, the Telehealth Modernization Act Issue: Support efforts to expand patient access to telehealth HR 1397, the Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP Issue: Support efforts to improve access to childrens mental health care HR 5035, The Child Suicide Prevention and Lethal Means Safety Act Issue: Support expansion of training for health professionals to prevent self-harm or suicide Issue: Support funding to support hospital-based violence intervention programs and community violence interventions S. 2061 Telemental Health Care Access Act Issue: Support policy to remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create IME payments for outpatient services while remaining budget neutral. Issue: Support efforts to reverse cuts in Medicare OPPS reimbursements to hospitals for drugs acquired under the 340B program. Draft Value in Health Care Act Issue: Support changes to alternative payment models (APMs) to increase participation in value-based health programs and promote quality care and improved health outcomes. H.R. 3746 Accountable Care in Rural America Act Issue: Support improving the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location. H.R. 4970 Rural Medical Residency Expansion Act of 2021 Issue: Support providing funds for rural teaching hospitals to expand their residency programs. Issue: Support efforts to investigate nurse-staffing agencies conduct during the COVID-19 pandemic.

Medicaid program reforms, including telemedicine Implementation of health care reform Section 340B Drug Pricing program Health care disparities issues generally Drug pricing reforms generally Implementation of electronic health records regulations generally Telemedicine policy generally, including FCC COVID-19 Telehealth Program Juvenile mental and behavioral health legislation generally Asthma prevention issues generally H.R. 623 (Gabriella Miller Kids First Research Act 2.0), all provisions H.R. 708 and S. 168 (TREAT Act), all provisions Advanced Research Projects Agency for Health proposed legislation H.R. 1397 and S. 1798 (Telehealth Improvement for Kids' Essential Services (TIKES) Act), all provisions H.R. 3089 and S. 1544 (Accelerating Kids' Access to Care Act), all provisions H.R. 3773 and S. 1357 (Pediatricians Accelerate Childhood Therapies (PACT) Act), all provisions H.R. 4943 (Children's Mental Health Infrastructure Act of 2021), all provisions H.R. 4944 (Helping Kids Cope Act of 2021), all provisions H.R. 5131 and S. 2762 (Pediatric Access to Critical Healthcare (PATCH) Act), all provisions H.R. 3894 (CARING for Social Determinants Act of 2021), all provisions H.R. 5414 and S. 2689 (Ensuring Medicaid Continuity for Children in Foster Care Act of 2021), all provisions H.R. 959 (Black Maternal Health Momnibus Act of 2021), all provisions H.R. 5585 (Advanced Research Project Agency - Health Act), all provisions Draft 21st Century Cures Act 2.0, regarding regulation of new biomedical products and technologies Neonatal health generally

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

H.R. 3894 - CARING for Social Determinants Medicaid and Social Determinants of Health (SDOH) legislation. S. 1798/H.R. 1397 - TIKES Act. H.R. 3894 - CARING for Social Determinants Act of 2021. S. 2112/H.R. 4036 - The Enhance Access to Support Essential Behavior Health Services (EASE) Act. S. 1554/H.R. 3089 - Accelerating Kids' Access to Care Act. H.R. 2503 - Social Determinants Accelerator Act of 2021. S. 1727/H.R. 3450 - The Medicaid BUMP Act.

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

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.P, and DSH.

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

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

HR 5- Equality Act HR 366- Protecting Access to Post-COVID-19 Telehealth Act of 2021 HR 1319- American Rescue Act of 2021 HR 1677- To Direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission... S 620 Keep Telehealth Options Act of 2021 HR 4502- Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act... S. 1544- Accelerating Kids' Access to Care Act HR 3089- Accelerating Kids' Access to Care Act HR 4943- The Children's Mental Health Infrastructure Act of 2021 HR 4944- The Helping Kids Cope Act of 2021 HR 4390- The PROTECT 340B Act HR 1916- Lasting Smiles Act HR 1397- The Telehealth Improvement for Kids' Essential Services HR 3783- Medical Nutrition Equity Act S 2013- Medical Nutrition Equity Act General issues regarding mental health, physical health, Medicaid, CHIP, and DSH.

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

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

Issues regarding childrens health care coverage and access to care under Medicaid, CHIP, the Exchanges, and private insurance Issues related to implementation of aspects of childrens health coverage under Medicaid, CHIP, the Exchanges, and private insurance Issues regarding the implementation of the ACE Kids Act S.1544/H.R. 3089 - Accelerating Kids Access to Care Act Issues regarding childrens health included in Build Back Better Act H.R. 4934, the Childrens Mental Health Infrastructure Act, H.R. 4944, the Helping Kids Cope Act, S.1902, the Behavioral Health Crisis Services Expansion Act, H.R. 5772, Brycen Gray and Ben Price COVID-19 Neurological Impact Act, H.R. 5703, the Post-Disaster Mental Health Response Act, Issues regarding childrens mental health, the national emergency in childrens mental health, and the Surgeon General Advisory on youth mental health. Issue regarding Medicaid supplemental payments reporting requirements and DSH third party policy implementation S.2762/H.R. 5131, the Pediatric Access to Critical Healthcare (PATCH) Act, and issues regarding pediatric health care infrastructure and capacity Issues regarding the importance of Medicaid to military and veteran families FY 2022 Senate and House Labor-HHS appropriations provisions - Children's Hospitals Graduate Medical Education (CHGME) program funding Issues regarding Children's Hospitals Graduate Medical Education (CHGME) program appropriations Issues related to 340B Drug Pricing Program, prescription drug pricing, drug shortages, and pharmaceutical supply chain, including H.R. 4390, the PROTECT 340B Act of 2021 Issues regarding the passage and implementation of COVID-19 relief packages, increased FMAP funding, and the impact of COVID-19 on childrens hospitals, the pediatric supply chain, and pediatric residency programs Issues regarding COVID-19 vaccination efforts for children Issues regarding surprise billing in health care H.R. 1397 - Telehealth Improvement for Kids Essential Services (TIKES) Act Mental health funding provided in Consolidated Appropriations Act and ARPA

Issues regarding childrens health care coverage and access to care under Medicaid and CHIP. Issues related to implementation of aspects of childrens health coverage under Medicaid and CHIP. Issues regarding childrens health included in Build Back Better Act Issue regarding Medicaid supplemental payments reporting requirements and implementation of DSH third party policy Issues regarding the implementation of the ACE Kids Act S.1544/H.R. 3089 - Accelerating Kids Access to Care Act Issues regarding the importance of Medicaid to military and veteran families Issue regarding the passage and implementation of COVID-19 relief packages, increased FMAP funding, and the impact of COVID-19 on childrens hospitals, the pediatric supply chain, and pediatric residency programs. H.R. 1397 - Telehealth Improvement for Kids Essential Services (TIKES) Act

Client expense: $980,000 · Firm income: Not reported

Medicaid and Social Determinants of Health (SDOH) legislation (proposal under development related to social determinants of health) S. 1798 and H.R.1397, TIKES Act H.R.3894, CARING for Social Determinants Act of 2021 S.2112 and H.R.4036, The Enhance Access to Support Essential Behavioral Health Services (EASE) Act S.1554 and H.R.3089, Accelerating Kids Access to Care Act H.R.6216, Sickle Cell Disease Comprehensive Care Act H.R.2503, Social Determinants Accelerator Act of 2021 S.1727 and H.R. 3450, The Medicaid BUMP Act

Client expense: $227,157 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid program reforms, including telemedicine Implementation of health care reform Section 340B Drug Pricing program Healthcare disparities issues generally Drug pricing reforms generally Implementation of electronic health records regulations generally Telemedicine policy generally, including FCC COVID-19 Telehealth Program Mental and behavioral health legislation generally Asthma prevention issues generally H.R. 623 (Gabriella Miller Kids First Research Act 2.0), all provisions H.R. 708 and S. 168 (TREAT Act), all provisions Advanced Research Projects Agency for Health proposed legislation H.R. 1397 and S. 1798 (Telehealth Improvement for Kids Essential Services (TIKES) Act), all provisions H.R. 3089 and S. 1544 (Accelerating Kids Access to Care Act), all provisions H.R. 3773 and S. 1357 (Pediatricians Accelerate Childhood Therapies (PACT) Act), all provisions H.R. 4943 (Children's Mental Health Infrastructure Act of 2021), all provisions H.R. 4944 (Helping Kids Cope Act of 2021), all provisions H.R. 5131 and S. 2762 (Pediatric Access to Critical Healthcare (PATCH) Act), all provisions H.R. 3894 (CARING for Social Determinants Act of 2021), all provisions H.R. 5414 and S. 2689 (Ensuring Medicaid Continuity for Children in Foster Care Act of 2021), all provisions

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

Issue: Support policies to close the Medicaid coverage gap, including through 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. H.R. 2256 / S. 834, Resident Physician Shortage Reduction Act of 2021 Issue: Support additional Medicare funding for graduate medical education S. 1438 Opioid Workforce Act H.R. 3441 Substance Use Disorder Workforce Act Issue: Support additional Medicare funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs S.1893, Draft House bill Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals H.R. 5376, Build Back Better Act Issue: Support additional Medicare funding for graduate medical education slots. Issue: Support efforts to increase physician workforce diversification through novel, targeted scholarship programs. Issue: Support protection of the 340B Drug Pricing Program in the budget reconciliation package Issue: Support for 12-months continuous coverage for children on Medicaid and CHIP Issue: Support strengthening the ACA and address the Medicaid coverage gap Rural-Urban Physician Workforce Act Issue: Support improvements to Rural Training Track programs. Issue: Provide feedback to CMS on its proposed distribution of the 1,000 new GME slots authorized be the Consolidated Appropriations Act, 2021 as described in the 2022 Inpatient Prospective Payment System (IPPS) proposed rule. Support CMS adopting alternative 2 with modifications to allow for more than 1.0 FTE per hospital. 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. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives Draft, Improving Seniors Timely Access to Care Act Issue: Support protecting patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency Issue: Modify CMS Hospital Compare Star Ratings to allow stakeholders time to work together to address concerns with methodology. Support inclusion of sociodemographic status as part of quality programs HHS Rebate Rule Medicare Part D benefit re-design Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Issue: Support expansion of Medicaid and CHIP coverage for postpartum women. H.R. 315 Medicare Sequester COVID Moratorium Act S. 748 Medicare Sequester Relief Act H.R. 1868 To prevent across-the-board direct spending cuts, and for other purposes. Issue: Support extension of Medicare sequester moratorium. Issue: Support clearing the PAYGO scorecard to avoid another Medicare sequester due to the use of reconciliation to pass the American Rescue Plan Act. Issue: Oppose use of extended Medicare sequester and repurposing of unused Provider Relief Fund as a financing mechanism for bipartisan infrastructure package. Issue: Support congressional extension of 3.75% temporary increase in the Medicare physician fee schedule that Congress provided in the Consolidated Appropriations Act, 2021 to avoid payment cuts due to budget neutrality requirements. 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 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 policy of incorporating revenue distinctions into the Medicare Shared Savings Program. Issue: Support permanent extension of Medicare telehealth waivers, including removing patient location restrictions and rural site requirements, allowing payment for audio-only services, and reimbursing providers for telehealth services as services delivered in-person. Issue: Support extension of Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support permanent extension of current Covid telehealth flexibilities HR 1332, the Telehealth Modernization Act Issue: Support efforts to expand patient access to telehealth HR 1397, the Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP Issue: Support efforts to improve access to childrens mental health care HR 5035, The Child Suicide Prevention and Lethal Means Safety Act Issue: Support expansion of training for health professionals to prevent self-harm or suicide Issue: Support funding to support hospital-based violence intervention programs and community violence interventions S. 2061 Telemental Health Care Access Act Issue: Support policy to remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create IME payments for outpatient services while remaining budget neutral. Issue: Support efforts to reverse cuts in Medicare OPPS reimbursements to hospitals for drugs acquired under the 340B program. Issue: Support extension of 24/7 nursing care waiver for Acute Hospital Care at Home program. Draft Value in Health Care Act Issue: Support changes to alternative payment models (APMs) to increase participation in value-based health programs and promote quality care and improved health outcomes. H.R. 3746 Accountable Care in Rural America Act Issue: Support improving the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location.

Issues regarding childrens health care coverage and access to care under Medicaid, CHIP, the Exchanges, and private insurance Issues related to implementation of aspects of childrens health coverage under Medicaid, CHIP, the Exchanges, and private insurance S. 1727/H.R. 345 - Medicaid Bump Act Issues regarding the implementation of the ACE Kids Act S.1544/H.R. 3089 - Accelerating Kids Access to Care Act Issues regarding childrens health included in Build Back Better Act H.R. 4934, the Childrens Mental Health Infrastructure Act, H.R. 4944, the Helping Kids Cope Act, H.R. 5035, Child Suicide Prevention and Lethal Means Safety Act, and issues regarding childrens mental health Issue regarding Medicaid supplemental payments reporting requirements H.R. 5131/S.2762, the Pediatric Access to Critical Healthcare (PATCH) Act, and issues regarding pediatric health care infrastructure and capacity Issues regarding the importance of Medicaid to military and veteran families FY 2022 Senate and House Labor-HHS appropriations provisions - Children's Hospitals Graduate Medical Education (CHGME) program funding Issues regarding Children's Hospitals Graduate Medical Education (CHGME) program appropriations Issues related to 340B Drug Pricing Program, prescription drug pricing, drug shortages, and pharmaceutical supply chain, including H.R. 4390, the PROTECT 340B Act of 2021 Issues regarding the passage and implementation of COVID-19 relief packages, increased FMAP funding, and the impact of COVID-19 on childrens hospitals, the pediatric supply chain, and pediatric residency programs Issues regarding COVID-19 vaccination efforts for children Issues regarding Emergency Temporary Standard (ETS) for workplace settings in health care settings Issues regarding surprise billing in health care S.168/H.R. 708 - Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act H.R. 1397 - Telehealth Improvement for Kids Essential Services (TIKES) Act

Issues regarding childrens health care coverage and access to care under Medicaid, CHIP, the Exchanges, and private insurance Issues related to implementation of aspects of childrens health coverage under Medicaid, CHIP, the Exchanges, and private insurance Issues regarding childrens health included in Build Back Better Act S. 1727/H.R. 345 - Medicaid Bump Act Issue regarding Medicaid supplemental payments reporting requirements Issues regarding the implementation of the ACE Kids Act S.1544/H.R. 3089 - Accelerating Kids Access to Care Act Issues regarding the importance of Medicaid to military and veteran families Issue regarding the passage and implementation of COVID-19 relief packages, increased FMAP funding, and the impact of COVID-19 on childrens hospitals, the pediatric supply chain, and pediatric residency programs. H.R. 1397 - Telehealth Improvement for Kids Essential Services (TIKES) Act

Client expense: $790,000 · Firm income: Not reported

Medicaid program reforms, including telemedicine Implementation of health care reform Section 340B Drug Pricing program Health care disparities issues generally Drug pricing reforms generally Implementation of electronic health records regulations generally Telemedicine policy generally, including FCC COVID-19 Telehealth Program Mental and behavioral health legislation generally Asthma prevention issues generally H.R. 623 (Gabriella Miller Kids First Research Act 2.0), all provisions H.R. 708 and S. 168 (TREAT Act), all provisions Advanced Research Projects Agency for Health proposed legislation H.R. 1397 and S. 1798 (Telehealth Improvement for Kids' Essential Services (TIKES) Act), all provisions H.R. 3089 and S. 1544 (Accelerating Kids' Access to Care Act), all provisions H.R. 3773 and S. 1357 (Pediatricians Accelerate Childhood Therapies (PACT) Act), all provisions H.R. 4943 (Children's Mental Health Infrastructure Act of 2021), all provisions H.R. 4944 (Helping Kids Cope Act of 2021), all provisions H.R. 5131 and S. 2762 (Pediatric Access to Critical Healthcare (PATCH) Act), all provisions H.R. 3894 (CARING for Social Determinants Act of 2021), all provisions H.R. 5414 and S. 2689 (Ensuring Medicaid Continuity for Children in Foster Care Act of 2021), all provisions

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

Medicaid and Social Determinants of Health (SDOH) legislation (proposal under development related to social determinants of health) S. 1798 and H.R.1397, TIKES Act S. 1544 and H.R. 3089, Accelerating Kids Access to Care Act H.R.3894, CARING for Social Determinants Act of 2021 S.2112 and H.R.4036, The Enhance Access to Support Essential Behavioral Health Services (EASE) Act S.1727and H.R. 3450, Medicaid BUMP Act

Client expense: $173,896 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Safe Step Act (H.R.2163/S. 464); Telehealth Improvement for Kids' Essential Services Act "TIKES Act",(H.R. 1397/S. 1798); National Triple-Negative Breast Cancer Day (H.R.185); March 2021 as National Colorectal Cancer Awareness Month (H.R. 209); Improving Senior's Timely Access to Care Act (H.R. 3173);Lymphedema Treatment Act. (H.R. 3630/S. 1315) Waiting for reintroduction: Palliative Care Hospice Education & Treatment Act ("PCHETA"); Cancer Drug Parity Act;

Client expense: $77,000 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE, White House Office

Medicaid program reforms, including telemedicine Implementation of health care reform Section 340B Drug Pricing program Healthcare disparities issues generally Drug pricing reforms generally Implementation of electronic health records regulations generally Telemedicine policy generally, including FCC COVID-19 Telehealth Program Mental and behavioral health legislation generally Asthma prevention issues generally H.R. 623 (Gabriella Miller Kids First Research Act 2.0), all provisions H.R. 708 and S. 168 (TREAT Act), all provisions Advanced Research Projects Agency for Health proposed legislation H.R. 2877 (Behavioral Intervention Guidelines Act of 2021), all provisions S. 1902 (Behavioral Health Crisis Services Expansion Act), all provisions H.R. 1397 and S. 1798 (Telehealth Improvement for Kids Essential Services (TIKES) Act), all provisions H.R. 3089 and S. 1544 (Accelerating Kids Access to Care Act), all provisions H.R. 3773 and S. 1357 (Pediatricians Accelerate Childhood Therapies (PACT) Act), all provisions

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

Medicaid program reforms, including telemedicine Implementation of health care reform Section 340B Drug Pricing program Health care disparities issues generally Drug pricing reforms generally Implementation of electronic health records regulations generally Telemedicine policy generally, including FCC COVID-19 Telehealth Program Mental and behavioral health legislation generally Asthma prevention issues generally H.R. 623 (Gabriella Miller Kids First Research Act 2.0), all provisions H.R. 708 and S. 168 (TREAT Act), all provisions Advanced Research Projects Agency for Health proposed legislation H.R. 2877 (Behavioral Intervention Guidelines Act of 2021), all provisions S. 1902 (Behavioral Health Crisis Services Expansion Act), all provisions H.R. 1397 and S. 1798 (Telehealth Improvement for Kids Essential Services (TIKES) Act), all provisions H.R. 3089 and S. 1544 (Accelerating Kids Access to Care Act), all provisions H.R. 3773 and S. 1357 (Pediatricians Accelerate Childhood Therapies (PACT) Act), all provisions

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