Medicaid DSH Payment Adjustment Fairness Act of 2021

Medicaid DSH Payments including the Medicaid DSH Payment Adjustment Fairness Act (H.R. 5015) or other proposed solutions to amend Section 203 of Title II of the Consolidated Appropriations Act of 2021; Prevent annual DSH cuts; Graduate Medical Education (GME) including the Resident Physician Shortage Reduction Act (HR 2389); increased federal funding for public safety net hospitals including workforce development; and COVID-19 reimbursement from FEMA to public hospitals.

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

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

H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Worker Act OSHA Funding Draft resolution on treating racism as a public health crisis H.R. 9475, TEACH Act S. 3663, Kids Online Safety Act Draft educator mental health bill H.R.1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, Entirety Health Worker Shortage/Staffing Crisis Visas for international healthcare professionals Green New Deal for Health, Entirety Monitor the following: Public Law 117-169, Inflation Reduction Act, Prescription drug reform Public Law 117-159, Bipartisan Safer Communities Act H.R.5015, the Medicaid DSH Payment Adjustment Fairness Act, Hospital funding formula Abortion Access related issues H.R.7784, the Supporting Trauma Informed Education Practices Act H.R.7666, Restoring Hope for Mental Health and Well‐Being Act S.2110, Better Care Better Jobs Act Nurse Overtime and Patient Safety Act S.632, Health Force and Resilience Force Act, H.R.959/S.346, Black Maternal Health Momnibus Act Student Loan Forgiveness for Frontline Health Workers S.102, the Prescription Drug Price Relief Act S.99, the Medicare Drug Price Negotiation Act S.97, the Affordable and Safe Prescription Drug Importation Act H.R.1391/S.482, Taxpayer Research and Coronavirus Knowledge Act, Entirety H.R.7296/S.4439, Make Medications Affordable by Preventing Pandemic Pricegouging Act, Entirety Affordability of pharmaceuticals, generally Treating gun violence as a public health epidemic related issues The National Nurse Act, Entirety Health Equity Issues during COVID Pandemic H.R.728/S.187, Pandemic Emergency Manufacturing Act of 2021, Entirety Support Medicare/ACA enrollment H.R. 6637, Health Equity and Accountability Act, Entirety Delivery of healthcare services to students during COVID pandemic Telehealth issues H.R.1227/S.386, Medicare X Choice Act Rural Healthcare related issues and initiatives Federal response to COVID-19 Pandemic H.R.3755, the Women's Health Protection Act, Entirety H.R.7116, 9-8-8 Implementation Act H.R.6833, the Affordable Insulin Now Act Mental health supports for educators S.3796/H.R.7045, Closing Health Coverage Gaps for Public Servants Act Dobbs v. Jackson, United States Supreme Court decision Public Law 117-168, Honoring our Promise to Address Comprehensive Toxics (PACT) Act, Entirety

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

Federal Medicaid Funding (FMAP) and the territories Monitor the following: Public Law 117-169, Inflation Reduction Act, Prescription Drug related issues H.R.5015, the Medicaid DSH Payment Adjustment Fairness Act, Hospital funding formula Medicare Negotiation and Competitive Licensing Act, Entirety Medicare for America Act, Entirety Medicaid funding in schools

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for elimination of statutory PAY-GO reductions Support for fair and reasonable implementation of No Surprises Act regulations Support for Improving Seniors Timely Access to Care Act (H.R. 3173/S. 3018) Support for Healthcare Workforce Resilience Act of 2021 Support for delay/elimination of Medicare sequestration cuts Support for increased flexibility and expansion of eligible expenses eligible for reimbursement under COVID-19 FEMA Public Assistance program. Support for Hospital Inpatient Services Modernization Act (H.R. 7053) Support for additional Provider Relief Funding Support for Protecting Rural Access to Care Act (H.R. 489) Support for Substance Use Disorder Workforce Act of 2021 (H.R.3441)/Opioid Workforce Act of 2021 (S.1438) Support for bolstering Medicare Graduate Medical Education program including the Resident Physician Shortage Reduction Act of 2021 (H.R. 2256/S.834) Support for Rural Hospital Support Act (H.R. 1887) and making permanent the Medicare Dependent Hospital and enhanced Low-Volume Payment Adjustment Support for The Assistance for Rural Community Hospitals (ARCH) Act (H.R. 8747) Support for Medicaid DSH Payment Adjustment Fairness Act (H.R. 5015) and amending Medicaid DSH Cap policy established in Section 203 of CAA of 2021. Support for continuing telehealth flexibilities beyond COVID-19 pandemic including the Advancing Telehealth Beyond COVID-19 Act (H.R. 4040) Support for extending hospital at home program flexibilities including the Hospital Inpatient Services Modernization Act (H.R. 7053/S. 3792). Support for preserving Medicares previously longstanding Critical Access Hospital mileage requirements

Client expense: $150,000 · Firm income: Not reported

Public Law 117-169, Inflation Reduction Act, Prescription Drug related issues Monitor the following: H.R.5015, the Medicaid DSH Payment Adjustment Fairness Act, Hospital funding formula Federal Medicaid Funding (FMAP) and the territories Medicare Negotiation and Competitive Licensing Act, Entirety H.R.1976, To establish an improved Medicare for All national health insurance program, Entirety Medicare for America Act, Entirety Medicaid funding in schools

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

Government targets: SENATE

Public Law 117-169, Inflation Reduction Act, Prescription drug reform Public Law 117-159, Bipartisan Safer Communities Act Monitor the following: H.R.5015, the Medicaid DSH Payment Adjustment Fairness Act, Hospital funding formula Abortion Access related issues H.R.7784, the Supporting Trauma Informed Education Practices Act H.R.7666, Restoring Hope for Mental Health and Well‐Being Act S.2110, Better Care Better Jobs Act Nurse Overtime and Patient Safety Act H.R.1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, Entirety S.632, Health Force and Resilience Force Act, H.R.959/S.346, Black Maternal Health Momnibus Act Student Loan Forgiveness for Frontline Health Workers S.102, the Prescription Drug Price Relief Act S.99, the Medicare Drug Price Negotiation Act S.97, the Affordable and Safe Prescription Drug Importation Act H.R.1391/S.482, Taxpayer Research and Coronavirus Knowledge Act, Entirety H.R.7296/S.4439, Make Medications Affordable by Preventing Pandemic Pricegouging Act, Entirety Affordability of pharmaceuticals, generally Treating gun violence as a public health epidemic related issues The National Nurse Act, Entirety Health Equity Issues during COVID Pandemic H.R.728/S.187, Pandemic Emergency Manufacturing Act of 2021, Entirety Support Medicare/ACA enrollment H.R. 6637, Health Equity and Accountability Act, Entirety Delivery of healthcare services to students during COVID pandemic Telehealth issues H.R.1227/S.386, Medicare X Choice Act Rural Healthcare related issues and initiatives Federal response to COVID-19 Pandemic H.R.3755, the Women's Health Protection Act, Entirety Health Worker Shortage/Staffing Crisis H.R.7116, 9-8-8 Implementation Act H.R.6833, the Affordable Insulin Now Act Mental health supports for educators S.3796/H.R.7045, Closing Health Coverage Gaps for Public Servants Act S.4182, Workplace Violence Prevention for Health Care and Social Service Worker Act Dobbs v. Jackson, United States Supreme Court decision Visas for international healthcare professionals Public Law 117-168, Honoring our Promise to Address Comprehensive Toxics (PACT) Act, Entirety

Support for fair and reasonable implementation of No Surprises Act regulations Support for Improving Seniors Timely Access to Care Act (H.R. 3173/S. 3018) Support for Healthcare Workforce Resilience Act of 2021 Support for delay/elimination of Medicare sequestration cuts Support for increased flexibility and expansion of eligible expenses eligible for reimbursement under COVID-19 FEMA Public Assistance program. Support for Hospital Inpatient Services Modernization Act (H.R. 7053) Support for additional Provider Relief Funding Support for Protecting Rural Access to Care Act (H.R. 489) Support for Substance Use Disorder Workforce Act of 2021 (H.R.3441)/Opioid Workforce Act of 2021 (S.1438) Support for Resident Physician Shortage Reduction Act of 2021 (H.R. 2256/S.834) Support for Rural Hospital Support Act (H.R. 1887) Support for The Assistance for Rural Community Hospitals (ARCH) Act (H.R. 8747) Support for Medicaid DSH Payment Adjustment Fairness Act (H.R. 5015). Support for continuing telehealth flexibilities beyond COVID-19 pandemic including the Advancing Telehealth Beyond COVID-19 Act (H.R. 4040) Support for preserving Medicares previously longstanding Critical Access Hospital mileage requirements

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

H.Res.1141, Educator Mental Health Awareness Week Resolution Mental health supports for educators H.R.7828, the PRICED Act H.R. 4132, the Womens Health Protection Act Prescription drug reform, reconciliation H.R. 7784, the Supporting Trauma Informed Education Practices Act Medicare for All H.R.7666, Restoring Hope for Mental Health and Well‐Being Act S.3796/H.R.7045, Closing Health Coverage Gaps for Public Servants Act S.4182, Workplace Violence Prevention for Health Care and Social Service Worker Act Dobbs v. Jackson, United States Supreme Court decision Monitor the following: H.R.5015, the Medicaid DSH Payment Adjustment Fairness Act, Hospital funding formula Reconciliation bill Abortion Access related issues S.2110, Better Care Better Jobs Act Nurse Overtime and Patient Safety Act H.R.1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, Entirety S.632, Health Force and Resilience Force Act, H.R.959/S.346, Black Maternal Health Momnibus Act Student Loan Forgiveness for Frontline Health Workers S.102, the Prescription Drug Price Relief Act S.99, the Medicare Drug Price Negotiation Act S.97, the Affordable and Safe Prescription Drug Importation Act H.R.1391/S.482, Taxpayer Research and Coronavirus Knowledge Act, Entirety H.R.7296/S.4439, Make Medications Affordable by Preventing Pandemic Pricegouging Act, Entirety Affordability of pharmaceuticals, generally Treating gun violence as a public health epidemic related issues The National Nurse Act, Entirety Health Equity Issues during COVID Pandemic H.R.728/S.187, Pandemic Emergency Manufacturing Act of 2021, Entirety Support Medicare/ACA enrollment H.R. 6637, Health Equity and Accountability Act, Entirety Delivery of healthcare services to students during COVID pandemic Telehealth issues H.R.1227/S.386, Medicare X Choice Act Rural Healthcare related issues and initiatives Federal response to COVID-19 Pandemic H.R.3755, the Women's Health Protection Act, Entirety Health Worker Shortage/Staffing Crisis H.R.7116, 9-8-8 Implementation Act H.R.6833, the Affordable Insulin Now Act

Monitor the following: H.R.5015, the Medicaid DSH Payment Adjustment Fairness Act, Hospital funding formula Federal Medicaid Funding (FMAP) and the territories Medicare Negotiation and Competitive Licensing Act, Entirety H.R.1976, To establish an improved Medicare for All national health insurance program, Entirety Medicare for America Act, Entirety Medicaid funding in schools

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

Build Back Better Act (H.R. 5376) VALID Act (H.R 4128) Provider Relief Fund Improvement Act (H.R. 5963 / S. 3611) No Surprises Act regulations Improving Seniors Timely Access to Care Act (H.R. 1587/S. 3018) Healthcare Workforce Resilience Act of 2021 Support for delay/elimination of Medicare sequestration cuts Support for legislation to continue expansion of telehealth services during and beyond COVID-19 pandemic Support for additional Provider Relief Funding Support for changes to Medicare Volume Decrease Adjustment calculation Support for Protecting Rural Access to Care Act (H.R. 489) Support for flexibility in 340B drug pricing program DSH threshold (H.R. 3203/S.773) Support for Substance Use Disorder Workforce Act of 2021 (H.R.3441)/Opioid Workforce Act of 2021 (S.1438) Support for Resident Physician Shortage Reduction Act of 2021 (H.R. 2256/S.834) Support for Rural Hospital Support Act (H.R. 1887) Support for Medicaid DSH Payment Adjustment Fairness Act (H.R. 5015). Support for continuing telehealth flexibilities beyond COVID-19 pandemic Support for preserving Medicares previously longstanding Critical Access Hospital mileage requirements

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

Medicaid DSH Payments including the Medicaid DSH Payment Adjustment Fairness Act (H.R. 5015); Medicare sequestration cuts; Graduate Medical Education (GME); 340B drug pricing Program; and increased federal funding for public safety net hospitals.

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

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

Support for delay/elimination of Medicare sequestration cuts Support for legislation to continue expansion of telehealth services during and beyond COVID-19 pandemic Support for additional Provider Relief Funding Support for conversion of Medicare Accelerated/Advance Payments to loans Support for changes to Medicare Volume Decrease Adjustment calculation Support for Protecting Rural Access to Care Act (H.R. 489) Support for flexibility in 340B drug pricing program DSH threshold (H.R. 3203/S.773) Support for Substance Use Disorder Workforce Act of 2021 (H.R.3441)/Opioid Workforce Act of 2021 (S.1438) Support for Resident Physician Shortage Reduction Act of 2021 (H.R. 2256/S.834) Support for Rural Hospital Support Act (H.R. 1887) Support for Medicaid DSH Payment Adjustment Fairness Act (H.R. 5015). Support for continuing telehealth flexibilities beyond COVID-19 pandemic Support for preserving Medicares previously longstanding Critical Access Hospital mileage requirements

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

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

Support for hospital funding in federal infrastructure package Support for delay/elimination of Medicare sequestration cuts Support for legislation to continue expansion of telehealth services during and beyond COVID-19 pandemic Support for fair and accurate distribution of CARES Act Provider Relief Funds Support for conversion of Medicare Accelerated/Advance Payments to loans Support for changes to Medicare Volume Decrease Adjustment calculation Support for Protecting Rural Access to Care Act (H.R. 489) Support for flexibility in 340B drug pricing program DSH threshold (H.R. 3203/S.773) Support for Substance Use Disorder Workforce Act of 2021 (H.R.3441)/Opioid Workforce Act of 2021 (S.1438) Support for Resident Physician Shortage Reduction Act of 2021 (H.R. 2256/S.834) Support for Rural Hospital Support Act (H.R. 1887) Support for Medicaid DSH Payment Adjustment Fairness Act (H.R. 5015). Support for continuing telehealth flexibilities beyond COVID-19 pandemic Support for preserving Medicares previously longstanding Critical Access Hospital mileage requirements

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

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

S.3796/H.R.7045, Closing Health Coverage Gaps for Public Servants Act H.R.7116, 9-8-8 Implementation Act H.R.6833, the Affordable Insulin Now Act H.R.1195, Workplace Violence Prevention for Health Care and Social Service Worker Act Monitor the following: H.R.5015, the Medicaid DSH Payment Adjustment Fairness Act, Hospital funding formula H.R.5376, Build Back Better Act S.2110, Better Care Better Jobs Act Nurse Overtime and Patient Safety Act H.R.1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, Entirety S.632, Health Force and Resilience Force Act, H.R.959/S.346, Black Maternal Health Momnibus Act Student Loan Forgiveness for Frontline Health Workers S.102, the Prescription Drug Price Relief Act S.99, the Medicare Drug Price Negotiation Act S.97, the Affordable and Safe Prescription Drug Importation Act H.R.1391/S.482, Taxpayer Research and Coronavirus Knowledge Act, Entirety H.R.7296/S.4439, Make Medications Affordable by Preventing Pandemic Pricegouging Act, Entirety Affordability of pharmaceuticals, generally Treating gun violence as a public health epidemic related issues The National Nurse Act, Entirety Health Equity Issues during COVID Pandemic H.R.728/S.187, Pandemic Emergency Manufacturing Act of 2021, Entirety Support Medicare/ACA enrollment H.R. 6637, Health Equity and Accountability Act, Entirety Delivery of healthcare services to students during COVID pandemic Telehealth issues H.R.1227/S.386, Medicare X Choice Act Rural Healthcare related issues and initiatives Federal response to COVID-19 Pandemic H.R.3755, the Women's Health Protection Act, Entirety Health Worker Shortage/Staffing Crisis

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

Monitor the following: H.R.5015, the Medicaid DSH Payment Adjustment Fairness Act, Hospital funding formula Federal Medicaid Funding (FMAP) and the territories Medicare Negotiation and Competitive Licensing Act, Entirety H.R.1976, To establish an improved Medicare for All national health insurance program, Entirety Medicare for America Act, Entirety Medicaid funding in schools

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

Medicaid DSH Payments including the Medicaid DSH Payment Adjustment Fairness Act (H.R. 5015); Graduate Medical Education (GME); COVID-19 funding relief for public safety net hospitals, including Provider Relief Fund (PRF); 340B drug pricing Program; federal medical nutrition therapy programs; federal child nutrition programs; and FDAs Rulemaking Process and Planned Tobacco Product Standards to Prohibit Menthol as a Characterizing Flavor in Cigarettes and Flavors in Cigars.

Client expense: $92,000 · Firm income: Not reported

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

HR 315 - Medicare Sequester Moratorium Act Issues related to Graduate Medical Education Issues related to Medicaid coverage Issues related to Medicaid disproportionate share hospital (DSH) funding and payment Issues related to uncompensated care pool payments Issues related to Medicaid funding Issues related to Medicare payment Issues related to Medicare quality measures Issues related to the Medicare Accelerated and Advance Payment (AAP) programs Medicaid and CHIP Payment and Access Commission (MACPAC) Medicaid Federal Medical Assistance Percentage (FMAP) Medicare Payment Advisory Commission (MedPAC) H.R. 5015 - Medicaid DSH Payment Adjustment Fairness Act of 2021 S. 1512 - CONNECT for Health Act S. 1988 - Protecting Rural Telehealth Access Act S. 610 Protecting Medicare and American Farmers from Sequester Cuts Act S. 834 - Resident Physician Shortage Reduction Act of 2021 S.368/H.R.1332 - Telehealth Modernization Act S. 3018 - Improving Seniors Timely Access to Care Act

Client expense: $340,000 · Firm income: Not reported

H.R.5015, the Medicaid DSH Payment Adjustment Fairness Act, Hospital funding formula Monitor the following: Federal Medicaid Funding (FMAP) and the territories Medicare Negotiation and Competitive Licensing Act, Entirety H.R.1976, To establish an improved Medicare for All national health insurance program, Entirety Medicare for America Act, Entirety Medicaid funding in schools

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

Government targets: Agriculture, Dept of (USDA), Education, Dept of, HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, White House Office

H.R.5015, the Medicaid DSH Payment Adjustment Fairness Act, Hospital funding formula Monitor the following: H.R.5376, Build Back Better Act S.2110, Better Care Better Jobs Act Nurse Overtime and Patient Safety Act H.R.1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, Entirety S.632, Health Force and Resilience Force Act, H.R.959/S.346, Black Maternal Health Momnibus Act Student Loan Forgiveness for Frontline Health Workers S.102, the Prescription Drug Price Relief Act S.99, the Medicare Drug Price Negotiation Act S.97, the Affordable and Safe Prescription Drug Importation Act H.R.1391/S.482, Taxpayer Research and Coronavirus Knowledge Act, Entirety H.R.7296/S.4439, Make Medications Affordable by Preventing Pandemic Pricegouging Act, Entirety Affordability of pharmaceuticals, generally Treating gun violence as a public health epidemic related issues The National Nurse Act, Entirety Health Equity Issues during COVID Pandemic H.R.728/S.187, Pandemic Emergency Manufacturing Act of 2021, Entirety Support Medicare/ACA enrollment H.R. 6637, Health Equity and Accountability Act, Entirety Delivery of healthcare services to students during COVID pandemic Telehealth issues H.R.1227/S.386, Medicare X Choice Act Rural Healthcare related issues and initiatives Federal response to COVID-19 Pandemic

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

HR 315 - Medicare Sequester Moratorium Act Issues related to Graduate Medical Education Issues related to Medicaid coverage Issues related to Medicaid disproportionate share hospital (DSH) funding and payment Issues related to uncompensated care pool payments Issues related to Medicaid funding Issues related to Medicare payment Issues related to Medicare quality measures Issues related to the Medicare Accelerated and Advance Payment (AAP) programs Medicaid and CHIP Payment and Access Commission (MACPAC) Medicaid Federal Medical Assistance Percentage (FMAP) Medicare Payment Advisory Commission (MedPAC) H.R. 5015 - Medicaid DSH Payment Adjustment Fairness Act of 2021 S. 1512 - CONNECT for Health Act S. 1988 - Protecting Rural Telehealth Access Act S. 610 Protecting Medicare and American Farmers from Sequester Cuts Act S. 834 - Resident Physician Shortage Reduction Act of 2021 S.368/H.R.1332 - Telehealth Modernization Act S. 3018 - Improving Seniors Timely Access to Care Act

Client expense: $340,000 · Firm income: Not reported

Q4 Lobbying Report (October 1-December 31) Health Issues Provider Relief Fund Improvement Act (H.R. 5963) Provider Relief Fund Deadline Extension Act (S. 2493/H.R. 4735) Infrastructure Investment and Jobs Act (H.R. 3684) Build Back Better Act (H.R. 5376) FY 2022 Budget Resolution Public Service Loan Forgiveness program/physician federal loan forgiveness Coronavirus Provider Protection Act (H.R. 3021) Healthcare Workforce Resilience Act of 2021 Increasing Behavioral Health Treatment Act (H.R.2611) Rural America Health Corps Act (S.54) Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Conrad State 30 & Physician Access Act 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 American Rescue Plan (H.R. 1319) American Jobs Plan Leading Infrastructure for Tomorrows America Act/LIFT America Act (H.R. 1848) Rural Hospital Closure Relief Act (H.R. 1639/S.644) National Coronavirus Commission Act (S. 412) Strengthening Mental Health Supports for BIPOC Communities Act (H.R. 1331) 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) Resident Physician Shortage Act (S. 834/H.R. 2256) OSHA rule on COVID-19 Healthcare Workplace Safety No Surprises Act regulations Medicare/Medicaid Protecting Medicare and American Farmers from Sequester Cuts Act (S.610) Medicaid DSH Payment Adjustment Fairness Act of 2021 (H.R. 5015) Stopping Doctor Shortages Act (H.R. 1133/S. 311) Better Way for Providers to Repay Act of 2021 (H.R. 2407) Public Health Emergency designation Accelerated and Advance Payment Program repayment flexibility Rural hospital policies (Rural Health Clinic payment - H.R. 1868) Sequestration relief (H.R. 1868) Graduate Medical Education (GME) funding (Resident Physician Shortage Reduction Act of 2021 (S. 834) Disproportionate share hospital allotment increase (technical correction) Telehealth flexibilities and payment (TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act -S. 368/H.R. 1332; TREATS Act - S. 340) Medicare for All (H.R. 1976) Resetting the Impact Act (TRIA) of 2021 (H.R. 2455) Submitted Comments SUBJECT: [Docket No. FDA-2016-D-0271], Hospital and Health System Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act; Revised Draft Guidance for Industry; (Vol 86, No 192), October 7, 2021 Subject: CMS-9908-IFC, Requirements Related to Surprise Billing; Part II; Interim Final Rule with Comment Period, Federal Register (Vol. 86, No. 192), October 7, 2021 SUBJECT: CMS-9907-P, Requirements Related to Air Ambulance Services, Agent and Broker Disclosures, and Provider Enforcement, Federal Register (Vol. 86, No. 177), September 16, 2021 SUBJECT: [IS No. 2696-21; DHS Docket No. USCIS- 2021-0013; Public Charge Ground of Inadmissibility; Advanced Notice of Proposed Rulemaking; Federal Register (Vol. 86, No. 160), August 23, 2021

Support for hospital funding in federal infrastructure package Support for delay/elimination of Medicare sequestration cuts Support for legislation to continue expansion of telehealth services during and beyond COVID-19 pandemic Support for fair and accurate distribution of CARES Act Provider Relief Funds Support for conversion of Medicare Accelerated/Advance Payments to loans Support for changes to Medicare Volume Decrease Adjustment calculation Support for Protecting Rural Access to Care Act (H.R. 489) Support for flexibility in 340B drug pricing program DSH threshold (H.R. 3203/S.773) Support for Substance Use Disorder Workforce Act of 2021 (H.R.3441)/Opioid Workforce Act of 2021 (S.1438) Support for Resident Physician Shortage Reduction Act of 2021 (H.R. 2256/S.834) Support for Rural Hospital Support Act (H.R. 1887) Support for Medicaid DSH Payment Adjustment Fairness Act (H.R. 5015). Support for continuing telehealth flexibilities beyond COVID-19 pandemic Support for preserving Medicares previously longstanding Critical Access Hospital mileage requirements

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

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

H.R. 5376, Build Back Better Act; Healthcare workforce provisions; maternal health provisions H.R. 133, Consolidated Appropriations Act, 2021 (P.L. 116-260); Medicaid shortfall definition; Graduate Medical Education (GME) allocations H.R. 801, Expanding Medical Education Act H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act H.R. 5015, Medicaid DSH Payment Adjustment Fairness Act of 2021 S. 610, Protecting Medicare and American Farmers from Sequester Cuts Act; Medicare payment cuts H.R. 2256/S. 834, Resident Physician Shortage Reduction Act of 2021 Hospital at home waivers extension issues Telehealth waiver extension issues Requirements Related to Surprise Billing; Part II; Interim Final Rule (October 7, 2021; 86 FR 55980; CMS-2021-0156) Tentative proposals to streamline Schedule I research

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

Government targets: Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Natl Oceanic & Atmospheric Administration (NOAA), Office of Science & Technology Policy (OSTP), SENATE, Transportation, Dept of (DOT), U.S. Coast Guard (USCG), Veterans Affairs, Dept of (VA)

Support for hospital funding in federal infrastructure package Support for delay/elimination of Medicare sequestration cuts Support for legislation to continue expansion of telehealth services during and beyond COVID-19 pandemic Support for fair and accurate distribution of CARES Act Provider Relief Funds Support for conversion of Medicare Accelerated/Advance Payments to loans Support for changes to Medicare Volume Decrease Adjustment calculation Support for Protecting Rural Access to Care Act (H.R. 489) Support for flexibility in 340B drug pricing program DSH threshold (H.R. 3203/S.773) Support for Substance Use Disorder Workforce Act of 2021 (H.R.3441)/Opioid Workforce Act of 2021 (S.1438) Support for Resident Physician Shortage Reduction Act of 2021 (H.R. 2256/S.834) Support for Rural Hospital Support Act (H.R. 1887) Support for Medicaid DSH Payment Adjustment Fairness Act (H.R. 5015).

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

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

H.R. 5015, Medicaid DSH Payment Adjustment Fairness Act of 2021

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

Government targets: Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Natl Oceanic & Atmospheric Administration (NOAA), Office of Science & Technology Policy (OSTP), SENATE, U.S. Coast Guard (USCG), Veterans Affairs, Dept of (VA)

Q3 Lobbying Report (July 1-September 30) Health Issues Provider Relief Fund Deadline Extension Act (S. 2493/H.R. 4735) Infrastructure Investment and Jobs Act (H.R. 3684) Build Back Better Act (H.R. 5376) FY 2022 Budget Resolution Public Service Loan Forgiveness program/physician federal loan forgiveness Coronavirus Provider Protection Act (H.R. 3021) Healthcare Workforce Resilience Act of 2021 Increasing Behavioral Health Treatment Act (H.R.2611) Rural America Health Corps Act (S.54) Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Conrad State 30 & Physician Access Act 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 American Rescue Plan (H.R. 1319) American Jobs Plan Leading Infrastructure for Tomorrows America Act/LIFT America Act (H.R. 1848) Rural Hospital Closure Relief Act (H.R. 1639/S.644) National Coronavirus Commission Act (S. 412) Strengthening Mental Health Supports for BIPOC Communities Act (H.R. 1331) 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) Resident Physician Shortage Act (S. 834/H.R. 2256) OSHA rule on COVID-19 Healthcare Workplace Safety No Surprises Act regulations Medicare/Medicaid Medicaid DSH Payment Adjustment Fairness Act of 2021 (H.R. 5015) Stopping Doctor Shortages Act (H.R. 1133/S. 311) Better Way for Providers to Repay Act of 2021 (H.R. 2407) Public Health Emergency designation Accelerated and Advance Payment Program repayment flexibility Rural hospital policies (Rural Health Clinic payment - H.R. 1868) Sequestration relief (H.R. 1868) Graduate Medical Education (GME) funding (Resident Physician Shortage Reduction Act of 2021 (S. 834) Disproportionate share hospital allotment increase (technical correction) Telehealth flexibilities and payment (TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act -S. 368/H.R. 1332; TREATS Act - S. 340) Medicare for All (H.R. 1976) Resetting the Impact Act (TRIA) of 2021 (H.R. 2455) Submitted Comments Subject: CMS-9909-IFC, Requirements Related to Surprise Billing; Part I; Interim Final Rule with Comment Period, Federal Register (Vol. 86, No. 131), July 13, 2021 SUBJECT: CMS-1753-P, Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Price Transparency of Hospital Standard Charges; Radiation Oncology Model; Request for Information on Rural Emergency Hospitals (Vol 86, No 147), August 4, 2021 SUBJECT: CMS-1751-P, Medicare Program; CY 2022 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Provider Enrollment Regulation Updates; Provider and Supplier Prepayment and Post Payment Medical Review Requirements; Proposed Rule; Federal Register (Vol. 86, No.139), July 23, 2021 SUBJECT: CMS-1747-P, Medicare and Medicaid Programs; CY 2022 Home Health Prospective Payment System Update: Home Health Value-Based Purchasing Model Requirements and Proposed Model Expansion; Home Health Quality Reporting Requirements; Home Infusion Therapy Services Requirements; survey and Enforcement Requirements for Hospice Programs; Medicare Provider Enrollment Requirements; Inpatient Rehabilitation Facility Quality Reporting Program Requirements; and Long-term Care Hospital Quality Reporting Program Requirements; Federal Register (Vol. 86, No.127), July 7, 2021 Subject: Information Collection Request Title: COVID-19 Provider Relief Fund Reporting Activities, OMB No. 0906- XXXX New, Federal Register (Vol. 86, No. 140), July 26, 2021