Medicare Sequester COVID Moratorium Act

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response. Monitoring and outreach on legislative and administrative activity related to infrastructure. Monitoring and outreach on legislative and administrative activity related to reconciliation and the congressional budget resolution. H.R. 4432 - Department of Defense Appropriations Act, FY2022. Senate Draft, Department of Defense Appropriations Act, FY2022 P.L. 116-136, CARES Act P.L. 116-260, FY2021 Omnibus and COVID Relief and Response Act P.L. 117-2, American Rescue Plan Act of 2021 H.R. 3684 - Infrastructure Investment and Jobs Act S. 464 - Safe Step Act H.R. 2163 - Safe Step Act H.R. 1319 - American Rescue Plan Act of 2021 S. 834 - Resident Physician Shortage Reduction Act of 2021 H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R. 1868 - To prevent across-the-board direct spending cuts, and for other purposes H.R. 315 - Medicare Sequester COVID Moratorium Act S. 368 - Telehealth Modernization Act H.R. 1332 - Telehealth Modernization Act H.R. 366 - Protecting Access to Post-COVID-19 Telehealth Act of 2021 S. 298 - Pharmacy Benefit Manager Accountability Study Act of 2021 S. 1024 - Healthcare Workforce Resilience Act H.R. 2255 - Healthcare Workforce Resilience Act H.R. 1819 - Pharmacy Benefit Manager Accountability Study Act H.R. 3107 - The Improving Seniors Timely Access to Care Act H.R. 3517 - Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act H.R. 315 - The Medicare Sequester COVID Moratorium Act S. 748 - Medicare Sequester Relief Act H.R. 5067 - Preserving Patient Access to Home Infusion Act S. 2652 - Preserving Patient Access to Home Infusion Act H.R. 3541 - Conrad State 30 and Physician Access Reauthorization Act S. 1810 - Conrad State 30 and Physician Access Reauthorization Act H.R. 5376 - Build Back Better Act S. 3314 - Supporting Medicare Providers Act H.R. 6020 - Supporting Medicare Providers Act H.R. 5801 - Help Ensure Lower Patient (HELP) Copays Act S. 4408 Health and Location Data Protection Act of 2022 H.R. 4122 - Resident Education Deferred Interest Act or the REDI Act S. 3658 - Resident Education Deferred Interest Act or the REDI Act H.R.8800 - Supporting Medicare Providers Act of 2022 S.5194 - Protecting Medicare Patients and Physicians Act H.R. 8800 - Protecting Medicare Patients and Physicians Act H.R.9424 - Creating Access to Residency Education Act of 2022 FY2023 Labor Health and Human Services Appropriations content Draft House, Department of Defense Appropriations Act, FY2023 Draft Senate, Department of Defense Appropriations Act, FY2023 Fiscal Year 2023 Omnibus

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

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response. Monitoring and outreach on legislative and administrative activity related to infrastructure. Monitoring and outreach on legislative and administrative activity related to reconciliation and the congressional budget resolution. H.R. 4432 - Department of Defense Appropriations Act, FY2022. Senate Draft, Department of Defense Appropriations Act, FY2022 P.L. 116-136, CARES Act P.L. 116-260, FY2021 Omnibus and COVID Relief and Response Act P.L. 117-2, American Rescue Plan Act of 2021 H.R. 3684 - Infrastructure Investment and Jobs Act S. 464 - Safe Step Act H.R. 2163 - Safe Step Act H.R. 1319 - American Rescue Plan Act of 2021 S. 834 - Resident Physician Shortage Reduction Act of 2021 H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R. 1868 - To prevent across-the-board direct spending cuts, and for other purposes H.R. 315 - Medicare Sequester COVID Moratorium Act S. 368 - Telehealth Modernization Act H.R. 1332 - Telehealth Modernization Act H.R. 366 - Protecting Access to Post-COVID-19 Telehealth Act of 2021 S. 298 - Pharmacy Benefit Manager Accountability Study Act of 2021 S. 1024 - Healthcare Workforce Resilience Act H.R. 2255 - Healthcare Workforce Resilience Act H.R. 1819 - Pharmacy Benefit Manager Accountability Study Act H.R. 3107 - The Improving Seniors Timely Access to Care Act H.R. 3517 - Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act H.R. 315 - The Medicare Sequester COVID Moratorium Act S. 748 - Medicare Sequester Relief Act H.R. 5067 - Preserving Patient Access to Home Infusion Act S. 2652 - Preserving Patient Access to Home Infusion Act H.R. 3541 - Conrad State 30 and Physician Access Reauthorization Act S. 1810 - Conrad State 30 and Physician Access Reauthorization Act H.R. 5376 - Build Back Better Act S. 3314 - Supporting Medicare Providers Act H.R. 6020 - Supporting Medicare Providers Act H.R. 5801 - Help Ensure Lower Patient (HELP) Copays Act S. 4408 Health and Location Data Protection Act of 2022 H.R. 4122 - Resident Education Deferred Interest Act or the REDI Act S. 3658 - Resident Education Deferred Interest Act or the REDI Act H.R.8800 - Supporting Medicare Providers Act of 2022 S.5194 - Protecting Medicare Patients and Physicians Act H.R. 8800 - Protecting Medicare Patients and Physicians Act H.R.9424 - Creating Access to Residency Education Act of 2022 FY2023 Labor Health and Human Services Appropriations content Draft House, Department of Defense Appropriations Act, FY2023 Draft Senate, Department of Defense Appropriations Act, FY2023 Fiscal Year 2023 Omnibus

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

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response. Monitoring and outreach on legislative and administrative activity related to infrastructure. Monitoring and outreach on legislative and administrative activity related to reconciliation and the congressional budget resolution. H.R. 4432 - Department of Defense Appropriations Act, FY2022. Senate Draft, Department of Defense Appropriations Act, FY2022 P.L. 116-136, CARES Act P.L. 116-260, FY2021 Omnibus and COVID Relief and Response Act P.L. 117-2, American Rescue Plan Act of 2021 H.R. 3684 - Infrastructure Investment and Jobs Act S. 464 - Safe Step Act H.R. 2163 - Safe Step Act H.R. 1319 - American Rescue Plan Act of 2021 S. 834 - Resident Physician Shortage Reduction Act of 2021 H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R. 1868 - To prevent across-the-board direct spending cuts, and for other purposes H.R. 315 - Medicare Sequester COVID Moratorium Act S. 368 - Telehealth Modernization Act H.R. 1332 - Telehealth Modernization Act H.R. 366 - Protecting Access to Post-COVID-19 Telehealth Act of 2021 S. 298 - Pharmacy Benefit Manager Accountability Study Act of 2021 S. 1024 - Healthcare Workforce Resilience Act H.R. 2255 - Healthcare Workforce Resilience Act H.R. 1819 - Pharmacy Benefit Manager Accountability Study Act H.R. 3107 - The Improving Seniors Timely Access to Care Act H.R. 3517 - Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act H.R. 315 - The Medicare Sequester COVID Moratorium Act S. 748 - Medicare Sequester Relief Act H.R. 5067 - Preserving Patient Access to Home Infusion Act S. 2652 - Preserving Patient Access to Home Infusion Act H.R. 3541 - Conrad State 30 and Physician Access Reauthorization Act S. 1810 - Conrad State 30 and Physician Access Reauthorization Act H.R. 5376 - Build Back Better Act S. 3314 - Supporting Medicare Providers Act H.R. 6020 - Supporting Medicare Providers Act H.R. 5801 - Help Ensure Lower Patient (HELP) Copays Act S. 4408 Health and Location Data Protection Act of 2022 H.R. 4122 - Resident Education Deferred Interest Act or the REDI Act S. 3658 - Resident Education Deferred Interest Act or the REDI Act H.R.8800 - Supporting Medicare Providers Act of 2022 S.5194 - Protecting Medicare Patients and Physicians Act H.R. 8800 - Protecting Medicare Patients and Physicians Act H.R.9424 - Creating Access to Residency Education Act of 2022 FY2023 Labor Health and Human Services Appropriations content Draft House, Department of Defense Appropriations Act, FY2023 Draft Senate, Department of Defense Appropriations Act, FY2023 Fiscal Year 2023 Omnibus

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

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

Support H.R. 315,Medicare Sequester COVID Moratorium Act, a bill to amend the Coronavirus Aid, Relief, and Economic Security Act to extend the temporary suspension of Medicare sequestration; 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; Discussion with the Center for Medicare and Medicaid Innovation (CMMI) about the Radiation Oncology Alternative Payment Model; Support H.R. 1868, a bill that, among other health care provisions, would eliminate the 2% across-the-board cut to all Medicare payments, known as sequestration, until the end of 2021; Support H.R. 2455, The Resetting the Impact Act (TRIA), a bill to amend the IMPACT Act of 2014 to reset data collection and the development of a payment system technical prototype for post-acute care providers under the Medicare program to take into account the effects of COVID-19; Support H.R. 3173/ S.3018, Improving Seniors Timely Access to Care Act of 2021, a bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes; Support H.R. 1887/ S. 4009, Rural Hospital Support Act, a bill to make permanent the Medicare Dependent Hospital (MDH) and Low-volume Adjustment programs and rebases the MDH and Sole Community Hospital programs; Support relief for Medicare advanced payments; Discussion with CMMI about the priorities for alternative payment models; Support HR 4587, Value in Health Care Act of 2021, a bill to direct the Secretary of Health and Human Services to revise certain regulations in relation to the Medicare shared savings program and other advanced alternative payment arrangements to encourage participation in such program, and for other purposes; Support HR 3746, Accountable Care in Rural America Act, a bill to amend title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program; Support H.R. 5425/ S. 1988, Protecting Rural Telehealth Access Act, a bill to amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program; Letter asking Congress to address two important issues by the end of the year: an extension of the moratorium on Medicare sequester cuts, as well as preventing the Statutory Pay-As-You-Go (PAYGO) sequester from taking effect; Letter urging Congress to remove the reductions to the Medicaid disproportionate share hospital (DSH) program and uncompensated care pools from the Build Back Better Act; Support H.R. 5674/ S. 3061Medicare Mental Health Inpatient Equity Act of 2021, a bill to amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare Program; Letter to the HHS secretary asking for PHE extension and urging HHS to extend the declaration for at least 90 days; Letter to the HHS secretary asking to renew the COVID-19 PHE; Letter to CMS urging changes to MA prior authorization requirements for PHE; Letter expressing our disappointment that Congress is adjourning for April recess without addressing the needs of hospitals and health systems and urging Congress to act to ensure health care providers have the critical relief, including but not limited to extending the Medicare sequester relief, adding more PRF dollars, and providing flexibility in the repayment terms for Medicare accelerated and advance repayments; Provide comments in response to the (CMS) request for information regarding access to coverage and care in the Medicaid and Childrens Health Insurance Program (CHIP) programs. The critical components for a comprehensive access and coverage strategy for Medicaid and CHIP should include: Robust outreach and enrollment efforts to secure and maintain coverage for eligible individuals and families, as well as ensure beneficiary knowledge of how to use this coverage, Standards to ensure timely and equitable access to quality care, and Provider payments that are sufficient to enable beneficiaries' access to quality care; Provide comments in response to the Department of Homeland Securitys (DHS) proposed rule to codify standards and clarify policies that govern public charge determinations. Public charge determinations assess how likely it is that an individual will become dependent on government assistance (public benefits) for support and subsistence. These policy clarifications are intended to help immigrants and their family members better understand when the use of certain public benefits could impact their future immigration status and address the chilling effects of the now-repealed 2019 public charge final rule. The AHA supports DHSs efforts to clarify policies regarding how public charge determinations are made to help reverse the damaging effects of the repealed 2019 public charge rule; A bill to amend title XIX of the Social Security Act to expand the availability of mental, emotional, and behavioral health services under the Medicaid program; Letter urging Congress to halt further cuts to hospital payments. Need to stop a harmful Medicare payment cut to providers that will go into effect July 1 without congressional action. Specifically, a 1% Medicare sequester cut took effect April 1, and that cut will increase to 2% on July 1 if Congress does not act. This will result in billions of dollars being cut from hospitals and health systems by the end of the year; Submitted comment letter regarding Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2023 and Updates to the IRF Quality Reporting Program. We note that the proposed IRF PPS labor-related share would only modestly shift upward from 72.9% in FY 2022 to 73.2% in FY 2022. AHA is concerned that these changes neither align regarding massive cost growth in recent months and years; Provide Comments on the Medicare Program - Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities and Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2023 which stated the Proposed FY 2023 Payment Update warrants closer examination and we urge CMS to discuss in the final rule how the agency will account for these increased costs. The timing of this proposed net decrease in payments could not be worse, given the well-documented impact of the COVID-19 public emergency (PHE) on the SNF and nursing home field; Letter sent to the bipartisan, bicameral Leadership of the House and Senate, urging Congress to act to prevent further Medicare sequester cuts scheduled to take effect on July 1; Submitted comment letter about inpatient and long-term care hospital prospective payment system proposed rule for fiscal year 2023. Concerned that CMS is proposing policies and payment adjustment that do not take into account the current the COVID-19 public health emergency (PHE) and its atypical market forces and pandemic-driven aberrations affecting the utilization and cost of providing LTCH services. Specifically, we are concerned by proposals for an inadequate market basket update and an untenable spike in the high-cost outlier threshold; Letter urges Congress to call on CMS to make changes to the hospital inpatient prospective payment system (IPPS) proposed rule for fiscal year (FY) 2023 in order to ensure that Medicare payments for acute care services more accurately reflect the cost of providing hospital care to patients and communities; Support the bipartisan Dear Colleague letters that ask CMS to make critical changes to the hospital inpatient prospective payment system proposed rule for fiscal year (FY) 2023 to more accurately reflect the cost of providing hospital care to patients; Support HR 8487/ S 3173 Improving Seniors Timely Access to Care Act of 2022, a bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans; Support HR 8747 Assistance for Rural Community Hospitals Act of 2022 or the ARCH Act of 2022, a bill to amend title XVIII of the Social Security Act to extend Medicare-dependent hospital and Medicare low-volume hospital payments; Oppose HR 1330/ S 4130 Patient Access to Higher Quality Health Care Act of 2022, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 8188/ S4449 Saving Access to Laboratory Services Act, a bill to amend title XVIII of the Social Security Act to improve the accuracy of market-based Medicare payment for clinical diagnostic laboratory services, to reduce administrative burdens in the collection of data, and for other purposes; Letter urged Congress to prevent the Statutory Pay-As-You-Go Act of 2010 (Statutory PAYGO) sequester from taking effect at the end of this session of Congress. Failure to waive Statutory PAYGO sequester cuts would result in $38 billion in Medicare cuts in fiscal year 2023 which would have a devastating impact on the health care field, destabilizing health care access; Letter expressing opportunities to increase participation, enhance efficacy of Medicare Access and CHIP Reauthorization Act (MACRA) programs, and further transition our health care system from volume to value; Letter to provide feedback on the cybersecurity policy proposals released in Senator Warner report. Hospitals and health systems have prioritized protecting patients and defending their networks from cyberattacks. However, they need support from the federal government as the field continues to face targets from sophisticated cyber adversaries and nation-states; Letter to leadership encouraging Congress to take steps to provide relief to those seeking and administering behavioral health care; Support HR 7744, Building Americas Health Care Workforce Act, a bill to amend title XI of the Social Security Act to extend beyond the COVID-19 emergency period, with certain modifications, the Emergency Declaration Blanket Waiver relating to training and certification of nurse aides to alleviate burdens imposed on staff of skilled nursing facilities and nursing facilities.

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

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

H.R. 7667- Food and Drug Amendments of 2022, support passage S.4248- Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act, support passage H.R. 5435- BRAIN Act of 2021, establishing a Neuroscience Center of Excellence at the Food and Drug Administration, support passage H.R.315 - Common Sense Cannabis Reform for Veterans, Small Business and Medical Professionals Act, monitor to support H.R. 6000 - Cures 2.0 Act, supporting the goals of Rep. Upton/DeGette's Cures 2.0 initiative aimed at accelerating medical research, patient access to novel therapeutics and authorizing the Administration's Advanced Research Projects Agency for Health (ARPA-H) proposal -support passage S. 3726- CARE for Long COVID Act- support passage S.4447 - Modernizing Accelerated Approval Act, support passage and inclusion in Senate FDASLA package. S. 3799 Prevent Pandemics Act - support passage Lisa Blunt Rochester- Long-COVID RECOVERY NOW Act, support passage (bill number forthcoming)

Client expense: $58,169 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

H.R. 2815, BIOSIM Act, support passage H.R. 2855, the STAR Rating for Biosimilars Act, support passage H.R. 2846- Ensuring Access to Lower-Cost Medicines for Seniors Act of 021 - support passage S.2210/H.R. 4131- Better Care Better Jobs Act - support passage S.2315- Medicaid Saves Lives Act, support passage S.2327- Seniors Prescription Drug Relief Act- support passage S.2562-Choose Home Care Act of 2021- support passage S.2612- Prevent Interruptions in Physical Therapy Act of 2021- support passage S. 2694- Nursing Home Improvement and Accountability Act of 2021 - support passage H.R. 5011- Choose Medicare Act, support passage H.R. 5099- Lowering Medicare Premiums and Prescription Drug Costs Act, support passage H.R. 5165 - Improving Medicare Coverage Act - support passage H.R. 5237 - "To amend titles XI, XVIII, and XIX of the Social Security Act to lower prescription drug prices in the Medicare and Medicaid programs, to improve transparency related to pharmaceutical prices and transactions, to lower patients' out-of-pocket costs, and to ensure accountability to taxpayers, and for other purposes." - monitor for position determination H.R. 5260 - Reduced Costs and Continued Cures Act - monitor for position determination H.R. 5536 - SMART Act - support passage H.R. 5514 Choose Home Care Act of 2021, support passage Senate Reconciliation/Senate Finance prescription drug pricing package - supporting provisions that allow Medicare to negotiate for a specific amount of drugs, implement a $2,000 out-of-pocket cap on drug costs in Medicare Part D and a smoothing mechanism so that people in Medicare can spread their costs over the course of the year, and limit drug price increases by implementing rebates if prescription drug prices rise faster than inflation. H.R. 7667- Food and Drug Amendments of 2022, support passage S.4248- Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act, support passage H.R. 5435- BRAIN Act of 2021, establishing a Neuroscience Center of Excellence at the Food and Drug Administration, support passage H.R.315 - Common Sense Cannabis Reform for Veterans, Small Business and Medical Professionals Act, monitor to support H.R. 6000 - Cures 2.0 Act, supporting the goals of Rep. Upton/DeGette's Cures 2.0 initiative aimed at accelerating medical research, patient access to novel therapeutics and authorizing the Administration's Advanced Research Projects Agency for Health (ARPA-H) proposal -support passage S. 3726- CARE for Long COVID Act- support passage S.4447 - Modernizing Accelerated Approval Act, support passage and inclusion in Senate FDASLA package. S. 3799 Prevent Pandemics Act - support passage Lisa Blunt Rochester- Long-COVID RECOVERY NOW Act, support passage (bill number forthcoming)

Client expense: $58,169 · Firm income: Not reported

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

H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R.340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd - Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital payments Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2024 Rate Notice; issues related to the expiration of Medicaid continuous eligibility and transitions in coverage; issues related to coverage of EUA drugs under Medicare Part D; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; issues related to specialty infant formula; issues related to the Inflation Reduction Act passage and implementation; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to Managed Long Term Services and Supports (MLTSS); issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations or legislation, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; implications of physician fee schedule on MA; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value based payment models; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); issues relating to potential Medicare mental health parity requirements; Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the Affordable Care Act (ACA) including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.

Client expense: $2,470,000 · Firm income: Not reported

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

H.R. 2815, BIOSIM Act, support passage H.R. 2855, the STAR Rating for Biosimilars Act, support passage H.R. 2846- Ensuring Access to Lower-Cost Medicines for Seniors Act of 021 - support passage S.2210/H.R. 4131- Better Care Better Jobs Act - support passage S.2315- Medicaid Saves Lives Act, support passage S.2327- Seniors Prescription Drug Relief Act- support passage S.2562-Choose Home Care Act of 2021- support passage S.2612- Prevent Interruptions in Physical Therapy Act of 2021- support passage S. 2694- Nursing Home Improvement and Accountability Act of 2021 - support passage H.R. 5011- Choose Medicare Act, support passage H.R. 5099- Lowering Medicare Premiums and Prescription Drug Costs Act, support passage H.R. 5165 - Improving Medicare Coverage Act - support passage H.R. 5237 - "To amend titles XI, XVIII, and XIX of the Social Security Act to lower prescription drug prices in the Medicare and Medicaid programs, to improve transparency related to pharmaceutical prices and transactions, to lower patients' out-of-pocket costs, and to ensure accountability to taxpayers, and for other purposes." - monitor for position determination H.R. 5260 - Reduced Costs and Continued Cures Act - monitor for position determination H.R. 5536 - SMART Act - support passage H.R. 5514 Choose Home Care Act of 2021, support passage Senate Reconciliation/Senate Finance prescription drug pricing package - supporting provisions that allow Medicare to negotiate for a specific amount of drugs, implement a $2,000 out-of-pocket cap on drug costs in Medicare Part D and a smoothing mechanism so that people in Medicare can spread their costs over the course of the year, and limit drug price increases by implementing rebates if prescription drug prices rise faster than inflation. H.R. 7667- Food and Drug Amendments of 2022, support passage S.4248- Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act, support passage H.R. 5435- BRAIN Act of 2021, establishing a Neuroscience Center of Excellence at the Food and Drug Administration, support passage H.R.315 - Common Sense Cannabis Reform for Veterans, Small Business and Medical Professionals Act, monitor to support H.R. 6000 - Cures 2.0 Act, supporting the goals of Rep. Upton/DeGette's Cures 2.0 initiative aimed at accelerating medical research, patient access to novel therapeutics and authorizing the Administration's Advanced Research Projects Agency for Health (ARPA-H) proposal -support passage S. 3726- CARE for Long COVID Act- support passage S.4447 - Modernizing Accelerated Approval Act, support passage and inclusion in Senate FDASLA package. S. 3799 Prevent Pandemics Act - support passage Lisa Blunt Rochester- Long-COVID RECOVERY NOW Act, support passage (bill number forthcoming)

Client expense: $45,264 · Firm income: Not reported

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

H.R. 7667- Food and Drug Amendments of 2022, support passage S.4248- Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act, support passage H.R. 5435- BRAIN Act of 2021, establishing a Neuroscience Center of Excellence at the Food and Drug Administration, support passage H.R.315 - Common Sense Cannabis Reform for Veterans, Small Business and Medical Professionals Act, monitor to support H.R. 6000 - Cures 2.0 Act, supporting the goals of Rep. Upton/DeGette's Cures 2.0 initiative aimed at accelerating medical research, patient access to novel therapeutics and authorizing the Administration's Advanced Research Projects Agency for Health (ARPA-H) proposal -support passage S. 3726- CARE for Long COVID Act- support passage S.4447 - Modernizing Accelerated Approval Act, support passage and inclusion in Senate FDASLA package. S. 3799 Prevent Pandemics Act - support passage Lisa Blunt Rochester- Long-COVID RECOVERY NOW Act, support passage (bill number forthcoming)

Client expense: $45,264 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

Issue: Support policies to close the Medicaid coverage gap, including through ACA Medicaid expansion. Maintain commitment to match State spending on medical care for Medicaid beneficiaries without limits, caps, or block grants. Maintain and enforce network adequacy requirements and mandate sufficient payments to providers. Issue: Support programs and funds for safety-net providers. Educate Congress about the impact of Section 203 of the Consolidated Appropriations Act, 2021 and its changes to the Medicaid DSH cap calculation methodology on academic medical centers. P.L. 117-328, Consolidated Appropriations Act, 2023 Division FF Issue: Support increased Medicare funding for graduate medical education, including 200 new Medicare-supported GME slots included in the Consolidated Appropriations Act, 2023. H.R. 2256 / S. 834, Resident Physician Shortage Reduction Act of 2021 H.R. 5376, Build Back Better Act Issue: Support increased Medicare funding for graduate medical education S. 1438 Opioid Workforce Act H.R. 3441 Substance Use Disorder Workforce Act Issue: Support targeted Medicare funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs S.1893 / H.R. 8508, Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals Issue: Provide feedback to CMS on its proposed distribution of the 1,000 new GME slots authorized be the Consolidated Appropriations Act, 2021 as described in the 2022 Inpatient Prospective Payment System (IPPS) proposed rule. Support CMS adopting alternative 2 with modifications to allow for more than 1.0 FTE per hospital. Support policy to ensure each qualifying hospital that applies for CAA, 2021 GME positions would receive at least 1 (or a fraction of 1) of the positions before any qualifying hospital receives more than 1 of such positions Issue: Support Medicare Graduate Medical Education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issue: Oppose reduction of Medicare GME/IME payments Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose Medicare hospital, physician, and provider cuts. H.R. 8850, Fair Access In Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. Issue: Oppose overly burdensome Medicaid GME transparency language. Issue: Support technical correction to increase access to physician services in rural communities by allowing teaching hospitals to count resident time spent in critical access hospitals for purposes of Medicare GME payments. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives H.R.3173 / S.3018, Improving Seniors Timely Access to Care Act Issue: Protecting patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency Issue: Modify CMS Hospital Compare Star Ratings to allow stakeholders time to work together to address concerns with methodology. Support inclusion of sociodemographic status as part of quality programs. Draft Medicare Part D benefit re-design legislation Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support expansion of Medicaid and CHIP coverage during the postpartum period. S. 610, Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 315, Medicare Sequester COVID Moratorium Act S. 748, Medicare Sequester Relief Act H.R. 1868, To prevent across-the-board direct spending cuts, and for other purposes. Issue: Support extension of Medicare sequester moratorium. P.L. 117-328, Consolidated Appropriations Act, 2023 Issue: Support clearing the PAYGO scorecard to avoid another Medicare sequester due to the use of reconciliation to pass the American Rescue Plan Act. Issue: Oppose use of extended Medicare sequester and repurposing of unused Provider Relief Fund. P.L. 117-328, Consolidated Appropriations Act, 2023 Division FF H.R.8800, Supporting Medicare Providers Act of 2022 Issue: Support a 4.42% increase in the Medicare physician fee schedule that Congress provided in the Consolidated Appropriations Act, 2021 to avoid payment cuts due to budget neutrality requirements. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support making permanent the interim final rule that allows hospitals that unknowingly trigger their Medicare GME caps and per resident amounts to not have that happen and instead retain the ability to build a new resident cap / PRA so long as the cap / PRA is not above a minimum amount. Issue: Oppose aspects of CMS hospital price transparency rule. Issue: Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Oppose finalizing proposed rule for Medicare Coverage of Innovative Technology (MCIT) and definition of reasonable and necessary. Issue: Oppose enforcement of linking Medicare Conditions of Participation (CoP) compliance with requiring that hospitals report 38 COVID-19 related measures. Issue: Support continuation of the 3-Day Skilled Nursing Facility (SNF) Stay waiver after the conclusion of the COVID-19 public health emergency. Issue: Oppose policy of incorporating revenue distinctions into the Medicare Shared Savings Program. P.L. 117-328, Consolidated Appropriations Act, 2023 Division FF Issue: Support permanent extension of Medicare telehealth waivers, including removing patient location restrictions and rural site requirements, allowing payment for audio-only services, and reimbursing providers for telehealth services as services delivered in-person. Support 2 year or permanent extension of the waivers. P.L. 117-328, Consolidated Appropriations Act, 2023 Division FF H.R. 7053 / S. 3792, Hospital Inpatient Services Modernization Act Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support permanent extension of current Covid telehealth flexibilities HR 1332, the Telehealth Modernization Act Issue: Support efforts to expand patient access to telehealth HR 1397, the Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP Issue: Support efforts to improve access to childrens mental health care H.R. 4040 Advancing Telehealth Beyond COVID-19 Act of 2021 Issue: Support extension of COVID-19 telehealth waivers for two years beyond the end of the COVID-19 public health emergency. H.R. 7961 - Safety from Violence for Healthcare Employees Act (SAVE Act)Issue: Support funding for hospital-based violence intervention programs and community violence interventions Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support expanded Medicare reimbursement for integrated behavioral health Medicare payment codes. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). S. 2061 Telemental Health Care Access Act Issue: Support policy to remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create IME payments for outpatient services while remaining budget neutral. Issue: Support efforts to reverse cuts in Medicare OPPS reimbursements to hospitals for drugs acquired under the 340B program. H.R. 4547, Value in Health Care Act Issue: Support changes to alternative payment models (APMs) to increase participation in value-based health programs and promote quality care and improved health outcomes. P.L. 117-328, Consolidated Appropriations Act, 2023 Issue: Support extension of alternative payment model (APM) bonus. H.R. 3746, Accountable Care in Rural America Act Issue: Support improving the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location. H.R. 4970, Rural Medical Residency Expansion Act of 2021 Issue: Support providing funds for rural teaching hospitals to expand their residency programs. Issue: Support efforts to investigate nurse-staffing agencies conduct during the COVID-19 pandemic.

