Maternal Health Quality Improvement Act of 2021

Legislation and policies relating to: Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention H.R. 66, Comprehensive Access to Robust Insurance Now Guaranteed for Kids (CARING for Kids) Act H.R. 482/S. 350, Newborn Screening Saves Lives Reauthorization Act of 2021 H.R. 485, Stronger Child Abuse Prevention and Treatment Act H.R. 550, Immunization Infrastructure Modernization Act of 2021 H.R. 909/S. 484, Moms Matter Act H.R. 959/S. 346, Black Maternal Health Momnibus Act of 2021 H.R. 1065/S. 1486, Pregnant Workers Fairness Act H.R. 1324/S/ 467, Effective Suicide Screening and Assessment in the Emergency Department Act of 2021 H.R. 1390, Childrens Health Insurance Program Pandemic Enhancement and Relief (CHIPPER) Act H.R. 1620, Violence Against Women Act Reauthorization Act of 2021 H.R. 1791, Childrens Health Insurance Program Permanency (CHIPP) Act H.R. 2094/S. 1301, Promoting Physical Activity for Americans Act H.R. 2347/S. 2691, Strengthening the Vaccines for Children Program Act of 2021 H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act of 2021 H.R. 3182, Safe Sleep for Babies Act of 2021 H.R. 3407/S. 411, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act H.R. 3655, Vaccine Injury Compensation Modernization Act of 2021 H.R. 4128/S. 2209, Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021 H.R. 4217/S. 2779, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act Implementation of the Inflation Reduction Act (P.L. 117-169) provisions related to health equity and mental and behavioral health for patients and health care providers H.R. 5487/S. 3972, Stillbirth Health Improvement and Education (SHINE) for Autumn Act of 2021 H.R. 7076, Supporting Childrens Mental Health Care Access Act of 2022 H.R. 7236, Strengthen Kids Mental Health Now Act of 2022 H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022 H.R. 7780, Mental Health Matters Act H.R. 8296, Womens Health Protection Act of 2022 H.R. 8391, Continuity in Necessary Evaluative Crisis Treatment (CONNECT) Act of 2022 H.R. 8450, Healthy Meals, Healthy Kids Act H.R. 8812/S. 5212, Improving Care and Access to Nurses (I CAN) Act H.R. 8817/S. 4844, National Nursing Workforce Centers Act H.R. 9260, Stop Online Suicide Assistance Forums Act S. 104/H.R. 379, Improving Social Determinants of Health Act of 2021 S. 248/H.R. 804, Family and Medical Insurance Leave (FAMILY) Act S. 499/H.R. 369, Improving Health Insurance Affordability Act of 2021 S. 674, Public Health Infrastructure Saves Lives Act S. 844/H.R. 3109, PHIT Act of 2021 S. 1259, Safe Cribs Act S. 1275/H.R. 2119, Family Violence Prevention and Services Improvement Act of 2021 S. 1658/H.R. 3110, Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act S. 2069/H.R. 4323, Excellence in Mental Health and Addiction Treatment Act S. 3479/H.R. 8151, Building a Sustainable Workforce for Healthy Communities Act S. 3623, Violence Against Women Act Reauthorization Act of 2022 S. 3799, Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act) S. 4170, Mental Health Reform Reauthorization Act of 2022 S. 4472, Health Care Capacity for Pediatric Mental Health Act of 2022

Client expense: Not reported · Firm income: $24,000

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

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

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

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

Issue: Educate Congress and the administration on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. Draft Graduate Medical Education Reform Act Issue: Support increased funding for the National Health Service Corps, Teaching Health Center GME, and National Disaster Medical Service (NDMS) demonstration pilot. Support increased Medicare support for Graduate Medical Education/physician training. Issues: Educate Congress and the administration about the role of academic medicine in the provision of mental and behavioral health care, including initiatives to respond to the opioid epidemic. Support measures to expand access to mental health care and substance use disorder treatment, including funding for training on substance use disorders, pain management, and safe prescribing practices, enhance enforcement of mental health parity laws, increased financial support for integrated behavioral health models. Support the provision of additional Medicare-supported graduate medical education slots for psychiatry and psychiatry sub-specialties. P.L. 117-328, Consolidated Appropriations Act, 2023 Support the provision of 200 additional Medicare-supported graduate medical education (GME) positions. Support the extension of COVID-related telehealth flexibilities. Support elimination or delay of Statutory Pay-As-You-Go (PAYGO) Medicare sequester and eliminating or reducing scheduled cuts to the Physician Fee Schedule. Support one-year of continuous Medicaid coverage for children. Support extension of postpartum Medicaid and CHIP coverage for 12 months. H.R. 1384/ S.445, Mainstreaming Addiction Treatment (MAT) Act of 2021 P.L. 117-328, Consolidated Appropriations Act, 2023, Division FF Issue: Support suspension of waiver requirement for certain providers to prescribe buprenorphine. H.R. 2067, Medication Access and Training Expansion (MATE) Act of 2021 P.L. 117-328, Consolidated Appropriations Act, 2023, Division FF Issue: Oppose legislative mandates dictating medical education curriculum on pain management and addiction. H.R. 7236, Strengthen Kids Mental Health Now Act/ S. 2727 Investing in Kids Mental Health Now Act Issue: Support increasing Medicaid reimbursement rates for pediatric mental health services through a 100% federal match. P.L. 116-22, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 Issues: Support the Hospital Preparedness Program and the reauthorization of the Pandemic and All-Hazards Preparedness Act. Support increased funding authorization levels. Issue: Educate Congress on how the 340B Drug Pricing Program helps safety-net providers to fulfill their missions and care for patients and communities. Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, including restrictions on covered entities use of contract pharmacy to distribute covered drugs. H.R. 4390, Preserving Rules Ordered for the Entities Covered Through 340B Act of 2021 (PROTECT 340B Act) Issue: Support measures to prevent pharmacy benefit managers and commercial insurers from discriminating against 340B covered entities. H.R. 3203/S. 773 Issue: Support policy to allow 340B DSH hospitals to remain eligible to participate in the program throughout the current public health emergency even if their DSH adjustment falls below the current threshold due to changes in payer mix as a result of the COVID-19 pandemic. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Support increased interoperability and exchange of electronic health information and delayed enforcement of information blocking rule until comprehensive guidance is issued. Issue: Support the ongoing refinement of the two new mandatory alternative payment models, the Radiation Oncology Model and End-stage Renal Disease Treatment Choices Model, to better incentivize high-quality care for all patients. H.R. 4128/ S. 2209, Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021 S. 4348, Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act of 2022 P.L. 117-328, Consolidated Appropriations Act, 2023 Issue: Educate Congress on development of Laboratory Developed Tests at academic medical centers and oppose policies that would increase burdensome regulations and negatively impact patients access to care by allowing Food and Drug Administration regulation of the development of Laboratory Developed Tests at academic medical centers. S. 4348, Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act of 2022 H.R. 7667, Food and Drug Amendments of 2022 (FDA22) P.L. 117-328, Consolidated Appropriations Act, 2023 Issue: Support promotion of data sharing and clinical trials results reporting. Support increased clinical trials diversity. Issue: Development of Enhanced Primary Care Pilot Act proposal H.R. 2503 / S. 3039, Social Determinants Accelerator Act of 2021 Issue: Support grants to address social determinants of health H.R. 7585 / S. 4486, Health Equity and Accountability Act Issue: Support programs to improve health equity and address social determinants of health. Issue: Support incentives to encourage the inclusion of implicit bias training in medical education and residency training. Issue: Support congressional investment in the Centers for Medicare and Medicaid Innovation (CMMI) models to reduce maternal mortality and improve maternal health. Issue: Support maternal health initiatives to expand coverage during the postpartum period and expand demonstration project grants. H.R. 959, Black Maternal Health Momnibus Act of 2021 S. 1695 / H.R. 4387, Maternal Health Quality Improvement Act S. 1491/ H.R. 769, Rural MOMs Act H.R. 4387, Maternal Health Quality Improvement Act of 2021 H.R. 925 / S. 347, Data to Save Moms Act Issue: Support legislative efforts to improve maternal health and reduce rates of maternal mortality, including the Momnibus. Support legislative initiatives to improve data collection to improve maternal health equity. P.L. 117-159, Bipartisan Safer Communities Act Issue: Support policies to promote firearm safety, universal background checks, violence prevention programs, extreme risk protection orders, child access safety laws, reinstating assault weapons ban, data infrastructure, hospital based and community violence intervention programs, and programs to address mental and behavioral health impact of gun violence. Issue: Support funding for Community Violence Interventions / Hospital Based Violence Intervention Programs P.L. 117-105, Dr. Lorna Breen Health Care Provider Protection Act Issue: Support grants directed at improving clinician burnout and well-being. Issue: Provide feedback on implementation of the Provider Relief Fund. Support extension for use of PRF funds. Issue: Support improvements to the Medicare Accelerated and Advance Payment Programs, including delaying recoupment of MAAP loans. Issue: Support extension of public health emergency declaration. Issue: Provide feedback on COVID-19 and pandemic response. Provide feedback on monkeypox response including testing. S. 3799, PREVENT Pandemics Act P.L. 117-328, Consolidated Appropriations Act, 2023, Division FF Issue: Provide feedback on pandemic preparedness legislation, urge inclusion of provisions to support academic medical centers preparedness activities. Issue: Support establishment of regional pandemic response centers, stronger linkages between public health and academic medicine, and the role of medical students and academic medical centers in administering COVID vaccines. Issue: Support efforts of academic medical centers to respond to public health threats such as monkeypox and COVID-19. Urge establishment and implementation of robust national testing strategy; functional, redundant, and transparent supply chain; improved federal coordination; investments in public health and health care human and other resources; data modernization initiatives; and other actions to improve current and future pandemic response. H.R. 708, S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act Issue: Support for a temporary uniform licensing standard for all practitioners in all states throughout the COVID-19 public health emergency S. 674 Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Support ensuring patients are put first, that conscience protections align with medical professionalism standards, and oppose interference in the patient-physician relationship. Issue: Support increased interoperability and exchange of electronic health information. Support delay of enforcement beyond April 2021. H.R. 6000, Cures 2.0 Act Issue: Provide feedback on provisions related to public health, patients and caregivers, FDA, CMS, and research, and ARPA-H. Issue: Promote strategies to strengthen the health, public health, and research workforces. H.R. 3671, Doctors of Community Act Issue: Discuss authorization of the Teaching Health Center Graduate Medical Education program. H.R. 8131, Increasing Competition for Medical Residency Act Issue: Educate Congress on the medical education and training continuum, the annual residency Match, and the role of the National Resident Matching Program (NRMP) in medical education and residency. Issue: Provide guidance on the implementation of the No Surprises Act. Issue: Provide feedback on proposed modifications to the HIPAA privacy rule. H.R. 5035 / S. 2982, Child Suicide Prevention and Lethal Means Safety Act Issue: Support legislation to provide grants to improve suicide prevention and lethal means safety. Issue: Inform Congress and Administration about medical education on caring for older adults, nutrition, climate change, stigma around addiction, reproductive health, and accelerated medical education training programs. Issue: Provide feedback on efforts of the academic medicine community to address climate change and decarbonization. Issue: Support efforts of teaching hospitals to promote patient safety and high-quality care. H.R. 7152/ S.3534, The Tracking Pathogens Act P.L. 117-328, Consolidated Appropriations Act, 2023, Division FF Issue: Support expansion of CDC activities related to genomic sequencing of pathogens. Issue: Support reignition of Cancer Moonshot. H.R. 7961, Safety from Violence for Healthcare Employees (SAVE) Act Issue: Support statutory protections against violence and intimidation for health care workers and provide grants for hospital programs aimed at preventing violence in health care settings. P.L. 117-263, James M. Inhofe National Defense Authorization Act for Fiscal Year 2023 Issue: Support a one year pause in military medical billet reductions in the Military Health System.

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Natl Institutes of Health (NIH), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Vice President of the U.S., White House Office

Momnibus Legislation Medicaid Postpartum Coverage Extension MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act H.R. 3352, Midwives for Maximizing Optimal Maternity Services

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation Medicaid Postpartum Coverage Extension MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act H.R. 3352, Midwives for Maximizing Optimal Maternity Services

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Practice Support/Grants to Practice Foreign physician immigration status Medical liability H.R. 7259, Medical Controlled Substances Transportation Act of 2022: to enable physicians to more easily transport controlled substances safely and legally across state lines H.R. 133, the Consolidated Appropriations Act, 2021: No Surprises Act, surprise medical billing H.R. 2630, Extending Temporary Emergency Scheduling of Fentanyl Analogues Act: Opioids H.R. 3502, Protecting People From Surprise Medical Bills Act: Surprise Medical Bills S. 445, Mainstreaming Addiction Treatment Act of 2021: Opioids H.R. 4387, Maternal Health Quality Improvement Act of 2021: Maternal health H.R. 1565, Saving Lives, Saving Costs S. 1475, Saving Lives, Saving Costs S. 610, Dr. Lorna Breen Health Care Provider Protection Act: Physician wellness H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act: Physician wellness S. 987, CARA 3.0 Act of 2021: Opioids H.R. 3259, NOPAIN Act: Opioids S. 586, NOPAIN Act: Opioids S. 1292, Non-Opioid Directive Act: Opioids H.R. 7961, SAVE Act: To protect hospital personnel from violence, and for other purposes. FY 2021 LHHS Appropriations: Fiscal Year 2021 Appropriations for Subcommittee on Labor, Health and Human Services Pre-authorization; prior authorization Affordable Care Act reform efforts Medical Controlled Substances Transportation 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care Resident Education Deferred Interest Act (REDI Act): Student loan relief Student Loan Forgiveness for Frontline Health Workers Act: Student loan relief H.R. 842, Protecting the Right to Organize Act of 2021: PRO Act, labor protections 21st Century Cures Initiative H.R. 4369, National Centers of Excellence in Continuous Pharmaceutical Manufacturing Act: Drug shortages DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Ketamine use by law enforcement Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Brain health Certified Anesthesiologist Assistants Blood management Funding for physician practices impacted by the cancellation of elective surgeries, unique role of anesthesiologists in responding to COVID-19 pandemic, medical liability, scope of Practice (waiver of federal supervision requirement under the Emergency Declaration), insurance moratorium; COVID Update Memorandum 4/21/20 Long COVID research Anesthesia workforce shortages CDC Opioid Prescribing Guideline

Client expense: $270,000 · Firm income: Not reported

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

Continuing Appropriations Act, 2023 (H.R. 2617) Inflation Reduction Act of 2022 (H.R. 5376) Restoring Hope for Mental Health and Well-Being Act of 2022 (HR 7666) Healthcare Workforce Resilience Act of 2021 Maternal health: MOMMAs Act S. 411/HR 3407; Black Maternal Health Omnibus Act of 2021 S. 346/H.R. 959; Data to Save Moms Act S. 347/HR 925; IMPACT to Save Moms Act S 1675/HR 4387; Maternal Health Quality Improvement Act S. 1675/H.R. 4387 Conrad State 30 & Physician Access Reauthorization Act S. 1810/H.R. 3541 Public Health and Social Services Emergency Fund Regulatory relief in light of coronavirus Transparency (No Surprises Act regulations; public posting of hospital charges) 340B Drug Pricing Program Strengthening Americas Health Care Readiness Act (S. 54) Social Determinants Accelerator Act (H.R. 2503), Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act (S. 509) No Surprises Act regulations Protecting Providers Everywhere in America Act (S. 308/H.R. 1436) Behavioral health reimbursement and policies (Child Suicide Prevention and Lethal Means Safety Act - H.R. 5035; Childrens Mental Health Infrastructure Act - H.R. 4945; Helping Kids Cope Act - H.R. 4944; Restoring Hope for Mental Health and Well-Being Act of 2022 (HR 7666)) Public health emergency designation FAAN Future Advancement of Academic Nursing (FAAN) Act of 2022

Client expense: $200,000 · Firm income: Not reported

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

S. 411: MOMMA Act - Improve data collection, interventions, and expanded access for postpartum women S. 464/HR 2163: Safe Step Act-Implement transparency guidelines for step-therapy utilization S.1975/H.R. 3755: Womens Health Protection Act - Protect patient-physician relationship by allowing physicians to provide evidence-based womens health care S.1988: Protecting Rural Teleheath Access Act - Waive geographic restrictions and offer audio-only appointments S. 1893: Rural Physician Workforce Production Act - Provide federal support for rural residency training S1958/HR3671:DOC Act - Permanent authorization of THCGME program HR 379 Improving Social Determinants of Health Act: Would create a new SDoH program at the CDC HR 959: Black Maternal Health Momnibus Act - Comprehensive reforms to address maternal health challenges HR 976: Ensuring Transparent Honest Information on COVID-19 Act - Requires COVID-19 data reporting, including demographic information to the CDC, by states & localities & funds a study to examine public health data & infrastructure during & after the COVID-19 PHE. HR 1319: American Rescue Plan - Expansion of ACA coverage, investments in public health workforce, funding for COVID-19 response HR 1384: Mainstreaming Addiction Treatment Act of 2021- Eliminated the x-waiver HR 1848: LIFT America Act - Enhancing public health infrastructure, improve laboratory infrastructure, update care facilities, improve broadband infrastructure, and address social determinants of health HR 2125: Quit Because of Covid 19 Act - Would ensure that all Medicaid and CHIP enrollees have access to proven tobacco cessation treatments. HR 2347: Strengthening Vaccines for Childrens Act - Modifications to improve the Vaccine for Children (VFC) program HR 2418: Student Loan Forgiveness for Frontline Health Workers- Would forgive outstanding federal and private student loan debt for frontline physicians H.R. 5218: Collaborate in an Orderly and Cohesive Manner Act H.R. 4387/S.1675: Maternal Health Quality Improvement Act H.R. 5054: Physicians Serving Patients Act of 2021 H.R. 4770: Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act H.R. 5376: Build Back Better Act H.R. 4387/S. 1675: Maternal Health Quality Improvement Act H.R. 5218: Collaborate in an Orderly and Cohesive Manner Act H.R. 5541: Primary and Virtual Care Affordability Act S. 128: Primary Care Enhancement Act No Bill No: Physicians Serving Patients Act of 2021 No Bill No.: Congressional Primary Care Caucus;117th Congress membership in the bipartisan CPCC No Bill No.: Teaching Health Centers GME; Community Health Centers- National Health Service Corps; Special Diabetes Program; Special Diabetes Program for Indians - Increased funding and allocation of resources for teaching health center programs No Bill No.: Primary Care Patient Protection Act - Create a primary care benefit in high deductible health plans No Bill No.: No Surprise Bills for New Moms - Require health plans to cover newborns under mothers coverage for set time, SEP for enrollment post childbirth, and notification requirements No Bill No.: FY 2022 Appropriations Requests - CDC Programs (Climate/Health; Gun Violence Research; vaccine infrastructure); HRSA; AHRQ; CMS No Bill No.: Rural MOMS Act-Demonstration program to train physicians about maternal care in rural communities No Bill No.: COVID-19 Safe Birthing Act-Expand maternal telehealth for Medicaid beneficiaries; Medicaid/CHP post-partum coverage extension to one year No Bill No.: Anti-Racism in Public Health Act-Direct CDC to declare racism a public health crisis; establish a CDC-based center for addressing violence prevention No Bill No.: Equality Act-Provide affirmative, statutory nondiscrimination protections for LGBTQ Americans No Bill No.: Covid 19 vaccinations - Ensure Primary Care Physicians can access COVID-19 vaccines. No Bill No.: Telehealth Expansion - Preserve key telehealth flexibilities beyond COVID-19 PHE Affordable Insulin Now Act FY22 COVID-19 supplemental H.R. 7232: 9-8-8 and Parity Assistance Act Prevent Pandemics Act H.R. 7076: Supporting Children's Mental Health Care Access Act H.R. 3085: Equity in Neuroscience and Alzheimer's Clinical Trials Act H.R. 6584: Diverse and Equitable Participation in Clinical Trials Act H.R. 4122/S. 3658: REDI Act H.R. 1667: Dr. Lorna Breen Health Care Provider Protection Act S. 1893: Workforce Production Act of 2021 H.R. 7894/S.4347: Affordability is Access Act H.R. 8297: Ensuring Access to Abortion Act S.4306: Improving Access to Behavioral Health Integration Act S. 4170: Mental Health Reform Reauthorization Act H.R. 7666: Restoring Hope for Mental Health and Well-Being Act H.R. 7232: 9-8-8 and Parity Assistance Act H.R. 7076: Supporting Children's Mental Health Care Access Act S. 4408: Health and Location Data Protection Act No Bill No.: Behavioral health integration w/i primary care H.R. 5376: Inflation Reduction Act S. 198: Data Mapping to Save Moms' Lives Act H.R. 4040: Advancing Telehealth Beyond COVID-19 Act of 2021 Consolidated Appropriations Act of 2023

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

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

H.R. 5487 - Value in Health Care Act of 2021 S. 2652 / H.R. 5067 - Preserving Patient Access to Home Infusion Act S.308 / H.R.1436 - PPE in America Act S.1260 - United States Innovation and Competition Act of 2021 S. 936 / H.R. 5502 - INFORM Consumers Act S. 2648 - Rural ACO Improvement Act S. 1574 / H.R.5632 - Long-Term Care Pharmacy Definition Act S. 834 / H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R.3173 / S 3018 - Improving Seniors Timely Access to Care Act of 2021 H.R. 3746 - Accountable Care in Rural America Act H.R. 959 / S. 364 - Black Maternal Health Momnibus Act of 2021 H.R. 4387 / S. 1675 - Maternal Health Quality Improvement Act of 2021 S. 168 / H.R. 708 - Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act S. 150 - Ensuring Parity in MA for Audio Only-Telehealth Act S. 3146 - The Protecting Patients from Counterfeit Medical Devices Act S. 3799 - The PREVENT Pandemics Act H.R. 6520 - The Medical and Health Stockpile Accountability Act of 2022, automated data collection infrastructure for healthcare supply chain S. 3416 - The Protecting Patients from Counterfeit Medical Devices Act S. 3493 - Drug Shortages Shelf Life Extension Act H.R. 4521 - America COMPETES Act of 2022 S.610 - Protecting Medicare and American Farmers from Sequester Cuts Act H.R.3684 - Infrastructure Investment and Jobs Act H.R. 4735 / S. 2493 - The Provider Relief Extension Act H.R. 3589 - Better Way for Providers To Repay Act of 2021 H.R. 3203 / S. 773 - To allow hospitals that were participating in or applied for the 340B drug discount program before the public health emergency to temporarily maintain eligibility H.R. 7961 - Safety from Violence for Healthcare Employees (SAVE) Act H.R. 7410 - The American Made Medicine Act H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act H.R. 8747 - Assistance for Rural Community Hospitals (ARCH) Act H.R. 8800 - Supporting Medicare Providers Act of 2022 H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act FY 2022 Omnibus Appropriations Bill S. 5249 - Preserving Patient Access to Value-Based Care Act 340B Drug Discount Program eligbility Incentivize Domestic Manufacturing Hospital Infrastructure Support FDA User Fee Reauthorization Bills Healthcare workforce (Graduate medical education , health professional training programs, recruitment and retension incentives) Medicare provider payment cuts (Medicare sequestration cuts, physician fee schedule 3.75% reduction due to evaluation & management code increases/budget neturality adjustment, Pay-as-You-Go reductions due to American Rescue Plan) Climate change healthcare impact HHS FY 2023 appropriations - Removal of a ban on using federal funds for implementing a unique patient identification system (Section 510) and fuding for Childrens Hospitals Graduate Medical Education (CHGME) Program ACO Assignment Bill NQF/Quality Measurement funding authorization Preparing for the next pandemic and supply chain resiliency

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Legislation and policies relating to: Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention H.R. 66, Comprehensive Access to Robust Insurance Now Guaranteed for Kids (CARING for Kids) Act H.R. 482/S. 350, Newborn Screening Saves Lives Reauthorization Act of 2021 H.R. 485, Stronger Child Abuse Prevention and Treatment Act H.R. 550, Immunization Infrastructure Modernization Act of 2021 H.R. 909/S. 484, Moms Matter Act H.R. 959/S. 346, Black Maternal Health Momnibus Act of 2021 H.R. 1065/S. 1486, Pregnant Workers Fairness Act H.R. 1324/S/ 467, Effective Suicide Screening and Assessment in the Emergency Department Act of 2021 H.R. 1390, Childrens Health Insurance Program Pandemic Enhancement and Relief (CHIPPER) Act H.R. 1620, Violence Against Women Act Reauthorization Act of 2021 H.R. 1791, Childrens Health Insurance Program Permanency (CHIPP) Act H.R. 2094/S. 1301, Promoting Physical Activity for Americans Act H.R. 2347/S. 2691, Strengthening the Vaccines for Children Program Act of 2021 H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act of 2021 H.R. 3182, Safe Sleep for Babies Act of 2021 H.R. 3407/S. 411, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act H.R. 3655, Vaccine Injury Compensation Modernization Act of 2021 H.R. 4217/S. 2779, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act H.R. 5376, Inflation Reduction Act - provisions related to health equity and mental and behavioral health for patients and health care providers H.R. 5487/S. 3972, Stillbirth Health Improvement and Education (SHINE) for Autumn Act of 2021 H.R. 5585, Advanced Research Projects Agency-Health (ARPA-H) Act H.R. 7076, Supporting Childrens Mental Health Care Access Act of 2022 H.R. 7236, Strengthen Kids Mental Health Now Act of 2022 H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022 H.R. 7780, Mental Health Matters Act H.R. 8296, Womens Health Protection Act of 2022 H.R. 8391, Continuity in Necessary Evaluative Crisis Treatment (CONNECT) Act of 2022 H.R. 8450, Healthy Meals, Healthy Kids Act S. 104/H.R. 379, Improving Social Determinants of Health Act of 2021 S. 248/H.R. 804, Family and Medical Insurance Leave (FAMILY) Act S. 499/H.R. 369, Improving Health Insurance Affordability Act of 2021 S. 674, Public Health Infrastructure Saves Lives Act S. 844/H.R. 3109, PHIT Act of 2021 S. 1259, Safe Cribs Act S. 1275/H.R. 2119, Family Violence Prevention and Services Improvement Act of 2021 S. 1658/H.R. 3110, Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act S. 2069/H.R. 4323, Excellence in Mental Health and Addiction Treatment Act S. 3479/H.R. 8151, Building a Sustainable Workforce for Healthy Communities Act S. 3623, Violence Against Women Act Reauthorization Act of 2022 S. 3799, Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act) S. 4170, Mental Health Reform Reauthorization Act of 2022

Client expense: Not reported · Firm income: $24,000

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

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

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

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

Issue: Educate Congress and the administration on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. Draft Graduate Medical Education Reform Act Issue: Support increased funding for the National Health Service Corps, Teaching Health Center GME, and National Disaster Medical Service (NDMS) demonstration pilot. Support increased Medicare support for Graduate Medical Education/physician training. Issues: Educate Congress and the administration about the role of academic medicine in the provision of mental and behavioral health care, including initiatives to respond to the opioid epidemic. Support measures to expand access to mental health care and substance use disorder treatment, including funding for training on substance use disorders, pain management, and safe prescribing practices, enhance enforcement of mental health parity laws, increased financial support for integrated behavioral health models, and the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). Support Senate Finance Committee proposal to provide 400 additional Medicare-supported graduate medical education slots for psychiatry and psychiatry sub-specialties. H.R. 1384/ S.445 Mainstreaming Addiction Treatment (MAT) Act of 2021 Issue: Support suspension of waiver requirement for certain providers to prescribe buprenorphine. H.R. 2067 Medication Access and Training Expansion Act of 2021 Issue: Oppose legislative mandates dictating medical education curriculum on pain management and addiction. H.R. 7236 Strengthen Kids Mental Health Now Act Issue: Support increasing Medicaid reimbursement rates for pediatric mental health services through a 100% federal match. P.L. 116-22, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 Issues: Support the Hospital Preparedness Program and the reauthorization of the Pandemic and All-Hazards Preparedness Act. Support increased funding authorization levels. Issue: Educate Congress on how the 340B Drug Pricing Program helps safety-net providers to fulfill their missions and care for patients and communities. Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, including not providing 340B discounts on covered drugs purchased at community pharmacies. H.R. 4390 Preserving Rules Ordered for the Entities Covered Through 340B Act of 2021 (PROTECT 340B Act) Issue: Support measures to prevent pharmacy benefit managers and commercial insurers from discriminating against 340B covered entities. H.R. 3203/S. 773 Issue: Support policy to allow 340B DSH hospitals to remain eligible to participate in the program throughout the current public health emergency even if their DSH adjustment falls below the current threshold due to changes in payor mix as a result of the COVID-19 pandemic. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Support increased interoperability and exchange of electronic health information and delayed enforcement of information blocking rule until comprehensive guidance is issued. Issue: Support the ongoing refinement of the two new mandatory alternative payment models, the Radiation Oncology Model and End-stage Renal Disease Treatment Choices Model, to better incentivize high-quality care for all patients. H.R. 4128/ S. 2209 Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021 S. 4348, Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act of 2022 Issue: Educate Congress on development of Laboratory Developed Tests at academic medical centers and oppose policies that would increase burdensome regulations and negatively impact patients access to care by allowing Food and Drug Administration regulation of the development of Laboratory Developed Tests at academic medical centers. S. 4348, Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act of 2022 H.R. 7667, Food and Drug Amendments of 2022 (FDA22) Issue: Support promotion of data sharing and clinical trials results reporting. Support increased clinical trials diversity. Issue: Development of Enhanced Primary Care Pilot Act proposal Issue: Support initiatives of hospitals to promote affordable housing in local communities and eliminate other social determinants of health to improve health equity. H.R. 2503 Social Determinants Accelerator Act of 2021 Issue: Support grants to address social determinants of health H.R. 7585 / S. 4486, Health Equity and Accountability Act Issue: Support programs to improve health equity and address social determinants of health. Issue: Support incentives to encourage the inclusion of implicit bias training in medical education and residency training. Issue: Support congressional investment in the Centers for Medicare and Medicaid Innovation (CMMI) models to reduce maternal mortality and improve maternal health. Issue: Support maternal health initiatives to expand coverage for postpartum women and expand demonstration project grants. H.R. 959 Black Maternal Health Momnibus Act of 2021 S. 1695 / H.R. 4387 Maternal Health Quality Improvement Act S. 1491/ H.R. 769 Rural MOMs Act H.R. 4387 Maternal Health Quality Improvement Act of 2021 H.R. 5376, Build Back Better Act H.R. 925 / S. 347 Data to Save Moms Act Issue: Support legislative efforts to improve maternal health and reduce rates of maternal mortality, including the Momnibus. Support legislative initiatives to improve data collection to improve maternal health equity. P.L. 117-159, Bipartisan Safer Communities Act Issue: Support policies to promote firearm safety, universal background checks, violence prevention programs, extreme risk protection orders, child access safety laws, reinstating assault weapons ban, data infrastructure, hospital based and community violence intervention programs, and programs to address mental and behavioral health impact of gun violence. Issue: Support funding for Community Violence Interventions/ Hospital Based Violence Intervention Programs P.L. 117-105, Dr. Lorna Breen Health Care Provider Protection Act Issue: Support grants directed at improving clinician burnout and well-being. Issue: Provide feedback on implementation of the Provider Relief Fund. Support extension for use of PRF funds. Issue: Support improvements to the Medicare Accelerated and Advance Payment Programs, including delaying recoupment of MAAP loans. Issue: Support extension of public health emergency declaration. Issue: Provide feedback on COVID-19 and pandemic response. Provide feedback on monkeypox response including testing. S. 3799, PREVENT Pandemics Act Issue: Provide feedback on pandemic preparedness legislation, urge inclusion of provisions to support academic medical centers preparedness activities. Issue: Support establishment of regional pandemic response centers, stronger linkages between public health and academic medicine, and the role of medical students and academic medical centers in administering COVID vaccines. H.R. 8131 Increasing Competition for Medical Residency Act Issue: Educate Congress on the medical education and training continuum, the annual residency Match, and the role of the National Resident Matching Program (NRMP) in medical education and residency. Issue: Support efforts of academic medical centers to respond to public health threats such as monkeypox and COVID-19. Urge establishment and implementation of robust national testing strategy; functional, redundant, and transparent supply chain; improved federal coordination; investments in public health and health care human and other resources; data modernization initiatives; and other actions to improve current and future pandemic response. H.R. 708, S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act Issue: Support for a temporary uniform licensing standard for all practitioners in all states throughout the COVID-19 public health emergency S. 674 Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Support ensuring patients are put first, that conscience protections align with medical professionalism standards, and oppose interference in the patient-physician relationship. Issue: Support increased interoperability and exchange of electronic health information. Support delay of enforcement beyond April 2021. H.R. 6000, Cures 2.0 Act Issue: Provide feedback on provisions related to public health, patients and caregivers, FDA, CMS, and research, and ARPA-H. Issue: Promote strategies to strengthen the health, public health, and research workforces. H.R. 3671, Doctors of Community Act Issue: Discuss authorization of the Teaching Health Center Graduate Medical Education program. Issue: Provide guidance on the implementation of the No Surprises Act. Issue: Provide feedback on proposed modifications to the HIPAA privacy rule. H.R. 5035, S. 2982 Child Suicide Prevention and Lethal Means Safety Act Issue: Support legislation to provide grants to improve suicide prevention and lethal means safety. Issue: Inform Congress and Administration about medical education on caring for older adults, nutrition, climate change, stigma around addiction, reproductive health, and accelerated medical education training programs. Issue: Provide feedback on efforts of the academic medicine community to address climate change and decarbonization. H.R. 7152/ S.3534, The Tracking Pathogens Act Issue: Support expansion of CDC activities related to genomic sequencing of pathogens. Issue: Support reignition of Cancer Moonshot. H.R. 7961 - Safety from Violence for Healthcare Employees (SAVE) Act Issue: Support statutory protections against violence and intimidation for healthcare workers and provide grants for hospital programs aimed at preventing violence in healthcare settings. Issue: Support a one-year pause in military medical billet reductions in the Military Health System.

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of the Vice President of the United States, SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023 (H.R. 6833) Inflation Reduction Act of 2022 (H.R. 5376) Restoring Hope for Mental Health and Well-Being Act of 2022 (HR 7666) Healthcare Workforce Resilience Act of 2021 Maternal health: MOMMAs Act S. 411/HR 3407; Black Maternal Health Omnibus Act of 2021 S. 346/H.R. 959; Data to Save Moms Act S. 347/HR 925; IMPACT to Save Moms Act S 1675/HR 4387; Maternal Health Quality Improvement Act S. 1675/H.R. 4387 Conrad State 30 & Physician Access Reauthorization Act S. 1810/H.R. 3541 Public Health and Social Services Emergency Fund Regulatory relief in light of coronavirus Transparency (No Surprises Act regulations; public posting of hospital charges) 340B Drug Pricing Program Strengthening Americas Health Care Readiness Act (S. 54) Social Determinants Accelerator Act (H.R. 2503), Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act (S. 509) No Surprises Act regulations Protecting Providers Everywhere in America Act (S. 308/H.R. 1436) Behavioral health reimbursement and policies (Child Suicide Prevention and Lethal Means Safety Act - H.R. 5035; Childrens Mental Health Infrastructure Act - H.R. 4945; Helping Kids Cope Act - H.R. 4944; Restoring Hope for Mental Health and Well-Being Act of 2022 (HR 7666)) Public health emergency designation FAAN Future Advancement of Academic Nursing (FAAN) Act of 2022

Client expense: $200,000 · Firm income: Not reported

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

S. 411: MOMMA Act - Improve data collection, interventions, and expanded access for postpartum women S. 464/HR 2163: Safe Step Act-Implement transparency guidelines for step-therapy utilization S.1975/H.R. 3755: Womens Health Protection Act - Protect patient-physician relationship by allowing physicians to provide evidence-based womens health care S.1988: Protecting Rural Teleheath Access Act - Waive geographic restrictions and offer audio-only appointments S. 1893: Rural Physician Workforce Production Act - Provide federal support for rural residency training S1958/HR3671:DOC Act - Permanent authorization of THCGME program HR 379 Improving Social Determinants of Health Act: Would create a new SDoH program at the CDC HR 959: Black Maternal Health Momnibus Act - Comprehensive reforms to address maternal health challenges HR 976: Ensuring Transparent Honest Information on COVID-19 Act - Requires COVID-19 data reporting, including demographic information to the CDC, by states & localities & funds a study to examine public health data & infrastructure during & after the COVID-19 PHE. HR 1319: American Rescue Plan - Expansion of ACA coverage, investments in public health workforce, funding for COVID-19 response HR 1384: Mainstreaming Addiction Treatment Act of 2021- Eliminated the x-waiver HR 1848: LIFT America Act - Enhancing public health infrastructure, improve laboratory infrastructure, update care facilities, improve broadband infrastructure, and address social determinants of health HR 2125: Quit Because of Covid 19 Act - Would ensure that all Medicaid and CHIP enrollees have access to proven tobacco cessation treatments. HR 2347: Strengthening Vaccines for Childrens Act - Modifications to improve the Vaccine for Children (VFC) program HR 2418: Student Loan Forgiveness for Frontline Health Workers- Would forgive outstanding federal and private student loan debt for frontline physicians H.R. 5218: Collaborate in an Orderly and Cohesive Manner Act H.R. 4387/S.1675: Maternal Health Quality Improvement Act H.R. 5054: Physicians Serving Patients Act of 2021 H.R. 4770: Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act H.R. 5376: Build Back Better Act H.R. 4387/S. 1675: Maternal Health Quality Improvement Act H.R. 5218: Collaborate in an Orderly and Cohesive Manner Act H.R. 5541: Primary and Virtual Care Affordability Act S. 128: Primary Care Enhancement Act No Bill No: Physicians Serving Patients Act of 2021 No Bill No.: Congressional Primary Care Caucus;117th Congress membership in the bipartisan CPCC No Bill No.: Teaching Health Centers GME; Community Health Centers- National Health Service Corps; Special Diabetes Program; Special Diabetes Program for Indians - Increased funding and allocation of resources for teaching health center programs No Bill No.: Primary Care Patient Protection Act - Create a primary care benefit in high deductible health plans No Bill No.: No Surprise Bills for New Moms - Require health plans to cover newborns under mothers coverage for set time, SEP for enrollment post childbirth, and notification requirements No Bill No.: FY 2022 Appropriations Requests - CDC Programs (Climate/Health; Gun Violence Research; vaccine infrastructure); HRSA; AHRQ; CMS No Bill No.: Rural MOMS Act-Demonstration program to train physicians about maternal care in rural communities No Bill No.: COVID-19 Safe Birthing Act-Expand maternal telehealth for Medicaid beneficiaries; Medicaid/CHP post-partum coverage extension to one year No Bill No.: Anti-Racism in Public Health Act-Direct CDC to declare racism a public health crisis; establish a CDC-based center for addressing violence prevention No Bill No.: Equality Act-Provide affirmative, statutory nondiscrimination protections for LGBTQ Americans No Bill No.: Covid 19 vaccinations - Ensure Primary Care Physicians can access COVID-19 vaccines. No Bill No.: Telehealth Expansion - Preserve key telehealth flexibilities beyond COVID-19 PHE Affordable Insulin Now Act FY22 COVID-19 supplemental H.R. 7232: 9-8-8 and Parity Assistance Act Prevent Pandemics Act H.R. 7076: Supporting Children's Mental Health Care Access Act H.R. 3085: Equity in Neuroscience and Alzheimer's Clinical Trials Act H.R. 6584: Diverse and Equitable Participation in Clinical Trials Act H.R. 4122/S. 3658: REDI Act H.R. 1667: Dr. Lorna Breen Health Care Provider Protection Act S. 1893: Workforce Production Act of 2021 H.R. 7894/S.4347: Affordability is Access Act H.R. 8297: Ensuring Access to Abortion Act S.4306: Improving Access to Behavioral Health Integration Act S. 4170: Mental Health Reform Reauthorization Act H.R. 7666: Restoring Hope for Mental Health and Well-Being Act H.R. 7232: 9-8-8 and Parity Assistance Act H.R. 7076: Supporting Children's Mental Health Care Access Act S. 4408: Health and Location Data Protection Act No Bill No.: Behavioral health integration w/i primary care H.R. 5376: Inflation Reduction Act

Client expense: $746,388 · Firm income: Not reported

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

Practice Support/Grants to Practice Foreign physician immigration status Medical liability H.R. 7259, Medical Controlled Substances Transportation Act of 2022: to enable physicians to more easily transport controlled substances safely and legally across state lines H.R. 133, the Consolidated Appropriations Act, 2021: No Surprises Act, surprise medical billing H.R. 2630, Extending Temporary Emergency Scheduling of Fentanyl Analogues Act: Opioids H.R. 3502, Protecting People From Surprise Medical Bills Act: Surprise Medical Bills S. 445, Mainstreaming Addiction Treatment Act of 2021: Opioids H.R. 4387, Maternal Health Quality Improvement Act of 2021: Maternal health H.R. 1565, Saving Lives, Saving Costs S. 1475, Saving Lives, Saving Costs S. 610, Dr. Lorna Breen Health Care Provider Protection Act: Physician wellness H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act: Physician wellness S. 987, CARA 3.0 Act of 2021: Opioids H.R. 3259, NOPAIN Act: Opioids S. 586, NOPAIN Act: Opioids S. 1292, Non-Opioid Directive Act: Opioids H.R. 7961, SAVE Act: To protect hospital personnel from violence, and for other purposes. FY 2021 LHHS Appropriations: Fiscal Year 2021 Appropriations for Subcommittee on Labor, Health and Human Services Pre-authorization; prior authorization Affordable Care Act reform efforts Medical Controlled Substances Transportation 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care Resident Education Deferred Interest Act (REDI Act): Student loan relief Student Loan Forgiveness for Frontline Health Workers Act: Student loan relief H.R. 842, Protecting the Right to Organize Act of 2021: PRO Act, labor protections 21st Century Cures Initiative H.R. 4369, National Centers of Excellence in Continuous Pharmaceutical Manufacturing Act: Drug shortages DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Ketamine use by law enforcement Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Brain health Certified Anesthesiologist Assistants Blood management Funding for physician practices impacted by the cancellation of elective surgeries, unique role of anesthesiologists in responding to COVID-19 pandemic, medical liability, scope of Practice (waiver of federal supervision requirement under the Emergency Declaration), insurance moratorium; COVID Update Memorandum 4/21/20 Long COVID research

Client expense: $350,000 · Firm income: Not reported

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

H.R. 5487 - Value in Health Care Act of 2021 S. 2652/H.R. 5067 - Preserving Patient Access to Home Infusion Act H.R. 6520 - The Medical and Health Stockpile Accountability Act of 2022, automated data collection infrastructure for healthcare supply chain S.308 / H.R.1436 - PPE in America Act S.1260 - United States Innovation and Competition Act of 2021 S. 936 / H.R. 5502 - INFORM Consumers Act S. 2648 - Rural ACO Improvement Act S. 1574/H.R.5632 - Long-Term Care Pharmacy Definition Act H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act S. 834 / H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R.3173 / S 3018 - Improving Seniors Timely Access to Care Act of 2021 H.R. 3746 - Accountable Care in Rural America Act H.R. 959 / S. 364 - Black Maternal Health Momnibus Act of 2021 H.R. 4387 / S. 1675 - Maternal Health Quality Improvement Act of 2021 S. 168 / H.R. 708 - Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act S. 150 - Ensuring Parity in MA for Audio Only-Telehealth Act S. 3799 - The PREVENT Pandemics Act S. 3416 - The Protecting Patients from Counterfeit Medical Devices Act S. 3493 - Drug Shortages Shelf Life Extension Act H.R. 4521 - America COMPETES Act of 2022 S.610 - Protecting Medicare and American Farmers from Sequester Cuts Act H.R.3684 - Infrastructure Investment and Jobs Act H.R. 4735/S. 2493 - The Provider Relief Extension Act H.R. 3589 - Better Way for Providers To Repay Act of 2021 H.R. 3203 / S. 773 - To allow hospitals that were participating in or applied for the 340B drug discount program before the public health emergency to temporarily maintain eligibility H.R. 7961 - Safety from Violence for Healthcare Employees (SAVE) Act H.R. 7410 - The American Made Medicine Act Hospital Infrastructure Support FDA User Fee Reauthorization Bills Healthcare workforce (Graduate medical education , health professional training programs, recruitment and retention incentives) Medicare provider payment cuts (Medicare sequestration cuts, physician fee schedule 3% reduction due to evaluation & management code increases/budget neutrality adjustment, Pay-as-You-Go reductions due to American Rescue Plan) HHS FY 2023 appropriations - Removal of a ban on using federal funds for implementing a unique patient identification system (Section 510) and funding for Childrens Hospitals Graduate Medical Education (CHGME) Program NQF/Quality Measurement funding authorization

Client expense: $290,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Momnibus Legislation Medicaid Postpartum Coverage Extension MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act H.R. 3352, Midwives for Maximizing Optimal Maternity Services

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies relating to: Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Implementation of the Dr. Lorna Breen Health Care Provider Protection Act (P.L. 117-105) H.R. 66, Comprehensive Access to Robust Insurance Now Guaranteed for Kids (CARING for Kids) Act H.R. 482/S. 350, Newborn Screening Saves Lives Reauthorization Act of 2021 H.R. 485, Stronger Child Abuse Prevention and Treatment Act H.R. 550, Immunization Infrastructure Modernization Act of 2021 H.R. 909/S. 484, Moms Matter Act H.R. 959/S. 346, Black Maternal Health Momnibus Act of 2021 H.R. 1065/S. 1486, Pregnant Workers Fairness Act H.R. 1324/S/ 467, Effective Suicide Screening and Assessment in the Emergency Department Act of 2021 H.R. 1390, Childrens Health Insurance Program Pandemic Enhancement and Relief (CHIPPER) Act H.R. 1620, Violence Against Women Act Reauthorization Act of 2021 H.R. 1791, Childrens Health Insurance Program Permanency (CHIPP) Act H.R. 2094/S. 1301, Promoting Physical Activity for Americans Act H.R. 2347/S. 2691, Strengthening the Vaccines for Children Program Act of 2021 H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act of 2021 H.R. 3182, Safe Sleep for Babies Act of 2021 H.R. 3407/S. 411, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act H.R. 4217/S. 2779, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act H.R. 5376, Build Back Better Act - provisions related to nursing education infrastructure, health equity, social determinants of health, mental and behavioral health for patients and health care providers, and child and maternal health H.R. 5487/S. 3972, Stillbirth Health Improvement and Education (SHINE) for Autumn Act of 2021 H.R. 5585, Advanced Research Projects Agency-Health (ARPA-H) Act H.R. 7076, Supporting Childrens Mental Health Care Access Act of 2022 H.R. 7236, Strengthen Kids Mental Health Now Act of 2022 H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022 H.R. 7790, Infant Formula Supplemental Appropriations Act, 2022 S. 104/H.R. 379, Improving Social Determinants of Health Act of 2021 S. 248/H.R. 804, Family and Medical Insurance Leave (FAMILY) Act S. 499/H.R. 369, Improving Health Insurance Affordability Act of 2021 S. 674, Public Health Infrastructure Saves Lives Act S. 844/H.R. 3109, PHIT Act of 2021 S. 1259, Safe Cribs Act S. 1275/H.R. 2119, Family Violence Prevention and Services Improvement Act of 2021 S. 1658/H.R. 3110, Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act S. 1738, Hallways to Health Care Act S. 2069/H.R. 4323, Excellence in Mental Health and Addiction Treatment Act S. 3479, Building a Sustainable Workforce for Healthy Communities Act S. 3623, Violence Against Women Act Reauthorization Act of 2022 S. 3799, Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act) S. 4170, Mental Health Reform Reauthorization Act of 2022

Client expense: Not reported · Firm income: $24,000

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

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

Client expense: $4,580,000 · Firm income: Not reported

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

Issue: Educate Congress and the administration on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. Draft Graduate Medical Education Reform Act Issue: Support increased funding for the National Health Service Corps, Teaching Health Center GME, and National Disaster Medical Service (NDMS) demonstration pilot. Support increased Medicare support for Graduate Medical Education/physician training. Issues: Educate Congress and the administration about the role of academic medicine in the provision of mental and behavioral health care, including initiatives to respond to the opioid epidemic. Support measures to expand access to mental health care and substance use disorder treatment, including funding for training on substance use disorders, pain management, and safe prescribing practices, enhance enforcement of mental health parity laws, increased financial support for integrated behavioral health models, and the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). H.R. 1384/ S.445 Mainstreaming Addiction Treatment (MAT) Act of 2021 Issue: Support suspension of waiver requirement for certain providers to prescribe buprenorphine. H.R. 2067 Medication Access and Training Expansion Act of 2021 Issue: Oppose legislative mandates dictating medical education curriculum on pain management and addiction. H.R. 7236 Strengthen Kids Mental Health Now Act Issue: Support increasing Medicaid reimbursement rates for pediatric mental health services through a 100% federal match. P.L. 116-22, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 Issues: Support the Hospital Preparedness Program and the reauthorization of the Pandemic and All-Hazards Preparedness Act. Support increased funding authorization levels. Issue: Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, including not providing 340B discounts on covered drugs purchased at community pharmacies. H.R. 4390 Preserving Rules Ordered for the Entities Covered Through 340B Act of 2021 (PROTECT 340B Act) Issue: Support measures to prevent pharmacy benefit managers and commercial insurers from discriminating against 340B covered entities. H.R. 3203/S. 773 Issue: Support policy to allow 340B DSH hospitals to remain eligible to participate in the program throughout the current public health emergency even if their DSH adjustment falls below the current threshold due to changes in payor mix as a result of the COVID-19 pandemic. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Support increased interoperability and exchange of electronic health information and delayed enforcement of information blocking rule until comprehensive guidance is issued. Issue: Support the ongoing refinement of the two new mandatory alternative payment models, the Radiation Oncology Model and End-stage Renal Disease Treatment Choices Model, to better incentivize high-quality care for all patients. H.R. 4128/ S. 2209 Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021 S. 4348, Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act of 2022 Issue: Educate Congress on development of Laboratory Developed Tests at academic medical centers and oppose policies that would increase burdensome regulations and negatively impact patients access to care. Issue: Development of Enhanced Primary Care Pilot Act proposal H.R.7585, Health Equity and Accountability Act Issue: Support programs to improve health equity and address social determinants of health. Issue: Support initiatives of hospitals to promote affordable housing in local communities and eliminate other social determinants of health to improve health equity. H.R. 2503 Social Determinants Accelerator Act of 2021 Issue: Support grants to address social determinants of health Issue: Support congressional investment in the Centers for Medicare and Medicaid Innovation (CMMI) models to reduce maternal mortality and improve maternal health. Issue: Support maternal health initiatives to expand coverage for postpartum women and expand demonstration project grants. H.R. 959 Black Maternal Health Momnibus Act of 2021 S. 1695 / H.R. 4387 Maternal Health Quality Improvement Act S. 1491/ H.R. 769 Rural MOMs Act H.R. 4387 Maternal Health Quality Improvement Act of 2021 H.R. 5376, Build Back Better Act H.R. 925 / S. 347 Data to Save Moms Act Issue: Support legislative efforts to improve maternal health and reduce rates of maternal mortality, including the Momnibus. Support legislative initiatives to improve data collection to improve maternal health equity. P.L. 117-159, Bipartisan Safer Communities Act Issue: Support policies to promote firearm safety, universal background checks, violence prevention programs, extreme risk protection orders, child access safety laws, reinstating assault weapons ban, data infrastructure, hospital based and community violence intervention programs, and programs to address mental and behavioral health impact of gun violence. Issue: Support funding for Community Violence Interventions/ Hospital Based Violence Intervention Programs P.L. 117-105, Dr. Lorna Breen Health Care Provider Protection Act Issue: Support grants directed at improving clinician burnout and well-being. Issue: Provide feedback on implementation of the Provider Relief Fund. Support extension for use of PRF funds. Issue: Support improvements to the Medicare Accelerated and Advance Payment Programs, including delaying recoupment of MAAP loans. Issue: Support extension of public health emergency declaration. Issue: Provide feedback on COVID-19 and pandemic response. S. 3799, PREVENT Pandemics Act Issue: Provide feedback on pandemic preparedness legislation, urge inclusion of provisions to support academic medical centers preparedness activities. Issue: Support establishment of regional pandemic response centers, stronger linkages between public health and academic medicine, and the role of medical students and academic medical centers in administering COVID vaccines. Issue: Support efforts of academic medical centers to respond to public health threats such as monkeypox and COVID-19. Urge establishment and implementation of robust national testing strategy; functional, redundant, and transparent supply chain; improved federal coordination; investments in public health and health care human and other resources; data modernization initiatives; and other actions to improve current and future pandemic response. H.R. 708, S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act Issue: Support for a temporary uniform licensing standard for all practitioners in all states throughout the COVID-19 public health emergency S. 674 Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Support ensuring patients are put first, that conscience protections align with medical professionalism standards, and oppose interference in the patient-physician relationship. Issue: Support increased interoperability and exchange of electronic health information. Support delay of enforcement beyond April 2021. S. 4348, Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act of 2022 H.R. 7667, Food and Drug Amendments of 2022 (FDA22) Issue: Support promotion of data sharing and clinical trials results reporting. Support increased clinical trials diversity. H.R. 6000, Cures 2.0 Act Issue: Provide feedback on provisions related to public health, patients and caregivers, FDA, CMS, and research, and ARPA-H. Issue: Promote strategies to strengthen the health, public health, and research workforces. H.R. 3671, Doctors of Community Act Issue: Discuss authorization of the Teaching Health Center Graduate Medical Education program. Issue: Provide guidance on the implementation of the No Surprises Act. Issue: Provide feedback on proposed modifications to the HIPAA privacy rule. H.R. 5035, S. 2982 Child Suicide Prevention and Lethal Means Safety Act Issue: Support legislation to provide grants to improve suicide prevention and lethal means safety. Issue: Inform Congress about medical education on caring for older adults, nutrition, climate change, and opportunities to accelerate training. Issue: Provide feedback on efforts of the academic medicine community to address climate change and decarbonization. H.R. 7152/ S.3534, The Tracking Pathogens Act Issue: Support expansion of CDC activities related to genomic sequencing of pathogens. Issue: Support reignition of Cancer Moonshot. Issue: Educate Congress on accelerated medical education programs. Issue: Educate Congress and the administration on AAMC member curriculum on climate change and nutrition.

Client expense: $1,090,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of the Vice President of the United States, SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

Momnibus Legislation Medicaid Postpartum Coverage Extension MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act H.R. 3352, Midwives for Maximizing Optimal Maternity Services

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 411: MOMMA Act - Improve data collection, interventions, and expanded access for postpartum women S. 464/HR 2163: Safe Step Act-Implement transparency guidelines for step-therapy utilization S.1975/H.R. 3755: Womens Health Protection Act - Protect patient-physician relationship by allowing physicians to provide evidence-based womens health care S.1988: Protecting Rural Teleheath Access Act - Waive geographic restrictions and offer audio-only appointments S. 1893: Rural Physician Workforce Production Act - Provide federal support for rural residency training S1958/HR3671:DOC Act - Permanent authorization of THCGME program HR 379 Improving Social Determinants of Health Act: Would create a new SDoH program at the CDC HR 959: Black Maternal Health Momnibus Act - Comprehensive reforms to address maternal health challenges HR 976: Ensuring Transparent Honest Information on COVID-19 Act - Requires COVID-19 data reporting, including demographic information to the CDC, by states & localities & funds a study to examine public health data & infrastructure during & after the COVID-19 PHE. HR 1319: American Rescue Plan - Expansion of ACA coverage, investments in public health workforce, funding for COVID-19 response HR 1384: Mainstreaming Addiction Treatment Act of 2021- Eliminated the x-waiver HR 1848: LIFT America Act - Enhancing public health infrastructure, improve laboratory infrastructure, update care facilities, improve broadband infrastructure, and address social determinants of health HR 2125: Quit Because of Covid 19 Act - Would ensure that all Medicaid and CHIP enrollees have access to proven tobacco cessation treatments. HR 2347: Strengthening Vaccines for Childrens Act - Modifications to improve the Vaccine for Children (VFC) program HR 2418: Student Loan Forgiveness for Frontline Health Workers- Would forgive outstanding federal and private student loan debt for frontline physicians H.R. 5218: Collaborate in an Orderly and Cohesive Manner Act H.R. 4387/S.1675: Maternal Health Quality Improvement Act H.R. 5054: Physicians Serving Patients Act of 2021 H.R. 4770: Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act H.R. 5376: Build Back Better Act H.R. 4387/S. 1675: Maternal Health Quality Improvement Act H.R. 5218: Collaborate in an Orderly and Cohesive Manner Act H.R. 5541: Primary and Virtual Care Affordability Act S. 128: Primary Care Enhancement Act No Bill No: Physicians Serving Patients Act of 2021 No Bill No.: Congressional Primary Care Caucus;117th Congress membership in the bipartisan CPCC No Bill No.: Teaching Health Centers GME; Community Health Centers- National Health Service Corps; Special Diabetes Program; Special Diabetes Program for Indians - Increased funding and allocation of resources for teaching health center programs No Bill No.: Primary Care Patient Protection Act - Create a primary care benefit in high deductible health plans No Bill No.: No Surprise Bills for New Moms - Require health plans to cover newborns under mothers coverage for set time, SEP for enrollment post childbirth, and notification requirements No Bill No.: FY 2022 Appropriations Requests - CDC Programs (Climate/Health; Gun Violence Research; vaccine infrastructure); HRSA; AHRQ; CMS No Bill No.: Rural MOMS Act-Demonstration program to train physicians about maternal care in rural communities No Bill No.: COVID-19 Safe Birthing Act-Expand maternal telehealth for Medicaid beneficiaries; Medicaid/CHP post-partum coverage extension to one year No Bill No.: Anti-Racism in Public Health Act-Direct CDC to declare racism a public health crisis; establish a CDC-based center for addressing violence prevention No Bill No.: Equality Act-Provide affirmative, statutory nondiscrimination protections for LGBTQ Americans No Bill No.: Covid 19 vaccinations - Ensure Primary Care Physicians can access COVID-19 vaccines. No Bill No.: Telehealth Expansion - Preserve key telehealth flexibilities beyond COVID-19 PHE Affordable Insulin Now Act FY22 COVID-19 supplemental H.R. 7232: 9-8-8 and Parity Assistance Act Prevent Pandemics Act H.R. 7076: Supporting Children's Mental Health Care Access Act H.R. 3085: Equity in Neuroscience and Alzheimer's Clinical Trials Act H.R. 6584: Diverse and Equitable Participation in Clinical Trials Act H.R. 4122/S. 3658: REDI Act H.R. 1667: Dr. Lorna Breen Health Care Provider Protection Act S. 1893: Workforce Production Act of 2021 H.R. 7894/S.4347: Affordability is Access Act H.R. 8297: Ensuring Access to Abortion Act S.4306: Improving Access to Behavioral Health Integration Act S. 4170: Mental Health Reform Reauthorization Act H.R. 7666: Restoring Hope for Mental Health and Well-Being Act H.R. 7232: 9-8-8 and Parity Assistance Act H.R. 7076: Supporting Children's Mental Health Care Access Act S. 4408: Health and Location Data Protection Act No Bill No.: Behavioral health integration w/i primary care

Client expense: $892,176 · Firm income: Not reported

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

Practice Support/Grants to Practice Foreign physician immigration status Medical liability H.R. 7259, Medical Controlled Substances Transportation Act of 2022: to enable physicians to more easily transport controlled substances safely and legally across state lines H.R. 133, the Consolidated Appropriations Act, 2021: No Surprises Act, surprise medical billing H.R. 2630, Extending Temporary Emergency Scheduling of Fentanyl Analogues Act: Opioids H.R. 3502, Protecting People From Surprise Medical Bills Act: Surprise Medical Bills S. 445, Mainstreaming Addiction Treatment Act of 2021: Opioids H.R. 4387, Maternal Health Quality Improvement Act of 2021: Maternal health H.R. 1565, Saving Lives, Saving Costs S. 1475, Saving Lives, Saving Costs S. 610, Dr. Lorna Breen Health Care Provider Protection Act: Physician wellness H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act: Physician wellness S. 987, CARA 3.0 Act of 2021: Opioids H.R. 3259, NOPAIN Act: Opioids S. 586, NOPAIN Act: Opioids S. 1292, Non-Opioid Directive Act: Opioids FY 2021 LHHS Appropriations: Fiscal Year 2021 Appropriations for Subcommittee on Labor, Health and Human Services Pre-authorization Affordable Care Act reform efforts Medical Controlled Substances Transportation 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care Resident Education Deferred Interest Act (REDI Act): Student loan relief Student Loan Forgiveness for Frontline Health Workers Act: Student loan relief H.R. 842, Protecting the Right to Organize Act of 2021: PRO Act, labor protections 21st Century Cures Initiative H.R. 4369, National Centers of Excellence in Continuous Pharmaceutical Manufacturing Act: Drug shortages DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Ketamine use by law enforcement Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Brain health Certified Anesthesiologist Assistants Blood management Funding for physician practices impacted by the cancellation of elective surgeries, unique role of anesthesiologists in responding to COVID-19 pandemic, medical liability, scope of Practice (waiver of federal supervision requirement under the Emergency Declaration), insurance moratorium; COVID Update Memorandum 4/21/20 Long COVID research

Client expense: $300,000 · Firm income: Not reported

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

FY23 Appropriations for: Title V Maternal and Child Health Block Grant (HRSA); Surveillance for Emerging Threats to Mothers and Babies (CDC); Safe Motherhood and Infant Health (CDC). Support for several authorizing bills to improve maternal health, including the Black Maternal Health Momnibus Act (H.R.959, S.346), the Maternal Health Quality Improvement Act (H.R.4387, S.1675), the MOMMA's Act (H.R.3407, S.411), the MOMMIES Act (H.R.3063, S.1542), and the Helping MOMS Act (H.R.3345). Support for the reauthorization of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program.

Client expense: $10,000 · Firm income: Not reported

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

Health Insurance Coverage (general); Health Disparities (general); Breastfeeding (general); Assisted Reproductive Technology (general); Smoking Cessation (general); Substance Use Disorder (general); Gynecologic Cancer (general); Gynecologic Devices (general); Reproductive Health (general); Intimate Partner Violence (general); Gun Violence (general); Immunization (general); Breast Cancer (general); Medical Liability Reform (general); Health IT (general); Patient-Physician Relationship (general); Child Welfare (general); Prematurity (general); Maternal Mortality and Morbidity (general); Graduate Medical Education (general); Contraception (general); Abortion (general); Mifepristone (general); Indian Health (general); Teaching Health Centers Graduate Medical Education (general); Community Health Centers (general); National Health Service Corps (general); Health care workforce (general); Title VII Health Workforce Programs (general); Title VIII Health Workforce Programs (general); Special Diabetes Program (general); Special Diabetes Program for Indians (general); Sexuality Education (general); Teen Pregnancy Prevention Program (general); Personal Responsibility Education Program (general); Sexually Transmitted Infections (general); Access and Provision of Medication-based Opioid Use Disorder Treatment (HHS); Research in Pregnant and Breastfeeding Women (general); Health Care Reform (general); Title X Family Planning Program (general); Womens Preventive Services (general); Administrative Burden (general); COVID-19 Response (general); Risk Evaluation and Mitigation Strategies (general); Data Collection (general); Health Equity (general); Social Determinants of Health (General) Pregnancy Risk Assessment Monitoring System (CDC); Provider Relief Fund (general); Maternal Mental Health (general); Violence Against Women Act (general); COVID-19 Vaccine (general); H.R. 3755/S. 1975, Womens Health Protection Act; implementation of P.L. 115-344, Preventing Maternal Deaths Act; implementation of P.L. 115-320, Improving Access to Maternity Care Act; H.R. 4387/S.1675, Maternal Health Quality Improvement Act; H.R. 959/ S. 346, the Black Maternal Health Momnibus Act of 2021; implementation of P.L. 116-123, the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020; implementation of P.L. 116-127, the Families First Coronavirus Response Act; implementation of P.L. 116-136, the Coronavirus Aid, Relief, and Economic Security Act; implementation of P.L. 116-139, Paycheck Protection Program and Health Care Enhancement Act; H.R. 3021 the Coronavirus Provider Protection Act; H.R. 1065/S. 1486, the Pregnant Workers Fairness Act; implementation of P.L. 117-105, Lorna Breen Health Care Provider Protection Act; S. 176, Ensuring Understanding of COVID-19 to Protect Public Health Act; H.R. 736/S. 167, Community Immunity During COVID-19 Act; H.R. 1350/ S.408, Supporting Best Practices for Healthy Moms Act; H.R. 3407/S. 411, MOMMAs Act; H.R. 769/S.1491, Rural MOMS Act; implementation of P.L. 117-2, the American Rescue Plan Act of 2021; H.R. 2216 /S.1063, the Jeanette Acosta Invest in Womens Health Act; H.R. 2007/S. 2444, Stephanie Tubbs Jones Uterine Fibroid Research and Education Act of 2021; H.R. 3110/S. 1658, PUMP for Nursing Mothers Act; H.R. 2903/S.1515, CONNECT for Health Act; H.R. 3671/S.1958, Doctors of Community (DOC) Act; Implementation of P.L. 114-255, the 21st Century Cures Act; Implementation of the No Surprises Act contained in P.L. 116-260, Consolidated Appropriations Act, 2021; S. 1234/H.R. 2556, the Maternal CARE Act; S. 1333, the MOMS Act; S. 198/H.R. 1218, the Data Mapping to Save Moms Lives Act; H.R. 1439, Expanded Genetic Screening Act of 2021; S. 1622, the HEALTH for MOM Act of 2021; H.R. 482/S. 350, Newborn Screening Saves Lives Reauthorization Act; H.R. 804/S. 248, FAMILY Act; H.R. 5/S. 393, Equality Act; H.R. 4151/S. 2238, FASD Respect Act; H.R. 6000, Cures 2.0 Act; Advanced Research Projects Agency for Health (ARPA-H); H.R. 5376/S.___, Build Back Better Act; H.R. 5218, Collaborate in an Orderly and Cohesive Manner Act; H.R. 5239/ S. 2941, Good Samaritan Health Professionals Act of 2021; H.R. 4576/S. 2390, Support Through Loss Act; H.R 6143, Supporting Health Care Providers During the COVID-19 Pandemic Act; H.R. 7073/S.3824, Into the Light for MMH and SUD Act of 2022; H.R.5487/S.3972, SHINE for Autumn Act of 2021; Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) (general); H.R.4128/ S.2209, VALID Act of 2021; Pandemic Preparedness (general); S.3799, PREVENT Pandemics Act; S.Res.560, A resolution recognizing the significance of endometriosis as an unmet chronic disease for women and designating March 2022 as "Endometriosis Awareness Month"; Disclosure of Ingredients in Menstrual Products (general); H.R.7011/S.3797, Maternal and Child Health Stillbirth Prevention Act of 2022; Healthy Start Program (HRSA); Tobacco Product Standard for Characterizing Flavors in Cigars (OMB); Tobacco Product Standard for Menthol in Cigars (OMB); H.R. 2234/S. 1021, Equal Access to Abortion Coverage (EACH) Act; S. 4467, Protecting Access to Medication Abortion Act; S.Res.664, A resolution expressing opposition to the criminalization of essential healthcare, including the full range of sexual and reproductive healthcare such as abortion, gender-affirming care, and contraceptive care, and disapproving of the criminalization of pregnancy outcomes; H.Res.589, Expressing the sense of the House of Representatives that policies governing access to medication abortion care in the United States should be equitable and based on science; H.R. 7894/S. 4347, Affordability is Access Act (AAA); H.R. 6005/S. 3223, Access to Birth Control Act; H.R. 7845, NIH Clinical Trial Diversity Act of 2022; H.R. 4217, TRIUMPH for New Moms Act of 2021; H.R.7974 - Endometriosis CARE Act of 2022; H.R. 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022; H.R. 8185/S. 4440 Screening for Communities to Receive Early and Equitable Needed Services for Cancer Act; H.R. 7617/S. 309, Preventive Care Awareness Act of 2022; H.Res.1072/S.Res.602, Expressing support for the designation of April 30, 2022, as "National Adult Hepatitis B Vaccination Awareness Day"; Safety and efficacy of noninvasive prenatal screening tests (FDA/CMS); COVID-19 public health emergency unwinding (general); ; Implementation of the Maternal Health Quality Improvement Act and Rural MOMS Act included in P.L. 117-103H.R.2471, Consolidated Appropriations Act, 2022; fertility fraud and assisted reproductive technology (general); health care provider conscience protections (general).

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

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

Build Back Better Act (Reconciliation bill) Bipartisan Safer Communities Act (S. 2938) Restoring Hope for Mental Health and Well-Being Act of 2022 (HR 7666) Dr. Lorna Breen Health Care Provider Protection Act S. 4349/HR 809 Healthcare Workforce Resilience Act of 2021 Maternal health: MOMMAs Act S. 411/HR 3407; Black Maternal Health Omnibus Act of 2021 S. 346/H.R. 959; Data to Save Moms Act S. 347/HR 925; IMPACT to Save Moms Act S 1675/HR 4387; Maternal Health Quality Improvement Act S. 1675/H.R. 4387 Conrad State 30 & Physician Access Reauthorization Act S. 1810/H.R. 3541 Public Health and Social Services Emergency Fund Regulatory relief in light of coronavirus Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Strengthening Americas Health Care Readiness Act (S. 54) Social Determinants Accelerator Act (H.R. 2503), Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act (S. 509) OSHA rule on COVID-19 Healthcare Workplace Safety No Surprises Act regulations Protecting Providers Everywhere in America Act (S. 308/H.R. 1436) 340B Drug Pricing Program legislation (S. 773/HR 3203) Behavioral health reimbursement and policies (Child Suicide Prevention and Lethal Means Safety Act - H.R. 5035; Childrens Mental Health Infrastructure Act - H.R. 4945; Helping Kids Cope Act - H.R. 4944; Restoring Hope for Mental Health and Well-Being Act of 2022 (HR 7666) )

Client expense: $200,000 · 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. 5487 - Value in Health Care Act of 2021 S. 2652/H.R. 5067 - Preserving Patient Access to Home Infusion Act S.308 / H.R.1436 - PPE in America Act S.1260 - United States Innovation and Competition Act of 2021 S. 936 / H.R. 5502 - INFORM Consumers Act S. 2648 - Rural ACO Improvement Act S. 1574/H.R.5632 - Long-Term Care Pharmacy Definition Act S. 834 / H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R.3173 / S 3018 - Improving Seniors Timely Access to Care Act of 2021 H.R. 3746 - Accountable Care in Rural America Act H.R. 959 / S. 364 - Black Maternal Health Momnibus Act of 2021 H.R. 4387 / S. 1675 - Maternal Health Quality Improvement Act of 2021 S. 168 / H.R. 708 - Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act S. 150 - Ensuring Parity in MA for Audio Only-Telehealth Act S. 3146 - The Protecting Patients from Counterfeit Medical Devices Act S. 3799 - The PREVENT Pandemics Act H.R. 6520 - The Medical and Health Stockpile Accountability Act of 2022, automated data collection infrastructure for healthcare supply chain S. 3416 - The Protecting Patients from Counterfeit Medical Devices Act S. 3493 - Drug Shortages Shelf Life Extension Act H.R. 4521 - America COMPETES Act of 2022 S.610 - Protecting Medicare and American Farmers from Sequester Cuts Act H.R.3684 - Infrastructure Investment and Jobs Act H.R. 4735/S. 2493 - The Provider Relief Extension Act H.R. 3589 - Better Way for Providers To Repay Act of 2021 H.R. 3203 / S. 773 - To allow hospitals that were participating in or applied for the 340B drug discount program before the public health emergency to temporarily maintain eligibility HHS FY 2023 appropriations - Removal of a ban on using federal funds for implementing a unique patient identification system (Section 510) and funding for Childrens Hospitals Graduate Medical Education (CHGME) Program 340B Drug Discount Program eligibility Incentivize Domestic Manufacturing Hospital Infrastructure Support FDA User Fee Reauthorization Bills Healthcare workforce (Graduate medical education , health professional training programs, recruitment and retention incentives) Medicare provider payment cuts (Medicare sequestration cuts, physician fee schedule 3.75% reduction due to evaluation & management code increases/budget neutrality adjustment, Pay-as-You-Go reductions due to American Rescue Plan)

Client expense: $300,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Legislation and policies relating to: Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Provisions of the Infrastructure Investment and Jobs Act (P.L. 117-58) related to public health infrastructure improvements H.R. 66, Comprehensive Access to Robust Insurance Now Guaranteed for Kids (CARING for Kids) Act H.R. 482/S. 350, Newborn Screening Saves Lives Reauthorization Act of 2021 H.R. 485, Stronger Child Abuse Prevention and Treatment Act H.R. 550, Immunization Infrastructure Modernization Act of 2021 H.R. 909/S. 484, Moms Matter Act H.R. 959/S. 346, Black Maternal Health Momnibus Act of 2021 H.R. 1065/S. 1486, Pregnant Workers Fairness Act H.R. 1324/S/ 467, Effective Suicide Screening and Assessment in the Emergency Department Act of 2021 H.R. 1390, Childrens Health Insurance Program Pandemic Enhancement and Relief (CHIPPER) Act H.R. 1791, Childrens Health Insurance Program Permanency (CHIPP) Act H.R. 2094/S. 1301, Promoting Physical Activity for Americans Act H.R. 2347/S. 2691, Strengthening the Vaccines for Children Program Act of 2021 H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act of 2021 H.R. 3182, Safe Sleep for Babies Act of 2021 H.R. 3407/S. 411, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act H.R. 4217/S. 2779, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act H.R. 5376, Build Back Better Act - provisions related to nursing education infrastructure, health equity, social determinants of health, mental and behavioral health for patients and health care providers, and child and maternal health H.R. 5487/S. 3972, Stillbirth Health Improvement and Education (SHINE) for Autumn Act of 2021 H.R. 7076, Supporting Childrens Mental Health Care Access Act of 2022 S. 104/H.R. 379, Improving Social Determinants of Health Act of 2021 S. 248/H.R. 804, Family and Medical Insurance Leave (FAMILY) Act S. 499/H.R. 369, Improving Health Insurance Affordability Act of 2021 S. 610/H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act S. 674, Public Health Infrastructure Saves Lives Act S. 844/H.R. 3109, PHIT Act of 2021 S. 1259, Safe Cribs Act S. 1275/H.R. 2119, Family Violence Prevention and Services Improvement Act of 2021 S. 1658/H.R. 3110, Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act S. 2069/H.R. 4323, Excellence in Mental Health and Addiction Treatment Act S. 3479, Building a Sustainable Workforce for Healthy Communities Act S. 3799, Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act)

Client expense: Not reported · Firm income: $24,000

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

Support H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021, a bill to provide for special enrollment periods during public health emergencies; Letter urging Congress to provide additional funds to the Provider Relief Fund and for vaccine distribution and administration, which will allow for continued support of hospitals' COVID-19-related lost revenues, as well as additional expenses incurred due to purchasing supplies and equipment, staffing, establishing emergency testing and vaccination centers and constructing and retrofitting facilities; Support H.R. 708 and S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, a bill to provide temporary licensing reciprocity for telehealth and interstate health care treatment; Support H.R. 1306 and S. 412, National Coronavirus Commission Act of 2021, a bill to establish the Commission on the Coronavirus Pandemic in the United States; Support S. 610/ H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 773 a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; Support S.834, Resident Physician Shortage Reduction Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan and urge the Committee on Education and Labor not to report it favorably; Support S.924 and H.R. 2130, Rural America Health Corps Act, a bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Discussions with ASPR about COVID-19 related medical supply and personnel shortages; Discussions with FEMA about COVID-19 public assistance funding policies; Letter asking Congress to consider an infrastructure proposal that you prioritize hospital and health system needs to ensure our nations health care system is well positioned to meet the opportunities and challenges that lie ahead; Support S.1512/H.R. 2903, CONNECT for Health Act of 2021, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services; Support H.R. 2255/ S 1024, Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Support S.1568, Technical Reset to Advance the Instruction of Nurses (TRAIN) Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Support H.R. 3203, a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Statement to Senate Committee on Homeland Security and Governmental Affairs hearing on "COVID-19 Part II: Evaluating the Medical Supply Chain and Pandemic Response Gaps" urges Congress to take steps to strengthen the nations medical supply chain; Statement to Senate Committee on Finance hearing on COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned stating that these flexibilities can continue to drive significant improvements in patient care long after the public health emergency (PHE) ends and given the beneficial impact of those specific flexibilities urges Congress and the Administration to make them permanent. In addition, a second group of flexibilities will remain critically important for some time following the PHE and will require a carefully crafted phase-out plan to ensure enough time is provided for a necessary transition. Without action from Congress and the Administration prior to the termination of the PHE, we are concerned that much of the progress made because of the implementation of many of these flexibilities may be unnecessarily halted or even lost; Letter urges Senate HELP Committee to consider recommendations and prioritize programs that support the health care workforce needs of the country in the wake of the COVID-19 pandemic and into the future; Support H.R. 769/S. 1491, Rural Maternal and Obstetric Modernization of Services Act or the Rural MOMS Act, a bill to amend the Public Health Service Act to improve obstetric care in rural areas; Support for S.1675/ H.R. 4387, Maternal Health Quality Improvement Act, a bill to improve maternal health; Support 1438, Opioid Workforce Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Support HR 3441,Substance Use Disorder Workforce Act, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the substance use disorder crisis; Support S.1810 / H.R.3541, Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; Statement to the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights for the hearing on Antitrust Applied: Hospital Consolidation Concerns and Solutions expressing that integration helps to ensure every community, whether rural, urban or suburban, has access to the same high standard of affordable, evidenced based care; discussions to ensure that H.R. 2547s limits on unfair practice under FDCPA for debt collectors does not inappropriately interfere with or restrict the ability of hospitals to be able to obtain payment for care provided; Support for revising/repealing changes to the Rural Health Clinic (RHC) Program that reduced reimbursement for provider-based RHCs; Hill outreach expressing concerns with United Healths retroactive denial of coverage for emergency-level care in facilities; Hill outreach expressing concern about CMS mid-build audit denials; Senate outreach on prior authorization legislation; Urge support for legislation/administrative action to extend the deadline to use PRF money; Urged HRSA to ensure that the drug companies that denied 340B Statute appropriate discounts make the impacted hospitals whole for the benefit of the vulnerable communities they serve; Support S. 2304 Drug-Price Transparency for Competition Act of 2021 (DTC Act of 2021), a bill to amend title XI of the Social Security Act to require that direct-to-consumer advertisements for prescription drugs and biological products include an appropriate disclosure of pricing information; Support S.246/H.R.851 Future Advancement of Academic Nursing Act or the FAAN Act, a bill to amend the Public Health Service Act to authorize grants to support schools of nursing in program enhancement and infrastructure modernization, increasing the number of nursing faculty and students, and for other purposes; Support S. 1568/HR 4407Technical Reset to Advance the Instruction of Nurses Act or the TRAIN Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Comment letter to the Occupational Safety and Health Administration (OSHA) recommending the withdrawal of the COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Meeting with Department of Labor staff to discuss our concerns about the OSHA COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Discussion with ASPR staff overseeing the Strategic National Stockpile about their intent to procure supplies of surgical masks; Call with Senator Cassidys staff to discuss concerns about impact of FEMA COVID-19 funding of traveling nurse agencies on hospital nursing shortages; Oppose S 2428, False Claims Amendments Act of 2021A bill to amend title 31, United States Code, to modify False Claims Act procedures, and for other purposes; Discussions about Provider Relief Fund - reporting on past disbursements and urging HHS to disburse remaining PRF money; Discussions about the challenges that teaching hospitals have with training the physician workforce, residency caps that limit funding for training programs, a shortage of residents pursuing primary care specialties, a growing patient pool due to the newly insured and aging of the population; Discussions about the hospital and health system priorities for infrastructure and reconciliation bills; Letter urging Congress to maintain the current legal and regulatory framework for evaluating mergers and acquisitions; Hill outreach to discuss the benefits of health care integration; Hill outreach about the negative impact of potentially anticompetitive conduct by nurse-staffing agencies; Support HR 5035/ S 2982 Child Suicide Prevention and Lethal Means Safety Act, a bill to authorize the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes; Support H.R.5376 Build Back Better Act, this bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment; Discussions with members of congress about the implementation of Rural Emergency Hospital payment designation; Discussions on the No Surprises Act Implementation (surprise billing) and urging federal regulators to restore the independence of the independent dispute resolution process in the No Surprises Act Part 2 regulations; Support HR 5699 Student Assisted Vaccination Effort (SAVE) Act, a bill to expand the definition of qualified persons for purposes of the Public Readiness and Emergency Preparedness Act to include health professional students; Support S 2873 Preventing and Addressing Trauma with Health Services Act (PATHS Act), a bill to require the Secretary of Health and Human Services to award grants to establish or expand programs and activities to increase access to high-quality culturally competent trauma support and mental health care; Letter urging HRSA to delay proposals to withdraw certain HPSAs; Support S 3497 and HR 6397, Medical Student Education Authorization Act of 2022, a bill to amend the Public Health Service Act to establish a grant program to award grants to public institutions of higher education located in a covered State; Support HR 6279 and S 3629, Opioid Treatment Access Act of 2022, a bill to authorize a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs during the COVID-19 public health emergency; Support HR 5703 and S 3677, Post-Disaster Mental Health Response Act, a bill to amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to authorize the President to provide professional counseling services to victims of emergencies declared under such Act; Submitted a statement on the hearing for Pandemic Profiteers: Legislation to Stop Corporate Price Gouging regarding concerns about anticompetitive conduct on the part of health care staffing agencies, some of which have been exploiting the severe shortage of health care providers during the COVID-19 pandemic; Submitted a statement on the hearing for Americas Mental Health Crisis and supports additional approaches to help ensure improved access to needed comprehensive, affordable and quality behavioral health services; Provide comments to the Affordability Subcommittee of the Healthy Future Task Force expressing our shared focus with Congress on providing relief from the pandemic, ensuring a smooth recovery and rebuilding a better health care system for the future, all while continuing to support efforts to promote greater affordability and value to patients and the health care system; Submitted statement on the hearing for Recruiting, Revitalizing & Diversifying: Examining the Health Care Workforce Shortage about the challenges ahead and the need to examine Americas health care workforce shortage. We must work together to solve these issues so that our nations hospitals and health systems can continue to care for the patients and communities they serve; Submitted statement on the hearing for Protecting Youth Mental Health: Part II - Identifying and Addressing Barriers to Care examines ways to protect the mental health of our nations youth; Submitted statement on the hearing for Exploring Pathways to Affordable, Universal Health Coverage Care expressing the need to build upon and improve our existing system to increase access to coverage of comprehensive health benefits; Submitted a letter to provide information regarding the challenges facing Americas health care workforce as the country enters the third year of the COVID-19 pandemic; Provided comments to the Modernization Subcommittee of the Healthy Future Task Force urging Congress to consider how to ensure the telehealth flexibilities could remain in place for patients and health care providers beyond the PHE; Support HR 7053 and S 3792, Hospital Inpatient Services Modernization Act, a bill to amend title XVIII of the Social Security Act to extend acute hospital care at home waiver flexibilities; Support resolution, H. Res. 909, Expressing support for healthcare personnel and condemning assaults on healthcare personnel as the U.S. healthcare system faces unprecedented staffing shortages and increased workplace-related stressors; Letter urges Congress to provide immediate additional support for hospitals and health systems serving their communities during this unprecedented public health crisis. While the support Congress has provided during the last two years of the COVID-19 pandemic has helped hospitals care for their patients and communities, there is still a significant need for financial support and relief as COVID-19 challenges persist; Support S 3904, Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Letter urging OSHA to extend the comment deadline for the rule making on the occupational exposure to COVID-19 in healthcare settings by at least an additional 30 days, through May 23; Meeting with the Office of the Assistant Secretary of Health (OASH) at HHS to discuss the widespread blood shortages in the U.S. and next steps; Stakeholder calls with HHS ASPR regarding the distribution/administration of COVID-19 therapeutics; Discussions on S 571, Public Health Funding Prevents Pandemics Act, a bill to fully fund the Prevention and Public Health Fund and reaffirm the importance of prevention in the United States healthcare system; Regular calls with ASPR and other stakeholders participating in the Health Care and Public Health (HPH) Sector Joint Supply Chain Resilience Working Group (Joint SCRWG), a formal Working Group under the authority of the Critical Infrastructure Partnership Advisory Council (CIPAC) to support the Presidents vision for a resilient public health supply chain; Monthly calls with ASPRs Hospital Preparedness Program (HPP) to discuss updates on the hospital association COVID-19 funding program; Call with ASPR Healthcare and Public Health Government Coordinating Council leadership and other hospital associations to provide feedback on the COVID-19 hospital data guidance update.

Client expense: $5,400,000 · Firm income: Not reported

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

Issue: Educate Congress and the administration on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. Draft Graduate Medical Education Reform Act Issue: Support increased funding for the National Health Service Corps, Teaching Health Center GME, and National Disaster Medical Service (NDMS) demonstration pilot. Support increased Medicare support for Graduate Medical Education/physician training. Issues: Educate Congress and the administration about academic medicines response to the opioid epidemic. Support funding for training on substance use disorders, pain management, and safe prescribing practices. Support suspension of DATA waivers and new guidelines to expand access to buprenorphine. Support continuation of telehealth flexibilities allowing authorized practitioners to prescribe buprenorphine. Issue: Educate Congress on the role of academic medicine in the provision of mental and behavioral health care. Support measures to expand access to mental health care, including enhanced enforcement of mental health parity laws, expanded funding for integrated behavioral health models, and the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). H.R. 1384/ S.445 Mainstreaming Addiction Treatment (MAT) Act of 2021 Issue: Support suspension of waiver requirement for certain providers to prescribe buprenorphine. P.L. 116-22, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 Issues: Support the Hospital Preparedness Program and the reauthorization of the Pandemic and All-Hazards Preparedness Act. Support increased funding authorization levels. Issue: Support high-quality affordable health insurance. Support programs and funds for safety-net providers. Issue: Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, including not providing 340B discounts on covered drugs purchased at community pharmacies. H.R. 3203/S. 773 Issue: Support policy to allow 340B DSH hospitals to remain eligible to participate in the program throughout the current public health emergency even if their DSH adjustment falls below the current threshold due to changes in payor mix as a result of the COVID-19 pandemic. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Support increased interoperability and exchange of electronic health information and delayed enforcement of information blocking rule until comprehensive guidance is issued. Issue: Support the ongoing refinement of the two new mandatory alternative payment models, the Radiation Oncology Model and End-stage Renal Disease Treatment Choices Model, to better incentivize high-quality care for all patients. H.R. 4128/ S. 2209 Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021 Issue: Educate Congress on development of Laboratory Developed Tests and impact of burdensome regulation on patients access to care at academic medical centers. Issue: Development of Enhanced Primary Care Pilot Act proposal Draft Health Equity and Accountability Act Issue: Support programs to improve health equity and address social determinants of health. Issue: Support initiatives of hospitals to promote affordable housing in local communities and eliminate other social determinants of health to improve health equity. H.R. 2503 Social Determinants Accelerator Act of 2021 Issue: Support grants to address social determinants of health Issue: Support congressional investment in the Centers for Medicare and Medicaid Innovation (CMMI) models to reduce maternal mortality and improve maternal health. Issue: Support maternal health initiatives to expand coverage for postpartum women and expand demonstration project grants. H.R. 959 Black Maternal Health Momnibus Act of 2021 S. 1695 / H.R. 4387 Maternal Health Quality Improvement Act S. 1491/ H.R. 769 Rural MOMs Act H.R. 4387 Maternal Health Quality Improvement Act of 2021 H.R. 5376, Build Back Better Act H.R. 925 / S. 347 Data to Save Moms Act Issue: Support legislative efforts to improve maternal health and reduce rates of maternal mortality, including the Momnibus. Support legislative initiatives to improve data collection to improve maternal health equity. Issue: Support policies to promote firearm safety, universal background checks, violence prevention programs, extreme risk protection orders, child access safety laws, and reinstating assault weapons ban. Issue: Support funding for Community Violence Interventions/ Hospital Based Violence Intervention Programs P.L. 117-105, Dr. Lorna Breen Health Care Provider Protection Act Issue: Support grants directed at improving clinician burnout and well-being. Issue: Provide feedback on implementation of the Provider Relief Fund. Support extension for use of PRF funds. Issue: Support improvements to the Medicare Accelerated and Advance Payment Programs, including delaying recoupment of MAAP loans. Issue: Support extension of public health emergency declaration. Issue: Provide feedback on COVID-19 and pandemic response. S. 3799, PREVENT Pandemics Act Issue: Provide feedback on pandemic preparedness legislation, urge inclusion of provisions to support academic medical centers preparedness activities. Issue: Support establishment of regional pandemic response centers, stronger linkages between public health and academic medicine, and the role of medical students and academic medical centers in administering COVID vaccines. Issue: Urge establishment and implementation of robust national COVID-19 testing strategy; functional, redundant, and transparent supply chain; improved federal coordination; investments in public health and health care human and other resources; data modernization initiatives; and other actions to improve current and future pandemic response. H.R. 708, S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act Issue: Support for a temporary uniform licensing standard for all practitioners in all states throughout the COVID-19 public health emergency S. 674 Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Support ensuring patients are put first, that conscience protections align with medical professionalism standards, and oppose interference in the patient-physician relationship. Issue: Support increased interoperability and exchange of electronic health information. Support delay of enforcement beyond April 2021. Issue: Support robust research agenda for the Patient-Centered Outcomes Research Institute. Issue: Support promotion of data sharing and clinical trials results reporting. H.R. 6000, Cures 2.0 Act Issue: Provide feedback on provisions related to public health, patients and caregivers, FDA, CMS, and research, and ARPA-H. Issue: Promote strategies to strengthen the health, public health, and research workforces. H.R. 3671, Doctors of Community Act Issue: Discuss authorization of the Teaching Health Center Graduate Medical Education program. Issue: Provide guidance on the implementation of the No Surprises Act. Issue: Provide feedback on proposed modifications to the HIPAA privacy rule. H.R. 5035, S. 2982 Child Suicide Prevention and Lethal Means Safety Act Issue: Support legislation to provide grants to improve suicide prevention and lethal means safety. Issue: Inform about medical education on caring for older adults, nutrition, climate change, and opportunities to accelerate training. H.R. 7152/ S.3534, The Tracking Pathogens Act Issue: Support expansion of CDC activities related to genomic sequencing of pathogens. Issue: Support reignition of Cancer Moonshot. HR 5035, The Child Suicide Prevention and Lethal Means Safety Act Issue: Support expansion of training for health professionals to prevent self-harm or suicide

Client expense: $874,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of the Vice President of the United States, SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

FY22 and FY23 Appropriations for: Title V Maternal and Child Health Block Grant (HRSA); Surveillance for Emerging Threats to Mothers and Babies (CDC); Safe Motherhood and Infant Health (CDC). Support for several authorizing bills to improve maternal health, including the Black Maternal Health Momnibus Act (H.R.959, S.346), the Maternal Health Quality Improvement Act (H.R.4387, S.1675), the MOMMA's Act (H.R.3407, S.411), the MOMMIES Act (H.R.3063, S.1542), and the Helping MOMS Act (H.R.3345). Support for the reauthorization of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Practice Support/Grants to Practice Foreign physician immigration status Medical liability H.R. 133, the Consolidated Appropriations Act, 2021: No Surprises Act, surprise medical billing H.R. 2630, Extending Temporary Emergency Scheduling of Fentanyl Analogues Act: Opioids H.R. 3502, Protecting People From Surprise Medical Bills Act: Surprise Medical Bills S. 445, Mainstreaming Addiction Treatment Act of 2021: Opioids H.R. 4387, Maternal Health Quality Improvement Act of 2021: Maternal health H.R. 1565, Saving Lives, Saving Costs S. 1475, Saving Lives, Saving Costs S. 610, Dr. Lorna Breen Health Care Provider Protection Act: Physician wellness H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act: Physician wellness S. 987, CARA 3.0 Act of 2021: Opioids H.R. 3259, NOPAIN Act: Opioids S. 586, NOPAIN Act: Opioids S. 1292, Non-Opioid Directive Act: Opioids FY 2021 LHHS Appropriations: Fiscal Year 2021 Appropriations for Subcommittee on Labor, Health and Human Services Pre-authorization Affordable Care Act reform efforts Medical Controlled Substances Transportation 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care Resident Education Deferred Interest Act (REDI Act): Student loan relief Student Loan Forgiveness for Frontline Health Workers Act: Student loan relief H.R. 842, Protecting the Right to Organize Act of 2021: PRO Act, labor protections 21st Century Cures Initiative H.R. 4369, National Centers of Excellence in Continuous Pharmaceutical Manufacturing Act: Drug shortages DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Ketamine use by law enforcement Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Brain health Certified Anesthesiologist Assistants Blood management Funding for physician practices impacted by the cancellation of elective surgeries, unique role of anesthesiologists in responding to COVID-19 pandemic, medical liability, scope of Practice (waiver of federal supervision requirement under the Emergency Declaration), insurance moratorium; COVID Update Memorandum 4/21/20

Client expense: $430,000 · Firm income: Not reported

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

H.R. 1384, Mainstreaming Addiction Treatment (MAT) Act of 2021, all provisions S. 445, Mainstreaming Addiction Treatment (MAT) Act of 2021, all provisions H.R. 1218, Data Mapping to Save Moms Lives Act, all provisions S. 198, Data Mapping to Save Moms' Lives Act, all provisions H.R. 4387, Maternal Health Quality Improvement Act of 2021, all provisions S. 1675, Maternal Health Quality Improvement Act, all provisions H.R. 1446, Enhanced Background Checks Act of 2021, all provisions H.R. 8, Bipartisan Background Checks Act of 2021, all provisions H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, all provisions S. 610, Dr. Lorna Breen Health Care Provider Protection Act, all provisions H.R. 379, Improving Social Determinants of Health Act of 2021, all provisions S. 104, Improving Social Determinants of Health Act of 2021, all provisions S. 54, Strengthening Americas Health Care Readiness Act, all provisions H.R. 5248, Temporary Responders for Immediate Aid in Grave Emergencies (TRIAGE) Act of 2021, all provisions H.R. 3753, Parity Implementation Assistance Act, all provisions S. 1962, Parity Implementation Assistance Act, all provisions S. 3904, Healthcare Cybersecurity Act of 2022, all provisions H.R. 4128, Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021, all provisions S. 2209, Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021, all provisions H.R. 6000, Cures 2.0 Act, all provisions S. 3799, Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act, all provisions S. 253, Cannabidiol and Marihuana Research Expansion Act, all provisions S. 2866, Treatment Restoration for Emergency Antibody Therapeutics (TREAT) Act, all provisions H.R. 708, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, provisions relating to waste, fraud, and abuse in telehealth S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, provisions relating to waste, fraud, and abuse and telehealth H.R. 4480, Telehealth Coverage and Payment Parity Act, all provisions H.R. 1306, National Coronavirus Commission Act of 2021, all provisions S. 412, National Coronavirus Commission Act of 2021, all provisions H.R. 1843, COVID-19 Hate Crimes Act, all provisions S.937, COVID-19 Hate Crimes Act, all provisions H.R. 6279, Opioid Treatment Access Act of 2022, all provisions H.R. 3778, Nullifying Opportunities for Variants to Infect and Decimate (NOVID) Act, all provisions S. 1976, Nullifying Opportunities for Variants to Infect and Decimate (NOVID) Act, all provisions H.R. 6904, Patients Before Profits Act of 2022, all provisions H.R. 2503, Social Determinants Accelerator Act of 2021, all provisions S. 3039, Social Determinants Accelerator Act of 2021, all provisions H.R. 6072, Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act of 2021, all provisions S. 509, Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act of 2021, all provisions H.R. 5224, Preventing Overdoses and Saving Lives Act of 2021, all provisions H.R. 925, Data to Save Moms Act, all provisions H.R. 3352, Midwives for MOMS Act of 2021, all provisions H.R. 847, Promoting Digital Privacy Technologies Act, all provisions S. 224, Promoting Digital Privacy Technologies Act, all provisions H.R. 4098, Non-Opioid Directive Act, all provisions S. 3620, Health Data Use and Privacy Commission Act, all provisions Emergency Room Hero and Patient Safety Act Primary Care Physician Reentry Act 21st Century Cures Act/implementation Affordable Care Act (ACA)/Stabilization Ryan Haight Act/telemedicine/controlled substances No Surprises Act/implementation Physician workforce issues Opioid overdose epidemic Medical device user fee reauthorization Telehealth study COVID-19/vaccine distribution/vaccine in physician offices COVID-19/health equity/vaccine COVID-19/testing/personal protective equipment(PPE)/misinformation Pandemic preparedness and public health Health insurance affordability Mental health parity Prior authorization Health equity and technology/biometric technologies Health Equity COVID-19/Provider Relief Fund Modifier 25/OIG Information blocking/Patient privacy Naloxone/over the counter (OTC) EHR Certification Precision medicine/diagnostics/coverage/payment/coding Digital health/AI/Digital therapeutics/transparency/equity

Client expense: $6,520,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), SENATE, White House Office

Momnibus Legislation Medicaid Postpartum Coverage Extension MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act

Client expense: Not reported · Firm income: $10,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Consolidated Appropriations Act (H.R. 2471) Build Back Better Act H.R 5376 (Reconciliation bill Dr. Lorna Breen Health Care Provider Protection Act S. 4349/HR 809 Provider Relief Fund Improvement Act H.R. 5963/S. 3611 Healthcare Workforce Resilience Act of 2021 Rural America Health Corps Act S.54 Maternal health: MOMMAs Act S. 411/HR 3407; Black Maternal Health Omnibus Act of 2021 S. 346/H.R. 959; Data to Save Moms Act S. 347/HR 925; IMPACT to Save Moms Act S 1675/HR 4387; Maternal Health Quality Improvement Act S. 1675/H.R. 4387 Conrad State 30 & Physician Access Reauthorization Act S. 1810/H.R. 3541 Public Health and Social Services Emergency Fund Regulatory relief in light of coronavirus Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Rural Hospital Closure Relief Act H.R. 1639/S.644 Rural and Underserved Small Hospital Protection Act/RUSH Act (H.R. 1885) Rural America Health Corps Act (S. 924/H.R. 2130), Strengthening Americas Health Care Readiness Act (S. 54) Social Determinants Accelerator Act (H.R. 2503), Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act (S. 509) OSHA rule on COVID-19 Healthcare Workplace Safety Drug-price Transparency for Competition (DTC) Act (S. 2304) No Surprises Act regulations Protecting Providers Everywhere in America Act (S. 308/H.R. 1436) 340B legislation (S. 773 HR 3203) Childrens Mental Health Infrastructure Act H.R. 4945; Helping Kids Cope Act H.R. 4944; Child Suicide Prevention and Lethal Means Safety Act H.R. 5035 HEALTH CARE REFORM - Discussions about addressing social determinants of health

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

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

Health Insurance Coverage (general); Health Disparities (general); Breastfeeding (general); Assisted Reproductive Technology (general); Smoking Cessation (general); Substance Use Disorder (general); Gynecologic Cancer (general); Gynecologic Devices (general); Reproductive Health (general); Intimate Partner Violence (general); Gun Violence (general); Immunization (general); Breast Cancer (general); Medical Liability Reform (general); Health IT (general); Patient-Physician Relationship (general); Child Welfare (general); Prematurity (general); Maternal Mortality and Morbidity (general); Graduate Medical Education (general); Contraception (general); Abortion (general); Mifepristone (general); Indian Health (general); Teaching Health Centers Graduate Medical Education (general); Community Health Centers (general); National Health Service Corps (general); Health care workforce (general); Title VII Health Workforce Programs (general); Special Diabetes Program (general); Special Diabetes Program for Indians (general); Sexuality Education (general); Teen Pregnancy Prevention Program (general); Personal Responsibility Education Program (general); Sexually Transmitted Infections (general); Access and Provision of Medication-based Opioid Use Disorder Treatment (HHS); Research in Pregnant and Breastfeeding Women (general); Health Care Reform (general); Title X Family Planning Program (general); Womens Preventive Services (general); Administrative Burden (general); COVID-19 Response (general); Risk Evaluation and Mitigation Strategies (general); Data Collection (general); Health Equity (general); Social Determinants of Health (General) Pregnancy Risk Assessment Monitoring System (CDC); Provider Relief Fund (general); Maternal Mental Health (general); Violence Against Women Act (general); COVID-19 Vaccine (general); H.R. 3755/S. 1975, Womens Health Protection Act; implementation of P.L. 115-344, Preventing Maternal Deaths Act; implementation of P.L. 115-320, Improving Access to Maternity Care Act; H.R. 4387/S.1675, Maternal Health Quality Improvement Act; H.R. 959/ S. 346, the Black Maternal Health Momnibus Act of 2021; implementation of P.L. 116-123, the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020; implementation of P.L. 116-127, the Families First Coronavirus Response Act; implementation of P.L. 116-136, the Coronavirus Aid, Relief, and Economic Security Act; implementation of P.L. 116-139, Paycheck Protection Program and Health Care Enhancement Act; H.R. 3021 the Coronavirus Provider Protection Act; H.R. 1065/S. 1486, the Pregnant Workers Fairness Act; H.R.1667/S. 610, Lorna Breen Health Care Provider Protection Act; S. 176, Ensuring Understanding of COVID-19 to Protect Public Health Act; H.R. 736/S. 167, Community Immunity During COVID-19 Act; H.R. 1350/ S.408, Supporting Best Practices for Healthy Moms Act; H.R. 3407/S. 411, MOMMAs Act; H.R. 769/S.1491, Rural MOMS Act; implementation of P.L. 117-2, the American Rescue Plan Act of 2021; H.R. 2216 /S.1063, the Jeanette Acosta Invest in Womens Health Act; H.R. 2007/S. 2444, Stephanie Tubbs Jones Uterine Fibroid Research and Education Act of 2021; H.R. 3110/S. 1658, PUMP for Nursing Mothers Act; H.R. 2903/S.1515, CONNECT for Health Act; H.R. 3671/S.1958, Doctors of Community (DOC) Act; Implementation of P.L. 114-255, the 21st Century Cures Act; Implementation of the No Surprises Act contained in P.L. 116-260, Consolidated Appropriations Act, 2021; S. 1234/H.R. 2556, the Maternal CARE Act; S. 1333, the MOMS Act; S. 198/H.R. 1218, the Data Mapping to Save Moms Lives Act; H.R. 1439, Expanded Genetic Screening Act of 2021; S. 1622, the HEALTH for MOM Act of 2021; H.R. 482/S. 350, Newborn Screening Saves Lives Reauthorization Act; H.R. 804/S. 248, FAMILY Act; H.R. 5/S. 393, Equality Act; H.R. 4151/S. 2238, FASD Respect Act; H.R. 6000, Cures 2.0 Act; Advanced Research Projects Agency for Health (ARPA-H); H.R. 5376/S.___, Build Back Better Act; H.R. 5218, Collaborate in an Orderly and Cohesive Manner Act; H.R. 5239/ S. 2941, Good Samaritan Health Professionals Act of 2021; H.R. 4576/S. 2390, Support Through Loss Act; H.R 6143, Supporting Health Care Providers During the COVID-19 Pandemic Act; H.R. 7073/S.3824, Into the Light for MMH and SUD Act of 2022; H.R.5487/S.3972, SHINE for Autumn Act of 2021; Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) (general); H.R.4128/ S.2209, VALID Act of 2021; Pandemic Preparedness (general); S.3799, PREVENT Pandemics Act; S.Res.560, A resolution recognizing the significance of endometriosis as an unmet chronic disease for women and designating March 2022 as "Endometriosis Awareness Month"; Disclosure of Ingredients in Menstrual Products (general); H.R.7011/S.3797, Maternal and Child Health Stillbirth Prevention Act of 2022; Healthy Start Program (HRSA); Tobacco Product Standard for Characterizing Flavors in Cigars (OMB); Tobacco Product Standard for Menthol in Cigars (OMB).

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

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

S. 411: MOMMA Act - Improve data collection, interventions, and expanded access for postpartum women S. 464/HR 2163: Safe Step Act-Implement transparency guidelines for step-therapy utilization S.1975/H.R. 3755: Womens Health Protection Act - Protect patient-physician relationship by allowing physicians to provide evidence-based womens health care S.1988: Protecting Rural Teleheath Access Act - Waive geographic restrictions and offer audio-only appointments S. 1893: Rural Physician Workforce Production Act - Provide federal support for rural residency training S1958/HR3671:DOC Act - Permanent authorization of THCGME program HR 379 Improving Social Determinants of Health Act: Would create a new SDoH program at the CDC HR 959: Black Maternal Health Momnibus Act - Comprehensive reforms to address maternal health challenges HR 976: Ensuring Transparent Honest Information on COVID-19 Act - Requires COVID-19 data reporting, including demographic information to the CDC, by states & localities & funds a study to examine public health data & infrastructure during & after the COVID-19 PHE. HR 1319: American Rescue Plan - Expansion of ACA coverage, investments in public health workforce, funding for COVID-19 response HR 1384: Mainstreaming Addiction Treatment Act of 2021- Eliminated the x-waiver HR 1848: LIFT America Act - Enhancing public health infrastructure, improve laboratory infrastructure, update care facilities, improve broadband infrastructure, and address social determinants of health HR 2125: Quit Because of Covid 19 Act - Would ensure that all Medicaid and CHIP enrollees have access to proven tobacco cessation treatments. HR 2347: Strengthening Vaccines for Childrens Act - Modifications to improve the Vaccine for Children (VFC) program HR 2418: Student Loan Forgiveness for Frontline Health Workers- Would forgive outstanding federal and private student loan debt for frontline physicians H.R. 5218: Collaborate in an Orderly and Cohesive Manner Act H.R. 4387/S.1675: Maternal Health Quality Improvement Act H.R. 5054: Physicians Serving Patients Act of 2021 H.R. 4770: Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act H.R. 5376: Build Back Better Act H.R. 4387/S. 1675: Maternal Health Quality Improvement Act H.R. 5218: Collaborate in an Orderly and Cohesive Manner Act H.R. 5541: Primary and Virtual Care Affordability Act S. 128: Primary Care Enhancement Act No Bill No: Physicians Serving Patients Act of 2021 No Bill No.: Congressional Primary Care Caucus;117th Congress membership in the bipartisan CPCC No Bill No.: Teaching Health Centers GME; Community Health Centers- National Health Service Corps; Special Diabetes Program; Special Diabetes Program for Indians - Increased funding and allocation of resources for teaching health center programs No Bill No.: Primary Care Patient Protection Act - Create a primary care benefit in high deductible health plans No Bill No.: No Surprise Bills for New Moms - Require health plans to cover newborns under mothers coverage for set time, SEP for enrollment post childbirth, and notification requirements No Bill No.: FY 2022 Appropriations Requests - CDC Programs (Climate/Health; Gun Violence Research; vaccine infrastructure); HRSA; AHRQ; CMS No Bill No.: Rural MOMS Act-Demonstration program to train physicians about maternal care in rural communities No Bill No.: COVID-19 Safe Birthing Act-Expand maternal telehealth for Medicaid beneficiaries; Medicaid/CHP post-partum coverage extension to one year No Bill No.: Anti-Racism in Public Health Act-Direct CDC to declare racism a public health crisis; establish a CDC-based center for addressing violence prevention No Bill No.: Equality Act-Provide affirmative, statutory nondiscrimination protections for LGBTQ Americans No Bill No.: Covid 19 vaccinations - Ensure Primary Care Physicians can access COVID-19 vaccines. No Bill No.: Telehealth Expansion - Preserve key telehealth flexibilities beyond COVID-19 PHE Affordable Insulin Now Act FY22 COVID-19 supplemental H.R. 7232: 9-8-8 and Parity Assistance Act Prevent Pandemics Act H.R. 7076: Supporting Children's Mental Health Care Access Act H.R. 3085: Equity in Neuroscience and Alzheimer's Clinical Trials Act H.R. 6584: Diverse and Equitable Participation in Clinical Trials Act H.R. 4122/S. 3658: REDI Act H.R. 1667: Dr. Lorna Breen Health Care Provider Protection Act S. 1893: Workforce Production Act of 2021

Client expense: $811,538 · Firm income: Not reported

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

a. Incentivize Domestic Manufacturing b. Hospital Infrastructure Support c. H.R. 5487 - Value in health Care Act of 2021 d. S. 2652/H.R. 5067 - Preserving Patient Access to Home Infusion Act e. S.308/H.R.1436 - PPE in America Act f. S.1260 - United States Innovation and Competition Act of 2021 g. S. 936 / H.R. 5502 - INFORM Consumers Act h. S. 2648 - Rural ACO Improvement Act i. S. 1574/H.R.5632 - Long-Term Care Pharmacy Definition Act j. S. 834 / H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 k. H.R.3173 S 3018 - Improving Seniors Timely Access to Care Act of 2021 l. H.R. 3746 - Accountable Care in Rural America Act m. H.R.1319 - American Rescue Plan Act of 2021 n. H.R. 959 / S. 364 - Black Maternal Health Momnibus Act of 2021 o. H.R. 4387 / S. 1675 - Maternal Health Quality Improvement Act of 2021 p. S. 168 / H.R. 708 - Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act q. S. 150 - Ensuring Parity in MA for Audio Only-Telehealth Act r. 340B Drug Discount Program eligbility t. Healthcare workforce (Graduate medical education , health professional training programs, recruitment and retension incentives) u. Medicare provider payment cuts (Medicare sequestration cuts, physician fee schedule 3.75% reduction due to evaluation & management code increases/budget neturality adjustment, Pay-as-You-Go reductions due to American Rescue Plan) v. Automated data collection infrastructure for healthcare supply chain w. S. 3146 - The Protecting Patients from Counterfeit Medical Devices Act x. S. 3799 - The PREVENT Pandemics Act y. H.R. 650 - The Medical and Health Stockpile Accountability Act of 2022 z. S. 3416 - The Protecting Patients from Counterfeit Medical Devices Act aa. S. 3493 - Drug Shortages Shelf Life Extension Act ab. H.R. 4521 - America COMPETES Act of 2022 ac. H.R.5376 - Build Back Better Act ad. S.610 - Protecting Medicare and American Farmers from Sequester Cuts Act ae. H.R.3684 - Infrastructure Investment and Jobs Act af. H.R. 4735/S. 2493 - The Provider Relief Extension Act ag. H.R. 3589 - Better Way for Providers To Repay Act of 2021 ah. H.R. 3203 / S. 773 - To allow hospitals that were participating in or applied for the 340B drug discount program before the public health emergency to temporarily maintain eligibility ai. HHS FY 2022 appropriations - Removal of a ban on using federal funds for implementing a unique patient identification system (Section 510) aj. ACO Assignment Bill ak. NQF/Quality Measurement funding authorization al. Preparing for the next pandemic and supply chain resiliency

Client expense: $290,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

FY22 Appropriations for: Title V Maternal and Child Health Block Grant (HRSA); Surveillance for Emerging Threats to Mothers and Babies (CDC); Safe Motherhood and Infant Health (CDC). Support for several authorizing bills to improve maternal health, including the Black Maternal Health Momnibus Act (H.R.959, S.346), the Maternal Health Quality Improvement Act (H.R.4387, S.1675), the MOMMA's Act (H.R.3407, S.411), the MOMMIES Act (H.R.3063, S.1542), and the Helping MOMS Act (H.R.3345). Support for the reauthorization of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021, a bill to provide for special enrollment periods during public health emergencies; Letter urging Congress to provide additional funds to the Provider Relief Fund and for vaccine distribution and administration, which will allow for continued support of hospitals' COVID-19-related lost revenues, as well as additional expenses incurred due to purchasing supplies and equipment, staffing, establishing emergency testing and vaccination centers and constructing and retrofitting facilities; Support H.R. 708 and S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, a bill to provide temporary licensing reciprocity for telehealth and interstate health care treatment; Support H.R. 1306 and S. 412, National Coronavirus Commission Act of 2021, a bill to establish the Commission on the Coronavirus Pandemic in the United States; Support S. 610/ H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 773 a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; Support S.834, Resident Physician Shortage Reduction Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan and urge the Committee on Education and Labor not to report it favorably; Support S.924 and H.R. 2130, Rural America Health Corps Act, a bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Discussions with ASPR about COVID-19 related medical supply and personnel shortages; Discussions with FEMA about COVID-19 public assistance funding policies; Letter asking Congress to consider an infrastructure proposal that you prioritize hospital and health system needs to ensure our nations health care system is well positioned to meet the opportunities and challenges that lie ahead; Support S.1512/H.R. 2903, CONNECT for Health Act of 2021, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services; Support H.R. 2255/ S 1024, Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Support S.1568, Technical Reset to Advance the Instruction of Nurses (TRAIN) Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Support H.R. 3203, a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Statement to Senate Committee on Homeland Security and Governmental Affairs hearing on "COVID-19 Part II: Evaluating the Medical Supply Chain and Pandemic Response Gaps" urges Congress to take steps to strengthen the nations medical supply chain; Statement to Senate Committee on Finance hearing on COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned stating that these flexibilities can continue to drive significant improvements in patient care long after the public health emergency (PHE) ends and given the beneficial impact of those specific flexibilities urges Congress and the Administration to make them permanent. In addition, a second group of flexibilities will remain critically important for some time following the PHE and will require a carefully crafted phase-out plan to ensure enough time is provided for a necessary transition. Without action from Congress and the Administration prior to the termination of the PHE, we are concerned that much of the progress made because of the implementation of many of these flexibilities may be unnecessarily halted or even lost; Letter urges Senate HELP Committee to consider recommendations and prioritize programs that support the health care workforce needs of the country in the wake of the COVID-19 pandemic and into the future; Support H.R. 769/S. 1491, Rural Maternal and Obstetric Modernization of Services Act or the Rural MOMS Act, a bill to amend the Public Health Service Act to improve obstetric care in rural areas; Support for S.1675/ H.R. 4387, Maternal Health Quality Improvement Act, a bill to improve maternal health; Support 1438, Opioid Workforce Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Support HR 3441,Substance Use Disorder Workforce Act, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the substance use disorder crisis; Support S.1810 / H.R.3541, Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; Statement to the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights for the hearing on Antitrust Applied: Hospital Consolidation Concerns and Solutions expressing that integration helps to ensure every community, whether rural, urban or suburban, has access to the same high standard of affordable, evidenced based care; discussions to ensure that H.R. 2547s limits on unfair practice under FDCPA for debt collectors does not inappropriately interfere with or restrict the ability of hospitals to be able to obtain payment for care provided; Support for revising/repealing changes to the Rural Health Clinic (RHC) Program that reduced reimbursement for provider-based RHCs; Hill outreach expressing concerns with United Healths retroactive denial of coverage for emergency-level care in facilities; Hill outreach expressing concern about CMS mid-build audit denials; Senate outreach on prior authorization legislation; Urge support for legislation/administrative action to extend the deadline to use PRF money; Urged HRSA to ensure that the drug companies that denied 340B Statute appropriate discounts make the impacted hospitals whole for the benefit of the vulnerable communities they serve; Support S. 2304 Drug-Price Transparency for Competition Act of 2021 (DTC Act of 2021), a bill to amend title XI of the Social Security Act to require that direct-to-consumer advertisements for prescription drugs and biological products include an appropriate disclosure of pricing information; Support S.246/H.R.851 Future Advancement of Academic Nursing Act or the FAAN Act, a bill to amend the Public Health Service Act to authorize grants to support schools of nursing in program enhancement and infrastructure modernization, increasing the number of nursing faculty and students, and for other purposes; Support S. 1568/HR 4407Technical Reset to Advance the Instruction of Nurses Act or the TRAIN Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Comment letter to the Occupational Safety and Health Administration (OSHA) recommending the withdrawal of the COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Meeting with Department of Labor staff to discuss our concerns about the OSHA COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Discussion with ASPR staff overseeing the Strategic National Stockpile about their intent to procure supplies of surgical masks; Call with Senator Cassidys staff to discuss concerns about impact of FEMA COVID-19 funding of traveling nurse agencies on hospital nursing shortages; Oppose S 2428, False Claims Amendments Act of 2021A bill to amend title 31, United States Code, to modify False Claims Act procedures, and for other purposes; Discussions about Provider Relief Fund - reporting on past disbursements and urging HHS to disburse remaining PRF money; Discussions about the challenges that teaching hospitals have with training the physician workforce, residency caps that limit funding for training programs, a shortage of residents pursuing primary care specialties, a growing patient pool due to the newly insured and aging of the population; Discussions about the hospital and health system priorities for infrastructure and reconciliation bills; Letter urging Congress to maintain the current legal and regulatory framework for evaluating mergers and acquisitions; Hill outreach to discuss the benefits of health care integration; Hill outreach about the negative impact of potentially anticompetitive conduct by nurse-staffing agencies; Support HR 5035/ S 2982Child Suicide Prevention and Lethal Means Safety Act.A bill to authorize the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes; Support H.R.5376 Build Back Better Act, this bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment; Discussions with members of congress about the implementation of Rural Emergency Hospital payment designation; Discussions on the No Surprises Act Implementation (surprise billing) and urging federal regulators to restore the independence of the independent dispute resolution process in the No Surprises Act Part 2 regulations; Support HR 5699 Student Assisted Vaccination Effort (SAVE) Act, a bill to expand the definition of qualified persons for purposes of the Public Readiness and Emergency Preparedness Act to include health professional students; Support S 2873Preventing and Addressing Trauma with Health Services Act (PATHS Act), a bill to require the Secretary of Health and Human Services to award grants to establish or expand programs and activities to increase access to high-quality culturally competent trauma support and mental health care.

Client expense: $6,430,000 · Firm income: Not reported

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