Save Rural Hospitals Act of 2021

The Medicare-dependent Hospitals (MDH) and Low-volume Hospital (LVH) adjustment programs o The Assistance for Rural Community Hospitals (ARCH) Act (H.R. 8747) would extend the Medicare-dependent hospital (MDH) program and low-volume hospital (LVH) adjustment for five years. o The Rural Hospital Support Act (H.R. 1887 / S.4009) would make both the MDH and the enhanced LVH adjustment programs permanent. PAYGO cut Extend Telehealth flexibilities - Advancing Telehealth Beyond COVID-19 Act (H.R. 4040) Hospital at Home waiver - Hospital Inpatient Services Modernization Act would extend by 2 years the Hospital at Home waiver program (S. 3792/ H.R. 7053). The Rural America Health Corps Act (S. 924/H.R. 2130) - support for this legislation which will provide incentives for clinicians to practice in rural health professional shortage areas. Improving Seniors Timely Access to Care Act (S. 3018 / H.R. 3173) - steamline Medicare Advantage Prior Authorization Conrad State 30 and Physician Access Reauthorization Act (S. 1810 / H.R. 3541) Mental and Behavioral Health - Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R. 7666) Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); Inpatient Rehabilitation Facilities - CMS Review Choice Demonstration

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the Medicare Wage Index and hospital price transparency; S.999, Save Rural Hospitals Act of 2021; H.R.4066, To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments.

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

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

Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); behavioral health; Workforce -Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256); Healthcare Workforce Resilience Act (S. 1024); Future Advancement of Academic Nursing Act (S. 246/H.R. 851); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); rural hospital medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130); post-acute care/inpatient rehabilitation facilities - IMPACT Act (TRIA) of 2021 (H.R. 2455),IRF CMS Review Choice Demonstration; 340b Eligibility requirements waiver - H.R. 3203 and S.773; Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better; relief to repay payments received through the Medicare Accelerated and Advance Payments program.

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

H.R. 1330 / S. 4130 - "Patient Access to Higher Quality Health Care Act of 2021" - Provisions that would weaken or repeal current law limiting self-referral to physician-owned hospitals. Advocate for legislation that would reform rural hospital DSH payments. H.R. 4040 - "Advancing Telehealth Beyond COVID-19 Act of 2021" - Expanding access to telehealth beyond PHE. S. 1568 / H.R. 4407 - "Technical Reset to Advance the Instruction of Nurses Act" - CMS payments for Nursing Education Hospitals. H.R. 1887 / S. 4009 - "Rural Hospital Support Act" - Rural Extenders. H.R. 4066 / S. 999 - "Save Rural Hospitals Act of 2021" - Area wage adjustment for certain Medicare hospitals. H.R. 3173/H.R. 8487 - The Improving Seniors Timely Access to Care Act of 2021 - Simplify/streamline Medicare Advantage prior authorization process. Urge Congress to Support Improvements to IPPS Proposed Rule. H.R. 8747 - "The Assistance for Rural Community Hospitals (ARCH) Act" - Rural health payment program extensions. H.R. 6833 - "Legislative Vehicle for Continuing Resolution Until Dec. 16" - Rural health payment program extensions. S. 1512 / H.R. 2903- "Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021" - Telehealth provisions. H.R. 2455 - The Resetting the IMPACT Act (TRIA) of 2021 - IMPACT Act implementation / unified payment timeline reset. Garner Congressional support for CMS to withdraw the Inpatient Rehabilitation Facility Review Choice Demonstration (IRF RCD). Discussions with Congress regarding waiving PAYGO.

Client expense: $640,000 · Firm income: Not reported

General health care issues; S. 999/H.R. 4066, Save Rural Hospitals Act of 2021.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General health care issues; S. 999/H.R. 4066, Save Rural Hospitals Act of 2021.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Medicare-dependent Hospitals (MDH) and Low-volume Hospital (LVH) adjustment programs o The Assistance for Rural Community Hospitals (ARCH) Act (H.R. 8747) would extend the Medicare-dependent hospital (MDH) program and low-volume hospital (LVH) adjustment for five years. o The Rural Hospital Support Act (H.R. 1887 / S.4009) would make both the MDH and the enhanced LVH adjustment programs permanent. PAYGO cut Extend Telehealth flexibilities - Advancing Telehealth Beyond COVID-19 Act (H.R. 4040) Hospital at Home waiver - Hospital Inpatient Services Modernization Act would extend by 2 years the Hospital at Home waiver program (S. 3792/ H.R. 7053). The Rural America Health Corps Act (S. 924/H.R. 2130) - support for this legislation which will provide incentives for clinicians to practice in rural health professional shortage areas. Improving Seniors Timely Access to Care Act (S. 3018 / H.R. 3173) - steamline Medicare Advantage Prior Authorization Conrad State 30 and Physician Access Reauthorization Act (S. 1810 / H.R. 3541) Mental and Behavioral Health - Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R. 7666) Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); Inpatient Rehabilitation Facilities - CMS Review Choice Demonstration

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

S.999, Save Rural Hospitals Act and H.R. 4066, the Save Rural Hospitals Act of 2021; issues related to workforce and staffing; issues related to FY23 IPPS proposed rule; reauthorization of the Medicare-Dependent Hospital Program and the Low-Volume Hospital Program; issues related to health care financing and delivery innovation, generally; FY23 Labor-HHS-Education appropriations, community funding projects.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the Medicare Wage Index and hospital price transparency; S.999, Save Rural Hospitals Act of 2021; H.R.4066, To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments.

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

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

Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); behavioral health; Workforce -Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256); Healthcare Workforce Resilience Act (S. 1024); Future Advancement of Academic Nursing Act (S. 246/H.R. 851); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); rural hospital medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130); post-acute care/inpatient rehabilitation facilities - IMPACT Act (TRIA) of 2021 (H.R. 2455),IRF CMS Review Choice Demonstration; 340b Eligibility requirements waiver - H.R. 3203 and S.773; Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better; relief to repay payments received through the Medicare Accelerated and Advance Payments program.

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

Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); behavioral health; Workforce - Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256); Healthcare Workforce Resilience Act (S. 1024); Future Advancement of Academic Nursing Act (S. 246/H.R. 851); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); rural hospital medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130); post-acute care/inpatient rehabilitation facilities - IMPACT Act (TRIA) of 2021 (H.R. 2455),IRF CMS Review Choice Demonstration; 340b Eligibility requirements waiver - H.R. 3203 and S.773; Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better; relief to repay payments received through the Medicare Accelerated and Advance Payments program.

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

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

General health care issues; S. 999/H.R. 4066, Save Rural Hospitals Act of 2021.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General health care issues; S. 999/H.R. 4066, Save Rural Hospitals Act of 2021.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.999, Save Rural Hospitals Act and H.R.4066, the Save Rural Hospitals Act of 2021; issues related to workforce and staffing; issues related to health care financing and delivery innovation, generally; FY23 Labor-HHS-Education appropriations, community funding projects.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the Medicare Wage Index and hospital price transparency; S.999, Save Rural Hospitals Act of 2021; H.R.4066, To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments.

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

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

Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); behavioral health; Workforce -Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256); Healthcare Workforce Resilience Act (S. 1024); Future Advancement of Academic Nursing Act (S. 246/H.R. 851); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); rural hospital medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130); post-acute care/inpatient rehabilitation facilities - IMPACT Act (TRIA) of 2021 (H.R. 2455),IRF CMS Review Choice Demonstration; 340b Eligibility requirements waiver - H.R. 3203 and S.773; Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better; relief to repay payments received through the Medicare Accelerated and Advance Payments program.

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

General health care issues; S. 999/H.R. 4066, Save Rural Hospitals Act of 2021.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General health care issues; S. 999/H.R. 4066, Save Rural Hospitals Act of 2021.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Area wage index - Save Rural Hospitals Act (S.999, H.R. 4066); behavioral health; Workforce - Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256); Healthcare Workforce Resilience Act (S. 1024); Future Advancement of Academic Nursing Act (S. 246/H.R. 851); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); rural hospital medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130); post-acute care/inpatient rehabilitation facilities - IMPACT Act (TRIA) of 2021 (H.R. 2455),IRF CMS Review Choice Demonstration; 340b Eligibility requirements waiver - H.R. 3203 and S.773; Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better; relief to repay payments received through the Medicare Accelerated and Advance Payments program.

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

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

S.999, Save Rural Hospitals Act and H.R.4066, the Save Rural Hospitals Act of 2021; S.773, to enable certain hospitals that were participating in or applied for the drug discount program under Section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; policies related to the Covid-19 response; issues related to workforce and staffing; status of H.R.2471, FY2022 Consolidated Appropriations Act, Division H (Labor-HHS-Education)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the Medicare Wage Index and hospital price transparency; S.999, Save Rural Hospitals Act of 2021; H.R.4066, To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments.

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

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

Area Wage Index - Save Rural Hospitals Act (S. 999, H.R. 4066); Behavioral Health: (regulation) repeal the Institutions for Mental Disease Exclusion, Opioid Workforce Act of 2021 (S. 1438) & Substance Use Disorder Workforce Act of 2021 (H.R. 3441); Workforce: Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256), Healthcare Workforce Resilience Act (S. 1024), Future Advancement of Academic Nursing Act (S. 246/H.R. 851), Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Expand Medicaid coverage for individuals in Tennessee and extend provisions to reduce the cost of the Marketplace coverage for all subsidy-eligible individuals and families; Rural Hospitals: Invest in rural medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130), (regulation) Rural Emergency Hospital (REH) Medicare designation - support payment reform and equity for rural hospitals, including new payment demonstrations; Post-Acute Care / Inpatient Rehabilitation Facilities: Aid payment transition by supporting The Resetting the IMPACT Act (TRIA) of 2021 (H.R. 2455), IRF CMS Review Choice Demonstration; 340B - Waive 340b Eligibility requirements support legislation H.R. 3203 and S. 773; lobbied against Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better Reconciliation bill.

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

Area Wage Index - Save Rural Hospitals Act (S. 999, H.R. 4066); Behavioral Health: (regulation) repeal the Institutions for Mental Disease Exclusion, Opioid Workforce Act of 2021 (S. 1438) & Substance Use Disorder Workforce Act of 2021 (H.R. 3441); Workforce: Resident Physician Shortage Reduction Act of 2021 (S. 834/ H.R. 2256), Healthcare Workforce Resilience Act (S. 1024), Future Advancement of Academic Nursing Act (S. 246/H.R. 851), Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Expand Medicaid coverage for individuals in Tennessee and extend provisions to reduce the cost of the Marketplace coverage for all subsidy-eligible individuals and families; Rural Hospitals: Invest in rural medical residency and health workforce programs - Rural Health Health Corps Act (S. 924/H.R. 2130), (regulation) Rural Emergency Hospital (REH) Medicare designation - support payment reform and equity for rural hospitals, including new payment demonstrations; Post-Acute Care / Inpatient Rehabilitation Facilities: Aid payment transition by supporting The Resetting the IMPACT Act (TRIA) of 2021 (H.R. 2455), IRF CMS Review Choice Demonstration; 340B - Waive 340b Eligibility requirements support legislation H.R. 3203 and S. 773; lobbied against Disproportionate Share Hospital and Uncompensated Care funding cuts in the Build Back Better Reconciliation bill.

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

Issues related to the Medicare Wage Index and hospital price transparency; S.999, Save Rural Hospitals Act of 2021; H.R.4066, To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments.

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

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

S.999, Save Rural Hospitals Act and H.R. 4066, the Save Rural Hospitals Act of 2021; S.773, to enable certain hospitals that were participating in or applied for the drug discount program under Section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Provider Relief Fund relief distribution and other policies related to the Covid-19 response; workforce issues; health care financing and delivery innovation

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1330 - "Patient Access to Higher Quality Health Care Act of 2021" - Oppose legislation that would repeal current law limiting self-referral to physician-owned hospitals. H.R. 2455 - "The Resetting the IMPACT Act (TRIA) of 2021" - Support legislation to refresh the unified PAC PPS timeline and process under the IMPACT Act. S. 999/H.R. 4066 - "Save Rural Hospitals Act of 2021" - Support a national wage index floor of .85 in a non-budget neutral manner. S. 1512 - "Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021" - Advocate in support of the CONNECT Act to expand access to telehealth services. H.R. 4587 - "Value in Health Care Act of 2021" - Support ACO program reforms. S. 1568 / H.R. 4407 - "Technical Reset to Advance the Instruction of Nurses Act" - Support legislation that would direct CMS not to seek repayment from nursing and allied health programs. H.R. 1887 - "Rural Hospital Support Act" - Support rural MDH and LVH program extensions. H.R. 3746 - "Accountable Care In Rural America Act" - Support rural health ACOs. Rural - Seek introduction of legislation that would remove the current 12% DSH payment cap that currently applies to rural hospitals (with some exceptions) as well as urban hospitals under 100 beds. Urged Congress to waive Statutory PAYGO and advocated for extending the 2% Medicare sequester moratorium.

Client expense: $600,000 · Firm income: Not reported

H.R. 1330 - "Patient Access to Higher Quality Health Care Act of 2021" - Oppose legislation that would repeal current law limiting self-referral to physician-owned hospitals. H.R. 2455 - "The Resetting the IMPACT Act (TRIA) of 2021" - Support legislation to refresh the unified PAC PPS timeline and process under the IMPACT Act. S. 999/H.R. 4066 - "Save Rural Hospitals Act of 2021" - Support a national wage index floor of .85 in a non-budget neutral manner. S. 1512 - "Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021" - Advocate in support of the CONNECT Act to expand access to telehealth services. H.R. 4587 - "Value in Health Care Act of 2021" - Support ACO program reforms. S. 1568 / H.R. 4407 - "Technical Reset to Advance the Instruction of Nurses Act" - Support legislation that would direct CMS not to seek repayment from nursing and allied health programs. H.R. 1887 - "Rural Hospital Support Act" - Support rural MDH and LVH program extensions. H.R. 3746 - "Accountable Care In Rural America Act" - Support rural health ACOs. Rural - Seek introduction of legislation that would remove the current 12% DSH payment cap that currently applies to rural hospitals (with some exceptions) as well as urban hospitals under 100 beds. Urged Congress to waive Statutory PAYGO and advocated for extending the 2% Medicare sequester moratorium.

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

S. 999, Save Rural Hospitals Act and H.R. 4066, the Save Rural Hospitals Act of 2021; S. 773, To enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Provider Relief Fund relief distribution and other policies related to the Covid-19 response.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the Medicare Wage Index and hospital price transparency; S.999, Save Rural Hospitals Act of 2021; H.R.4066, To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the Medicare Wage Index and hospital price transparency; S.999, Save Rural Hospitals Act of 2021; H.R.4066, To amend the title XVIII of the Social Security Act to preserve access to rural health care by ensuring fairness in Medicare hospital payments.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

340B - Shared new study estimating the impact on seniors and hospitals of reversing the current Medicare Outpatient Prospective Payment System (OPPS) reimbursement policy for separately payable drugs under the 340B program. Physician Owned Hospitals - H.R. 1330 - "Patient Access to Higher Quality Health Care Act of 2021" - Oppose legislation that would repeal current law limiting self-referral to physician-owned hospitals. Post-Acute Care - H.R. 2455 - "The Resetting the IMPACT Act (TRIA) of 2021" - Support legislation to refresh the unified PAC PPS timeline and process under the IMPACT Act. Support making the MDH and LVH programs permanent. S. 999/H.R. 4066 - "Save Rural Hospitals Act of 2021" - Support a national wage index floor of .85 in a non-budget neutral manner. Prevent PAYGO sequester reductions. S. 1512 - "Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021" - Advocate in support of the CONNECT Act.

Client expense: $650,000 · Firm income: Not reported