Client expense: $876,000 · Firm income: Not reported

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

H.R. 1437, Further Continuing Appropriations and Extensions Act, 2023, provisions relating to Medicare and Medicaid, and Conrad State 30 H.R. 2617, Consolidated Appropriations Act, 2023, provisions relating to Medicare and Medicaid, Conrad State 30, telehealth flexibilities, and CDCs Office on Smoking and Health funding 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 S. 748, Medicare Sequester Relief Act, all provisions H.R. 6020, Supporting Medicare Providers Act of 2021, all provisions S. 3314, Supporting Medicare Providers Act of 2021, all provisions S. 610, Protecting Medicare and American Farmers from Sequester Cuts Act, provisions relating to 3% MPFS CF, 6-month extension of 2% sequester moratorium, Radiation Oncology APM, and clinical lab cuts H.R. 6048, Medicare Stability for Patients and Providers Act, all provisions H.R. 66, Comprehensive Access to Robust Insurance Now Guaranteed (CARING) for Kids Act, all provisions H.R. 6617, Further Additional Extending Government Funding Act, provisions relating to Conrad State 30 H.R. 2471, Consolidated Appropriations Act, 2022, provisions relating to immigration H.R. 6833, Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023, provisions relating to Section 101, and Conrad 30 extension H.R. 5376, Inflation Reduction Act of 2022, all provisions H.R. 3671, Doctors of Community (DOC) Act, all provisions S. 1958, Doctors of Community (DOC) Act, all provisions

Client expense: $5,060,000 · Firm income: Not reported

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

Funding opportunities, including Community Project Funds, Provider Relief Funds, and PPP. COVID, PHE, and relief funding and regulatory issues. Post-acute care and Skilled Nursing Legislative and Regulatory Issues. Medicare and Medicaid coverage and reimbursement. Telehealth and PACE program. Nursing home staffing issues. Executive Order 14042, Requirements for COVID-19 Vaccination of Federal Contractors and DOL OSHA COVID-19 Vaccination Rule. S. 748, the Medicare Sequester Relief Act; H.R. 315, the Medicare Sequester COVID Moratorium Act; H.R. 1319, the American Rescue Plan Act (P.L. 117-2); H.R. 1330, the Patient Access to Higher Quality Care Act; H.R.5376 the Inflation Reduction Act of 2022 (P.L. No: 117-169); House (H.R.8295) and Senate Labor-HHS FY23 Appropriations; Health provisions of the Consolidated Appropriations Act, 2023 (Omnibus) (P.L. No: 117-328).

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Funding opportunities, including Community Project Funds, Provider Relief Funds, and PPP. COVID, PHE, and relief funding and regulatory issues. Post-acute care and Skilled Nursing Legislative and Regulatory Issues. Medicare and Medicaid coverage and reimbursement. Telehealth and PACE program. Nursing home staffing issues. S. 748, the Medicare Sequester Relief Act; H.R. 315, the Medicare Sequester COVID Moratorium Act; H.R. 1319, the American Rescue Plan Act (P.L. 117-2); H.R. 1330, the Patient Access to Higher Quality Care Act; House (H.R.8295) and Senate Labor- HHS FY23 Appropriations; Health provisions of the Consolidated Appropriations Act, 2023 (Omnibus) (P.L. No: 117-328).

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare Advantage and Part D prescription drug programs; Issues related to Prescription Drug Rebates; Issues related to Dual Eligible and Medicare Advantage Special Needs Plans; Issues related to Social Determinants of Health (SDOH)/Health Equity; and Issues related to Telehealth. 117th Congress Inflation Reduction Act of 2022 Budget Reconciliation/Biden Administration Build Back Better Plan COVID-19 American Rescue Plan American Jobs Plan Medicare Sequester COVID Moratorium Act (H.R. 315) Delay of the Prescription Drug Rebate Rule Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 (S. 150) The Ensuring Parity in MA and PACE for Audio-Only Telehealth Act (HR 2166) Previous Congresses H.R. 3461, Community-Based Independence for Seniors Act H.R. 3877, Bipartisan Budget Act H.R. 19, Lower Costs, More Cures Act of 2019 S. 3013, Encouraging Innovative Benefit Design to Lower Costs for Seniors Act H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 H.R. 6201, Families First Coronavirus Response Act H.R. 748, CARES Act H.R. 6800, HEROES Act H.R. 7659, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 S. 4318, American Workers, Families and Employers Assistance Act S. 4199, Prescription Drug Pricing Reduction Act of 2020 S.4840, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Bipartisan Coronavirus Relief and Omnibus Funding Bill H.R. 4074, Addressing Social Determinants in Medicare Advantage PL 115-123: H.R. 1892, The bipartisan Budget Act of 2018; H.R. 3168, To amend title XVIII of the Social Security Act to provide continued access to specialized Medicare Advantage plans for special needs individuals, and for other purposes; S. 870, CHRONIC Care Bill PL 115-271: H.R. 6, SUPPORT for Patients and Communities Act

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

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

H.R. 1260 - The Bipartisan Solution to Cyclical Violence Act of 2021 H.R. 8/S. 529 - The Bipartisan Background Checks Act/Background Check Expansion Act H.R. 2256/S. 834 - The Resident Physician Shortage Reduction Act Public Law No. 117-105/S. 610/H.R. 1667 - Dr. Lorna Breen Health Care Provider Protection Act H.R. 1319/PL 117-2 - American Rescue Plan Act H.R. 315 - Medicare Sequester COVID Moratorium Act H.R. 3173/S. 3018 - Improving Seniors' Timely Access to Care Act S. 1593/H.R. 5149 - Ensuring Access to General Surgery Act H.R. 1025 - Kids Access to Primary Care Act of 2021 H.R. 5239/S. 2941 - Good Samaritan Health Professionals Act of 2021 H.R. 5305, the Extending Government Funding and Delivering Emergency Assistance Act. H.R. 4502 - Labor HHS Appropriations H.R. 4350 National Defense Authorization Act for Fiscal Year 2022 H.R. 2903/S. 1512 - CONNECT for Health Act H.R. 1332/S. 368 - Telehealth Modernization Act S. 2565 - Expanding Access to Palliative Care H.R. 5377 - Cancer Patient Equity Act H.R. 6020 the Supporting Medicare Providers Act of 2021 H.R.2256 - Build Back Better Act S. 3799 - PREVENT Pandemics Act H. Res 951/S. Res 532 - Recognizing 100 Years of the COT H. Res 997/S. Res 566 - ACS CoC anniversary resolution PL 109-417 - Pandemic and All Hazards Preparedness Act Reauthorization H.R. 7995 - Gold Card Act of 2022 S. 4269/H.R. 7850 - Prevent BLEEDing Act S. 4330 - SPARC Act S. 3658/H.R. 4122 - REDI Act S. 2938 - Bipartisan Safer Communities Act H.R. 2163/S. 464 - Safe Step Act H.R. 8163 - Improving Trauma Systems and Emergency Care Act H.R. 8800 - Supporting Medicare Providers Act of 2022 Department of Veterans Affairs Supremacy Project VA Scope of Practice Stop the Bleed training/program Rural health and equity NSA good faith estimate rule Global Surgery/Rare Surgery Commission on Cancer Legislative Agenda Appropriate Use Criteria (AUC) Firearms injury prevention, safety & research ACS Quality legislative proposal Local Coverage Determinations/Carrier Advisory Committees No Surprises Act Implementation Scope of Practice issues National Trauma and Emergency Preparedness System (NTEPS) Public Health Preparedness CY2022 Medicare Physician Fee Schedule Final Rule Multi-Cancer Early Detection Screening Coverage Act NO PAIN Act COVID-19 Vaccines and Mental Health Maternal and gender disparities in health care The role of immigrant physicians in the U.S. Healthcare system Local Coverage Determinations/Carrier Access Committee Issues New Hernia Repair CPT Codes for 2023 Regional medical operations centers (RMOCs) Remote Patient Monitoring Social Determinants of Health Sequestration relief Ocular Regional Clinical Centers of Excellence (RCOEs) 21st Century Cures 2.0 Act Price Transparency Legislation Medicare Physician Payment Cuts MACRA Improvements National Trauma Systems Legislation Mission Zero Funding Prior Authorization Unique Patient Identifier/Appropriations Surgical Workforce Shortages ACA coverage expansion Global Surgical Codes Graduate Medical Education (GME) Alternative Payment Models

Client expense: $23,000 · Firm income: Not reported

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

H.R. 1260 - The Bipartisan Solution to Cyclical Violence Act of 2021 H.R. 8/S. 529 - The Bipartisan Background Checks Act/Background Check Expansion Act H.R. 2256/S. 834 - The Resident Physician Shortage Reduction Act Public Law No. 117-105/S. 610/H.R. 1667 - Dr. Lorna Breen Health Care Provider Protection Act H.R. 1319/PL 117-2 - American Rescue Plan Act H.R. 315 - Medicare Sequester COVID Moratorium Act H.R. 3173/S. 3018 - Improving Seniors' Timely Access to Care Act S. 1593/H.R. 5149 - Ensuring Access to General Surgery Act H.R. 1025 - Kids Access to Primary Care Act of 2021 H.R. 5239/S. 2941 - Good Samaritan Health Professionals Act of 2021 H.R. 5305, the Extending Government Funding and Delivering Emergency Assistance Act. H.R. 4502 - Labor HHS Appropriations H.R. 4350 National Defense Authorization Act for Fiscal Year 2022 H.R. 2903/S. 1512 - CONNECT for Health Act H.R. 1332/S. 368 - Telehealth Modernization Act S. 2565 - Expanding Access to Palliative Care H.R. 5377 - Cancer Patient Equity Act H.R. 6020 the Supporting Medicare Providers Act of 2021 H.R.2256 - Build Back Better Act S. 3799 - PREVENT Pandemics Act H. Res 951/S. Res 532 - Recognizing 100 Years of the COT H. Res 997/S. Res 566 - ACS CoC anniversary resolution PL 109-417 - Pandemic and All Hazards Preparedness Act Reauthorization H.R. 7995 - Gold Card Act of 2022 S. 4269/H.R. 7850 - Prevent BLEEDing Act S. 4330 - SPARC Act S. 3658/H.R. 4122 - REDI Act S. 2938 - Bipartisan Safer Communities Act H.R. 2163/S. 464 - Safe Step Act H.R. 8163 - Improving Trauma Systems and Emergency Care Act H.R. 8800 - Supporting Medicare Providers Act of 2022 Department of Veterans Affairs Supremacy Project VA Scope of Practice Stop the Bleed training/program Rural health and equity NSA good faith estimate rule Global Surgery/Rare Surgery Commission on Cancer Legislative Agenda Appropriate Use Criteria (AUC) Firearms injury prevention, safety & research ACS Quality legislative proposal Local Coverage Determinations/Carrier Advisory Committees No Surprises Act Implementation Scope of Practice issues National Trauma and Emergency Preparedness System (NTEPS) Public Health Preparedness CY2022 Medicare Physician Fee Schedule Final Rule Multi-Cancer Early Detection Screening Coverage Act NO PAIN Act COVID-19 Vaccines and Mental Health Maternal and gender disparities in health care The role of immigrant physicians in the U.S. Healthcare system Local Coverage Determinations/Carrier Access Committee Issues New Hernia Repair CPT Codes for 2023 Regional medical operations centers (RMOCs) Remote Patient Monitoring Social Determinants of Health Sequestration relief Ocular Regional Clinical Centers of Excellence (RCOEs) 21st Century Cures 2.0 Act Price Transparency Legislation Medicare Physician Payment Cuts MACRA Improvements National Trauma Systems Legislation Mission Zero Funding Prior Authorization Unique Patient Identifier/Appropriations Surgical Workforce Shortages ACA coverage expansion Global Surgical Codes Graduate Medical Education (GME) Alternative Payment Models

Client expense: $23,000 · Firm income: Not reported

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

H.R. 1260 - The Bipartisan Solution to Cyclical Violence Act of 2021 H.R. 8/S. 529 - The Bipartisan Background Checks Act/Background Check Expansion Act H.R. 2256/S. 834 - The Resident Physician Shortage Reduction Act Public Law No. 117-105/S. 610/H.R. 1667 - Dr. Lorna Breen Health Care Provider Protection Act H.R. 1319/PL 117-2 - American Rescue Plan Act H.R. 315 - Medicare Sequester COVID Moratorium Act H.R. 3173/S. 3018 - Improving Seniors' Timely Access to Care Act S. 1593/H.R. 5149 - Ensuring Access to General Surgery Act H.R. 1025 - Kids Access to Primary Care Act of 2021 H.R. 5239/S. 2941 - Good Samaritan Health Professionals Act of 2021 H.R. 5305, the Extending Government Funding and Delivering Emergency Assistance Act. H.R. 4502 - Labor HHS Appropriations H.R. 4350 National Defense Authorization Act for Fiscal Year 2022 H.R. 2903/S. 1512 - CONNECT for Health Act H.R. 1332/S. 368 - Telehealth Modernization Act S. 2565 - Expanding Access to Palliative Care H.R. 5377 - Cancer Patient Equity Act H.R. 6020 the Supporting Medicare Providers Act of 2021 H.R.2256 - Build Back Better Act S. 3799 - PREVENT Pandemics Act H. Res 951/S. Res 532 - Recognizing 100 Years of the COT H. Res 997/S. Res 566 - ACS CoC anniversary resolution PL 109-417 - Pandemic and All Hazards Preparedness Act Reauthorization H.R. 7995 - Gold Card Act of 2022 S. 4269/H.R. 7850 - Prevent BLEEDing Act S. 4330 - SPARC Act S. 3658/H.R. 4122 - REDI Act S. 2938 - Bipartisan Safer Communities Act H.R. 2163/S. 464 - Safe Step Act H.R. 8163 - Improving Trauma Systems and Emergency Care Act H.R. 8800 - Supporting Medicare Providers Act of 2022 Department of Veterans Affairs Supremacy Project VA Scope of Practice Stop the Bleed training/program Rural health and equity NSA good faith estimate rule Global Surgery/Rare Surgery Commission on Cancer Legislative Agenda Appropriate Use Criteria (AUC) Firearms injury prevention, safety & research ACS Quality legislative proposal Local Coverage Determinations/Carrier Advisory Committees No Surprises Act Implementation Scope of Practice issues National Trauma and Emergency Preparedness System (NTEPS) Public Health Preparedness CY2022 Medicare Physician Fee Schedule Final Rule Multi-Cancer Early Detection Screening Coverage Act NO PAIN Act COVID-19 Vaccines and Mental Health Maternal and gender disparities in health care The role of immigrant physicians in the U.S. Healthcare system Local Coverage Determinations/Carrier Access Committee Issues New Hernia Repair CPT Codes for 2023 Regional medical operations centers (RMOCs) Remote Patient Monitoring Social Determinants of Health Sequestration relief Ocular Regional Clinical Centers of Excellence (RCOEs) 21st Century Cures 2.0 Act Price Transparency Legislation Medicare Physician Payment Cuts MACRA Improvements National Trauma Systems Legislation Mission Zero Funding Prior Authorization Unique Patient Identifier/Appropriations Surgical Workforce Shortages ACA coverage expansion Global Surgical Codes Graduate Medical Education (GME) Alternative Payment Models

Client expense: $236,000 · Firm income: Not reported

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

H.R. 1260 - The Bipartisan Solution to Cyclical Violence Act of 2021 H.R. 8/S. 529 - The Bipartisan Background Checks Act/Background Check Expansion Act H.R. 2256/S. 834 - The Resident Physician Shortage Reduction Act Public Law No. 117-105/S. 610/H.R. 1667 - Dr. Lorna Breen Health Care Provider Protection Act H.R. 1319/PL 117-2 - American Rescue Plan Act H.R. 315 - Medicare Sequester COVID Moratorium Act H.R. 3173/S. 3018 - Improving Seniors' Timely Access to Care Act S. 1593/H.R. 5149 - Ensuring Access to General Surgery Act H.R. 1025 - Kids Access to Primary Care Act of 2021 H.R. 5239/S. 2941 - Good Samaritan Health Professionals Act of 2021 H.R. 5305, the Extending Government Funding and Delivering Emergency Assistance Act. H.R. 4502 - Labor HHS Appropriations H.R. 4350 National Defense Authorization Act for Fiscal Year 2022 H.R. 2903/S. 1512 - CONNECT for Health Act H.R. 1332/S. 368 - Telehealth Modernization Act S. 2565 - Expanding Access to Palliative Care H.R. 5377 - Cancer Patient Equity Act H.R. 6020 the Supporting Medicare Providers Act of 2021 H.R.2256 - Build Back Better Act S. 3799 - PREVENT Pandemics Act H. Res 951/S. Res 532 - Recognizing 100 Years of the COT H. Res 997/S. Res 566 - ACS CoC anniversary resolution PL 109-417 - Pandemic and All Hazards Preparedness Act Reauthorization H.R. 7995 - Gold Card Act of 2022 S. 4269/H.R. 7850 - Prevent BLEEDing Act S. 4330 - SPARC Act S. 3658/H.R. 4122 - REDI Act S. 2938 - Bipartisan Safer Communities Act H.R. 2163/S. 464 - Safe Step Act H.R. 8163 - Improving Trauma Systems and Emergency Care Act H.R. 8800 - Supporting Medicare Providers Act of 2022 Department of Veterans Affairs Supremacy Project VA Scope of Practice Stop the Bleed training/program Rural health and equity NSA good faith estimate rule Global Surgery/Rare Surgery Commission on Cancer Legislative Agenda Appropriate Use Criteria (AUC) Firearms injury prevention, safety & research ACS Quality legislative proposal Local Coverage Determinations/Carrier Advisory Committees No Surprises Act Implementation Scope of Practice issues National Trauma and Emergency Preparedness System (NTEPS) Public Health Preparedness CY2022 Medicare Physician Fee Schedule Final Rule Multi-Cancer Early Detection Screening Coverage Act NO PAIN Act COVID-19 Vaccines and Mental Health Maternal and gender disparities in health care The role of immigrant physicians in the U.S. Healthcare system Local Coverage Determinations/Carrier Access Committee Issues New Hernia Repair CPT Codes for 2023 Regional medical operations centers (RMOCs) Remote Patient Monitoring Social Determinants of Health Sequestration relief Ocular Regional Clinical Centers of Excellence (RCOEs) 21st Century Cures 2.0 Act Price Transparency Legislation Medicare Physician Payment Cuts MACRA Improvements National Trauma Systems Legislation Mission Zero Funding Prior Authorization Unique Patient Identifier/Appropriations Surgical Workforce Shortages ACA coverage expansion Global Surgical Codes Graduate Medical Education (GME) Alternative Payment Models

Client expense: $236,000 · Firm income: Not reported

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

S. 167/H.R. 736: Community Immunity During COVID-19 Act-Public health infrastructure - state and local public health $$ for vaccines S.245: States Achieve Medicaid Expansion - Enhanced Federal matching for states that expand Medicaid coverage S. 368: Telehealth Modernization Act- Expands telehealth flexibilities in Medicare beyond the PHEq S. 748/HR 315: Medicare Sequestration - Prevent the 2 percent sequester for Medicare under the BCA HR 959: Black Maternal Health Momnibus Act - Comprehensive reforms to address maternal health challenges HR 1025: Kids Access to Primary Care Act - Create parity between Medicaid/Medicare reimbursement for women and children HR 1319: American Rescue Plan - Expansion of ACA coverage, investments in public health workforce, funding for COVID-19 response H.R. 4770: Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act H.R. 5054: Physicians Serving Patients Act of 2021 S. 610: Protecting Medicare and American Farmers from Sequester Act H.R. 3713/S.3018: Improving Seniors' Timely Access to Care Act H.R. 6020: Supporting Medicare Providers Act No Bill No.: Congressional Primary Care Caucus;117th Congress membership in the bipartisan CPCC No Bill No. COVID Medicaid Response Act: Increase Medicaid funding for states impacted by COVID 19 No Bill No.: FY 2022 Appropriations Requests - CDC Programs (Climate/Health; Gun Violence Research; vaccine infrastructure); HRSA; AHRQ; CMS No Bill No.: Telehealth Expansion - Preserve key telehealth flexibilities beyond COVID-19 PHE No Bill No.: Medicare GME allocation - Advocate for equitable distribution of additional GME slots NO Bill No.: Medicare physician fee schedule No Bill No.: MACRA/value-based payment No Bill No.: FY22 COVID-19 supplemental No Bill No.: Medicaid Redeterminations No Bill No.: Behavioral Health Integration No Bill No.: Save America's Rural Hospitals Act No Bill No.: Behavioral health integration w/i primary care No Bill No.: Medicare Part B provider payment No Bill No.: CY23 Medicare Physician Fee Schedule H.R. 8800: Supporting Medicare Providers Act H.R. 4040: Advancing Telehealth Beyond COVID-19 Act of 2021 H.R. 6576: SURS Extension Act Consolidated Appropriations Act of 2023

Client expense: $788,015 · Firm income: Not reported

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

HR 315 - Medicare Sequester Moratorium Act - relief from Medicare sequester HR 1332/ S 368 -Telehealth Modernization Act - permanent repeal of Medicare geographic and originating site restrictions HR 1946/S 1873- Multi Cancer Early Detection Coverage and Screening Act - provide for Medicare coverage of multi-cancer early detection screening tests HR 1577/S 596 - Treat and Reduce Obesity Act of 2021 - expands Medicare coverage of intensive behavioral therapy for obesity HR 2347/S 2691 - Strengthening the Vaccines for Children Program Act of 2021 - ensure adequate access to vaccines under the Medicaid program and the Vaccines for Children program S 1287 - REFUND Act of 2021 - provide refunds for certain single dose vial drugs HR 2903/S 1512- CONNECT for Health Act of 2021 - expand access to telehealth services HR 3173/S 3018- Improving Seniors Timely Access to Care Act of 2021- establishes several requirements and standards relating to prior authorization processes under Medicare Advantage plans HR 3447 - Permanency for Audio-Only Telehealth Act- expand accessibility to certain telehealth services under Medicare HR 4110/S 3656- Reducing Hereditary Cancer Act- provide hereditary cancer genetic testing HR 3089/S 1544- Accelerating Kids' Access to Care Act- streamline enrollment under the Medicaid program of certain providers across State lines HR 1978/S 912- Protecting Seniors Through Immunization Act of 2021- improve Medicare coverage of vaccinations HR 7995- GOLD CARD Act of 2022- exempts qualifying physicians from prior authorization requirements in Medicare Advantage plans HR 5377- Cancer Patient Equity Act of 2021- provides coverage of cancer diagnostic and laboratory tests under Medicare, Medicaid, and CHIP Drug pricing- Inflation Reduction Act HR 8800- Supporting Medicare Providers Act of 2022- Medicare reimbursement HR 8487- Improving Seniors Timely Access to Care Act of 2022- establishes several requirements and standards relating to prior authorization processes under Medicare Advantage plans Omnibus: PAYGO, sequestration, HR 8800, APM bonus HR 2410/S 5117- Medicare & You Handbook Improvement Act of 2021- requires the inclusion of information on prior authorization requirements and other utilization management techniques in the Medicare & You annual notice.

Client expense: $80,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2256/S. 834, Resident Physician Shortage Reduction Act of 2021 Issue: To expand the physician workforce by funding new Medicare-supported graduate medical education (GME) positions. H.R. 1868, Preventing Across-the-Board Direct Spending Cuts Issue: Support extending the moratorium on the Medicare sequester and act to prevent mandatory PAYGO cuts, including 4% Medicare spending sequestration, stemming from the American Rescue Plan Act of 2021. H.R. 315/S.748, Medicare Sequester Moratorium Act of 2021 Issue: Support eliminating Medicare sequester cuts through the duration of the public health emergency. H.R. 3322/S. 826, Medicare Patient Empowerment Act of 2021 Support: Support authorizing Medicare payment option for patients and eligible professionals to freely contract Medicare fee-for-service items and services. Medicare Physician Fee Schedule (MPFS) Issue: Support measures to mitigate expected reductions to the Medicare conversion factor set to take effect in 2022. Medicare Access and CHIP Reauthorization Act (MACRA) Issue: Support request for an oversight hearing on the implementation of MACRA and physician-focused value-based care initiatives.

Client expense: $240,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

S.2999 A bill to prohibit the Secretary of Health and Human Services, any officer or employee of the Department of Health and Human Services, and States from requiring COVID-19 vaccination as a condition of eligibility for benefits or assistance under the Medicare, Medicaid, or CHIP program; S.J.Res.32 A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination; H.R.1677 - KEEP Telehealth Options Act of 2021 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021; S.4067 A bill to amend title XI of the Social Security Act to improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation, and for other purposes; H.R.3755 Women's Health Protection Act of 2022; . S.J.Res.32 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination"; H.J.Res.79 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of the Treasury and the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond".

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Any bill(s) or provision(s) regarding CMSs hospital transparency rule requiring hospitals to publicly disclose negotiated rates with commercial health plans. Any provision(s) on the CMS hospital inpatient and outpatient prospective payment system/ ambulatory surgical center proposed rule reducing payment rates received by hospitals. Any issue(s) related to Medicare pass-through funding and other payment technicalities in relation to colleges of nursing and allied health professions. Any bill(s) or provision(s) addressing Medicaid Disproportionate Share Hospital (DSH) cuts, namely having to do with a delay in cuts. H.R. 315, S. 748, or any other bill(s) or provision(s) addressing the elimination of Medicare sequester cuts during the COVID-19 public health emergency. Any bill(s) or provision(s) addressing the expansion of Medicaid and increasing the level of Federal matching assistance for states that choose to expand Medicaid coverage.

Client expense: $68,735 · Firm income: Not reported

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

Any COVID-19 stimulus bill(s), package(s), or provision(s) impacting hospitals and health systems, including but not limited to: Additional money and reporting requirements for the Provider Relief Fund; Support for front-line caregivers; Maintaining health benefits for individuals and families and increasing coverage options for the uninsured; Expansion of resources for testing, tracing, and vaccine development; and Expansion of resources for vaccine rollout and administration. Any requirement(s) for hospitals to collect and report infectious disease data. Any bill(s) or provision(s) regarding CMSs hospital transparency rule requiring hospitals to publicly disclose negotiated rates with commercial health plans. Any provision(s) on the CMS hospital inpatient and outpatient prospective payment system/ ambulatory surgical center proposed rule reducing payment rates received by hospitals. Any bill(s) or provision(s) addressing surprise medical billing rule which are harmful to patients and hospitals/health systems. Any bill(s) or provision(s) enabling or making it easier for providers to use telemedicine to increase access for patients. Any provision(s) expanding telehealth services and access. Any issue(s) related to Medicare pass-through funding and other payment technicalities in relation to colleges of nursing and allied health professions. Any bill(s) or provision(s) addressing Medicaid Disproportionate Share Hospital (DSH) cuts, namely having to do with a delay in cuts. Any bill(s) or provision(s) addressing access to mental health care for patients and teammates. RESTORING HOPE FOR MENTAL HEALTH AND WELL-BEING ACT (H.R. 7666). THE BIPARTISAN SAFER COMMUNITIES ACT (S. 2938). Any bill(s) or provision(s) addressing access to rural health care for patients. H.R. 315, S. 748, or any other bill(s) or provision(s) addressing the elimination of Medicare sequester cuts during the COVID-19 public health emergency. Any bill(s) or provision(s) addressing the expansion of Medicaid and increasing the level of Federal matching assistance for states that choose to expand Medicaid coverage. Any bill(s) or provision(s) relating to appropriations funding for the Atrium Health/Wake Forest Baptist Innovation Quarter, The Pearl, and Innovation Corridor. Any bill(s) or provision(s) relating to funding/appropriations for the Atrium Health/Wake Forest Baptist School of Medicine. Any bill(s) or provision(s) related to workforce and continued support for healthcare workers. S.1024 - HEALTHCARE WORKFORCE RESILIENCE ACT; S 834: RESIDENT PHYSICIAN SHORTAGE REDUCTION ACT OF 2021; S. 1024: HEALTHCARE WORKFORCE RESILIENCE ACT. THE SAFETY FROM VIOLENCE FOR HEALTHCARE EMPLOYEES (SAVE) Act (H.R. 7961). Any bill(s) or provision(s) advocating for The Advanced Research Projects Agency for Health (ARPA-H) to be located in North Carolina. Any bill(s) or provision(s) related to laboratory developed tests. S.2209. VALID Act Any bill(s) or provision(s) related to funding for the Wake Forest Institute of Regenerative Medicine (WFIRM). Any bill related to the ending or extension of hospital at home waivers. HR 7053/S. 3792. Hospital @ Home. HR 7667. Prescription Drug User Fee Authorization Any bill(s) or provision(s) related to maternal health and access to care. Any issue(s) related to approval of DPP waivers in Georgia.

Client expense: $68,735 · Firm income: Not reported

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

Federal funding to implement Alternatives to Opioids (ALTO) program Federal funding to implement Preventing Overdoses While in Emergency Rooms (POWER) program Federal funding to implement MISSION ZERO program Federal funding to implement firearm injury prevention Federal funding to implement Emergency Medical Services for Children (EMSC) Federal funding for emergency medicine research activities H.R.315-Medicare Sequester COVID Moratorium Act H.R.2471-Consolidated Appropriations Act, 2022 H.R.4502-Labor, Health and Human Services, Education, Agriculture, Rural Development, Energy and Water Development, Financial Services and General Government, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2022 H.R.5305-Extending Government Funding and Delivering Emergency Assistance Act

Client expense: $447,388 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES

H.R.315-Medicare Sequester COVID Moratorium Act H.R.3650-Improving Access to Medicare Coverage Act of 2021 H.R.6020-Supporting Medicare Providers Act of 2021 S.2048-Improving Access to Medicare Coverage Act of 2021 S.3314-Supporting Medicare Providers Act of 2021

Client expense: $447,388 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 7667- Food and Drug Amendments of 2022, support passage S.4248- Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act, support passage H.R. 5435- BRAIN Act of 2021, establishing a Neuroscience Center of Excellence at the Food and Drug Administration, support passage H.R.315 - Common Sense Cannabis Reform for Veterans, Small Business and Medical Professionals Act, monitor to support H.R. 6000 - Cures 2.0 Act, supporting the goals of Rep. Upton/DeGette's Cures 2.0 initiative aimed at accelerating medical research, patient access to novel therapeutics and authorizing the Administration's Advanced Research Projects Agency for Health (ARPA-H) proposal -support passage S. 3726- CARE for Long COVID Act- support passage S.4447 - Modernizing Accelerated Approval Act, support passage and inclusion in Senate FDASLA package. S. 3799 Prevent Pandemics Act - support passage Lisa Blunt Rochester- Long-COVID RECOVERY NOW Act, support passage (bill number forthcoming)

Client expense: $11,123 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

H.R. 7667- Food and Drug Amendments of 2022, support passage S.4248- Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act, support passage H.R. 5435- BRAIN Act of 2021, establishing a Neuroscience Center of Excellence at the Food and Drug Administration, support passage H.R.315 - Common Sense Cannabis Reform for Veterans, Small Business and Medical Professionals Act, monitor to support H.R. 6000 - Cures 2.0 Act, supporting the goals of Rep. Upton/DeGette's Cures 2.0 initiative aimed at accelerating medical research, patient access to novel therapeutics and authorizing the Administration's Advanced Research Projects Agency for Health (ARPA-H) proposal -support passage S. 3726- CARE for Long COVID Act- support passage S.4447 - Modernizing Accelerated Approval Act, support passage and inclusion in Senate FDASLA package. S. 3799 Prevent Pandemics Act - support passage Lisa Blunt Rochester- Long-COVID RECOVERY NOW Act, support passage (bill number forthcoming)

Client expense: $11,123 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response. Monitoring and outreach on legislative and administrative activity related to infrastructure. Monitoring and outreach on legislative and administrative activity related to reconciliation and the congressional budget resolution. H.R. 4432 - Department of Defense Appropriations Act, FY2022. Senate Draft, Department of Defense Appropriations Act, FY2022 P.L. 116-136, CARES Act P.L. 116-260, FY2021 Omnibus and COVID Relief and Response Act P.L. 117-2, American Rescue Plan Act of 2021 H.R. 3684 - Infrastructure Investment and Jobs Act S. 464 - Safe Step Act H.R. 2163 - Safe Step Act H.R. 1319 - American Rescue Plan Act of 2021 S. 834 - Resident Physician Shortage Reduction Act of 2021 H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R. 1868 - To prevent across-the-board direct spending cuts, and for other purposes H.R. 315 - Medicare Sequester COVID Moratorium Act S. 368 - Telehealth Modernization Act H.R. 1332 - Telehealth Modernization Act H.R. 366 - Protecting Access to Post-COVID-19 Telehealth Act of 2021 S. 298 - Pharmacy Benefit Manager Accountability Study Act of 2021 S. 1024 - Healthcare Workforce Resilience Act H.R. 2255 - Healthcare Workforce Resilience Act H.R. 1819 - Pharmacy Benefit Manager Accountability Study Act H.R. 3107 - The Improving Seniors Timely Access to Care Act H.R. 3517 - Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act H.R. 315 - The Medicare Sequester COVID Moratorium Act S. 748 - Medicare Sequester Relief Act H.R. 5067 - Preserving Patient Access to Home Infusion Act S. 2652 - Preserving Patient Access to Home Infusion Act H.R. 3541 - Conrad State 30 and Physician Access Reauthorization Act S. 1810 - Conrad State 30 and Physician Access Reauthorization Act H.R. 5376 - Build Back Better Act S. 3314 - Supporting Medicare Providers Act H.R. 6020 - Supporting Medicare Providers Act H.R. 5801 - Help Ensure Lower Patient (HELP) Copays Act S. 4408 Health and Location Data Protection Act of 2022 H.R. 4122 - Resident Education Deferred Interest Act or the REDI Act S. 3658 - Resident Education Deferred Interest Act or the REDI Act H.R.8800 - Supporting Medicare Providers Act of 2022 FY2023 Labor Health and Human Services Appropriations content Draft House, Department of Defense Appropriations Act, FY2023 Draft Senate, Department of Defense Appropriations Act, FY2023

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

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response. Monitoring and outreach on legislative and administrative activity related to infrastructure. Monitoring and outreach on legislative and administrative activity related to reconciliation and the congressional budget resolution. H.R. 4432 - Department of Defense Appropriations Act, FY2022. Senate Draft, Department of Defense Appropriations Act, FY2022 P.L. 116-136, CARES Act P.L. 116-260, FY2021 Omnibus and COVID Relief and Response Act P.L. 117-2, American Rescue Plan Act of 2021 H.R. 3684 - Infrastructure Investment and Jobs Act S. 464 - Safe Step Act H.R. 2163 - Safe Step Act H.R. 1319 - American Rescue Plan Act of 2021 S. 834 - Resident Physician Shortage Reduction Act of 2021 H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R. 1868 - To prevent across-the-board direct spending cuts, and for other purposes H.R. 315 - Medicare Sequester COVID Moratorium Act S. 368 - Telehealth Modernization Act H.R. 1332 - Telehealth Modernization Act H.R. 366 - Protecting Access to Post-COVID-19 Telehealth Act of 2021 S. 298 - Pharmacy Benefit Manager Accountability Study Act of 2021 S. 1024 - Healthcare Workforce Resilience Act H.R. 2255 - Healthcare Workforce Resilience Act H.R. 1819 - Pharmacy Benefit Manager Accountability Study Act H.R. 3107 - The Improving Seniors Timely Access to Care Act H.R. 3517 - Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act H.R. 315 - The Medicare Sequester COVID Moratorium Act S. 748 - Medicare Sequester Relief Act H.R. 5067 - Preserving Patient Access to Home Infusion Act S. 2652 - Preserving Patient Access to Home Infusion Act H.R. 3541 - Conrad State 30 and Physician Access Reauthorization Act S. 1810 - Conrad State 30 and Physician Access Reauthorization Act H.R. 5376 - Build Back Better Act S. 3314 - Supporting Medicare Providers Act H.R. 6020 - Supporting Medicare Providers Act H.R. 5801 - Help Ensure Lower Patient (HELP) Copays Act S. 4408 Health and Location Data Protection Act of 2022 H.R. 4122 - Resident Education Deferred Interest Act or the REDI Act S. 3658 - Resident Education Deferred Interest Act or the REDI Act H.R.8800 - Supporting Medicare Providers Act of 2022 FY2023 Labor Health and Human Services Appropriations content Draft House, Department of Defense Appropriations Act, FY2023 Draft Senate, Department of Defense Appropriations Act, FY2023

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

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Monitoring and outreach on legislative activity related to the COVID-19 pandemic and the federal governments response. Monitoring and outreach on legislative and administrative activity related to infrastructure. Monitoring and outreach on legislative and administrative activity related to reconciliation and the congressional budget resolution. H.R. 4432 - Department of Defense Appropriations Act, FY2022. Senate Draft, Department of Defense Appropriations Act, FY2022 P.L. 116-136, CARES Act P.L. 116-260, FY2021 Omnibus and COVID Relief and Response Act P.L. 117-2, American Rescue Plan Act of 2021 H.R. 3684 - Infrastructure Investment and Jobs Act S. 464 - Safe Step Act H.R. 2163 - Safe Step Act H.R. 1319 - American Rescue Plan Act of 2021 S. 834 - Resident Physician Shortage Reduction Act of 2021 H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R. 1868 - To prevent across-the-board direct spending cuts, and for other purposes H.R. 315 - Medicare Sequester COVID Moratorium Act S. 368 - Telehealth Modernization Act H.R. 1332 - Telehealth Modernization Act H.R. 366 - Protecting Access to Post-COVID-19 Telehealth Act of 2021 S. 298 - Pharmacy Benefit Manager Accountability Study Act of 2021 S. 1024 - Healthcare Workforce Resilience Act H.R. 2255 - Healthcare Workforce Resilience Act H.R. 1819 - Pharmacy Benefit Manager Accountability Study Act H.R. 3107 - The Improving Seniors Timely Access to Care Act H.R. 3517 - Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act H.R. 315 - The Medicare Sequester COVID Moratorium Act S. 748 - Medicare Sequester Relief Act H.R. 5067 - Preserving Patient Access to Home Infusion Act S. 2652 - Preserving Patient Access to Home Infusion Act H.R. 3541 - Conrad State 30 and Physician Access Reauthorization Act S. 1810 - Conrad State 30 and Physician Access Reauthorization Act H.R. 5376 - Build Back Better Act S. 3314 - Supporting Medicare Providers Act H.R. 6020 - Supporting Medicare Providers Act H.R. 5801 - Help Ensure Lower Patient (HELP) Copays Act S. 4408 Health and Location Data Protection Act of 2022 H.R. 4122 - Resident Education Deferred Interest Act or the REDI Act S. 3658 - Resident Education Deferred Interest Act or the REDI Act H.R.8800 - Supporting Medicare Providers Act of 2022 FY2023 Labor Health and Human Services Appropriations content Draft House, Department of Defense Appropriations Act, FY2023 Draft Senate, Department of Defense Appropriations Act, FY2023

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

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

Support H.R. 315,Medicare Sequester COVID Moratorium Act, a bill to amend the Coronavirus Aid, Relief, and Economic Security Act to extend the temporary suspension of Medicare sequestration; 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; Discussion with the Center for Medicare and Medicaid Innovation (CMMI) about the Radiation Oncology Alternative Payment Model; Support H.R. 1868, a bill that, among other health care provisions, would eliminate the 2% across-the-board cut to all Medicare payments, known as sequestration, until the end of 2021; Support H.R. 2455, The Resetting the Impact Act (TRIA), a bill to amend the IMPACT Act of 2014 to reset data collection and the development of a payment system technical prototype for post-acute care providers under the Medicare program to take into account the effects of COVID-19; Support H.R. 3173/ S.3018, Improving Seniors Timely Access to Care Act of 2021, a bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, and for other purposes; Support H.R. 1887/ S. 4009, Rural Hospital Support Act, a bill to make permanent the Medicare Dependent Hospital (MDH) and Low-volume Adjustment programs and rebases the MDH and Sole Community Hospital programs; Support relief for Medicare advanced payments; Discussion with CMMI about the priorities for alternative payment models; Support HR 4587, Value in Health Care Act of 2021, a bill to direct the Secretary of Health and Human Services to revise certain regulations in relation to the Medicare shared savings program and other advanced alternative payment arrangements to encourage participation in such program, and for other purposes; Support HR 3746, Accountable Care in Rural America Act, a bill to amend title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program; Support H.R. 5425/ S. 1988, Protecting Rural Telehealth Access Act, a bill to amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program; Letter asking Congress to address two important issues by the end of the year: an extension of the moratorium on Medicare sequester cuts, as well as preventing the Statutory Pay-As-You-Go (PAYGO) sequester from taking effect; Letter urging Congress to remove the reductions to the Medicaid disproportionate share hospital (DSH) program and uncompensated care pools from the Build Back Better Act; Support H.R. 5674/ S. 3061Medicare Mental Health Inpatient Equity Act of 2021, a bill to amend title XVIII of the Social Security Act to eliminate the 190-day lifetime limit on inpatient psychiatric hospital services under the Medicare Program; Letter to the HHS secretary asking for PHE extension and urging HHS to extend the declaration for at least 90 days; Letter to the HHS secretary asking to renew the COVID-19 PHE; Letter to CMS urging changes to MA prior authorization requirements for PHE; Letter expressing our disappointment that Congress is adjourning for April recess without addressing the needs of hospitals and health systems and urging Congress to act to ensure health care providers have the critical relief, including but not limited to extending the Medicare sequester relief, adding more PRF dollars, and providing flexibility in the repayment terms for Medicare accelerated and advance repayments; Provide comments in response to the (CMS) request for information regarding access to coverage and care in the Medicaid and Childrens Health Insurance Program (CHIP) programs. The critical components for a comprehensive access and coverage strategy for Medicaid and CHIP should include: Robust outreach and enrollment efforts to secure and maintain coverage for eligible individuals and families, as well as ensure beneficiary knowledge of how to use this coverage, Standards to ensure timely and equitable access to quality care, and Provider payments that are sufficient to enable beneficiaries' access to quality care; Provide comments in response to the Department of Homeland Securitys (DHS) proposed rule to codify standards and clarify policies that govern public charge determinations. Public charge determinations assess how likely it is that an individual will become dependent on government assistance (public benefits) for support and subsistence. These policy clarifications are intended to help immigrants and their family members better understand when the use of certain public benefits could impact their future immigration status and address the chilling effects of the now-repealed 2019 public charge final rule. The AHA supports DHSs efforts to clarify policies regarding how public charge determinations are made to help reverse the damaging effects of the repealed 2019 public charge rule; A bill to amend title XIX of the Social Security Act to expand the availability of mental, emotional, and behavioral health services under the Medicaid program; Letter urging Congress to halt further cuts to hospital payments. Need to stop a harmful Medicare payment cut to providers that will go into effect July 1 without congressional action. Specifically, a 1% Medicare sequester cut took effect April 1, and that cut will increase to 2% on July 1 if Congress does not act. This will result in billions of dollars being cut from hospitals and health systems by the end of the year; Submitted comment letter regarding Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2023 and Updates to the IRF Quality Reporting Program. We note that the proposed IRF PPS labor-related share would only modestly shift upward from 72.9% in FY 2022 to 73.2% in FY 2022. AHA is concerned that these changes neither align regarding massive cost growth in recent months and years; Provide Comments on the Medicare Program - Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities and Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2023 which stated the Proposed FY 2023 Payment Update warrants closer examination and we urge CMS to discuss in the final rule how the agency will account for these increased costs. The timing of this proposed net decrease in payments could not be worse, given the well-documented impact of the COVID-19 public emergency (PHE) on the SNF and nursing home field; Letter sent to the bipartisan, bicameral Leadership of the House and Senate, urging Congress to act to prevent further Medicare sequester cuts scheduled to take effect on July 1; Submitted comment letter about inpatient and long-term care hospital prospective payment system proposed rule for fiscal year 2023. Concerned that CMS is proposing policies and payment adjustment that do not take into account the current the COVID-19 public health emergency (PHE) and its atypical market forces and pandemic-driven aberrations affecting the utilization and cost of providing LTCH services. Specifically, we are concerned by proposals for an inadequate market basket update and an untenable spike in the high-cost outlier threshold; Letter urges Congress to call on CMS to make changes to the hospital inpatient prospective payment system (IPPS) proposed rule for fiscal year (FY) 2023 in order to ensure that Medicare payments for acute care services more accurately reflect the cost of providing hospital care to patients and communities; Support the bipartisan Dear Colleague letters that ask CMS to make critical changes to the hospital inpatient prospective payment system proposed rule for fiscal year (FY) 2023 to more accurately reflect the cost of providing hospital care to patients; Support HR 8487/ S 3173 Improving Seniors Timely Access to Care Act of 2022, a bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans; Support HR 8747 Assistance for Rural Community Hospitals Act of 2022 or the ARCH Act of 2022, a bill to amend title XVIII of the Social Security Act to extend Medicare-dependent hospital and Medicare low-volume hospital payments; Oppose HR 1330/ S 4130 Patient Access to Higher Quality Health Care Act of 2022, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 8188/ S4449 Saving Access to Laboratory Services Act, a bill to amend title XVIII of the Social Security Act to improve the accuracy of market-based Medicare payment for clinical diagnostic laboratory services, to reduce administrative burdens in the collection of data, and for other purposes.

Client expense: $5,120,000 · Firm income: Not reported

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

Medicare Advantage (risk adjustment, coding intensity, encounter data, dual-eligible members, star ratings, extreme and uncontrollable circumstances policy, normalization factors, stars contract consolidation, ESRD, audio-only telehealth H.R. 4074 -To amend title XVIII of the Social Security Act Medicare RAD-V Mental health and substance use (42 CFR Part 2) Medicaid (IMD Exclusion) Medicaid expansion Medicaid reform (block grants, per capita caps) Medicaid and CHIP reauthorization Medicaid actuarial soundness Long-term services and supports Social Determents of Health (SDOH) Medicare Part D prescription drug program and Medicare Part D coverage gap (donut hole) Opioid addiction issues and response (prescription drug monitoring programs) Medicaid medical loss ratio remittance Medicare Advantage Pilot Program in TRICARE Pharmacy Benefit Manager (PBM) operations and practices, Spread pricing Against Direct and Indirect Remuneration (DIR) reforms in the FY 2023 Medicare Part D Notice H.R.6833 - Affordable Insulin Now Act Maternal health (Medicaid postpartum coverage extension, H.R.959 Black Maternal Health Momnibus Act of 2021) Helping MOMS Act of 2021 CMS Extreme & Uncontrollable Circumstances Policy Medicare Sequester (H.R.315, S.748) Medicare Audio-Only Telehealth (H.R.2166, S.150) Continuing Resolution (CR)FY 2022 Medicaid Funding for Puerto Rico Medicaid Funding for Puerto Rico including discussions on the FMAP, ESRD, and LTSS. Medicare Advantage issues such as rates, benchmarks, providers payments, and disparities in funding for territories. Medicare Advantage asks regarding the underfunding and disparity for Puerto Rico H.R.5376 - Build Back Better Act Medicaid eligibility Health Equity/Health Disparities

Client expense: $1,570,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of

Issues regarding healthcare work force shortages. Palliative Care and Hospice Education & Training Act (S. 2460). Issues related to community based palliative care and advanced care illness management. The Grief Resilience Investment and Education Fund (GRIEF) Act (H.R. 9109) and issues regarding bereavement care. The Expanding Access to Palliative Care Act (S. 2565). Issues affecting hospice providers. The extension of sequestration relief provided under H.R.1868, the Medicare Sequester COVID Moratorium Act (H.R. 315) and Protecting Medicare and American Farmers from Sequester Cuts Act (H.R. 610); the Telehealth Modernization Act (S. 368/H.R.1332) and the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) Act (S. 1512/H.R. 2903) as it relates to use of telehealth in the certification of a beneficiary for the hospice benefit; The Childrens Program of All-inclusive Coordinated Care (ChiPACC) Act of 2021 (H.R. 4952); The Expanding Access to Palliative Care Act (S.2565). The Health Care Workforce Resilience Act (S. 1024/H.R. 2255); The Provider Training in Palliative Care Act (S. 2890); The Palliative Care Training for Providers Act (H.R. 5376); The Consolidated Appropriations Act, 2022 (H.R. 2471) as related to Medicare sequester relief, telehealth flexibilities, and hospice payment reimbursement; care; Issues related to regulatory relief; Issues involving hospice providers and COVID relief; Issues related to coronavirus; Telehealth Extension and Evaluation Act (S. 3593); the Telehealth Extension Act (H.R. 6202). Issues related to healthcare workforce shortages; Issues related to community-based palliative care and advanced care illness management. The Bipartisan Safer Communities Act (S. 2938) and issues concerning bereavement care. Issues related to safe opioid disposal and implementation of the SUPPORT Act (H.R. 2379).

Client expense: $280,000 · 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 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 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. H.R. 5376 (P.L. 117-169), the Inflation Reduction Act, as it relates to home and community-based services and palliative care. S. 2565, Expanding Access to Palliative Care Act. Issues regarding bereavement care. The FY 2023 Proposed Hospice Wage Rule, as it relates to hospice reimbursement. 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. Issues related to hospice codes. Issues related to hospice telehealth flexibilities. Issues concerning hospice payment and alternative payment models. Issues regarding in-patient and in-home respite care. Issues related to COVID-19 emergency funding, extension of the public health emergency, testing, vaccines, and COVID-19 related legislation. 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 H.R.1868, Medicare Sequester COVID Moratorium Act (H.R. 315), and Protecting Medicare and American Farmers from Sequester Cuts Act (H.R. 610); The Children's 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); The Telehealth Extension & Evaluation Act (S. 3593); the Telehealth Extension Act (H.R. 6202). Medicare Hospice Payment Rule. Issues related to the implementation of the Helping Our Senior Population in Comfort Environments (HOSPICE) Act and the Rural Access to Hospice Act.

Client expense: $280,000 · 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

H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern - CHIP H.R. 265 - Insular Area Medicaid Parity Act - Rep. Sablan, Gregorio Kilili Camacho - Medicaid funding H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott - Medicare sequestration H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 432 - Mental Health Access Improvement Act of 2021 - Rep. Thompson, Mike -Medicare coverage of marriage and family therapist services and mental health counselor H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz - Medicare coverage of dental and oral health services H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie - increased FMAP for HCBS H.R. 871 - Expand Medicaid Now Act - Rep. Fletcher, Lizzie - FMAP H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony - COVID-19 coverage for the uninsured via Medicaid H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul -Medicaid coverage for incarcerated individuals H.R. 1167 - Advancing Enrollment and Reducing Drug Costs Act of 2021 - Rep. Pappas, Chris - Medicaid eligibility for low-income subsidies H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio - Medicare public option H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl - telehealth services under Medicare H.R. 1349 - The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021- Rep. Kaptur, Marcy - advance payments under parts A and B of Medicare H.R. 1353 - Coronavirus Medicaid Response Act - Rep. Lee, Susie - FMAP H.R. 1390 - CHIPPER Act - Rep. Wild, Susan - CHIP funding H.R. 1397 - TIKES Act - Rep. Blunt Rochester, Lisa - telehealth under Medicaid and CHIP H.R. 1609 - Treatment in Place Act - Rep. Axne, Cynthia - Medicare coverage of ambulance services H.R. 1676 - Jack Reynolds Memory Medigap Expansion Act - Rep. Axne, Cynthia - Medigap coverage for ESRD H.R. 1677 - KEEP Telehealth Options Act of 2021 - Rep. Balderson, Troy - telehealth expansion H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred - permanent protections against spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia - Medicaid in Puerto Rico H.R. 1738 - Stabilize Medicaid and CHIP Coverage Act - Rep. Dingell, Debbie - Medicaid and CHIP continuous enrollment H.R. 1784 - Medicaid REACH Act - Rep. Doggett, Lloyd - requirements for non-expansion H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz - extending CHIP H.R. 1792 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Rep. Barragan, Nanette Diaz - dental coverage under CHIP H.R. 1793 - Immediate Coverage for Former Foster Youth Act - Rep. Bass, Karen - Medicaid coverage for foster youth H.R. 1794 - Foster Youth Dental Act of 2021 - Rep. Bass, Karen - Medicaid dental coverage for foster youth H.R. 1823 - To amend title XIX of the Social Security Act to remove the matching requirement for a territory to use specially allocated Federal funds for Medicare covered part D drugs for low-income individuals - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare covered part D H.R. 1825 - Territories Medicare Prescription Drug Assistance Equality Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicare Part D premium and cost-sharing subsidies H.R. 1826 - Fairness in Medicare Part B Enrollment Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - late enrollment penalties under part B of the Medicare program H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie - Money Follows the Person Rebalancing Demonstration H.R. 1885 - RUSH Protection Act of 2021 - Rep. Kind, Ron - Medicare rural health clinic payments H.R. 1887 - Rural Hospital Support Act - Rep. Reed, Tom - Medicare payments for hospitals H.R. 1890 - Health Insurance Consumer Protection Act - Rep. Schakowsky, Janice D. - network adequacy standards and premium rates H.R. 1914 - CAHOOTS Act - Rep. DeFazio, Peter A. - Medicaid mobile crisis intervention services H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 2035 - Improving Access to Mental Health Act of 2021 - Rep. Lee, Barbara - mental health services under Medicare H.R. 2080 - SAVE Act - Rep. Bishop, Sanford D., Jr. - Medicare coverage of transportation services H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri - Medicare Advantage payments for audio-only diagnoses H.R. 2168 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 2170 - HAPI Act - Rep. Soto, Darren - access to vaccines and Medicaid H.R. 2179 - Affordable Insulin for the COVID-19 Emergency Act - Rep. Waters, Maxine - cost-sharing regarding insulin coverage H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer - Medicaid FMAP for Territories H.R. 2228 - Rural Behavioral Health Access Act of 2021 - Rep. Kildee, Daniel - Medicare coverage of outpatient telehealth services H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. - Medicare Advantage supplemental benefits H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd - Medigap policies H.R. 6833 - Affordable Insulin Now Act - Rep. Craig, Angie - Insulin prices and cost sharing S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez-Masto, Catherine - coverage of audio-only telehealth services in MA S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert - FMAP and HCBS S. 245 - SAME Act of 2021 - Sen. Warner, Mark - Medicaid expansion S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael - COVID-19 coverage for the uninsured via Medicaid S. 285 - Medicaid Reentry Act of 2021 - Sen. Baldwin, Tammy - Medicaid coverage for incarcerated individuals S. 368 - Telehealth Modernization Act - Sen. Scott, Tim - coverage of telehealth services under Medicare S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael - Medicare public option S. 439 - Coronavirus Medicaid Response Act - Sen. Casey, Robert - increases FMAP S. 440 - Continued Funding for Senior Services During COVID-19 Act - Sen. Casey, Robert - funding for services under the Older Americans Act of 1965 S. 453 - CHIPPER Act - Sen. Casey, Robert - CHIP funding S. 581 - HAPI Act -Sen. Brown, Sherrod - vaccines under Medicaid S. 620 - KEEP Telehealth Options Act of 2021 - Sen. Fischer, Deb - telehealth expansion S. 644 - Rural Hospital Closure Relief Act of 2021 - Sen. Durbin, Richard - Medicare coverage for critical access hospitals S. 646 - Stabilize Medicaid and CHIP Coverage Act of 2021 - Sen. Brown, Sherrod - Medicaid and CHIP enrollment S. 653 - COMP Act - Sen. Portman, Rob - Medicare secondary payer rules S. 712 - Dosha Joi Immediate Coverage for Former Foster Youth Act - Sen. Casey, Robert P., Jr. - Medicaid coverage for foster youth S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne - Medicare payment sequestration S. 764 - CAHOOTS Act - Sen. Wyden, Ron - Medicaid mobile crisis intervention services S. 826 - Medicare Patient Empowerment Act of 2021 - Sen. Paul, Rand - Medicaid payment options S. 870 - Improving Access to Mental Health Act of 2021 - Sen. Stabenow, Debbie - mental health services in Medicare S. 999 - Save Rural Hospitals Act of 2021 - Sen. Warner, Mark - Medicare hospital payments Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2023 policy and technical regulation for MA and Part D; issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2023 Rate Notice; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; issues related to specialty infant formula; issues related to the Inflation Reduction Act passage and implementation; contraceptive coverage and reproductive health; Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to Managed Long Term Services and Supports (MLTSS); issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations or legislation, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; implications of physician fee schedule on MA; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value based payment models; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); issues relating to potential Medicare mental health parity requirements; Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the Affordable Care Act (ACA) including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation. *Add MACPAC to Agency List.

Client expense: $3,230,000 · Firm income: Not reported

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

H.R. 1332, Telehealth Modernization Act, all provisions S. 368, Telehealth Modernization Act, all provisions H.R. 3259, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, all provisions S. 586, NOPAIN Act, all provisions H.R. 2903, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021, all provisions S. 1512, CONNECT for Health Act of 2021, all provisions H.R. 2256, Resident Physician Shortage Reduction Act of 2021, all provisions S. 834, Resident Physician Shortage Reduction Act of 2021, all provisions H.R. 7995, Getting Over Lengthy Delays in Care As Required by Doctors (GOLD CARD) Act of 2022, all provisions H.R. 3407, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act, all provisions S. 411, MOMMAs Act, all provisions H.R. 3173, Improving Seniors Timely Access to Care Act of 2021, all provisions S. 3018, Improving Seniors Timely Access to Care Act of 2021, all provisions H.R. 8487, Improving Seniors Timely Access to Care Act of 2022, 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. 3441, Substance Use Disorder Workforce Act, all provisions S. 1438, Substance Use Disorder Workforce Act, 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, provisions related to scope of practice H.R. 6020, Supporting Medicare Providers Act of 2021, all provisions S. 3314, Supporting Medicare Providers Act of 2021, all provisions H.R. 4587, Value in Health Care Act of 2021, all provisions S. 2938, Bipartisan Safer Communities Act, all provisions H.R. 8800, Supporting Medicare Providers Act of 2022, all provisions H.R. 4040, Advancing Telehealth Beyond COVID-19 Act of 2022, all provisions H.R. 8850, Fair Access In Residency (FAIR) Act, all provisions S. 2173, Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies (PREVENT DIABETES) Act, all provisions S. 4873, Improving Access to Advance Care Planning Act, all provisions H.R. 4014, Physician Shortage GME Cap Flex Act of 2021, all provisions S. 2094, Physician Shortage GME Cap Flex Act of 2021, all provisions H.R. 7213, Equitable Community Access to Pharmacist Services Act, all provisions H.R. 8594, Restore Protections for Dialysis Patients Act, all provisions S. 4750, Restore Protections for Dialysis Patients Act, all provisions H.R. 8188, Saving Access to Laboratory Services Act (SALSA), all provisions S. 4449, SALSA Act, 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 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 S. 610, Protecting Medicare and American Farmers from Sequester Cuts Act, all provisions H.R. 6048, Medicare Stability for Patients and Providers Act, all provisions H.R. 3434, Territories Health Equity Act of 2021, all provisions H.R. 4406, Supporting Medicaid in the U.S. Territories Act of 2021, all provisions S. 801, Connected Maternal Online Monitoring Act, all provisions S. 346, Black Maternal Health Momnibus Act of 2021, 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. 748, Medicare Sequester Relief 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. 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. 7573, Telehealth Extension and Evaluation Act, all provisions S. 3593, Telehealth Extension and Evaluation Act, 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 H.R. 7053, Hospital Inpatient Services Modernization Act, all provisions S. 3792, Hospital Inpatient Services Modernization Act, all provisions H.R. 7116, 9-8-8 Implementation Act of 2022, all provisions H.R. 8879, Inpatient Psychiatric Facility Improvement Act, all provisions H.R. 8878, To amend title XVIII of the Social Security Act to ensure adequate coverage of outpatient mental health services under the Medicare program, all provisions H.R. 432, Mental Health Access Improvement Act of 2021, all provisions H.R. 8910, Behavioral Health Integration Awareness Act of 2022, all provisions H.R. 8884, To direct the Secretary of Health and Human Services to provide outreach and reporting on opioid use disorder treatment services furnished by opioid treatment programs under the Medicare program, all provisions S. 987, CARA 3.0 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. 5067, Preserving Patient Access to Home Infusion Act, all provisions S. 2652, Preserving Patient Access to Home Infusion Act, all provisions H.R. 8812, To amend titles XVIII and XIX of the Social Security Act and the Bipartisan Budget Act of 2018 to increase access to services provided by advanced practice registered nurses under the Medicare and Medicaid programs, and for other purposes, provisions related to scope of practice Medicare program: 21st Century Cures Act/implementation Medicare program: EHR Certification Medicare program: Medicare and CHIP Reauthorization Act (MACRA) Reform Medicare program: MACRA implementation Medicare program: Laboratory testing/Diagnostics/PAMA Medicare program: Merit-based Incentive Payment System (MIPS) quality/cost/improvement activities/promoting interoperability Medicare program: Merit-based Value Pathway Medicare program: Physician Fee Schedule (PFS) inflation updates/budget neutrality rules Medicare program: 2023 Medicare Physician Fee Schedule/4.5% cut Medicare program: Accountable specialty care/payments Medicare program: Alternative Payment Models/incentive payments Medicare program: Telehealth/COVID flexibilities Medicare program: Health IT burdens Medicare program: Self-measured blood pressure devices/benefit category Medicare program: Coding Medicare program: Primary Care First models Medicare program: Appropriate Use Criteria Medicare program: Opioids Medicare program: Medicare Shared Savings Program (MSSP) Medicare program: Dental benefits Medicaid program: Uninsured and healthcare coverage/COVID-19 Medicare program: Provider Enrollment, Chain, and Ownership System (PECOS)/revalidation Medicare program: Open Payments Medicaid program: Special Enrollment Period Medicaid program: Sickle Cell Disease Medicaid program: Improving Access to Physical and Mental Health Care for Children and Youth Under Medicaid and CHIP/draft Medicare program: Provider compliance and regulatory relief Medicare program: Medicare Administrative Contractors (MACs)/Downcoding Medicare and Medicaid programs: Health Equity Medicare and Medicaid programs: Modifier 25, Impossible Day Medicare and Medicaid programs: Connected health technologies Medicare and Medicaid programs: Diabetes

Client expense: $4,360,000 · Firm income: Not reported

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

H.R. 7667- Food and Drug Amendments of 2022, support passage S.4248- Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act, support passage H.R. 5435- BRAIN Act of 2021, establishing a Neuroscience Center of Excellence at the Food and Drug Administration, support passage H.R.315 - Common Sense Cannabis Reform for Veterans, Small Business and Medical Professionals Act, monitor to support H.R. 6000 - Cures 2.0 Act, supporting the goals of Rep. Upton/DeGette's Cures 2.0 initiative aimed at accelerating medical research, patient access to novel therapeutics and authorizing the Administration's Advanced Research Projects Agency for Health (ARPA-H) proposal -support passage S. 3726- CARE for Long COVID Act- support passage S.4447 - Modernizing Accelerated Approval Act, support passage and inclusion in Senate FDASLA package. S. 3799 Prevent Pandemics Act - support passage Lisa Blunt Rochester- Long-COVID RECOVERY NOW Act, support passage (bill number forthcoming)

Client expense: $42,877 · Firm income: Not reported

Government targets: Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

Regulatory and reimbursement policy issues relating to healthcare programs, including diabetes and diabetic retinopathy, Medicare and Medicaid, safe mobility issues, drug pricing, medical device, innovation, telemedicine/ telehealth, supply chain, and provider issues. Monitor issues regarding COVID short and long term challenges; the Public Health Emergency (PHE); pandemic issues and provider relief funding; medical technology and device innovation; supply chain issues; Medicare and Medicaid coverage and reimbursement; artificial intelligence; health care reform; rural health; telehealth; telemedicine; remote patient monitoring; quality measurement and outcomes; diabetes (including diabetic retinopathy); cardiac care; safe mobility standards; safe patient handling; and health infrastructure funding and initiatives. Hospital at Home. H.R. 4502/S.3062 Labor-HHS FY2022 Appropriations; H.R. 2471 FY2022 Omnibus Appropriation; S. 748, the Medicare Sequester Relief Act; H.R. 315, the Medicare Sequester COVID Moratorium Act; H.R. 5376 The Inflation Reduction Act of 2022 (P.L. No: 117-169); H.R. 8295 Labor-HHS FY2023 Appropriations; H.R. 6833 Making continuing appropriations for fiscal year 2023, and for other purposes (P.L. No: 117-180); H.R. 4346 The CHIPS and Science Act of 2022 (P.L. No: 117-167). Medical Device User Fee Amendments Reauthorization, included in P.L. No: 117-180. Safe mobility issues, including H.Res.1177, Expressing the sense of the House of Representatives regarding the Centers for Medicare & Medicaid Services developing a mobility metric to guide providers in preventing mobility loss among hospitalized older adults.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Regulatory and reimbursement policy issues relating to healthcare programs, including Medicare and Medicaid coverage and reimbursement, safe mobility issues, diabetes and diabetic retinopathy, monitor medical device, drug pricing, supply chain, innovation, and provider issues. Monitor issues regarding COVID short and long term challenges; the Public Health Emergency (PHE); pandemic issues and provider relief funding; medical technology and device innovation; supply chain issues; Medicare and Medicaid coverage and reimbursement; artificial intelligence; health care reform; rural health; telehealth; telemedicine; remote patient monitoring; quality measurement and outcomes; cardiac care; and health infrastructure funding and initiatives. Hospital at Home. S. 748, the Medicare Sequester Relief Act; H.R. 315, the Medicare Sequester COVID Moratorium Act; H.R. 1319, the American Rescue Plan Act (P.L. 117-2); H.R. 1330, the Patient Access to Higher Quality Care Act; H.R. 5376 the Inflation Reduction Act of 2022 (P.L. No: 117-169); H.R. 8295 Labor-HHS FY2023 Appropriations; H.R. 6833 Making continuing appropriations for fiscal year 2023, and for other purposes (P.L. No: 117-180); H.R. 4346 The CHIPS and Science Act of 2022 (P.L. No: 117-167). Medical Device User Fee Amendments Reauthorization, included in P.L. No: 117-180. Safe mobility issues, including H.Res.1177, Expressing the sense of the House of Representatives regarding the Centers for Medicare & Medicaid Services developing a mobility metric to guide providers in preventing mobility loss among hospitalized older adults.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issue: Support policies to close the Medicaid coverage gap, including through ACA Medicaid expansion. Maintain commitment to match State spending on medical care for Medicaid beneficiaries without limits, caps, or block grants. Maintain and enforce network adequacy requirements and mandate sufficient payments to providers. Issue: Support programs and funds for safety-net providers. Educate Congress about the impact of Section 203 of the Consolidated Appropriations Act, 2021 and its changes to the Medicaid DSH cap calculation methodology on academic medical centers. Support legislative efforts to address concerns. H.R. 2256 / S. 834, Resident Physician Shortage Reduction Act of 2021 Issue: Support increased Medicare funding for graduate medical education S. 1438 Opioid Workforce Act H.R. 3441 Substance Use Disorder Workforce Act Issue: Support targeted Medicare funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs S.1893 / H.R. 8508, Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals Issue: Provide feedback to CMS on its proposed distribution of the 1,000 new GME slots authorized be the Consolidated Appropriations Act, 2021 as described in the 2022 Inpatient Prospective Payment System (IPPS) proposed rule. Support CMS adopting alternative 2 with modifications to allow for more than 1.0 FTE per hospital. Issue: Support Medicare Graduate Medical Education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issue: Oppose reduction of Medicare GME/IME payments Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose Medicare hospital cuts. H.R. 8850 Fair Access In Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. Issue: Oppose overly burdensome Medicaid GME transparency language. Issue: Support technical correction to increase access to physician services in rural communities by allowing teaching hospitals to count resident time spent in critical access hospitals for purposes of Medicare GME payments. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives H.R.3173 / S.3018, Improving Seniors Timely Access to Care Act Issue: Protecting patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency Issue: Modify CMS Hospital Compare Star Ratings to allow stakeholders time to work together to address concerns with methodology. Support inclusion of sociodemographic status as part of quality programs. Draft Medicare Part D benefit re-design legislation Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Issue: Support expansion of Medicaid and CHIP coverage for postpartum women. S. 610 Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 315 Medicare Sequester COVID Moratorium Act S. 748 Medicare Sequester Relief Act H.R. 1868 To prevent across-the-board direct spending cuts, and for other purposes. Issue: Support extension of Medicare sequester moratorium. Issue: Support clearing the PAYGO scorecard to avoid another Medicare sequester due to the use of reconciliation to pass the American Rescue Plan Act. Issue: Oppose use of extended Medicare sequester and repurposing of unused Provider Relief Fund. H.R.8800 - Supporting Medicare Providers Act of 2022 Issue: Support a 4.42% increase in the Medicare physician fee schedule that Congress provided in the Consolidated Appropriations Act, 2021 to avoid payment cuts due to budget neutrality requirements. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support making permanent the interim final rule that allows hospitals that unknowingly trigger their Medicare GME caps and per resident amounts to not have that happen and instead retain the ability to build a new resident cap / PRA so long as the cap / PRA is not above a minimum amount. Issue: Oppose aspects of CMS hospital price transparency rule. Issue: Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Oppose finalizing proposed rule for Medicare Coverage of Innovative Technology (MCIT) and definition of reasonable and necessary. Issue: Oppose enforcement of linking Medicare Conditions of Participation (CoP) compliance with requiring that hospitals report 38 COVID-19 related measures. Issue: Support continuation of the 3-Day Skilled Nursing Facility (SNF) Stay waiver after the conclusion of the COVID-19 public health emergency. Issue: Oppose policy of incorporating revenue distinctions into the Medicare Shared Savings Program. Issue: Support permanent extension of Medicare telehealth waivers, including removing patient location restrictions and rural site requirements, allowing payment for audio-only services, and reimbursing providers for telehealth services as services delivered in-person. Support 2 year or permanent extension of the waivers. H.R. 7053 / S. 3792, Hospital Inpatient Services Modernization Act Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support permanent extension of current Covid telehealth flexibilities HR 1332, the Telehealth Modernization Act Issue: Support efforts to expand patient access to telehealth HR 1397, the Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP Issue: Support efforts to improve access to childrens mental health care H.R. 4040 Advancing Telehealth Beyond COVID-19 Act of 2021 Issue: Support extension of COVID-19 telehealth waivers for two years beyond the end of the COVID-19 public health emergency. Issue: Support funding for hospital-based violence intervention programs and community violence interventions S. 2061 Telemental Health Care Access Act Issue: Support policy to remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services H.R. 3173/Sr. 3018 Improving Seniors Timely Access to Care Act of 2022 Issue: Support policy that would implement an electronic prior authorization program in Medicare Advantage that would simplify processes and save time for both providers and patients. Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create IME payments for outpatient services while remaining budget neutral. Issue: Support efforts to reverse cuts in Medicare OPPS reimbursements to hospitals for drugs acquired under the 340B program. Draft Value in Health Care Act Issue: Support changes to alternative payment models (APMs) to increase participation in value-based health programs and promote quality care and improved health outcomes. H.R. 3746 Accountable Care in Rural America Act Issue: Support improving the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location. H.R. 4970 Rural Medical Residency Expansion Act of 2021 Issue: Support providing funds for rural teaching hospitals to expand their residency programs. Issue: Support efforts to investigate nurse-staffing agencies conduct during the COVID-19 pandemic.

Client expense: $912,077 · Firm income: Not reported

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

Issues related to Medicare Advantage and Part D prescription drug programs; Issues related to Prescription Drug Rebates; Issues related to Dual Eligible and Medicare Advantage Special Needs Plans; Issues related to Social Determinants of Health (SDOH)/Health Equity; and Issues related to Telehealth. 117th Congress Inflation Reduction Act of 2022 Budget Reconciliation/Biden Administration Build Back Better Plan COVID-19 American Rescue Plan American Jobs Plan Medicare Sequester COVID Moratorium Act (H.R. 315) Delay of the Prescription Drug Rebate Rule Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 (S. 150) The Ensuring Parity in MA and PACE for Audio-Only Telehealth Act (HR 2166) Previous Congresses H.R. 3461, Community-Based Independence for Seniors Act H.R. 3877, Bipartisan Budget Act H.R. 19, Lower Costs, More Cures Act of 2019 S. 3013, Encouraging Innovative Benefit Design to Lower Costs for Seniors Act H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 H.R. 6201, Families First Coronavirus Response Act H.R. 748, CARES Act H.R. 6800, HEROES Act H.R. 7659, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 S. 4318, American Workers, Families and Employers Assistance Act S. 4199, Prescription Drug Pricing Reduction Act of 2020 S.4840, Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 Bipartisan Coronavirus Relief and Omnibus Funding Bill H.R. 4074, Addressing Social Determinants in Medicare Advantage PL 115-123: H.R. 1892, The bipartisan Budget Act of 2018; H.R. 3168, To amend title XVIII of the Social Security Act to provide continued access to specialized Medicare Advantage plans for special needs individuals, and for other purposes; S. 870, CHRONIC Care Bill PL 115-271: H.R. 6, SUPPORT for Patients and Communities Act

Client expense: $147,000 · Firm income: Not reported

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

Funding opportunities, including Community Project Funds, Provider Relief Funds, PPP; COVID, PHE and relief funding and regulatory issues; Post-acute care and Skilled Nursing Legislative and Regulatory Issues; Medicare and Medicaid coverage and reimbursement; telehealth and PACE program; Nursing home staffing issues. Executive Order 14042, Requirements for COVID-19 Vaccination of Federal Contractors and DOL OSHA COVID-19 Vaccination Rule. S. 748, the Medicare Sequester Relief Act; H.R. 315, the Medicare Sequester COVID Moratorium Act; H.R. 1319, the American Rescue Plan Act (P.L. 117-2); H.R. 1330, the Patient Access to Higher Quality Care Act; H.R.5376 the Inflation Reduction Act of 2022 (P.L. No: 117-169); House (H.R.8295) and Senate Labor-HHS FY23 Appropriations; H.R. 6833 Making continuing appropriations for fiscal year 2023, and for other purposes (P.L. No: 117-180).

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

Funding opportunities, including Community Project Funds, Provider Relief Funds, PPP; COVID, PHE and relief funding and regulatory issues; Post-acute care and Skilled Nursing Legislative and Regulatory Issues; Medicare and Medicaid coverage and reimbursement; telehealth and PACE program; Nursing home staffing issues. S. 748, the Medicare Sequester Relief Act; H.R. 315, the Medicare Sequester COVID Moratorium Act; H.R. 1319, the American Rescue Plan Act (P.L. 117-2); H.R. 1330, the Patient Access to Higher Quality Care Act; House (H.R.8295) and Senate Labor-HHS FY23 Appropriations; H.R. 6833 Making continuing appropriations for fiscal year 2023, and for other purposes (P.L. No: 117-180).

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE

S.2999 A bill to prohibit the Secretary of Health and Human Services, any officer or employee of the Department of Health and Human Services, and States from requiring COVID-19 vaccination as a condition of eligibility for benefits or assistance under the Medicare, Medicaid, or CHIP program; S.J.Res.32 A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination; H.R.1677 - KEEP Telehealth Options Act of 2021 To direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency; S.620 KEEP Telehealth Options Act of 2021; S104 HR379 Improving Social Determinants of Health Act of 2021; H.R.1227, S386 Medicare-X Choice Act of 2021; HR 3322-S826 Medicare Patient Empowerment Act of 2021; HR2410 Medicare & You Handbook Improvement Act of 2021; S1180 Choose Medicare Act' S748 Medicare Sequester Relief Act; HR 315 Medicare Sequester COVID Moratorium Act; HR599 Protecting Medicare Beneficiaries with Pre-Existing Conditions Act; S.2146 Improving Medicare Beneficiary Access to Innovative Diabetes Technologies Act of 2021; S.4067 A bill to amend title XI of the Social Security Act to improve access to care for all Medicare and Medicaid beneficiaries through models tested under the Center for Medicare and Medicaid Innovation, and for other purposes; H.R.3755 Women's Health Protection Act of 2022; . S.J.Res.32 - A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination"; H.J.Res.79 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of the Treasury and the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond".

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE