Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021

Medicare sequester, PAYGO H.R. 2474, Strengthening Medicare for Patients and Providers Act: an annual inflation adjustment to Medicare physician payments S. 1512, CONNECT for Health Act of 2021: Telehealth H.R. 2903, CONNECT for Health Act of 2021: Telehealth H.R. 5932, The Inpatient Opioid Safety Act: patient safety Medicare for All/Public Option Rural Anesthesiology: Rural Pass Through Out of Network/Out of Network Payment Network Adequacy Historical Medicare payment undervaluation for anesthesiology services (33% problem) Anesthesia Conversion Factor Perioperative Surgical Home Model Bundled payments CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services Medicare Physician Fee Schedule Rule CMS Value-Based purchasing CMS Medicare Data Final Rule Conditions of Participation - Anesthesia services, opt-outs, supervision Physician Quality Reporting System, PPACA, Sec. 3007 Quality Modifier implementation Graduate Medical Education Value-based modifier - PPACA Debt ceiling - Medicare sequestration QCDR - Qualified Clinical Data Registry CMS Meaningful Use Stage 3 Evaluation and Monitoring codes & cuts Certified Anesthesiologist Assistants CMS: Federal Independent Dispute Resolution (IDR) Process, Batching Budget neutrality Medicare Economic Index

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S. 368 / H.R. 1332: Telehealth Modernization Act S. 833 / H.R. 2071: Empowering Medicare Seniors to Negotiate Drug Prices Act S. 1512 / H.R. 2903: CONNECT for Health Act of 2021 H.R. 2474: Strengthening Medicare for Patients and Providers Act Improving Seniors Timely Access to Care Act Engagement with CMS regarding National Coverage Analysis (NCA) of monoclonal antibodies directed at amyloid beta plaque for the treatment of Alzheimers Disease. Support for a permanent expansion of telehealth in Medicare, including eliminating on originating site and geographic restrictions. Support for policies to address prescription drug costs, including supporting direct negotiation in Medicare, improving drug pricing transparency, and capping beneficiary out-of-pocket costs in Medicare Part D. Expressing concerns with Medicare physician payment Expressing concerns related to prior authorization Improvements in the National Coverage Determination (NCD) process related to treatment for Alzheimer's disease Support for access to innovative treatments in the field of neurology that are both safe and effective Support for implementation of proposed G2211 complexity add-on code in the MPFS

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

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

S. 368 / H.R. 1332: Telehealth Modernization Act S. 833 / H.R. 2071: Empowering Medicare Seniors to Negotiate Drug Prices Act S. 1512 / H.R. 2903: CONNECT for Health Act of 2021 H.R. 2474: Strengthening Medicare for Patients and Providers Act Improving Seniors Timely Access to Care Act Engagement with CMS regarding National Coverage Analysis (NCA) of monoclonal antibodies directed at amyloid beta plaque for the treatment of Alzheimers Disease. Support for a permanent expansion of telehealth in Medicare, including eliminating on originating site and geographic restrictions. Support for policies to address prescription drug costs, including supporting direct negotiation in Medicare, improving drug pricing transparency, and capping beneficiary out-of-pocket costs in Medicare Part D. Expressing concerns with Medicare physician payment Expressing concerns related to prior authorization Improvements in the National Coverage Determination (NCD) process related to treatment for Alzheimer's disease Support for access to innovative treatments in the field of neurology that are both safe and effective Support for implementation of proposed G2211 complexity add-on code in the MPFS

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

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

Medicare sequester, PAYGO H.R. 2474, Strengthening Medicare for Patients and Providers Act: an annual inflation adjustment to Medicare physician payments S. 1512, CONNECT for Health Act of 2021: Telehealth H.R. 2903, CONNECT for Health Act of 2021: Telehealth H.R. 5932, The Inpatient Opioid Safety Act: patient safety Medicare for All/Public Option Rural Anesthesiology: Rural Pass Through Out of Network/Out of Network Payment Network Adequacy Historical Medicare payment undervaluation for anesthesiology services (33% problem) Anesthesia Conversion Factor Perioperative Surgical Home Model Bundled payments CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services Medicare Physician Fee Schedule Rule CMS Value-Based purchasing CMS Medicare Data Final Rule Conditions of Participation - Anesthesia services, opt-outs, supervision Physician Quality Reporting System, PPACA, Sec. 3007 Quality Modifier implementation Graduate Medical Education Value-based modifier - PPACA Debt ceiling - Medicare sequestration QCDR - Qualified Clinical Data Registry CMS Meaningful Use Stage 3 Evaluation and Monitoring codes & cuts Certified Anesthesiologist Assistants CMS: Federal Independent Dispute Resolution (IDR) Process, Batching Budget neutrality Medicare Economic Index

Client expense: $390,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S. 368 / H.R. 1332: Telehealth Modernization Act S. 833 / H.R. 2071: Empowering Medicare Seniors to Negotiate Drug Prices Act S. 1512 / H.R. 2903: CONNECT for Health Act of 2021 H.R. 2474: Strengthening Medicare for Patients and Providers Act Improving Seniors Timely Access to Care Act Engagement with CMS regarding National Coverage Analysis (NCA) of monoclonal antibodies directed at amyloid beta plaque for the treatment of Alzheimers Disease. Support for a permanent expansion of telehealth in Medicare, including eliminating on originating site and geographic restrictions. Support for policies to address prescription drug costs, including supporting direct negotiation in Medicare, improving drug pricing transparency, and capping beneficiary out-of-pocket costs in Medicare Part D. Expressing concerns with Medicare physician payment Expressing concerns related to prior authorization Improvements in the National Coverage Determination (NCD) process related to treatment for Alzheimer's disease Support for access to innovative treatments in the field of neurology that are both safe and effective

Client expense: $380,000 · Firm income: Not reported

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

Medicare sequester, PAYGO H.R. 2474, Strengthening Medicare for Patients and Providers Act: an annual inflation adjustment to Medicare physician payments S. 1512, CONNECT for Health Act of 2021: Telehealth H.R. 2903, CONNECT for Health Act of 2021: Telehealth H.R. 5932, The Inpatient Opioid Safety Act: patient safety Medicare for All/Public Option Rural Anesthesiology: Rural Pass Through Out of Network/Out of Network Payment Network Adequacy Historical Medicare payment undervaluation for anesthesiology services (33% problem) Anesthesia Conversion Factor Perioperative Surgical Home Model Bundled payments CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services Medicare Physician Fee Schedule Rule CMS Value-Based purchasing CMS Medicare Data Final Rule Conditions of Participation - Anesthesia services, opt-outs, supervision Physician Quality Reporting System, PPACA, Sec. 3007 Quality Modifier implementation Graduate Medical Education Value-based modifier - PPACA Debt ceiling - Medicare sequestration QCDR - Qualified Clinical Data Registry CMS Meaningful Use Stage 3 Evaluation and Monitoring codes & cuts Certified Anesthesiologist Assistants CMS: Federal Independent Dispute Resolution (IDR) Process, Batching Budget neutrality Medicare Economic Index

Client expense: $330,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S. 368 / H.R. 1332: Telehealth Modernization Act S. 833 / H.R. 2071: Empowering Medicare Seniors to Negotiate Drug Prices Act S. 1512 / H.R. 2903: CONNECT for Health Act of 2021 H.R. 2474: Strengthening Medicare for Patients and Providers Act Improving Seniors Timely Access to Care Act Engagement with CMS regarding National Coverage Analysis (NCA) of monoclonal antibodies directed at amyloid beta plaque for the treatment of Alzheimers Disease. Support for a permanent expansion of telehealth in Medicare, including eliminating on originating site and geographic restrictions. Support for policies to address prescription drug costs, including supporting direct negotiation in Medicare, improving drug pricing transparency, and capping beneficiary out-of-pocket costs in Medicare Part D. Expressing concerns with Medicare physician payment Expressing concerns related to prior authorization

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

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

Medicare sequester, PAYGO S. 1512, CONNECT for Health Act of 2021: Telehealth H.R. 2903, CONNECT for Health Act of 2021: Telehealth H.R. 5932, The Inpatient Opioid Safety Act: patient safety Medicare for All/Public Option Rural Anesthesiology: Rural Pass Through Out of Network/Out of Network Payment Network Adequacy Historical Medicare payment undervaluation for anesthesiology services (33% problem) Anesthesia Conversion Factor Perioperative Surgical Home Model Bundled payments CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services Medicare Physician Fee Schedule Rule CMS Value-Based purchasing CMS Medicare Data Final Rule Conditions of Participation - Anesthesia services, opt-outs, supervision Physician Quality Reporting System, PPACA, Sec. 3007 Quality Modifier implementation Graduate Medical Education Value-based modifier - PPACA Debt ceiling - Medicare sequestration QCDR - Qualified Clinical Data Registry CMS Meaningful Use Stage 3 Evaluation and Monitoring codes & cuts Certified Anesthesiologist Assistants CMS: Federal Independent Dispute Resolution (IDR) Process, Batching

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Support reforming prior authorization procedures to be more seamless, automated and transparent for physicians: HR 3173/ S.3018, Improving Seniors Timely Access to Care Act of 2021. Support extending and expanding telehealth: HR 1332 and S 368, The Telehealth Modernization Act; HR 2903 and S 1512, The Connect for Health Act; HR 4480 The Telehealth Coverage and Payment Parity Act and HR 2168 The Expanded Telehealth Access Act. Oppose H.R. 6087, Improving Access to Workers Compensation for Injured Federal Workers Act. Would inappropriately permit nurse practitioners and physician assistants to diagnose, prescribe, treat and certify an injury for federal workers compensation claims. Ensure relevant traveling physicians can appropriately treat their patients by supporting HR7259 the Medical Controlled Substances Transportation Act of 2022.

Client expense: $326,542 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4014, Physician Shortage GME Cap Flex Act of 2021, provisions relating to Graduate Medical Education S. 2094, Physician Shortage GME Cap Flex Act of 2021, provisions relating to Graduate Medical Education H.R. 1332, Telehealth Modernization Act, all provisions S. 368, Telehealth Modernization Act, all provisions H.R. 4058, Telemental Health Care Access Act of 2021, all provisions S. 2061, Telemental Health Care Access Act of 2021, all provisions H.R. 3173, Improving Seniors Timely Access to Care Act of 2021, provisions relating to Prior Authorization and attachment standards S. 3018, Improving Seniors Timely Access to Care Act of 2021, provisions relating to Prior Authorization and attachment standards H.R. 7995, Getting Over Lengthy Delays in Care As Required by Doctors (GOLD CARD) Act of 2022, all provisions H.R. 3259, Non-Opioids Prevent Addiction In the Nation (NO PAIN) Act, all provisions S. 586, Non-Opioids Prevent Addiction In the Nation (NO PAIN) Act, all provisions H.R. 4587, Value in Health Care Act of 2021, all provisions H.R. 7213, Equitable Community Access to Pharmacist Services Act, all provisions S. 748, Medicare Sequester Relief Act, all provisions H.R. 2903, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions S. 1512, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions H.R. 2256, Resident Physician Shortage Reduction Act, all provisions S. 834, Resident Physician Shortage Reduction Act, all provisions H.R. 1218, Data Mapping to Save Moms Lives Act, all provisions S. 198, Data Mapping to Save Moms Lives Act, all provisions H.R. 3407, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act, all provisions S. 411, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act, all provisions H.R. 3441, Substance Use Disorder Workforce Act, all provisions S. 1438, Opioid Workforce Act of 2021, all provisions H.R. 955, Medicaid Reentry Act of 2021, all provisions S. 285, Medicaid Reentry Act of 2021, all provisions H.R. 2654, Chiropractic Medicare Coverage Modernization Act of 2021, all provisions H.R. 6020, Supporting Medicare Providers Act of 2021, all provisions S. 3314, Supporting Medicare Providers Act of 2021, all provisions H.R. 6311, Comprehensive Addiction Resources Emergency Act of 2021, all provisions S. 3418, Comprehensive Addiction Resources Emergency Act of 2021, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, all provisions H.R. 19, Lower Costs, More Cures Act of 2021, all provisions S. 801, Connected Maternal Online Monitoring Act, all provisions H.R. 1738, Stabilize Medicaid and CHIP Coverage Act, all provisions H.R. 1025, Kids Access to Primary Care Act of 2021, all provisions H.R. 66, Comprehensive Access to Robust Insurance Now Guaranteed (CARING) for Kids Act, all provisions S. 610, Protecting Medicare and American Farmers from Sequester Cuts Act, all provisions H.R. 6000, Cures 2.0 Act, all provisions H.R. 4043, Ensuring Patient Access to Critical Breakthrough Products Act of 2021, all provisions S. 2416, New Opportunities for Value that Extend Lives (NOVEL) Act of 2021, all provisions H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022, all provisions H.R. 3746, Accountable Care in Rural America Act, all provisions H.R. 4755, Seniors Chronic Care Management Improvement Act of 2021, all provisions H.R. 6308, ACO Assignment Improvement Act of 2021, all provisions H.R. 1868, To prevent across-the-board direct spending cuts, and for other purposes, all provisions H.R. 315, Medicare Sequester COVID Moratorium Act, all provisions H.R. 6048, Medicare Stability for Patients and Providers Act, all provisions H.R. 3348, SOS: Sustaining Outpatient Services Act, all provisions H.R. 366, Protecting Access to Post-COVID-19 Telehealth Act of 2021, all provisions H.R. 2166, Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021, all provisions H.R. 2228, Rural Behavioral Health Access Act of 2021, all provisions H.R. 3447, Permanency for Audio-Only Telehealth Act, all provisions H.R. 7051, Access to Prescription Digital Therapeutics Act of 2022, all provisions S. 3791, Access to Prescription Digital Therapeutics Act of 2022, all provisions H.R. 7878, Kidney Health Connect Act of 2022, all provisions S. 4307, Kidney Health Connect Act of 2022, all provisions H.R. 6202, Telehealth Extension Act of 2021, all provisions S. 987, CARA 3.0 Act of 2021, all provisions H.R. 1438, Opioid Workforce Act of 2021, all provisions H.R. 925, Data to Save Moms Act, all provisions H.R. 7475, Mamas First Act, all provisions H.R. 3746, Accountable Care in Rural America Act, all provisions H.R. 4587, Value in Health Care Act of 2021, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, all provisions H.R. 3614, Menstrual Equity For All Act of 2021, provisions related to menstrual products coverage in Medicaid Medicare program: Physician Payment and Delivery Reform Medicare program: Impending Medicare payment cuts Medicare program: Medicare Evaluation and Management/budget neutrality Medicare program: Statutory PAYGO/Sequester Relief Medicare program: Accountable Care Organizations/specialty care Medicare program: Alternative Payment Models Medicare program: AMA Recovery Plan for Americas Physicians/payment reform Medicare program: Global and Professional Direct Contracting alternative payment model/REACH ACOs Medicare program: Appropriate Use Criteria and Prior Authorization Medicare program: Medicare Advantage/prior authorization regulation Medicare program: Automatic blood pressure measurement devices/coverage Medicare program: Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs) Medicare program: MIPS/Promoting Interoperability/Cost/Improvement Activities Medicare program: MIPS/data sharing/transparency Medicare program: MACRA physician burdens Medicare program: Quality Payment Program Medicare program: Health IT burden Medicare program: Public Health Emergency COVID-19 /Accelerated and Advance Payments Medicare program: Primary Care First models Medicare program: Medicare Shared Savings Program (MSSP) Medicare program: Modifier 25 Medicare program: Split/shared billing Medicare program: Interoperability/data blocking/HIPAA Medicare program: Coding Medicare program: Provider compliance/Regulatory relief Medicare program: Provider Enrollment, Chain, and Ownership System (PECOS) Enrollment/Revalidation Medicare program: Open Payments Medicare program: Prescription drug pricing/Pharmacy Benefits Managers Medicare program: Step Therapy Medicare and Medicaid programs: Medicare Access and Chip Reauthorization Act (MACRA)/implementation Medicare and Medicaid programs: MACRA Oversight Medicaid program: Improving Access to Physical and Mental Health Care for Children and Youth Under Medicaid and CHIP draft Medicare and Medicaid programs: Health Equity Medicaid program: Maternal Mortality Medicaid program: Uninsured and healthcare coverage/COVID-19 Medicaid program: Special Enrollment Period Medicaid program: Sickle Cell Disease

Client expense: $4,550,000 · Firm income: Not reported

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

H.R.2903-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021 S.1512-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021

Client expense: $515,937 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

-Inflation Reduction Act (H.R. 5376) -- Provisions related to providing up to 12 weeks of paid family and medical leave; extending Medicare telehealth flexibilities beyond the COVID-19 public health emergency; the establishment Advanced Research Projects Agency for Health (ARPA-H); provisions related to extending marketplace subsidies under the Patient Protection and Affordable Care Act; and provisions related to an out-of-pocket maximum for Medicare beneficiaries' prescription drugs. Advancing Telehealth Beyond COVID-19 Act of 2021 (H.R. 4040) -- Provisions related to extension of Medicare flexibilities including originating site, allowance of occupational and physical therapists, speech-language pathologists, and audiologists to continue to provide services, allowance for qualified health centers and rural health clinics to serve as a distant site, behavioral services to continue to be provided via audio-only technology, and allowance of hospice physicians and nurse practitioners to complete patient recertification via telehealth. Additional provisions related to delay of in-person evaluation requirements for mental health services until January 1, 2025 or end of emergency period. -The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act (H.R. 2903 / S. 1512) Provisions related to the Centers for Medicare & Medicaid Services (CMS) to waive certain restrictions, such as geographic restrictions, for services provided in high-need health professional shortage areas; excludes mental health and emergency medical services, as well as services provided at rural health clinics, federally qualified health centers, and Indian Health Service facilities, from such geographic restrictions; and waive coverage restrictions during national emergencies. -Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708 / S. 168) temporarily authorizes the interstate provision of in-person and telehealth services. This authorization applies during, and for at least 180 days after, the COVID-19 (i.e. coronavirus disease 2019) emergency. Specifically, subject to scope of practice and other requirements, a health care professional may provide health services in any U.S. jurisdiction based on that individual's authorization to practice in any one state or territory. The bill also provides certain related powers to health care professional regulatory bodies, such as medical boards. Specifically, a regulatory may investigate and take disciplinary actions against a processional who provides services pursuant to this bill to a patient in that body's jurisdiction. -CURES 2.0 Act (H.R. 6000) -- Provisions related to drug development, research, and access to emerging therapies for Americans with ALS and other rare diseases through the creation of ARPA-H and other mechanisms. -Medicare Payment Reform for People with ALS (H.R.9638) Provides supplemental payment to designated ALS clinics that provide multidisciplinary services to people living with ALS. -Seniors Timely Access to Care Act (H.R.3173 / S.3018) -- Requires streamlined prior authorization process under Medicare Advantage Plans.

Client expense: $25,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Analyzing the Duration of Remote Monitoring Services Act of 2021 (H.R.4347) CONNECT for Health Act of 2021 (H.R.2903 / S.1512) Increasing Access to Quality Cardiac Rehabilitation Care Act of 2021 (S.1986) SOS: Sustaining Outpatient Services Act (H.R.3348) Telehealth Extension Act of 2021 (H.R. 6202) The Telehealth Modernization Act (S.368) Advancing Telehealth Beyond COVID-19 Act (H.R. 4040) Helping MOMS Act of 2021 (H.R. 3345) Medicaid Waivers National Coverage Determination for Self-Measured Blood Pressure Inpatient Rehabilitation Facility Prospective Payment System Medicare Hospital Inpatient Prospective Payment System

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

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

Analyzing the Duration of Remote Monitoring Services Act of 2021 (H.R.4347) CONNECT for Health Act of 2021 (H.R.2903 / S.1512) Increasing Access to Quality Cardiac Rehabilitation Care Act of 2021 (S.1986) SOS: Sustaining Outpatient Services Act (H.R.3348) Telehealth Extension Act of 2021 (H.R. 6202) The Telehealth Modernization Act (S.368) Medicaid Waivers National Coverage Determination for Self-Measured Blood Pressure Inpatient Rehabilitation Facility Prospective Payment System Medicare Hospital Inpatient Prospective Payment System

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

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

Analyzing the Duration of Remote Monitoring Services Act of 2021 (H.R.4347) CONNECT for Health Act of 2021 (H.R.2903 / S.1512) Consolidated Appropriations Act 2022 (Pub.L. 117-103): sections pertaining to Telehealth Increasing Access to Quality Cardiac Rehabilitation Care Act of 2021 (S.1986) SOS: Sustaining Outpatient Services Act (H.R.3348) Medicaid Waivers National Coverage Determination for Self-Measured Blood Pressure Telehealth Extension Act of 2021 (H.R. 6202) The Telehealth Modernization Act (S.368)

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

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

H.R. 469 - Comprehensive Breast Reconstruction Act of 2021; bill provides for Medicare, Medicaid, and private health insurance coverage of certain tattooing services in connection with post-mastectomy breast reconstruction, and aligns the scope of Medicare and Medicaid coverage of such breast reconstruction with that of private health insurance. H.R. 1946/S. 1873 -Medicare Multi-Cancer Early Detections Screening and Coverage Act; bill to amend title XVIII of the Social Security Act to provide for Medicare coverage of multi-cancer early detection screening test H.R. 3183/S. 1312 - Metastatic Breast Cancer Access to Care Act; bill to exempt individuals with metastatic breast cancer from certain waiting periods for disability insurance benefits under the Old-Age, Survivors, and Disability Insurance program and related Medicare coverage H.R. 2903/S. 1512 - CONNECT for Health Act; a bill to expand the use of telehealth and remote patient monitoring services in Medicare H.R. 3087/S. 2051 - Breast Cancer Patient Equity Act; a bill to provide for Medicare coverage of custom fabricated breast prostheses H.R. 3630/S. 1315 - Lymphedema Treatment Act; bill to include certain lymphedema compression treatment items as covered durable medical equipment under Medicare following the surgical removal of the breast (i.e., a mastectomy), including replacements of such prostheses H.R. 4110 - Reducing Hereditary Cancer Act of 2021; a bill to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation in a blood relative or a personal or ancestral history suspicious for hereditary cancer, and to provide coverage of certain cancer screenings or preventive surgeries that would reduce the risk for individuals with a germline (inherited) mutation associated with a high risk of developing a preventable cancer H.R. 4612/S. 2412 - Protecting Access to Lifesaving Screenings Act of 2021; a bill to make a series of changes relating to health insurance coverage of screening mammography including preserving Medicare coverage for screening mammography, without a requirement for coinsurance, and expands the definition of screening mammography to include any digital modality of such a procedure S. 2327 - Seniors Prescription Drug Relief Act; a bill to amend title XVIII of the Social Security Act to provide for a Medicare part D modernization redesign and to establish a monthly out-of-pocket cost sharing maximum for enrollees who incur a significant portion of costs towards the annual out-of-pocket threshold under Medicare part D H.R. 3173/S. 3018 - Improving Seniors Timely Access to Care Act; a bill which establishes several requirements and standards relating to prior authorization processes under Medicare Advantage (MA) plans H.R. 7213, Equitable Community Access to Pharmacist Services Act; a bill to provide pharmacy reimbursement for COVID-19-related and future emergency services. H.R. 9505, Find It Early Act; a bill to provide for health coverage with no cost-sharing additional breast screenings for certain individuals Comments regarding the temporary increase in federal medical assistance percentage (FMAP) in response to the COVID-19 Public Health Emergency (PHE) (CMS-9912-N) Comments in response to the Medicaid Eligibility and Enrollment NPRM (CMS-2421-P) Comments in response to the RFI regarding National Directory of Healthcare Providers & Services (CMS-0058-NC) Comments in response to the RFI regarding accessing healthcare and related challenges, understanding provider experiences, advancing health equity, and assessing the impact of waivers and flexibilities provided in response to the COVID-19 Public Health Emergency (PHE) Issues related to the upcoming Notice on Benefit and Payment Parameters for FY2024 Medicare coverage policy for drugs and drug pricing Medicare coverage policy for breast cancer treatments and services Proposed waivers under Sections 1115 and 1332 of the Social Security Act; policies related to work requirements, reinsurance and block grants in Medicaid Policies related to funding, state incentives, and federal efforts for for Medicaid expansion Coverage for telemedicine in Medicare

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), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, White House Office

Issues related to Centers for Medicare & Medicaid Services (CMS) policy, including the Home Health Patient Driven Groupings Model, hospice benefit quality and payment policy proposals, and home and community-based services; Issues concerning Medicare Advantage and the hospice benefit; Support H.R. 8581 and S. 4605, Preserving Access to Home Health Act of 2022, a bill that delays the Centers for Medicare & Medicaid Services (CMS) from decreasing payments for Medicare home health services based on certain adjustments until 2026; Support of H.R. 4040, Advancing Telehealth Beyond COVID-19 Act of 2022, a bill that modifies the extension of certain Medicare telehealth flexibilities after the end of the COVID-19 public health emergency, Sec. 7 - use of telehealth to conduct face-to-face encounter prior to recertification of eligibility for hospice care during emergency period; Support H.R. 1332 and S.368, Telehealth Modernization Act, a bill to amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program related to the COVID-19 public health emergency, as it relates to use of telehealth in the certification of a beneficiary for the hospice benefit; Support for S. 1512/H.R. 2903, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) Act, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes, Sec. 109 - use of telehealth in recertification for hospice care; Monitor implementation of P.L. 116-260/H.R. 133, Consolidated Appropriations Act, 2021, a bill making consolidated appropriations for the fiscal year ending September 30, 2021, providing coronavirus emergency response and relief, and for other purposes, Title IV - Health Care Offsets; Support of H.R. 2471/P.L. 117-703, Consolidated Appropriations Act, 2022, a bill making consolidated appropriations for the fiscal year ending September 30, 2022, and for providing emergency assistance for the situation in Ukraine, and for other purposes, Sections 306 and 307, and monitor section 312; Monitor issues related to the implementation P.L. 117-2/H.R. 1319, American Rescue Plan Act, a bill to provide for reconciliation pursuant to title II of S. Con. Res. 5, Section 9817 - additional support for Medicaid home and community-based services during the COVID-19 emergency.

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

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

Issues concerning access to the Medicare hospice benefit and palliative care. Issues regarding reimbursement for the Medicare hospice benefit. Issues related to community based palliative care and advanced care illness management. Issues related to regulatory relief. Issues concerning Medicare Advantage and the hospice benefit. Issues related to hospice coding as it relates to telehealth and spiritual care. Issues related to hospice telehealth flexibilities. Issues regarding program integrity. Issues regarding bereavement care. Issues concerning hospice payment and alternative payment models. Issues regarding in-patient and in-home respite care. Issues related to the extension of the COVID-19 public health emergency. Issues related to regulatory flexibilities granted under the public health emergency. Issues related to the hospice and palliative care workforce. Issues pertaining to the hospice election statement and election statement addendum. Issues pertaining to concurrent care. Issues related to children's access to hospice and palliative care. The extension of sequestration relief provided under the Protecting Medicare and American Farmers from Sequester Cuts Act (H.R. 610). The Childrens Program of All-inclusive Coordinated Care (ChiPACC) Act of 2021 (H.R. 4952); H.R. 2471 (P.L. 117-103), The Palliative Care and Hospice Education and Training Act (PCHETA) (S. 4260); Hospice Telehealth flexibilities, including H.R. 4040, Advancing Telehealth BeyondCovid-19 Act of 2021; S. 368 / H.R. 1332, the Telehealth Modernization Act; S. 1512 / H.R. 2903, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) Act, and H .R.8505 - To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule, and for other purposes, as they relate to use of telehealth in the certification of a beneficiary for the hospice benefit. Issues related to the implementation of the Helping Our Senior Population in Comfort Environments (HOSPICE) Act. H.R. 2617 (P.L. 117-328), the Consolidated Appropriations Act of 2023 and issues concerning hospice reimbursement, and bereavement care.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Issues related to health care, including employee health care plans, HIPAA, health information technology, telehealth, including the Telehealth Modernization Act (H.R. 1332 / S. 368), the CONNECT Act (H.R. 2903 / S. 1512), the Telehealth Expansion Act (S. 1704 / H.R. 5981), and the Food and Drug Amendments Act of 2023 (H.R. 7667), the Food and Drug Administration Safety and Landmark Advancements Act of 2022 (S. 4348), the FY 2023 Consolidated Appropriations Act (Public Law 117-328), and the Prescription Information Modernization Act of 2022 (H.R. 7559). Issues related to pharmacy, vaccines, and COVID-19 testing.

Client expense: $4,790,000 · Firm income: Not reported

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

Support H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021, a bill to provide for special enrollment periods during public health emergencies; Letter urging Congress to provide additional funds to the Provider Relief Fund and for vaccine distribution and administration, which will allow for continued support of hospitals' COVID-19-related lost revenues, as well as additional expenses incurred due to purchasing supplies and equipment, staffing, establishing emergency testing and vaccination centers and constructing and retrofitting facilities; Support H.R. 708 and S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, a bill to provide temporary licensing reciprocity for telehealth and interstate health care treatment; Support H.R. 1306 and S. 412, National Coronavirus Commission Act of 2021, a bill to establish the Commission on the Coronavirus Pandemic in the United States; Support S. 610/ H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 773 a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; Support S.834, Resident Physician Shortage Reduction Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan and urge the Committee on Education and Labor not to report it favorably; Support S.924 and H.R. 2130, Rural America Health Corps Act, a bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Discussions with ASPR about COVID-19 related medical supply and personnel shortages; Discussions with FEMA about COVID-19 public assistance funding policies; Letter asking Congress to consider an infrastructure proposal that you prioritize hospital and health system needs to ensure our nations health care system is well positioned to meet the opportunities and challenges that lie ahead; Support S.1512/H.R. 2903, CONNECT for Health Act of 2021, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services; Support H.R. 2255/ S 1024, Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Support S.1568, Technical Reset to Advance the Instruction of Nurses (TRAIN) Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Support H.R. 3203, a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Statement to Senate Committee on Homeland Security and Governmental Affairs hearing on "COVID-19 Part II: Evaluating the Medical Supply Chain and Pandemic Response Gaps" urges Congress to take steps to strengthen the nations medical supply chain; Statement to Senate Committee on Finance hearing on COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned stating that these flexibilities can continue to drive significant improvements in patient care long after the public health emergency (PHE) ends and given the beneficial impact of those specific flexibilities urges Congress and the Administration to make them permanent. In addition, a second group of flexibilities will remain critically important for some time following the PHE and will require a carefully crafted phase-out plan to ensure enough time is provided for a necessary transition. Without action from Congress and the Administration prior to the termination of the PHE, we are concerned that much of the progress made because of the implementation of many of these flexibilities may be unnecessarily halted or even lost; Letter urges Senate HELP Committee to consider recommendations and prioritize programs that support the health care workforce needs of the country in the wake of the COVID-19 pandemic and into the future; Support H.R. 769/S. 1491, Rural Maternal and Obstetric Modernization of Services Act or the Rural MOMS Act, a bill to amend the Public Health Service Act to improve obstetric care in rural areas; Support for S.1675/ H.R. 4387, Maternal Health Quality Improvement Act, a bill to improve maternal health; Support 1438, Opioid Workforce Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Support HR 3441,Substance Use Disorder Workforce Act, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the substance use disorder crisis; Support S.1810 / H.R.3541, Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; Statement to the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights for the hearing on Antitrust Applied: Hospital Consolidation Concerns and Solutions expressing that integration helps to ensure every community, whether rural, urban or suburban, has access to the same high standard of affordable, evidenced based care; discussions to ensure that H.R. 2547s limits on unfair practice under FDCPA for debt collectors does not inappropriately interfere with or restrict the ability of hospitals to be able to obtain payment for care provided; Support for revising/repealing changes to the Rural Health Clinic (RHC) Program that reduced reimbursement for provider-based RHCs; Hill outreach expressing concerns with United Healths retroactive denial of coverage for emergency-level care in facilities; Hill outreach expressing concern about CMS mid-build audit denials; Senate outreach on prior authorization legislation; Urge support for legislation/administrative action to extend the deadline to use PRF money; Urged HRSA to ensure that the drug companies that denied 340B Statute appropriate discounts make the impacted hospitals whole for the benefit of the vulnerable communities they serve; Support S. 2304 Drug-Price Transparency for Competition Act of 2021 (DTC Act of 2021), a bill to amend title XI of the Social Security Act to require that direct-to-consumer advertisements for prescription drugs and biological products include an appropriate disclosure of pricing information; Support S.246/H.R.851 Future Advancement of Academic Nursing Act or the FAAN Act, a bill to amend the Public Health Service Act to authorize grants to support schools of nursing in program enhancement and infrastructure modernization, increasing the number of nursing faculty and students, and for other purposes; Support S. 1568/HR 4407Technical Reset to Advance the Instruction of Nurses Act or the TRAIN Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Comment letter to the Occupational Safety and Health Administration (OSHA) recommending the withdrawal of the COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Meeting with Department of Labor staff to discuss our concerns about the OSHA COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Discussion with ASPR staff overseeing the Strategic National Stockpile about their intent to procure supplies of surgical masks; Call with Senator Cassidys staff to discuss concerns about impact of FEMA COVID-19 funding of traveling nurse agencies on hospital nursing shortages; Oppose S 2428, False Claims Amendments Act of 2021A bill to amend title 31, United States Code, to modify False Claims Act procedures, and for other purposes; Discussions about Provider Relief Fund - reporting on past disbursements and urging HHS to disburse remaining PRF money; Discussions about the challenges that teaching hospitals have with training the physician workforce, residency caps that limit funding for training programs, a shortage of residents pursuing primary care specialties, a growing patient pool due to the newly insured and aging of the population; Discussions about the hospital and health system priorities for infrastructure and reconciliation bills; Letter urging Congress to maintain the current legal and regulatory framework for evaluating mergers and acquisitions; Hill outreach to discuss the benefits of health care integration; Hill outreach about the negative impact of potentially anticompetitive conduct by nurse-staffing agencies; Support HR 5035/ S 2982 Child Suicide Prevention and Lethal Means Safety Act, a bill to authorize the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes; Support H.R.5376 Build Back Better Act, this bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment; Discussions with members of congress about the implementation of Rural Emergency Hospital payment designation; Discussions on the No Surprises Act Implementation (surprise billing) and urging federal regulators to restore the independence of the independent dispute resolution process in the No Surprises Act Part 2 regulations; Support HR 5699 Student Assisted Vaccination Effort (SAVE) Act, a bill to expand the definition of qualified persons for purposes of the Public Readiness and Emergency Preparedness Act to include health professional students; Support S 2873 Preventing and Addressing Trauma with Health Services Act (PATHS Act), a bill to require the Secretary of Health and Human Services to award grants to establish or expand programs and activities to increase access to high-quality culturally competent trauma support and mental health care; Letter urging HRSA to delay proposals to withdraw certain HPSAs; Support S 3497 and HR 6397, Medical Student Education Authorization Act of 2022, a bill to amend the Public Health Service Act to establish a grant program to award grants to public institutions of higher education located in a covered State; Support HR 6279 and S 3629, Opioid Treatment Access Act of 2022, a bill to authorize a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs during the COVID-19 public health emergency; Support HR 5703 and S 3677, Post-Disaster Mental Health Response Act, a bill to amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to authorize the President to provide professional counseling services to victims of emergencies declared under such Act; Submitted a statement on the hearing for Pandemic Profiteers: Legislation to Stop Corporate Price Gouging regarding concerns about anticompetitive conduct on the part of health care staffing agencies, some of which have been exploiting the severe shortage of health care providers during the COVID-19 pandemic; Submitted a statement on the hearing for Americas Mental Health Crisis and supports additional approaches to help ensure improved access to needed comprehensive, affordable and quality behavioral health services; Provide comments to the Affordability Subcommittee of the Healthy Future Task Force expressing our shared focus with Congress on providing relief from the pandemic, ensuring a smooth recovery and rebuilding a better health care system for the future, all while continuing to support efforts to promote greater affordability and value to patients and the health care system; Submitted statement on the hearing for Recruiting, Revitalizing & Diversifying: Examining the Health Care Workforce Shortage about the challenges ahead and the need to examine Americas health care workforce shortage. We must work together to solve these issues so that our nations hospitals and health systems can continue to care for the patients and communities they serve; Submitted statement on the hearing for Protecting Youth Mental Health: Part II - Identifying and Addressing Barriers to Care examines ways to protect the mental health of our nations youth; Submitted statement on the hearing for Exploring Pathways to Affordable, Universal Health Coverage Care expressing the need to build upon and improve our existing system to increase access to coverage of comprehensive health benefits; Submitted a letter to provide information regarding the challenges facing Americas health care workforce as the country enters the third year of the COVID-19 pandemic; Provided comments to the Modernization Subcommittee of the Healthy Future Task Force urging Congress to consider how to ensure the telehealth flexibilities could remain in place for patients and health care providers beyond the PHE; Support HR 7053 and S 3792, Hospital Inpatient Services Modernization Act, a bill to amend title XVIII of the Social Security Act to extend acute hospital care at home waiver flexibilities; Support resolution, H. Res. 909, Expressing support for healthcare personnel and condemning assaults on healthcare personnel as the U.S. healthcare system faces unprecedented staffing shortages and increased workplace-related stressors; Letter urges Congress to provide immediate additional support for hospitals and health systems serving their communities during this unprecedented public health crisis. While the support Congress has provided during the last two years of the COVID-19 pandemic has helped hospitals care for their patients and communities, there is still a significant need for financial support and relief as COVID-19 challenges persist; Support S 3904, Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Letter urging OSHA to extend the comment deadline for the rule making on the occupational exposure to COVID-19 in healthcare settings by at least an additional 30 days, through May 23; Meeting with the Office of the Assistant Secretary of Health (OASH) at HHS to discuss the widespread blood shortages in the U.S. and next steps; Stakeholder calls with HHS ASPR regarding the distribution/administration of COVID-19 therapeutics; Discussions on S 571, Public Health Funding Prevents Pandemics Act, a bill to fully fund the Prevention and Public Health Fund and reaffirm the importance of prevention in the United States healthcare system; Regular calls with ASPR and other stakeholders participating in the Health Care and Public Health (HPH) Sector Joint Supply Chain Resilience Working Group (Joint SCRWG), a formal Working Group under the authority of the Critical Infrastructure Partnership Advisory Council (CIPAC) to support the Presidents vision for a resilient public health supply chain; Monthly calls with ASPRs Hospital Preparedness Program (HPP) to discuss updates on the hospital association COVID-19 funding program; Call with ASPR Healthcare and Public Health Government Coordinating Council leadership and other hospital associations to provide feedback on the COVID-19 hospital data guidance update; Provide comment letter to OSHA on the re-opening of comments on the Occupational Exposure to COVID-19 Rulemaking in which we urge OSHA not to finalize its rule for occupational exposure to COVID-19. In our comments, we indicate that we continue to oppose establishing new regulations that are not fully aligned with the Centers for Disease Control and Preventions evolving evidence-based guidance. With the constantly evolving, science-based CDC guidance and recommendations, CMS vaccination requirement and existing OSHA general standards, we strongly believe that an inconsistent and overly strict OSHA COVID-19 health care standard is not necessary, would cause confusion and will ultimately lower hospital employees morale and worsen unprecedented personnel shortages in hospitals. It is essential to a well-functioning health care system that only one set of science-based standards be applied to health care providers, and that these standards be aligned across federal agencies; Letter urging Congress to make the expanded tax credits permanent, ensuring millions of low- and middle-income families continue to have access to affordable coverage in 2023 and beyond; Express concerns with the letter to CMS from Congressman Murphy that makes a number of requests for data surrounding the COVID-19 add on payments for hospitals. We are concerned about the questions as they do not take into account the continued needs of the nations hospitals and health systems. Hospitals continue to face numerous challenges, including increased labor and supply costs and workforce shortages. These additional payments have helped to address some but not all of the high costs associated with COVID-19 patient care. The complexity of care is still higher than pre-pandemic levels as measured by length of stay, which further indicates that its still more resource intensive to treat COVID inpatients. In addition, the high costs associated personal protective equipment, isolation measures, and other additional resources are necessary when treating all patients, unless and until it is determined they do not have COVID-19; Submitted a letter to Ways and Means per their request for information on the health care industry and climate change. We support the sustainability efforts while acknowledging that for a variety of reasons, many hospitals and health systems face challenges and barriers to implementing this work, especially while responding to a pandemic; Letter urging HHS to maintain the COVID-19 public health emergency (PHE) until it is clear that the global pandemic has receded and the capabilities authorized by the PHE are no longer necessary. This will help prevent any future surges from threatening the health and safety of patients and the ability of health care professionals to care for them; Long COVID Best Clinical Practices Discussion with the White House Policy Advisor, Office of the COVID-19 Response; Submitted comment letter to the Federal Trade Commission outlining the impact pharmacy benefit managers (PBMs) practices have on the field. Specifically, urging the FTC to increase scrutiny on insured-mandated white bagging policies, as well as the impact of PBM-negotiated rebates and other business practices on the 340B drug discount pricing program and overall drug prices and drug price increases; Submit a comment letter to the Internal Revenue Service for their proposed rule amending how employer coverage affordability would be measured for family members of employees. We advocated for a fix to the current methodology for assessing affordability of employer coverage for family members, often referred to as the family glitch, which is estimated to affect about 5 million individuals. We commend the IRS on proposing to revise the regulation and improve access to health insurance coverage for millions of American families; Concerns S.4348, Food and Drug Administration Safety and Landmark Advancements Act of 2022 or the FDASLA Act of 2022, a bill to amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological product; Comment letter on CMS Radiation Oncology (RO) Model proposed rule. We strongly supports CMS efforts to transform the delivery of cancer care. We also support the original intent of the RO Model, which was to protect access to care by ensuring fair, predictable payment for radiation oncologists. However, this important goal of the original RO Model has been marred by the incorporation of significant payment cuts and substantial administrative burdens for those participating in this mandatory model. As such, the AHA supports CMSs proposal to delay the start date of the RO model from Jan. 1, 2023 to a date to be determined through future rulemaking; Support S. 4352,Travel Nursing Agency Transparency Study Act, a bill to require a study on the effects of travel nurse agencies on the health industry during the COVID-19 pandemic; Letter in response to CMS request for guidance on implementing the regulatory requirement for convening providers and facilities exchange information with co-providers and co-facilities to create a comprehensive good faith estimate as part of the implementation of the No Surprises Act. Due to the lack of currently available automated solutions, this process would require a significant manual effort by providers, which would undoubtedly result in the convening provider being unable to meet the short statutory timeframes for delivering good faith estimates to the patients and could also lead to inadvertent errors. AHA has requested an extension in enforcement direction until a technical solution has been identified and implemented; Support HR 7691, Safety From Violence for Healthcare Employees Act or the SAVE Act, a bill to protect hospital personnel from violence, and for other purposes; Letter requesting that HHS, HRSA, and OIG take immediate enforcement action against the now 17 companies that are refusing to honor their obligations under the 340B program; Letter sent to HHS Secretary to discuss how best to ensure prompt repayment to 340B hospitals without penalizing the rest of the hospital field after the U.S. Supreme Court unanimously agreed that HHS outpatient payment cuts to hospitals in the 340B Drug Pricing Program were unlawful. The Courts decision did not determine a remedy for the unlawful payment cuts, instead, it remanded the case to the lower courts to address the proper remedy; Support HR 7084/ S 3983, Protecting and Transforming Cyber Health Care Act of 2022 or the PATCH Act of 2022, a bill to amend the Federal Food, Drug, and Cosmetic Act to require, for purposes of ensuring cybersecurity, the inclusion in any premarket submission for a cyber device of information to demonstrate a reasonable assurance of safety and effectiveness throughout the lifecycle of the cyber device, and for other purposes; Submit Comment letter of support for CMS continued focus on strengthening health insurance coverage and ensuring ease of enrollment and limited gaps in coverage, including proposed updates to Medicare enrollment and eligibility rules; Submit letter for oversight hearing on Medicare Advantage (MA) plans expressing concerns about some MA plans inappropriate restrictions on beneficiary access to medically necessary care, including those highlighted in a recent report issued by the Department of Health and Human Services Office of Inspector General (HHS-OIG), and urge Congress to increase its oversight of these plans; Provided feedback on the Senate Finance Committees discussion draft addressing mental health care and telehealth. AHA supports allowing Medicare beneficiaries who seek treatment for mental health disorders to receive their care through audio-only services, removing the requirement for Medicare patients to receive an in-person visit prior to receiving mental health services through telehealth, and expanding beyond physicians and limited non-physician practitioners the types of providers who can deliver and bill for telehealth services; Support HR 8576/ S 4352 Travel Nursing Agency Transparency Study Act, a bill to require a study on the effects of travel nurse agencies on the health industry during the COVID-19 pandemic; Support HR 8806 Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Submitted a statement for the record for the Senate Judiciary Subcommittee hearing on Flatlining Care: Why Immigrants Are Crucial to Bolstering Our Health Care Workforce. This hearing examines the importance of improving the immigration process in order to help alleviate Americas health care workforce shortage. We encourage Congress to help address domestic health care workforce shortage;

Client expense: $6,950,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), SENATE, White House Office

Mainstreaming Addiction Treatment Act (S. 445/H.R. 1384), all provisions related to removing the waiver requirement for health care providers to prescribe buprenorphine for opioid use disorder. Improving Access to Remote Behavioral Health Treatment Act of 2019, all provisions related to amending regulations for the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 and allowing community mental health centers to register to practice telemedicine. Medication Access and Training Expansion Act (H.R. 2067), all provisions related to requiring physicians and other prescribers of controlled substances to complete training on treating and managing patients with substance use disorders. CONNECT for Health Act of 2021 (H.R. 2903/S. 1512), all provisions related to expanding access to telehealth services. Telemental Health Care Access Act of 2021 (S. 2061), all provisions related to ensuring coverage of mental health services furnished through telehealth. HELP Act of 2021 (S. 1570), all provisions related to the accessibility and coordination of 211 services and 988 services. Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708/S. 168), all provisions related to temporary authorization of in-person and telehealth services. Behavioral Health Crisis Services Expansion Act (S. 1902), all provisions related to empowering communities to establish a continuum of care for individuals experiencing a behavioral health crisis. Preventing Overdoses and Saving Lives Act of 2021 (H.R. 5442), all provisions related to authorizing grants to develop strategic response plans with respect to the opioid crisis, and to require practitioners prescribing an opioid for certain patients to also prescribe an opioid overdose reversal drug. Coronavirus Mental Health and Addiction Assistance Act of 2021 (H.R. 593/S. 135), all provisions related to providing grants to entities that provide mental health and substance use disorder programs during the COVID-19 pandemic. Mental Health Services for Students Act of 2021 (H.R. 721/S. 1841), all provisions related to school-based mental health services. Stopping the Mental Health Pandemic Act (H.R. 7080/S. 4059), all provisions related to grants to support behavioral health treatment and services during the COVID-19 pandemic. Emergency Support for Substance Use Disorders Act (S. 4058), all provisions related to grants for harm reduction activities during the COVID-19 pandemic. Elementary and Secondary School Counseling Act (H.R. 6214/S. 3356), all provisions related to awarding grants to increase access to school-based, mental health services. Campus Prevention and Recovery Services for Students Act of 2019 (H.R. 3591), all provisions related to expanding the illicit drug and alcohol abuse prevention program to include campus efforts to prevent substance misuse. Opioid Treatment Access Act of 2022 (H.R. 6279), all provisions related to authorizing a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs. 9-8-8 Implementation Act of 2022 (H.R. 7116), all provisions related to providing for improvements in the implementation of the National Suicide Prevention Lifeline, and for other purposes. 9-8-8 and Parity Assistance Act of 2022 (H.R.7232), all provisions related to providing for improvements in the implementation of the National Suicide Prevention Lifeline, and for other purposes. Into the Light for MMH and SUD Act of 2022 (H.R. 7073), all provisions related to reauthorizing a grant program for screening, assessment, and treatment services for maternal mental health and substance use disorders, and for other purposes. Anna Westin Legacy Act (H.R. 7249/S. 3686), all provisions related to providing education and training on eating disorders for health care providers and communities, and for other purposes. Behavioral Health Information Technology Act, (H.R.7427), all provisions related to CMI testing of incentive payments for behavioral health providers and certain other providers for adoption and use of certified electronic health record technology, and for other purposes Safe Step Act (H.R. 2163/S. 464), all provisions related to creating an exception for medication step-therapy. Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act (S. 586), all provisions related to establishing separate payments for certain non-opioid treatments under the Medicare prospective payment system for hospital outpatient department services and the payment system for ambulatory surgical center services Food and Drug Administration Safety and Landmark Advancements Act of 2022 (S.4348), all provisions related to addressing substance use disorders and the safe disposal of opioids. Telemental Health Access to Care Act (S.2061/H.R. 4058), all provisions related to intended to increase access to tele-mental health care and telehealth. Stop Pills That Kill Act (S.4151), all provisions related to penalizing the manufacture and/or facilitation of manufacturing counterfeit pills that contain fentanyl, an analogue of fentanyl, or a counterfeit substance. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R. 7666), all provisions related to reauthorizations, expansions, and modifications of programs, grants, and activities that focus on mental and behavioral health. CONNECT Act of 2022 (H.R.8391), all provisions related to awarding grants for crisis centers to provide follow-up services to individuals receiving suicide prevention and crisis intervention services. BENEFIT Act of 2021 (H.R.4472), all provisions related to strengthen the use of patient-experience data within the benefit-risk framework for approval of new drugs. Advancing Telehealth Beyond COVID-19 Act of 2021 (H.R.4040), all provisions related to extending telehealth flexibilities under the Medicare program Expanding Access to Mental Health Training Act (S. 4461), all provisions related to reauthorizing grants for training teachers and other school personnel to recognize the symptoms of childhood and adolescent mental health disorders. Behavioral Health Network and Directory Improvement Act (S. 5093), all provisions related to protect patients and improve the accuracy of provider directory information by eliminating ghost networks. Any legislation published by the Senate Finance Committee relating to behavioral healthcare, including workforce, mental health integration, and parity policy.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Communications Commission (FCC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

Telemedicine legislation including H.R. 2903, S. 1512 - CONNECT for Health Act; H.R. 1332, S. 368 Telehealth Modernization Act; H.R. 366 -Protecting Access to Post-COVID Telehealth Act; H.R. 4058, S. 2061 - Telemental Health Care Access Act; H.R. 6202 - Telehealth Extension Act;H.R. 1647, S. 340 - TREATS Act; H.R. 5981, S. 1704 - Telehealth Expansion Act; H.R. 7353 Telehealth Benefit Expansion for Workers Act; H.R. 7573/S. 3593 Telehealth Extension and Evaluation Act; H.R. 4040 Advancing Telehealth Beyond COVID-19 Act; H.R. 2617 Consolidated Appropriations Act.

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

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

Telemedicine legislation including H.R. 2903, S. 1512 - CONNECT for Health Act; H.R. 1332, S. 368 Telehealth Modernization Act; H.R. 366 -Protecting Access to Post-COVID Telehealth Act; H.R. 4058, S. 2061 - Telemental Health Care Access Act; H.R. 6202 - Telehealth Extension Act; H.R. 1647, S. 340 - TREATS Act; H.R. 4040 Advancing Telehealth Beyond COVID-19 Act; H.R. 2617 Consolidated Appropriations Act.

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

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

Issues concerning access to and reimbursement for the Medicare hospice benefit. Issues related to community based palliative care and S. 2565, Expanding Access to Palliative Care Act. Issues related to regulatory relief. Monitored Medicare Advantage and the hospice benefit. Issues related to COVID. H.R. 8505, To amend Title XVIII of the Social Security Act to permit the use of telehealth for purposes of recertification of eligibility for hospice care; H.R. 4040, Advancing Telehealth Beyond Covid-19 Act of 2021; S. 368 / H.R. 1332, the Telehealth Modernization Act; S. 1512 / H.R. 2903, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) Act, as they relate to use of telehealth in the certification of a beneficiary for the hospice benefit. Medicare sequestration relief. Issues regarding program integrity. Issues regarding bereavement care. H.R. 2617 (P.L. 117-328), the Consolidated Appropriations Act of 2023 and issues concerning hospice reimbursement, bereavement care, and telehealth.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable prescription drugs; 340B Drug pricing program; Health care privacy; Patient privacy issues; Issues related to the American Rescue Plan Act, PL 117-2; Issues related to expanding health care coverage, including in non-Medicaid expansion states; Issues related to improving social determinants of health; Issues related to extending and expanding flexibilities for virtual care; Financial support for providers for diagnosis and treatment related to COVID-19, coverage of COVID-19 related conditions, access to PPE and other materials and equipment related to the treatment of patients with COVID-19, including funding for the Provider Relief Fund; Issues related to affordable health care coverage; H.R. 2228 - Rural Behavioral Health Access Act; Issues related to drug pricing; Issues related to Bipartisan Infrastructure Framework; Issues related to telehealth; Efforts to extend Medicare sequester delay, including H.R.1868; Issues related to Medicare policy on virtual care; Issues related to vaccine mandates; S. 168/H.R. 708 - Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act; S. 346/H.R. 959 - Black Maternal Health Momnibus Act; S. 773/H.R. 3203 - Legislation related to 340B eligibility; S. 834/H.R. 2256 - Resident Physician Shortage Reduction Act; S. 834/H.R. 2256 - Healthcare Workforce Resilience Act; S. 368/H.R. 1332 - Telehealth Modernization Act ; S. 1512/H.R. 2903 - CONNECT for Health Act; S. 1988 - Protecting Rural Telehealth Access Act; H.R. 3 - Elijah E. Cummings Lower Drug Costs Now Act; S.773/H.R. 3203 - A bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; H.R. 4943 - Childrens Mental Health Infrastructure Act; H.R. 4944 - Helping Kids Cope Act; H.R. 5376 - Build Back Better Act; H.R. 1667 - Dr. Lorna Breen Health Care Provider Protection Act; Issues related to workforce retention; H.R. 2471 - Consolidated Appropriations Act (FY 2022 Omnibus); H.R. 7007 - Covid-19 Supplemental Appropriations Act; H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act; issues related to the Acute Hospital Care at Home (AHCAH) waiver; H.R. 4407/S. 1568 - Technical Reset to Advance the Instruction of Nurses (TRAIN) Act; S. 3493 - Telehealth Extension and Evaluation Act; H.R. 6202 - Telehealth Extension Act; H.R. 5376 - Inflation Reduction Act (Public Law 117-169); H.R. 6833 - Continuing Resolution; H.R. 2617 - Consolidated Appropriations Act, 2023; Issues related to adequate financing for hospitals and providers; H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act; Issues related to extending the Medicare Dependent Hospital and Low Volume Hospital programs; Issues related to extending bonus payments for Advanced Alternative Payment models; H.R. 4587 - Value in Health Care Act; Issues related to coding and coverage of spiritual care through chaplain services; Issues related to value-based care programs, including the Bundled Payments for Care Improvement (BPCI) Advanced Model; Issues related to data and quality measure reporting and eligibility for corresponding reimbursements; Issues related to prior authorization; H.R. 3173 - Improving Seniors Timely Access to Care Act; Issues related to Rural Emergency Hospital designation; Issues related to safety net hospital reimbursements.

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

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

340B Drug Pricing Program; Issues related to 340B contract pharmacies; Financial support for providers for diagnosis and treatment related to COVID-19, including funding for the Provider Relief Fund; coverage of COVID-19 related conditions; S. 168/H.R. 708 - Temporary; Reciprocity to Ensure Access to Treatment (TREAT) Act; S. 346/H.R. 959 - Black Maternal Health Momnibus Act; S. 773/H.R. 3203 - Legislation related to 340B eligibility; S. 368/H.R. 1332 - Telehealth Modernization Act; S. 1512/H.R. 2903 - CONNECT for Health Act; S. 1988 -Protecting Rural Telehealth Access Act; H.R. 3 - Elijah E. Cummings Lower Drug Costs Now Act; S.773/H.R. 3203 - A bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; - S.773/H.R. 3203; H.R. 5376 - Build Back Better Act; H.R. 853 - Closing Loopholes for Orphan Drugs Act; H.R. 2471 - Consolidated Appropriations Act (FY 2022 Omnibus); H.R. 7007 - Covid-19 Supplemental Appropriations Act; H.R. 5376 - Inflation Reduction Act (Public Law 117-169); H.R. 6833 - Continuing Resolution

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

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

Issues related to Medicare and Medicaid coverage and Medicaid disproportionate share program; Financial support for providers for diagnosis and treatment related to COVID-19; coverage of COVID-19 related conditions; access to PPE and other materials and equipment related to the treatment of patients with COVID-19, including funding for the Provider Relief Fund; PL 117-2; Issues related to Bipartisan Infrastructure Framework; Issues related to telehealth; Efforts to extend Medicare sequester delay, including H.R.1868; Issues related to Medicare policy on virtual care; Childrens Health Graduate Medical Education; issues related to drug pricing; Issues related to hospital DSH eligibility; Issues related to Home and Community Based Services (HCBS); Medicaid waiver-related issues; Childrens transplant program issues; S. 346/H.R. 959 - Black Maternal Health Momnibus Act; S.773/H.R. 3203 - legislation to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; S. 834/H.R. 2256 - Resident Physician Shortage Reduction Act; S. 1024/H.R. 2255 - Healthcare Workforce Resilience Act; S. 368/H.R. 1332 - Telehealth Modernization Act; S. 1512/H.R. 2903 - CONNECT for Health Act ; S. 1988 - Protecting Rural Telehealth Access Act; H.R. 3 - Elijah E. Cummings Lower Drug Costs Now Act; H.R. 5376 - Build Back Better Act; H.R. 2617 - Consolidated Appropriations Act, 2023; Efforts to delay statutory PAYGO payment reductions; Efforts to offset physician payment reductions; Efforts to improve hospital reimbursement; Issues related to cuts to Medicaid DSH; Issues related to cuts to uncompensated care pools; Issues related to hospital at home programs; H.R. 2471 - Consolidated Appropriations Act (FY 2022 Omnibus); H.R. 7007 - Covid-19 Supplemental Appropriations Act; H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act; issues related to the Acute Hospital Care at Home (AHCAH) waiver; S. 3493 - Telehealth Extension and Evaluation Act; H.R. 6202 - Telehealth Extension Act; H.R. 5376 - Inflation Reduction Act (Public Law 117-169); H.R. 6833 - Continuing Resolution; Issues related to adequate financing for hospitals and providers; H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act; Issues related to extending the Medicare Dependent Hospital and Low Volume Hospital programs; Issues related to extending bonus payments for Advanced Alternative Payment models; H.R. 4587 - Value in Health Care Act; Issues related to coding and coverage of spiritual care through chaplain services; Issues related to value-based care programs, including the Bundled Payments for Care Improvement (BPCI) Advanced Model; Issues related to data and quality measure reporting and eligibility for corresponding reimbursements; Issues related to prior authorization; H.R. 3173 - Improving Seniors Timely Access to Care Act; Issues related to Rural Emergency Hospital designation; Issues related to safety net hospital reimbursements.

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

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

Healthcare Supply Chain - Highlighted the important role played by hospital group purchasing organizations in promoting resiliency and value in healthcare purchasing. Engaged to support policies to ensure greater transparency and mitigate or limit shortages of prescription drugs. Supported policies that would expedite critical cargo, including cargo necessary for medical care, during a public health emergency or disaster. Advocated for greater transparency in the health care supply chain for drugs and medical devices. Supported updating language related to the Unapproved Drugs Initiative, and incorporating the PASTUER Act (S.2076) and the PATCH Act (H.R. 7084) in omnibus legislation (H.R. 2617). Telehealth - Supported efforts to make telehealth flexibilities offered during COVID-19 Public Health Emergency permanent. Supported CONNECT for Health Act (H.R. 2617 S. 1512/H.R. 2903) and the Extending Telehealth Beyond COVID-19 Act (H.R. 4040). Encouraged reimbursement parity for certain telehealth services and support for audio-only telehealth services. Health Care Workforce - Urged passage of the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708; S. 168); The Health Care Workforce Resilience Act (S. 1024/H.R. 2255). Urged administration to examine practices of health care staffing agencies and supported passage of the Travel Nursing Agency Transparency Study Act (S. 4352). Supported passage of the Safety from Violence for Healthcare Employees Act (H.R. 7961). Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act (S. 3799; H.R 2617) - monitored PREVENT Pandemics Act and supported inclusion of provisions to improve supply chain transparency, enhance cybersecurity of medical devices and extend shelf life of prescription drugs in omnibus legislation. 340B Drug Pricing Program - Urged HHS to enforce guidance that would allow 340B Covered Entities to utilize contract pharmacies. Social Determinants of Health and Health Equity - Shared insights and offered suggestions to CMS regarding health equity measurement, indices and data collection. Supported the Social Determinants Accelerator Act (H.R. 2503; S. 3039); The LINC to Address Social Needs Act (S. 509). Supported passage of Opioid Treatment Access Act (S. 3629/H.R. 6279). Supported passage of Drug Shortages Shelf Life Extension Act (S. 3493). Supported passage of the Biologics Competition Act (H.R. 8877).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Medicare PAYGO Sequestration - (H.R 2617) - Supported inclusion of provisions in the Consolidated Appropriations Act to prevent 4% Medicare payment reductions due to sequestration required by statutory PAYGO requirements. Medicare Physician Reimbursement (H.R. 2617; H.R. 8800) - Supported legislation that would ease pending reimbursement cuts through the physician fee schedule conversion factor. Health Care Workforce (S.834/H.R. 2256; S. 1438/H.R. 3441; H.R. 2617) - Supported legislation to increase the number of Medicare-supported Graduate Medical Education slots. Advanced Alternative Payment Model (APM) Bonus Payment (H.R. 4587; H.R. 2617) - Supported passage of legislation to extend the APM bonus payments. Telehealth (H.R. 2617; H.R. 4040; S. 1512/H.R. 2903)- Advocated for Congress to extend or make permanent flexibilities related to distant site and geographic limitations, expanding the provider types and services available to be reimbursed by Medicare. Acute Hospital Care at Home Model (H.R. 2617; S. 3792/H.R. 7053) Supported passage of legislation to extend the Acute Hospital Care at Home Model beyond the end of the declared Public Health Emergency. Rural Health Care Extenders (H.R. 2617) - Supported extension of Medicare Dependent Hospital program and Medicare Low-Volume Adjustment. Mental and Behavioral Health (S. 4747; H.R. 7236; H.R. 2617) - Supported passage of legislation to better support access to mental and behavioral health needs for children and adults. Supported passage of the Improving Seniors' Timely Access to Care Act (S.3018/ H.R.3173). Supported passage of the Preserving Access to Home Infusion Act (H.R. 5067/S. 2652).

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

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

Medicare home health payment policy. Oppose home health and hospice payment cuts and co-pays. Home health rural add-on payment adjustment. CMMI VBID Medicare Advantage Carve-in proposal. H.R. 2898/S. 1399, Homecare for Seniors Act. Medicaid payment and eligibility policy. Medicaid Money Follows the Person program. Medicaid protections against spousal impoverishments. H.R. 3371/S. 1309, Home Health Emergency Access to Telehealth Act. Hospice Face to Face Telehealth recertification. Patient Choice and Quality Care Act (draft legislation). Medicaid HCBS FMAP increase. Increased minimum wage legislative proposals. H.R. 2903/S. 1512, CONNECT for Health Act of 2021. H.R. 3321/S. 1670, Credit for Caring Act of 2021. H.R. 2565, Expanding Access to Palliative Care Act. H.R. 5514/S. 2562, Choose Home Care Act of 2021. H.R. 4131/S.2210, Better Care Better Jobs Act. Health information technology funding and standards for long-term post-acuter care providers. Palliative dialysis payment policy in Medicare hospice. Medicare Sequestration Moratoria. Hospice concurrent care policy. Community-based palliative care in CMMI alternative payment model demonstrations. H.R. 3173/S. 3018, Improving Seniors' Timely Access to Care Act. H.R. 8812, The Improving Care and Access to Nurses (ICAN) Act. H.R. 432, Mental Health Access Improvement Act of 2021. S. 4873, Improving Access to Advance Care Planning Act. H.R. 8581/S. 4605, Preserving Access to Home Health Act of 2022. H.R. 4040, Advancing Telehealth Beyond COVID-19 Act of 2021. H.R. 5067/S. 2652, Preserving Patient Access to Home Infusion Act. H.R. 2617, Consolidated Appropriations Act, FY2023. Hospice aggregate cap. Hospice program integrity concerns. Hospice payment reform/benefit redesign.

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

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

S. 368/ H.R. 1332: Telehealth Modernization Act S. 833/ H.R. 2071: Empowering Medicare Seniors to Negotiate Drug Prices Act S. 1512/ H.R. 2903: CONNECT for Health Act of 2021 H.R. 3173: Improving Seniors Timely Access to Care Act H.R.8800 - Supporting Medicare Providers Act of 2022 Engagement with CMS regarding National Coverage Analysis (NCA) of Aduhelm and other monoclonal antibodies directed at amyloid beta plaque for the treatment of Alzheimers Disease. Support for the elimination of the Medicare Appropriate Use Criteria (AUC) Program for advanced diagnostic imaging. Support for policies to address the COVID-19 pandemic, including extending temporary relief for Medicare Physician Fee Schedule payments and postponing Medicare sequestration cuts beyond 2021. Support for a permanent expansion of telehealth in Medicare, including eliminating on originating site and geographic restrictions. Support for policies to address prescription drug costs, including supporting direct negotiation in Medicare, improving drug pricing transparency, and capping beneficiary out-of-pocket costs in Medicare Part D. Expressing concerns with changes finalized in the 2022 Medicare Physician Fee Schedule redefining the substantive portion of a split (or shared) visit starting in 2023

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

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

Issues related to lung disease treatment, prevention and research; Issues related to public health; Issues related asthma, COPD, influenza, lung cancer, pneumonia, pulmonary fibrosis, tuberculosis and other lung diseases; Issues related to tobacco cessation; Issues related to the Affordable Care Act; Issues related to the Childrens Health Insurance Program; Issues related to COVID-19 Response; Issues related to vaccines; Issues related to the SUNSET Rule; Issues related to infrastructure; Issues related to supplemental oxygen; Issues relating to the Presidents FY24 budget; Issues related to the implementation of the No Surprises Act; Issues related to Medicare sequestration; Issues related to FY23 appropriations bills; Issues related to Cancer Moonshot; Issues related to Implementation of ACA; Issues related to Short-Term Limited Duration Plans; Issues related to Healthy Future Taskforce, H.R. 8295 Labor HHS Appropriations bill; S. 4659 Labor HHS Appropriations bill; H.R.3173 Improving Seniors Timely Access to Care Act; H.R.107 Lung Cancer Screening Registry and Quality Improvement Act of 2021; H.R.1946 To amend title XVIII of the Social Security Act to provide for Medicare coverage of multi-cancer early detection screening tests; H.R.2140 To prioritize funding for an expanded and sustained national investment in basic science research; S.571 Public Health Funding Prevents Pandemics Act; S.961 A bill to prioritize funding for an expanded and sustained national investment in basic science research; S.962 A bill to prioritize funding for an expanded and sustained national investment in biomedical research; H.R.66 CARING for Kids Act; H.R.1390 CHIPPER Act; H.R.1583 To fully fund the Prevention and Public Health Fund and reaffirm the importance of prevention in the United States health care system; H.R.1738 To amend titles XIX and XXI of the Social Security Act to provide for 12-month continuous enrollment of individuals under the Medicaid program and Childrens Health Insurance Program, and for other purposes; H.R.1791 To amend title XXI of the Social Security Act to permanently extend the Childrens Health Insurance Program, and for other purposes; S.245 SAME Act of 2021; S.1114 A bill to increase vaccination rates among pregnant women enrolled in Medicaid or CHIP, and for other purposes; H.R.2347 To amend title XIX of the Social Security Act to ensure adequate access to vaccines under the Medicaid program and the Vaccines for Children program, and for other purposes; S.1117 A bill to amend title XIX of the Social Security Act to require Medicaid coverage of approved vaccines for pregnant women; S.368 Telehealth Modernization Act; H.R.2125 To amend title XIX and XXI of the Social Security Act to provide coverage of comprehensive tobacco cessation services under such titles, and for other purposes; H.R.1978 To amend title XVIII of the Social Security Act to provide information regarding vaccines for seniors as part of the Medicare & You handbook and to ensure that the treatment of cost sharing for vaccines under Medicare part D is consistent with the treatment of vaccines under Medicare part B, and for other purposes; H.R.2170 To amend title XIX of the Social Security Act to improve access to adult vaccines under Medicaid; H.R.379 Improving Social Determinants of Health Act of 2021; H.R.526 Ensuring Coverage in Public Health Emergencies Act of 2021; H.R.1872 To amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities, and for other purposes; H.R.1874 To amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes; H.R.1875 To amend title XXVII of the Public Health Service Act to eliminate the short-term limited duration insurance exemption with respect to individual health insurance coverage; H.R.1878 To amend the Patient Protection and Affordable Care Act to establish a health insurance affordability fund, and for other purposes; H.R.1888 To amend title XIX of the Social Security Act to require a Federal medical assistance percentage of 100 percent for Indian health care providers, and for other purposes; H.R.1890 To amend the Patient Protection and Affordable Care Act to require Exchanges to establish network adequacy standards for qualified health plans and amend the Public Health Service Act to provide protections for consumers against excessive, unjustified, or unfairly discriminatory increases in premium rates; S.104 Improving Social Determinants of Health Act of 2021; S.779 Protecting Americans with Pre-Existing Conditions Act of 2021; S.942 A bill to provide that the rule entitled "Short-Term, Limited Duration Insurance shall have no force or effect; H.R.1790 To amend the Patient Protection and Affordable Care Act to require the Secretary of Health and Human Services to set forth a method of determining maximum out-of-pocket limits and annual updates to premium tax credit eligibility; H.R.550 Immunization Infrastructure Modernization Act of 2021; H.R.736 Community Immunity During COVID-19 Act of 202; H.R.791 Tracking COVID-19 Variants Act; H.R.1268 Building COVID-19 Vaccine Confidence Act of 2021; S.167 Community Immunity During COVID-19 Act of 2021; S.236 Tracking COVID-19 Variants Act; H.R.173 COVID-19 Prevention and Awareness Act of 2021;; H.R.959 Black Maternal Health Momnibus Act of 2021; H.R.3904 Reducing COVID-19 Disparities by Investing in Public Health Act; S.1314 Tobacco Tax Equity Act of 2021; H.R.2786 Tobacco Tax Equity Act of 2021; H.R.1800 Women and Lung Cancer Research and Preventive Services Act of 2021; S.699 Women and Lung Cancer Research and Preventive Services Act of 2021; H.R.1946 Medicare Multi-Cancer Early Detection Screening Coverage Act of 2021; H.R.3749 Katherines Law for Lung Cancer Early Detection and Survival Act of 2021; H.R.3 Elijah E. Cummings Lower Drug Costs Now Act; H.R.1738 Stabilize Medicaid and CHIP Coverage Act; S.646 Stabilize Medicaid and CHIP Coverage Act of 2021; S.1114 Maternal Immunization Enhancement Act; S.1873 Medicare Multi-Cancer Early Detection Screening Coverage Act of 2021; H.R.2125 Quit Because of COVID-19 Act; S.2622 Quit Because of COIVD-19 Act; H.R.2347 Strengthening the Vaccines for Children Program Act of 2021; S.1117 Maternal Immunization Coverage Act; H.R.3149 HEAL for Immigrant Families Act of 2021; H.R.3961 To amend title XIX of the Social Security Act to provide for a demonstration project under the Medicaid program for political subdivisions of States to provide medical assistance for the expansion population under such program, and for other purposes; S.1660 HEAL for Immigrant Families Act of 2021; H.R.2903 CONNECT for Health Act of 2021; S.1512 CONNECT for Health Act of 2021; S.1424 Chronic Disease Management Act of 2021; H.R.3883 To amend title 38, United States Code, to prohibit smoking on the premises of any facility of the Veterans Health Administration, and for other purposes; S.2043 A bill to amend title 38, United States Code, to prohibit smoking on the premises of any facility of the Veterans Health Administration, and for other purposes; S.2315 Medicaid Saves Lives Act; H.R.4595 Medicaid Saves Lives Act; S.Con.Res.14 A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2022 and setting forth the appropriate budgetary levels for fiscal years 2023 through 2031; H.R.5227 LIFT the BAR Act of 2021; S.674 Public Health Infrastructure Saves Lives Act; Health Equity and Accountability Act; H.R.5030 DIVERSE Trials Act; S.2706 DIVERSE Trials Act; H.R.6302 Protecting the Health of Americas Older Adults Act; S.J.Res.29 A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Labor relating to COVID-19 Vaccination and Testing; Emergency Temporary Standard; S.Res.462 A resolution designating November 2021 as "National Lung Cancer Awareness Month and expressing support for early detection and treatment of lung cancer;; H.R.2909 To amend the Internal Revenue Code of 1986 to allow a one-time election for a qualified charitable distribution to a split-interest entity and to inflation adjust the limits for qualified charitable distributions.; H.R.2954 Securing a Strong retirement Act of 2021; H.R. 7055 Elijah E. Cummings Family Asthma Act; S. 3332 Let States Innovate Under Medicaid Act; S.4348 -FDASLA Act of 2022; H.R.7667 - Food and Drug Amendments of 2022, S.4535 -A bill to amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological products, and for other purposes; H.R. 7845 NIH Clinical Trial Diversity Act of 2022; H.R. 8885 Better Health Care Directories Act; S.Res.863 A resolution designating November 2022 as National Lung Cancer Awareness Month and expressing support for early detection and treatment of lung cancer; H.R. 9336 Increasing Access to Lung Cancer Screening Act; H.R. 9565 Comprehensive Cancer Survivorship Act; S. 5295 Comprehensive Cancer Survivorship Act; H.R. 2617 Consolidated Appropriations Act, 2023; S. Amdt.6552 to H.R.2617

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

Issues related to lung disease treatment, prevention and research; Issues related to public health; Issues related to tobacco cessation; Issues related to health inequities; Issues related to Medicaid waivers; Issues related to the Affordable Care Act; Issues related to supplemental oxygen; Issues related to access to healthcare; Issues related to COVID-19 Response; Issues related to Medicaid coverage for immigrants; Issues related to the SUNSET Rule; Issues related to infrastructure; Issues related to health equity; Issues related to the implementation of the No Surprises Act; Issues related to Medicare sequestration; Issues related to FY23 appropriations bills; Issues relating to the Presidents FY24 budget;H.R. 8295 Labor HHS Appropriations bill; S. 4659 Labor HHS Appropriations bill; H.R.3173 Improving Seniors Timely Access to Care Act; H.R.66 CARING for Kids Act; H.R.1390 CHIPPER Act; H.R.1583 To fully fund the Prevention and Public Health Fund and reaffirm the importance of prevention in the United States health care system; H.R.1738 To amend titles XIX and XXI of the Social Security Act to provide for 12-month continuous enrollment of individuals under the Medicaid program and Children's Health Insurance Program, and for other purposes; H.R.1791 To amend title XXI of the Social Security Act to permanently extend the Children's Health Insurance Program, and for other purposes; S.245 SAME Act of 2021; S.1114 A bill to increase vaccination rates among pregnant women enrolled in Medicaid or CHIP, and for other purposes; H.R.2347 To amend title XIX of the Social Security Act to ensure adequate access to vaccines under the Medicaid program and the Vaccines for Children program, and for other purposes; S.1117 A bill to amend title XIX of the Social Security Act to require Medicaid coverage of approved vaccines for pregnant women; S.368 Telehealth Modernization Act; H.R.2125 To amend title XIX and XXI of the Social Security Act to provide coverage of comprehensive tobacco cessation services under such titles, and for other purposes; H.R.1978 To amend title XVIII of the Social Security Act to provide information regarding vaccines for seniors as part of the Medicare & You handbook and to ensure that the treatment of cost sharing for vaccines under Medicare part D is consistent with the treatment of vaccines under Medicare part B, and for other purposes; H.R.2170 To amend title XIX of the Social Security Act to improve access to adult vaccines under Medicaid; H.R.1946 To amend title XVIII of the Social Security Act to provide for Medicare coverage of multi-cancer early detection screening tests; H.R.107 Lung Cancer Screening Registry and Quality Improvement Act of 2021; H.R.3 Elijah E. Cummings Lower Drug Costs Now Act; H.R.1738 Stabilize Medicaid and CHIP Coverage Act; S.646 Stabilize Medicaid and CHIP Coverage Act of 2021; S.1114 Maternal Immunization Enhancement Act; S.1873 Medicare Multi-Cancer Early Detection Screening Coverage Act of 2021; H.R.2125 Quit Because of COVID-19 Act; S.2622 Quit Because of COIVD-19 Act; H.R.2347 Strengthening the Vaccines for Children Program Act of 2021; S.1117 Maternal Immunization Coverage Act; H.R.3149 HEAL for Immigrant Families Act of 2021; H.R.3961 To amend title XIX of the Social Security Act to provide for a demonstration project under the Medicaid program for political subdivisions of States to provide medical assistance for the expansion population under such program, and for other purposes; S.1660 HEAL for Immigrant Families Act of 2021; H.R.2903 CONNECT for Health Act of 2021; S.1512 CONNECT for Health Act of 2021; H.R.1946 Medicare Multi-Cancer Early Detection Screening Coverage Act of 2021; S.2315 Medicaid Saves Lives Act; H.R.4595 Medicaid Saves Lives Act; S.Con.Res.14 A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2022 and setting forth the appropriate budgetary levels for fiscal years 2023 through 2031; H.R.5227 LIFT the BAR Act of 2021;; S. 3332 Let States Innovate Under Medicaid Act; S.4348 -FDASLA Act of 2022; H.R.7667 - Food and Drug Amendments of 2022, S.4535 -A bill to amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological products, and for other purposes; H.R. 7845 NIH Clinical Trial Diversity Act of 2022; H.R. 9336 Increasing Access to Lung Cancer Screening Act;; H.R. 2617 Consolidated Appropriations Act, 2023; S. Amdt.6552 to H.R.2617

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), Office of Management & Budget (OMB), SENATE, White House Office

Legislative and administrative monitoring and outreach on healthcare policy. Legislative and administrative monitoring and outreach on prescription drug pricing/PBMs. Legislative and administrative monitoring and outreach on policy issues affecting Medicaid programs. S. 150, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021. H.R. 955, Medicaid Reentry Act of 2021. H.R. 379, Improving Social Determinants of Health Act of 2021. H.R. 2903, CONNECT for Health Act of 2021. S. 1512 CONNECT for Health Act of 2021. S. 151, COVID HCBS Relief Act of 2021. H.R. 525, COVID HCBS Relief Act of 2021. H.R. 3203, To enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes. S. 1388, Prescription Pricing for the People Act of 2021. S. 773, A bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes. S. 3799, PREVENT Pandemics Act. H.R. 6963, Accelerated Approval Integrity Act of 2022. H.R. 6996, Accelerating Access for Patients Act of 2022. H.R, 7007, COVID Supplemental Appropriations Act, 2022. H.R. 6833, Affordable Insulin Now Act. S. 4348, Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act of 2022. H.R. 7667, Food and Drug Amendments of 2022. Implementation of H.R.5376, Inflation Reduction Act (Pub.L. 117-169) H.R.2617, Consolidated Appropriations Act, 2023

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1512/H.R. 2903 - Connect for Health Act of 2021 - provisions related to reducing barriers to Medicare coverage for telehealth services and to promote expansion of telehealth Proposals to expand access to telehealth services Proposals to prevent future sequester cuts, reducing Medicare payments H.R. 7053/S. 3792, Hospital Inpatient Services Modernization Act - provisions related to extending the CMS Acute Hospital Care at Home Waiver Flexibilities H.R. 2617, the Consolidated Appropriations Act, 2023 - provisions related to Medicare, Medicaid, telehealth and the CMS Acute Hospital Care at Home Waiver

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Funding for hospitals and physicians related to COVID 19 Additional legislative proposals modifying the 340B program Build Back Better Act proposals related to health policy, workforce and hospital emergency preparedness S. 1512/H.R. 2903 - Connect for Health Act of 2021 - provisions related to reducing barriers to telehealth services and to promote expansion of telehealth H.R. 2617, the Consolidated Appropriations Act, 2023 - provisions related to telehealth and mental health

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Analyzing the Duration of Remote Monitoring Services Act of 2021 (H.R.4347) CONNECT for Health Act of 2021 (H.R.2903 / S.1512) Increasing Access to Quality Cardiac Rehabilitation Care Act of 2021 (S.1986) Accelerating Kids' Access to Care Act (H.R.3089/ S.1544) SOS: Sustaining Outpatient Services Act (H.R.3348) Telehealth Extension Act of 2021 (H.R. 6202) The Telehealth Modernization Act (S.368) Advancing Telehealth Beyond COVID-19 Act (H.R. 4040) Helping MOMS Act of 2021 (H.R. 3345) Medicaid Waivers National Coverage Determination for Self-Measured Blood Pressure

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

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

Issues concerning access and reimbursement to the Medicare hospice benefit. Issues related to community based palliative care and advanced care illness management. S. 2565, Expanding Access to Palliative Care Act. Issues related to regulatory relief. Issues concerning Medicare Advantage and the hospice benefit. Issues related to COVID. H.R. 4040, Advancing Telehealth Beyond Covid-19 Act of 2021, S. 368 / H.R. 1332, the Telehealth Modernization Act, as they relate to use of telehealth in the certification of a beneficiary for the hospice benefit. S. 1512 / H.R. 2903, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) Act. Medicare sequestration relief. Issues regarding program integrity. Monitored S.1723 - Budgeting for Opioid Addiction Treatment Act. Monitored H.R. 5376 (P.L. 117-169), the Inflation Reduction Act, as it relates to palliative care. The FY 2023 Hospice Wage Rule, as it relates to reimbursement for the hospice Medicare benefit. H.R. 2617 (P.L. 117-328), the Consolidated Appropriations Act of 2023 and issues concerning hospice reimbursement, and telehealth and Medicare sequestration relief.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Home dialysis/home therapies issues; H.R. 5426 - Improving Access to Dialysis Act; H.R. 4065 and S. 1971 - Chronic Kidney Disease Improvement Act; H.R. 2903 and S. 1512 - CONNECT Act; H.R. 1255 and S. 377 - Living Donor Protection Act; H.R. 2568 and S. 1220 - US Cadet Nurse Corps Service Recognition Act.

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

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

Health Insurance Coverage (general); Health Equity (general); Breastfeeding (general); Assisted Reproductive Technology (general); Substance Use Disorder (general); Gynecologic Cancer (general); Reproductive Health (general); Intimate Partner Violence (general); Gun Violence (general); Immunization (general); Breast Cancer (general); Medical Liability Reform (general); Health IT (general); Patient-Physician Relationship (general); Child Welfare (general); Maternal Mortality and Morbidity (general); Graduate Medical Education (general); Contraception (general); Abortion (general); Indian Health (general); Teaching Health Centers Graduate Medical Education (general); Community Health Centers (general); National Health Service Corps (general); Health care workforce (general; Sexually Transmitted Infections (general); Access and Provision of Medication for Opioid Use Disorder (HHS); Research in Pregnant and Breastfeeding Women (general); Health Care Reform (general); Title X Family Planning Program (general); Womens Preventive Services (general); Administrative Burden (general); COVID-19 Response (general); COVID-19 Vaccines (general); Pandemic Preparedness (general); Risk Evaluation and Mitigation Strategies (general); Data Collection (general); Health Insurance and Portability and Accountability Act (general); Social Determinants of Health (General); Maternal Mental Health (general); Online misinformation (general); EMTALA (general); Father Engagement (general); Care for Individuals with Disabilities (general); H.R. 3755/S. 1975, Womens Health Protection Act; implementation of P.L. 115-320, Improving Access to Maternity Care Act; implementation of Maternal Health Quality Improvement Act contained in P.L. 117-103; H.R. 959/ S. 346, Black Maternal Health Momnibus Act; H.R. 1065/S. 1486, Pregnant Workers Fairness Act; H.R. 1350/ S.408, Supporting Best Practices for Healthy Moms Act; H.R. 3407/S. 411, MOMMAs Act; implementation of P.L. 117-2, the American Rescue Plan Act of 2021; H.R. 2007/S. 2444, Stephanie Tubbs Jones Uterine Fibroid Research and Education Act of 2021; H.R. 3110/S. 1658, PUMP for Nursing Mothers Act; H.R. 2903/S.1515, CONNECT for Health Act; H.R. 3671/S.1958, Doctors of Community (DOC) Act; Implementation of P.L. 114-255, the 21st Century Cures Act; Implementation of the No Surprises Act contained in P.L. 116-260; H.R. 482/S. 350, Newborn Screening Saves Lives Reauthorization Act; H.R. 804/S. 248, FAMILY Act; H.R. 5/S. 393, Equality Act; Implementation of P.L. 117-168, Inflation Reduction Act of 2022; H.R. 5218, Collaborate in an Orderly and Cohesive Manner Act; H.R. 5239/ S. 2941, Good Samaritan Health Professionals Act of 2021; H.R. 7073/S.3824, Into the Light for MMH and SUD Act of 2022; H.R.5487/S.3972, SHINE for Autumn Act of 2021; Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) (general); H.R.7011/S.3797, Maternal and Child Health Stillbirth Prevention Act of 2022; H.R. 2234/S. 1021, Equal Access to Abortion Coverage (EACH) Act; S. 4467, Protecting Access to Medication Abortion Act; S.Res.664, A resolution expressing opposition to the criminalization of essential healthcare, including the full range of sexual and reproductive healthcare such as abortion, gender-affirming care, and contraceptive care, and disapproving of the criminalization of pregnancy outcomes; H.Res.589, Expressing the sense of the House of Representatives that policies governing access to medication abortion care in the United States should be equitable and based on science; H.R. 7894/S. 4347, Affordability is Access Act; H.R. 6005/S. 3223, Access to Birth Control Act; H.R. 7845, NIH Clinical Trial Diversity Act of 2022; H.R. 4217/S. 2779, TRIUMPH for New Moms Act of 2021; H.R. 7974, Endometriosis CARE Act of 2022; H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022; Safety and efficacy of noninvasive prenatal screening tests (FDA/CMS); COVID-19 public health emergency unwinding (general); Implementation of the Maternal Health Quality Improvement Act and Rural MOMS Act included in P.L. 117-103; Implementation of P.L. 117-103, Consolidated Appropriations Act, 2022;; health care provider conscience protections (general);; H.R. 9247, Abortion Care Awareness Act; H.R. 9220, Informing New Factors and Options for Reproductive Care Act; H.R. 8834, EQUIP Act; S. 4688, Reproductive Freedom for All Act; S. 4748, Protecting National Access to Reproductive Care Act; H.R. 4040, Advancing Telehealth Beyond COVID-19 Act of 2021; Reproductive health care workforce (general); S.4467, Protecting Access to Medication Abortion Act; S.4723, Let Doctors Provide Reproductive Health Care Act; H.R. 8373, Right to Contraception Act; S.4764, Reproductive Health Care Accessibility Act; H.R. 9487, Advancing Safe Medications for Moms and Babies Act of 2022; H.R. 9602, Maternal Health Pandemic Response Act of 2022; Reauthorization of P.L. 115-328, PREEMIE Reauthorization Act of 2018; H.R. __, Improving Access to Prenatal Telehealth Care Act of 2022; H.R. 9689, Know Your Body Act; S.5276, Right to Build Families Act of 2022; S.5227/H.R.8452, Reproductive Health Travel Fund Act of 2022; H.R. 6216/S. 3389, Sickle Cell Disease Comprehensive Care Act

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

Support reforming prior authorization procedures to be more seamless, automated and transparent for physicians: HR 3173/ S.3018, Improving Seniors Timely Access to Care Act of 2021. Support extending and expanding telehealth: HR 1332 and S 368, The Telehealth Modernization Act; HR 2903 and S 1512, The Connect for Health Act; HR 4480 The Telehealth Coverage and Payment Parity Act and HR 2168 The Expanded Telehealth Access Act. Oppose H.R. 6087, Improving Access to Workers Compensation for Injured Federal Workers Act. Would inappropriately permit nurse practitioners and physician assistants to diagnose, prescribe, treat and certify an injury for federal workers compensation claims. Ensure relevant traveling physicians can appropriately treat their patients by supporting HR7259 the Medical Controlled Substances Transportation Act of 2022.

Client expense: $326,542 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Policies related to telehealth Policies related to transition of care for children and youth with special health care needs Request to become Health People 2030 Champion CONNECT for Health Act (S.1512/ H.R. 2903) Cures 2.0 Act (H.R. 6000) BRAIN Act of 2021 (H.R.5435) Policies related to newborn screening Support for caregivers Section 1557, Nondiscrimination in Health Programs and Activities (RIN Number 0945-AA17) Supporting the Reauthorization of the Orphan Drug Program Declaration of National Epilepsy Awareness Month

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, White House Office

Metastatic Breast Cancer Access to Care Act (S. 1312 / HR 3182) Multi-Cancer Early Detection Screening Coverage Act (HR 1946/S 1873) Lymphedema Treatment Act (HR 3630/ S 1315) Breast Cancer Patient Equity Act (HR 3087/S 2051) Reducing Hereditary Cancer Act of 2021 (HR 4110) CONNECT for Health Act (S.1512/ H.R. 2903) Improving Seniors' Timely Access to Care Act (H.R.3173) Comprehensive Breast Reconstruction Act of 2021 (H.R. 469) Seniors Prescription Drug Relief Act (S.2327) Medicare coverage policy for breast cancer treatments and services Radiation Oncology Alternative Payment Model Telehealth Policies related to funding, state incentives, and federal efforts for Medicaid expansion Issues related to 1115 and 1332 of the Social Security Act; policies related to work requirements, reinsurance and block grants in Medicaid Policies related to Medicare coverage for pharmacy services and the Equitable Community Access to Pharmacist Services Act (H.R.7213) Medicare coverage policy for drugs and drug pricing H.R. 9505 - Find It Early Act; a bill to provide for health coverage with no cost-sharing for additional breast screenings for certain individuals Comments regarding the temporary increase in federal medical assistance percentage (FMAP) in response to the COVID-19 Public Health Emergency (PHE) (CMS-9912-N) Comments in response to the Medicaid Eligibility and Enrollment NPRM (CMS-2421-P) Comments in response to the RFI regarding National Directory of Healthcare Providers & Services (CMS-0058-NC) Comments in response to the RFI regarding accessing healthcare and related challenges, understanding provider experiences, advancing health equity, and assessing the impact of waivers and flexibilities provided in response to the COVID-19 Public Health Emergency (PHE)

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

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

Advocate for adequate and accurate network coverage for dermatologic care within Medicare Advantage. Advocate for increased funding and reforms to Graduate Medical Education. Lobby members of Congress regarding improvements to Health Information Technology implementation. Advocate for expansion of telemedicine services under Medicare and increased reimbursement for such services. Advocate for improving disease management and care coordination for patients with chronic diseases. Support preservation of the In-Offices Ancillary Services Exemption (IOASE) under Stark Law regarding physician self-referral and oppose repeal of the in-office ancillary and physician services exception. Advocate for relief from Medicare regulations under Medicare Access and CHIP Reauthorization Act (MACRA P.L. 114-110), including the Quality Payment Program (QPP) and specifically the development of advanced alternative payment models (APMs) and implementation of the Merit-Based Incentive Payment System (MIPS). Advocate for relief for from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Lobby Congress to urge CMS to strengthen Qualified Clinical Data Registries (QCDRs) by removing barriers that restrict access to data from EHRs. (H.R. 6000) Advocate for congressional action to hold health care professionals harmless from any cuts related to CMS Evaluation and Management Code proposals in any forthcoming legislative package. Support the Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act (H.R. 1677/S. 620). Support H.R.8437, the Improving Seniors Timely Access to Care Act of 2022 Support H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act of 2021 Support H.R. 2903/S. 1512 the CONNECT for Health Act of 2021 Support H.R. 5054, Keep Physicians Serving Patients Act Advocate to support extension of moratorium on 2% Medicare sequester, replace scheduled and anticipated cuts in payments with positive, inflationary-based updates, eliminate the nearly 4.5% conversion factor cut in the CMS proposed rule for the 2023 Medicare Physician Fee Schedule (MPFS) associated with budget neutrality adjustments tied to Evaluation & Management (E/M) Code MPFS policy changes, and waive the 4% PAYGO sequester to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2 (H.R. 2617, Consolidated Appropriations Act). Support H.R. 8800, the Supporting Medicare Providers Act of 2022 Support H.R. 5394, the Meaningful Access to Federal Health Plan Claims Data Act Support H.R. 7995, GOLD CARD Act of 2022

Client expense: $410,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobby members of Congress regarding issues related to telemedicine. Advocate for increased transparency regarding drug pricing. Advocate for reducing barriers to entry of generic drugs into the marketplace. Advocate for transparency on the part of pharmaceutical benefit managers. Advocate for patient access to compounded medications. Advocate for reducing the burdens of utilization management tools, including step therapy and prior authorization for pharmaceuticals and services. Advocate for a stable supply of medications and mitigate drug shortages. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H. Res 436, sense of the House supporting state, local and community initiatives to curb incidences of skin cancer beginning with childhood skin cancer. Support H. Res 718, designating October 17, 2021 as National Vitiligo Awareness Day Support H.R. 2163/S. 464, Safe Step Act. Support S. 989, Ensuring Childrens Access to Specialty Care Act Support H.R. 153, Protecting Consumer Access to Generic Drugs Act Support S. 898, Fair Accountability & Innovative Research (FAIR) Drug Pricing Act Support H.R. 3662, Patient Access to Urgent-Use Pharmacy Compounding Act Support H.R. 1916/S. 754, Ensuring Lasting Smiles Act Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Advocate for the continued and increased funding of Community Health Centers. Advocate for implementation of surprise medical billing legislation (enacted as part of P.L. 116-260, Consolidated Appropriations Act, 2021, H.R. 133) as intended by Congress. Support H.R. 1677/S. 620, the KEEP Telehealth Options Act. Support H.R. 2903/S. 1512 the CONNECT for Health Act of 2021 Support the Dr. Lorna Breen Health Care Provider Protection Act (S. 610/H.R. 1667). Support H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act of 2021 Support H.R. 8437, the Improving Seniors Timely Access to Care Act of 2022 Support H.R. 4122/S. 3645, Resident Education Deferred Interest Act or the REDI Act Support the Resident Physician Shortage Reduction Act (S. 834/H.R. 2256) Advocate for the FDA to implement the 2015 rule, General and Plastic Surgery Devices: Restricted Sale, Distribution, and Use of Sunlamp Products; and the Sunlamp Products Proposed; Amendment to Performance Standard, which would ban minors under the age of 18 from using tanning beds. Support H.R. 5054, Keep Physicians Serving Patients Act Support H.R. 5394, the Meaningful Access to Federal Health Plan Claims Data Act Advocate for legislative solution to access problems to iPLEDGE/REMS program for isotretinoin (H.R. 7667, Food and Drug Amendments of 2022/S. 4348 FDASLA Act of 2022, H.R. 2617, Consolidated Appropriations Act). Support H.R. 7649, a bill to direct the Secretary of Health and Human Services to open a public docket for the submission of public comments regarding factors that should be taken into consideration when reviewing a proposed modification to an approved risk evaluation and mitigation strategy, and for other purposes. Support H.R. 5030/S. 2706, the Diversifying Investigations and Equitable Research Studies for Everyone (DIVERSE) Trials Act Support H.R. 7995, GOLD CARD Act of 2022 Advocate to provide relief from the 2% Medicare sequester, replace scheduled and anticipated cuts in payments with positive, inflationary-based updates, eliminate the nearly 4.5% conversion factor cut in the CMS proposed rule for the 2023 Medicare Physician Fee Schedule (MPFS) associated with budget neutrality adjustments tied to Evaluation & Management (E/M) Code MPFS policy changes, and waive the 4% PAYGO sequester to Medicare physician payment reimbursement due to enactment of H.R. 1319, American Recovery Act, P.L. 117-2 (H.R. 2617, Consolidated Appropriations Act). Support H.R. 8800, Supporting Medicare Providers Act of 2022 Advocate against H.R 6708, Improving Access to Workers Compensation for Injured Federal Workers Act, which expands the role of nurse practitioners and physician assistants in providing services to injured federal workers under the federal workers' compensation program. Oppose H.R. 8812, the Improving Care & Access to Nurses Act (I CAN Act)

Client expense: $410,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE