Collaborate in an Orderly and Cohesive Manner Act

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported Chronic Care Management Act that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supports those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 200 I to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S.323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of2 I and be subject to a criminal background check. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act, to improve the integration of behavioral health in primary care practices.

Client expense: $511,077 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

Expand Patient Access and Telehealth: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVJD and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported Chronic Care Management Act that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported Black Maternal Health Momnibus Act, H.R. 3305 and S. 1606, to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. The Department of Health and Human Services (HHS) and other specified departments would address the social determinants of maternal health, which include childcare, housing, food security, transportation, and environmental conditions. The bill also extends to 24 months postpartum eligibility for the Special Supplemental Nutrition Program for Woman, Infants, and Children. Additionally, HHS and other agencies must take actions to grow and diversify the maternal health workforce. To increase access to maternity care, HHS and other agencies must 1) award specified grants; 2) test an alternative payment model for perinatal care under Medicaid and the Children's Health Insurance Program (CHIP); and 3) support training, technology, and telehealth initiatives. Supported the Public Health Infrastructure Saves Lives Act, S. 1995, that provides annual funding for the CDC to strengthen core public health infrastructure. Core public health infrastructure includes the elements and workforce capabilities that enable health departments to perform critical functions such as disease surveillance and emergency response. Specifically, the CDC must award grants to health departments for their core infrastructure needs. In addition, the CDC must support the development of accreditation standards for health departments that emphasize core public health infrastructure. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Supports those provisions in the 2023 Farm Bill, the 5-year reauthorization legislation, related to food and nutrition - namely food security and Supplemental Nutrition Assistance Program (SNAP) provisions. We support the nutrition assistance and food distribution programs for nearly 40 million people with low-income, e.g. ((SNAP Supplemental Nutrition Assistance Program, The Emergency Food Assistance Program (TEFAP) and preserving the current SNAP entitlement and funding structure to ensure benefit adequacy without work requirements. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 200 I to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes. Advocated against a March 2023 ruling by a federal judge in Texas that the ACA's requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vil, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDC's programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Supported $60 million for Public Health Infrastructure and Capacity, $400 million for Title X Family Service Grants, and $35 million for CDC Firearm Injury Prevention and Control. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S.323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Social Determinants of Healthcare: Urged Congress to support legislation to expand utilization of social determinants of healthcare to expand governments capabilities to provide healthcare to underserved and disadvantaged communities. Supported the Improving the Social Determinants of Health Act of 2023 that would: award grants to state, local, territorial, and Tribal health agencies and organizations to address SDOHs in target communities; award grants to nonprofit organizations and institutions of higher education to conduct research on SDOH best practices; provide technical assistance, training, and evaluation assistance to target community grantees; and disseminate best practices; and collect and analyze data related to SDOH activities. Supported Donald McEachin Environmental Justice for All Act, H.R. 1705 and S. 1606. The bill contains environmental justice requirements, advisory bodies, and programs to address the disproportionate adverse human health or environmental effects of federal laws or programs on communities of color, low-income communities, or tribal and indigenous communities. Specifically, the bill prohibits disparate impacts on the basis of race, color, or national origin as discrimination. Aggrieved persons may seek legal remedy when faced with such discrimination. In addition, the bill directs agencies to follow certain requirements concerning environmental justice. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of2 I and be subject to a criminal background check. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors' Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduces H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Supported S. 1378, the Connecting Our Medical Providers with Links to Expand Tailored and Effective Care or the COMPLETE Care Act, to improve the integration of behavioral health in primary care practices.

Client expense: $93,542 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a March 2023 ruling by a federal judge in Texas that the ACAs requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Expand Patient Access: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVID and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Urged Congress to also: 1) provide a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced APM incentive payments for additional years to continue to recruit new providers into APMs. Additionally, to ensure that qualifying thresholds remain attainable to promote program growth, CMS should be given authority to adjust thresholds through rulemaking and to set varying thresholds for more targeted models where participants cannot meet the existing one-size-fits-all thresholds; 2) remove distinctions (i.e., the high-low revenue designation in the Medicare Shared Savings Program) that penalize safety net providers, improve financial methodologies so that APM participants are not penalized for their own success, reduce regulatory burdens by offering increased flexibilities and waivers for clinicians moving to risk, and provide technical assistance and an appropriate glidepath to financial risk for those newly transitioning to APMs; 3) work with the CMS Innovation Center to ensure that promising models have a more predictable pathway for being implemented and becoming permanent and are not cut short due to overly stringent criteria; and 4) should seek greater alignment between APMs and the MA program to ensure that both models provide attractive, sustainable options for innovating care delivery, and to ensure that APMs do not face a competitive disadvantage. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Preventions programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Preventions (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDCs programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Womens Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Acts prescription drug negotiation provisions. Firearm Safety (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 21 and be subject to a criminal background check. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: 1) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduce s H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs.

Client expense: $95,252 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a March 2023 ruling by a federal judge in Texas that the ACAs requirements for coverage for preventive services will harm the health of Americans. Previously, under the ACA, health insurance plans have been required to include coverage at no cost to patients for preventive services recommended by the U.S. Preventive Services Task Force. These preventive services include cancer screenings, mental health screenings, heart disease and hypertension screenings, among other services. Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Expand Patient Access: Urged Congress to support several bills to expand patient access to medical coverage. ACP supports H.R. 1114, the Long COVID Response is Care Optimized and Vitally Essential Resources that Yield New Opportunities for Wellness Act or the Long COVID RECOVERY NOW Act, which would optimize care by enhancing a coordinated federal government response, public education and insurance reimbursement guidance for Long COVID. H.R. 1114 would also authorize the Secretary of Health and Human Services to provide grants to primary care practices to facilitate the adoption of evidence-based Long COVID clinical practices that have been demonstrated to improve the wellness of individuals with Long COVID and submission of data to HHS on the characteristics, diagnoses, and health care service utilization of Long COVID patients. Urged Congress to pass H.R. 952, the Kids Access to Primary Care Act, which ensures that Medicaid payment rates for primary care services are equal to Medicare rates. The ACA included a provision that required states to raise Medicaid payment rates for primary care services equal to Medicare rates in 2013 and 2014 but this provision expired after those two years and was not renewed by Congress. Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Urged Congress to also: 1) provide a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced APM incentive payments for additional years to continue to recruit new providers into APMs. Additionally, to ensure that qualifying thresholds remain attainable to promote program growth, CMS should be given authority to adjust thresholds through rulemaking and to set varying thresholds for more targeted models where participants cannot meet the existing one-size-fits-all thresholds; 2) remove distinctions (i.e., the high-low revenue designation in the Medicare Shared Savings Program) that penalize safety net providers, improve financial methodologies so that APM participants are not penalized for their own success, reduce regulatory burdens by offering increased flexibilities and waivers for clinicians moving to risk, and provide technical assistance and an appropriate glidepath to financial risk for those newly transitioning to APMs; 3) work with the CMS Innovation Center to ensure that promising models have a more predictable pathway for being implemented and becoming permanent and are not cut short due to overly stringent criteria; and 4) should seek greater alignment between APMs and the MA program to ensure that both models provide attractive, sustainable options for innovating care delivery, and to ensure that APMs do not face a competitive disadvantage. FY2024 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Preventions programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Preventions (CDC) Office on Smoking and Health (OSH). Urged Congress to include at least $11.581 billion for the CDCs programs in the FY 2024 Labor, Health and Human Services, Education and Related Agencies appropriations bill. Submitted FY2024 report language to Congress regarding the overestimation of utilization of new codes. Womens Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Prescription Drug Reform: Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Acts prescription drug negotiation provisions. Firearm Safety (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 21 and be subject to a criminal background check. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process by reintroducing and passing the Improving Seniors Timely Access to Care Act. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: 1) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Mental and Behavioral Health: Urged members of Congress to cosponsor and reintroduce s H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs.

Client expense: $297,476 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

Health Issues (Andrew Hu) House and Senate       Issues/Topics Public health funding  Behavioral health and crisis intervention Healthcare Workforce Rural health care and rural hospitals Telehealth  Medicare   Medicaid  Dual Medicare and Medicaid Eligibility Hospital Consolidation     Nutrition Services and Food Security  Obesity in older adults School meals Child nutrition Opioids and Substance Use Disorders Caregiving and Aging Home and Community Based Services Pandemic Preparedness Bills S3799 PREVENT Pandemics Act H.R. 6613 - Keeping School Meals Flexible Act S1536/HR3108 - Medical Nutrition Therapy Act of 2021 HR 5218 - Collaborate in an Orderly and Cohesive Manner HR 7232 - 9-8-8 and Parity Assistance Act of 2022

Client expense: $630,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 253, Cannabidiol and Marihuana Research Expansion Act, all provisions H.R. 6087, Improving Access to Workers Compensation for Injured Federal Workers Act of 2022, all provisions H.R. 3085, Equity in Neuroscience and Alzheimers Clinical Trials (ENACT) Act of 2021, all provisions H.R. 5030, Diversifying Investigations Via Equitable Research Studies for Everyone (DIVERSE) Trials Act, all provisions 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. 2067, Medication Access and Training Expansion (MATE) Act of 2021, all provisions S. 2235, Medication Access and Training Expansion (MATE) Act of 2021, all provisions H.R. 6072, Leveraging Integrated Networks in Communities (LINC) To Address Social Needs Act of 2021, provisions relating to social determinants of health, impact on mental health and social services S. 509, Leveraging Integrated Networks in Communities (LINC) To Address Social Needs Act of 2021, provisions relating to social determinants of health, impact on mental health and social services 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. 3799, Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act, all provisions H.R. 8, Bipartisan Background Checks Act of 2021, all provisions H.R. 1446, Enhanced Background Checks Act of 2021, all provisions S. 1675, Maternal Health Quality Improvement Act, all provisions H.R. 2163, Safe Step Act, all provisions S. 464, Safe Step Act, all provisions H.R. 666, Anti-Racism in Public Health Act of 2021, all provisions S. 162, Anti-Racism in Public Health Act of 2021, all provisions H.R. 5248, Temporary Responders for Immediate Aid in Grave Emergencies (TRIAGE) Act of 2021, all provisions H.R. 6311, Comprehensive Addiction Resources Emergency Act of 2021, all provisions S. 3418, Comprehensive Addiction Resources Emergency Act of 2021, all provisions H.R. 1364, Parity Enforcement Act of 2021, all provisions H.R. 3735, Parity Implementation Assistance Act, all provisions H.R. 7232, 9-8-8 and Parity Assistance Act of 2022, all provisions H.R. 7116, 9-8-8 Implementation Act of 2022, all provisions S. 2938, Bipartisan Safer Communities Act, all provisions S. 4090, Dietary Supplement Listing Act of 2022, all provisions S. 1675, Maternal Health Quality Improvement Act, 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. 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. 2416, New Opportunities for Value that Extend Lives (NOVEL) Act of 2021, all provisions H.R. 8152, To provide consumers with foundational data privacy rights, create strong oversight mechanisms, and establish meaningful enforcement, all provisions H.R. 2377, Federal Extreme Risk Protection Order Act of 2022, all provisions H.R. 7910, Protecting Our Kids Act, all provisions S. 2938, Bipartisan Safer Communities Act, all provisions H.R. 7667, Food and Drug Amendments of 2022, all provisions H.R. 7666, Restoring Hope for Mental Health and Well-Being 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. 7192, Diagnostic Device Advisory Committee Act, all provisions H.R. 3085, Equity in Neuroscience and Alzheimers Clinical Trials (ENACT) Act of 2021, all provisions H.R. 5218, Collaborate in an Orderly and Cohesive Manner Act, all provisions H.R. 7845, NIH Clinical Trial Diversity Act of 2022, all provisions H.R. 708, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions H.R. 4480, Telehealth Coverage and Payment Parity Act, all provisions H.R. 7573, Telehealth Extension and Evaluation Act, all provisions S. 3593, Telehealth Extension and Evaluation Act, all provisions H.R. 5541, Primary and Virtual Care Affordability 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. 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. 7053, Hospital Inpatient Services Modernization Act, all provisions S. 3792, Hospital Inpatient Services Modernization Act, all provisions H.R. 1364, Parity Enforcement Act of 2021, all provisions H.R. 5224, Preventing Overdoses and Saving Lives Act of 2021, all provisions H.R. 6279, Opioid Treatment Access Act of 2022, all provisions H.R. 7234, Summer Barrow Prevention, Treatment, and Recovery 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. 3771, South Asian Heart Health Awareness and Research Act of 2021, all provisions H.R. 7559, Prescription Information Modernization Act of 2022, all provisions H.R. 8289, Banning Misleading Drug Ads Act of 2022, all provisions H.R. 3614, Menstrual Equity For All Act of 2021, all provisions No Surprises Act/implementation Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions 21st Century Cures Act/implementation Maternal mortality Maternal health and inequities/FY 2023 funding Prior Authorization AMA Recovery Plan for Americas Physicians/telehealth/prior authorization/physician burnout/scope Section 2527(b) of the U.S. Innovation and Competition Act (USICA)/Open Access Language Retired Physician Re-entry COVID-19 telehealth flexibilities COVID-19/Vaccine distribution/Vaccines in physician offices Physician burnout and suicide COVID-19/Health Equity/vaccines COVID-19 response/testing/misinformation/therapeutics/Paxlovid Public Health Emergency COVID-19 Health Equity/Men who have sex with men/3-month blood donation use deferral Health Equity/Federally qualified health centers and clinical trials Womens Reproductive Health Medication Abortion Access Diabetes Provider Relief Fund/COVID-19 Electronic Health Records (EHR) Certification Data Privacy Hunger, Nutrition, and Health Digital Health/AI/Digital Therapeutics Monkeypox/testing/vaccination

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), President of the U.S., SENATE, Vice President of the U.S., White House Office

Issues/Topics Public health funding  Behavioral health and crisis intervention Healthcare Workforce Rural health care and rural hospitals Telehealth  Medicare   Medicaid  Dual Medicare and Medicaid Eligibility Nutrition Services and Food Security  Obesity in older adults School meals Opioids and Substance Use Disorders Caregiving and Aging Home and Community Based Services Pandemic Preparedness Bills S. 3799, PREVENT Pandemics Act H.R. 6613, Keeping School Meals Flexible Act S. 1536 / H.R. 3108, Medical Nutrition Therapy Act of 2021 H.R. 5218, Collaborate in an Orderly and Cohesive Manner H.R. 7232, 9-8-8 and Parity Assistance Act of 2022 H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022 H.R. 1887 / S. 4009, Rural Hospital Support Act S. 2089, Keep Kids Fed Act S. 3913 / H.R. 8481, Improving DATA in Public Health Act S.4264, Advancing Integration in Medicare and Medicaid (AIM) Act S.3534 / H.R.7152, Tracking Pathogens Act S. 1162 / H.R. 6770, PACE Plus Act S.3626, PACE Expanded Act S. 569 / H.R. 1577, Treat and Reduce Obesity Act H.R. 4040, Advancing Telehealth Beyond COVID-19 Act of 2021

Client expense: $960,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues/Topics Public health funding  Behavioral health and crisis intervention Healthcare Workforce Rural health care and rural hospitals Telehealth  Medicare   Medicaid  Dual Medicare and Medicaid Eligibility Nutrition Services and Food Security  Obesity in older adults School meals Opioids and Substance Use Disorders Caregiving and Aging Home and Community Based Services Pandemic Preparedness Bills S. 3799, PREVENT Pandemics Act H.R. 6613, Keeping School Meals Flexible Act S. 1536 / H.R. 3108, Medical Nutrition Therapy Act of 2021 H.R. 5218, Collaborate in an Orderly and Cohesive Manner H.R. 7232, 9-8-8 and Parity Assistance Act of 2022 H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022 H.R. 1887 / S. 4009, Rural Hospital Support Act S. 2089, Keep Kids Fed Act S. 3913 / H.R. 8481, Improving DATA in Public Health Act S.4264, Advancing Integration in Medicare and Medicaid (AIM) Act S.3534 / H.R.7152, Tracking Pathogens Act S. 1162 / H.R. 6770, PACE Plus Act S.3626, PACE Expanded Act S. 569 / H.R. 1577, Treat and Reduce Obesity Act H.R. 4040, Advancing Telehealth Beyond COVID-19 Act of 2021

Client expense: $870,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act (ACA); Transparency; Surprise Billing, Telehealth; COVID-19; Extending ARPA Subsidies; Health Equity Issues; Mental Health Parity; Affordability; Inflation Reduction Act; No Surprises Act; Covid transition/PH.COVID-19 response in P.L. 117-103, The Consolidated Appropriations Act; Health care policies contained in P.L. 117-2, The American Rescue Plan Act; P.L. 117-169, Inflation Reduction Act of 2022 H.R. 2617 - Consolidated Appropriations Act, 2023; ACA subsidies, Medicaid redetermination, Medicaid Postpartum coverage, pharmacy benefit mangers H.R. 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 To amend the Public Health Service Act to reauthorize certain programs relating to mental health and substance use disorders, and for other purposes Sponsor: Rep. Frank Pallone (D-NJ-06) H.R. 5218 Collaborate in an Orderly and Cohesive Manner Act H.R. 7767 - Strengthening Behavioral Health Benefits Act to amend the Employee Retirement Income Security Act of 1974 to provide for the enforcement of mental health and substance abuse disorder parity requirements, and for other purposes. Sponsor: Rep. Joe Courtney (D-CT-02) H.R. 959 - Black Maternal Health Momnibus Act of 2021To end preventable maternal mortality and severe maternal morbidity in the United States and close disparities in maternal health outcomes, and for other purposes. Sponsor: Rep. Lauren Underwood (D-IL-14)

Client expense: $1,040,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation to amend the definition of physician in Medicare to provide for treatment of clinical psychologists as physicians, for purposes of providing clinical psychologist services under Medicare; issues related to reimbursement of psychologists in Medicare; issues related to integration of behavorial health services in primary care, including Improving Access to Behavioral Health Integration Act (S. 4306) and Collaborate in an Orderly and Cohesive Manner Act (HR 5218).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Implementation of funding provided for in Consolidated Appropriations Act, 2021 (P.L. 116-260) to address substance use disorder; Mainstreaming Addiction Treatment Act (H.R. 1384/S. 445); Medication Access and Training Expansion Act (H.R. 2067/S. 2235); Medicaid Reentry Act of 2021 (H.R. 955/S. 285); Collaborate in an Orderly and Cohesive Manner Act (H.R.5218); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Synthetic Opioid Danger Awareness Act (H.R. 2364); FENTANYL Results Act (H.R. 2538/S. 1160); issues related to fentanyl; Consolidated Appropriations Act, 2023 (P.L. 117-328).

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

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

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

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

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

S.800/H.R. 4870 - Promoting Access to Diabetic Shoes Act H.R. 1956/S. 1986 - Increasing Access to Quality Cardiac Rehabilitation Care Act of 2021 H.R. 2067/S. 2235 - Medication Access and Training Expansion (MATE) Act S. 987 - Comprehensive Addiction and Recovery Act (CARA) 3.0 H.R. 1319 - American Rescue Plan Act [Public Law No: 117-2] H.R. 1716 - COVID-19 Mental Health Research Act H.R. 1195 - the Workplace Violence Prevention for Health Care and Social Service Workers Act S. 54 - Strengthening Americas Health Care Readiness Act H.R. 851/S. 246 - the Future Advancement of Academic Nursing (FAAN) Act H.R. 959/S.346 - Black Maternal Health Momnibus Act of 2021 H.R. 1384 - the Mainstreaming Addiction Treatment Act of 2021 H.R. 955 - the Medicaid Reentry Act of 2021 H.R. 1025 - the Kids Access to Primary Care Act of 2021 S. 1315/H.R. 3630 - the Lymphedema Treatment Act S. 1833 - the Ensuring Access to Primary Care for Women & Children Act H.R. 3550/S. 4905 - the Primary and Behavioral Health Care Access Act S. 1512/H.R. 2903 - the CONNECT for Health Act of 2021 S. 287/H.R. 945 - the Perinatal Workforce Act S. 1536/H.R. 3108 - the Medical Nutrition Therapy Act of 2021 H.R. 1667/S. 610 - the Dr. Lorna Breen Health Care Provider Protection Act H.R. 736 - the Community Immunity During COVID-19 Act of 2021 H.R. 3087/S. 2051 - Breast Cancer Patient Equity Act H.R. 6000 - the Cures 2.0 Act S. 2652/H.R. 5067 - the Preserving Patient Access to Home Infusion Act S. 3149/H.R. 5848 - the Rural Health Equity Act H.R. 6308 - the ACO Assignment Improvement Act of 2021 H.R. 5248 - the Temporary Responders for Immediate Aid in Grave Emergencies (TRIAGE) Act of 2021 H.R. 5376 - the Build Back Better Act H.R.3925 - the Reducing Barriers to Substance Use Treatment Act S. Res. 626 and H. Res. 1100 - honoring and recognizing May 6 through 12, 2022 as National Nurses Week S.3098/H.R. 7617 - Preventive Care Awareness Act S.4182 - the Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 7236 - the Strengthen Kids Mental Health Now Act of 2022 H.R. 2376 - the Excellence in Recovery Housing Act H.R. 4944 - the Helping Kids Cope Act of 2021 H.R. 5218 - the Collaborate in an Orderly and Cohesive Manner Act H.R. 7076 - the Supporting Childrens Mental Health Care Access Act of 2022 H.R. 7232 - the 9-8-8 and Parity Assistance Act of 2022 H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 S.4170 - the Mental Health Reform Reauthorization Act H.R. 8812/S. 5212 - Improving Care and Access to Nurses (ICAN) Act H.R. 8454 - Medical Marijuana and Cannabidiol Research Expansion Act [Public Law No: 117-215] H.R. 3352/S. 1697 - Midwives for MOMs Act H.R. 8817/S. 4844 - the National Nursing Workforce Center Act of 2022 H.R. 3259/S. 586 - the NOPAIN Act H.R. 2617 - Consolidated Appropriations Act, 2023 The Senate Finance Committee Bipartisan Mental Health Workforce Discussion Draft National Healthcare Provider Directory Department of Labor independent contractor classification Issues pertaining to White House Hunger, Nutrition, and Health Conference Issues surrounding federal Monkeypox response Clinical Laboratory Improvement Amendments (CLIA) Replenish the COVID-19 Uninsured Relief Fund Nursing faculty shortage Nursing Education Use of telehealth to prescribe controlled substances under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 [Public Law No: 110-425] Rural health care issues, including rural workforce, COVID-19 vaccination, and reimbursement Medicare sequestration Medicare restrictions pertaining to telehealth Include nurses, APRNs, and nursing students in all National Public Health Plans Provide resources to support nurses, APRNs, and nursing students mental health needs, especially for those responding to the pandemic Funding to ensure childcare coverage Increased Federal Medical Assistance Percentage (FMAP) funding to states Access to personal protective equipment Extension of CMS waivers beyond public health emergency Skilled Nursing Facility admitting examination and assessment requirements COVID-19 Pandemic relief: funding, removal of barriers, telehealth, mental health, personal protective equipment, and testing Telehealth, remote patient monitoring and other forms of health technology COVID-19 Pandemic Reducing Regulatory Burdens, including those relating to home infusion therapy, Medicare Conditions of Participation, and hospice certification Medication-Assisted Treatment (MATs) Opioid Abuse Epidemic Documentation of medical records Health plan coverage and program requirements including provider non-discrimination Issues relating to Mental and Substance Use Disorder Workforce Addressing Health Equity Medicare Provider Reimbursement Clinical labor pricing update Tobacco flavors and menthol Site specific restrictions on providers under DEA controlled substances policy

Client expense: $320,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Nuclear Regulatory Commission (NRC), Office of Special Counsel, SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Issues generally in the Affordable Care Act; issues related to insurance markets and stabilization, transparency, surprise billing, access to and payment for mental health care, and COVID-19 response in P.L. 117-103, the Consolidated Appropriations Act, 2022; H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022; and health care policies contained in and amendments offered to P.L. 117-2, the American Rescue Plan Act of 2021; P.L. 117-169, Inflation Reduction Act of 2021; H.R. 5218, Collaborate in an Orderly and Cohesive Manner Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor the following: H.R.5218, Collaborate in an Orderly and Cohesive Manner Act, Collaborative care model Funding for mental health treatment H.R.7666, Restoring Hope for Mental Health and Well-Being Act

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

H.R. 432 - Mental Health Access Improvement Act H.R. 909 / S. 484 - The Moms Matter Act H.R. 1475/ S. 1795 - Pursuing Equity in Mental Health Act H.R. 3173 - Improving Seniors Timely Access to Care Act of 2021 H.R. 3541 / S. 1810 - Conrad State 30 and Physician Access Reauthorization Act H.R. 3753/ S. 1962 - Parity Implementation Assistance Act H.R. 4058 / S. 2061 - Telemental Health Care Access Act H.R. 4122 / S. 3658 - Resident Education Deferred Interest (REDI) Act H.R. 4217 / S. 2779 - TRIUMPH for New Moms Act H.R. 4770 - Evaluating Disparities and Outcomes of Telehealth (EDOT) Act of 2021 H.R. 5218 - Collaborate in an Orderly and Cohesive Manner Act H.R. 6000 - Cures 2.0 Act H.R. 6636 / S. 2697 - Due Process Continuity of Care Act H.R. 7073 / S. 3824 - Into the Light for Maternal Mental Health and Substance Use Disorders Act H.R. 7116 - 988 Implementation Act of 2022 H.R. 7232 - 988 and Parity Assistance Act of 2022 H.R. 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 H.R. 7667 - Food and Drug Amendments of 2022 H.R. 7857 - Minority Fellowship Program Reauthorization Act of 2022 H.R. 8180 - Undertaking Needed Investments in Therapy, Education, and De-Escalation (UNITED) Act of 2022 H.R. 8229 - Telemental Health Parity Act H.R. 8391 - CONNECT Act H.R. 8800 - Supporting Medicare Providers Act of 2022 H.R. 8830 / S. 4003 - Law Enforcement De-escalation Training Act H.R. 8878 - Intensive Outpatient Policy H.R. 8879 - Inpatient Psychiatric Facility Improvement Act H.R. 8881 - Mental Health Transparency Act H.R. 8884 - Medicare Opioid Use Disorder Outreach Act H.R. 8885 - Better Health Care Directories Act H.R. 8886 - Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act H.R. 8889 - Readable Insurance Coverage Enhancement (RICE) Act H.R. 8890 - Physician Wellness Program Act H.R. 8891 - No Surprises for Survivors Act H.R. 8892 - Access to Mental Health Services Act H.R. 8908 - Fighting Stimulant and other Substance Use Disorders Act H.R. 8910 - Behavioral Health Integration Awareness Act H.R. 9201 - Community Mental Wellness and Resilience Act H.R. 9499 - CCBHC Expansion Act of 2022 S. 2144 - PEERS Act of 2021 S. 2425 - Suicide Prevention Lifeline Improvement Act S. 4747 - Investing in Kids Mental Health Now Act S. 4965 - A bill to amend title XVIII of the Social Security Act to remove in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology. S.5041 - Training Psychiatrists for the Future Act S.5042 - More Behavioral Health Providers Act S.5043 - Expand the Behavioral Health Workforce Act S.5061 - Expand Qualified Psychologist Services Act S.5062 - Protect Our Physicians Act S.5272 - Increasing Mental Health Options of 2022 Senate Finance Kids Mental Health Draft Senate Finance Telehealth Draft Senate Finance Integrated Care Draft Senate Finance Workforce Draft Senate Finance Parity Draft

Client expense: $194,975 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Regarding CMS Medicare Physician Fee Schedule and Quality Payment Program (QPP) rules, expressed support for extending some of the services and increased flexibility for telehealth through the end of 2024, namely some audio-only services that were allowed during the COVID-19 public health emergency (PHE), support for collecting additional data on health equity issues to analyze disparities that occur across their programs, support for including chronic care management as one of the seven MIPS Value Pathways (MVPs) for 2023. Urged CMS to discontinue its split/shared visits policy and not move forward with the transition set to take effect in 2023. Urged Congress to support inclusion in must-pass legislation this year provisions to provide financial stability through a baseline positive annual update to the physician fee schedule reflecting inflation in practice costs, and eliminate, revise budget neutrality requirements to allow for appropriate changes in spending growth and prevent a 4.42 percent Medicare payment cut as contained in H.R. 8800, the Supporting Medicare Providers Act of 2022; Extend the moratoriums on sequester and PAYGO cuts that were approved by Congress at the end of last year. Recommended modifications to Medicare law to establish a mechanism for savings to be calculated across all aspects of the program-that is, increased investment in relative and absolute payments for primary care and preventive health care services (Part B) results in savings due to reduced emergency department visits and hospitalizations (Part A)-and to allow these savings to be reinvested back into primary and preventive care, as well as into social and public health services. With regard to Medicares Quality Payment Program, advocated with Congress to provide flexibility to CMS to set performance thresholds, improve the cost performance category, provide scoring flexibility to CMS to allow for multi-category credit, provide CMS flexibility to score and benchmark measures as appropriate and to test and incentivize new measures and MVPs to ensure successful implementation, update the Promoting Interoperability performance category, Extend the $500 million exceptional performance bonus for an additional six years , align comparisons in the MIPS Quality performance category and Physician Compare. FY2023 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Preventions programs in the FY 2023 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Preventions (CDC) Office on Smoking and Health (OSH). COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP); urged support for administering COVID-19 vaccinations to all eligible immigrants in Customs and Border Protection (CBP) custody. Urged CMS to support increasing COVID-19 vaccine uptake by ensuring clinicians are appropriately paid for vaccine counseling for beneficiaries of Medicaid and Medicare. Urged that telehealth services should remain in place for at least two years after the end of the PHE to ensure that our physicians are able to continue to use this modality to enhance patient care. Urged Congress to support the concept of a congressionally-mandated bipartisan commission to examine the U.S. preparations for and response to the COVID-19 pandemic, in order to inform future public policy and health systems preparedness. Urged that any uses of technology in the U.S. in the context of the pandemic should be demonstrated to be effective, be temporary, and ensure that safeguards for privacy and confidentiality are in place. Womens Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Urged support for mandatory, permanent extension of postpartum Medicaid coverage, from 60 days to 12 months after delivery. Urged support for the Womens Health Protection Act of 2021 and 2022 (H.R. 3755/S. 1975), bills that would protect a persons ability to determine whether to continue or end a pregnancy and to protect the health care clinicians ability to provide abortion services free from medically unnecessary restrictions such as waiting periods, biased counselling and admitting privilege requirements for clinicians. Access to Care: Urged members of Congress to cosponsor and pass H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place: Cosponsor and pass H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the Affordable Care Act. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots to 14,000 over seven years for specialties facing shortages, including internal medicine; Cosponsor and pass S. 1024, the Healthcare Workforce Resilience Act, to recapture 40,000 unused visas and use them to provide additional green cards to 15,000 physicians and 25,000 professional nurses; Cosponsor and pass H.R. 3541/S. 1810, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R.4122/S.3658, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2023 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Public Health and Pandemic Preparedness: Urged members of Congress to support funding in FY2023 appropriations - $11 billion total for the CDC, $35 million for the CDCs Injury Prevention and Control, Firearm Injury and Mortality Prevention Research; $49 billion in total for the NIH, $25 million for the Office of the Director, Firearm Injury and Mortality Prevention Research; Cosponsor and pass the COVID Supplemental Appropriations Act, 2022, H.R. 7007, or a similar supplemental funding package, to provide $15.6 billion in additional funding for COVID relief; Cosponsor and pass the CONNECT for Health Act (H.R. 2903/S. 1512) and the Telehealth Extension Act of 2021 (H.R. 6202/S. 3593), to remove arbitrary restrictions on where a patient must be located to utilize telehealth services; enable patients to continue to receive telehealth services in their homes; ensure federally-qualified health centers and rural health centers can furnish telehealth services and improve data collection and analysis for at least two years. Prescription Drug Reform: Urged members of Congress to cosponsor and pass S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; Cosponsor and pass S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; Cosponsor and pass S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Telehealth Services: Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends; H.R. 8487, the Improving Seniors Timely Access to Care Act that would help protect patients from unnecessary delays in care and reduce administrative burdens on physicians by standardizing and streamlining the prior authorization approval process in the Medicare Advantage (MA) program. Advocated with Congress for passage of H.R. 4040, the Advancing Telehealth Beyond COVID-19 Act of 2021, to extend coverage for critical telehealth services beyond the public health emergency. Mental and Behavioral Health: Urged members of Congress to cosponsor and pass H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Scope of Practice: Urged Congress to oppose the Improving Care and Access to Nurses Act, or the I CAN Act, H.R. 8812, which allows non-physician clinicians to deliver care that is not commensurate with their training, skills, and demonstrated competencies in accord with national standards

Client expense: $69,651 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Regarding CMS Medicare Physician Fee Schedule and Quality Payment Program (QPP) rules, expressed support for extending some of the services and increased flexibility for telehealth through the end of 2024, namely some audio-only services that were allowed during the COVID-19 public health emergency (PHE), support for collecting additional data on health equity issues to analyze disparities that occur across their programs, support for including chronic care management as one of the seven MIPS Value Pathways (MVPs) for 2023. Urged CMS to discontinue its split/shared visits policy and not move forward with the transition set to take effect in 2023. Urged Congress to support inclusion in must-pass legislation this year provisions to provide financial stability through a baseline positive annual update to the physician fee schedule reflecting inflation in practice costs, and eliminate, revise budget neutrality requirements to allow for appropriate changes in spending growth and prevent a 4.42 percent Medicare payment cut as contained in H.R. 8800, the Supporting Medicare Providers Act of 2022; Extend the moratoriums on sequester and PAYGO cuts that were approved by Congress at the end of last year. Recommended modifications to Medicare law to establish a mechanism for savings to be calculated across all aspects of the program-that is, increased investment in relative and absolute payments for primary care and preventive health care services (Part B) results in savings due to reduced emergency department visits and hospitalizations (Part A)-and to allow these savings to be reinvested back into primary and preventive care, as well as into social and public health services. With regard to Medicares Quality Payment Program, advocated with Congress to provide flexibility to CMS to set performance thresholds, improve the cost performance category, provide scoring flexibility to CMS to allow for multi-category credit, provide CMS flexibility to score and benchmark measures as appropriate and to test and incentivize new measures and MVPs to ensure successful implementation, update the Promoting Interoperability performance category, Extend the $500 million exceptional performance bonus for an additional six years , align comparisons in the MIPS Quality performance category and Physician Compare. FY2023 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Preventions programs in the FY 2023 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Preventions (CDC) Office on Smoking and Health (OSH). COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP); urged support for administering COVID-19 vaccinations to all eligible immigrants in Customs and Border Protection (CBP) custody. Urged CMS to support increasing COVID-19 vaccine uptake by ensuring clinicians are appropriately paid for vaccine counseling for beneficiaries of Medicaid and Medicare. Urged that telehealth services should remain in place for at least two years after the end of the PHE to ensure that our physicians are able to continue to use this modality to enhance patient care. Urged Congress to support the concept of a congressionally-mandated bipartisan commission to examine the U.S. preparations for and response to the COVID-19 pandemic, in order to inform future public policy and health systems preparedness. Urged that any uses of technology in the U.S. in the context of the pandemic should be demonstrated to be effective, be temporary, and ensure that safeguards for privacy and confidentiality are in place. Womens Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Urged support for mandatory, permanent extension of postpartum Medicaid coverage, from 60 days to 12 months after delivery. Urged support for the Womens Health Protection Act of 2021 and 2022 (H.R. 3755/S. 1975), bills that would protect a persons ability to determine whether to continue or end a pregnancy and to protect the health care clinicians ability to provide abortion services free from medically unnecessary restrictions such as waiting periods, biased counselling and admitting privilege requirements for clinicians. Access to Care: Urged members of Congress to cosponsor and pass H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place: Cosponsor and pass H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the Affordable Care Act. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots to 14,000 over seven years for specialties facing shortages, including internal medicine; Cosponsor and pass S. 1024, the Healthcare Workforce Resilience Act, to recapture 40,000 unused visas and use them to provide additional green cards to 15,000 physicians and 25,000 professional nurses; Cosponsor and pass H.R. 3541/S. 1810, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R.4122/S.3658, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2023 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Public Health and Pandemic Preparedness: Urged members of Congress to support funding in FY2023 appropriations - $11 billion total for the CDC, $35 million for the CDCs Injury Prevention and Control, Firearm Injury and Mortality Prevention Research; $49 billion in total for the NIH, $25 million for the Office of the Director, Firearm Injury and Mortality Prevention Research; Cosponsor and pass the COVID Supplemental Appropriations Act, 2022, H.R. 7007, or a similar supplemental funding package, to provide $15.6 billion in additional funding for COVID relief; Cosponsor and pass the CONNECT for Health Act (H.R. 2903/S. 1512) and the Telehealth Extension Act of 2021 (H.R. 6202/S. 3593), to remove arbitrary restrictions on where a patient must be located to utilize telehealth services; enable patients to continue to receive telehealth services in their homes; ensure federally-qualified health centers and rural health centers can furnish telehealth services and improve data collection and analysis for at least two years. Prescription Drug Reform: Urged members of Congress to cosponsor and pass S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; Cosponsor and pass S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; Cosponsor and pass S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Telehealth Services: Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends; H.R. 8487, the Improving Seniors Timely Access to Care Act that would help protect patients from unnecessary delays in care and reduce administrative burdens on physicians by standardizing and streamlining the prior authorization approval process in the Medicare Advantage (MA) program. Advocated with Congress for passage of H.R. 4040, the Advancing Telehealth Beyond COVID-19 Act of 2021, to extend coverage for critical telehealth services beyond the public health emergency. Mental and Behavioral Health: Urged members of Congress to cosponsor and pass H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs. Scope of Practice: Urged Congress to oppose the Improving Care and Access to Nurses Act, or the I CAN Act, H.R. 8812, which allows non-physician clinicians to deliver care that is not commensurate with their training, skills, and demonstrated competencies in accord with national standards.

Client expense: $300,406 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

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.6279/S.3629, Opioid Treatment Access Act, Entirety H.R.7666, Restoring Hope for Mental Health and Well-Being Act of 2022, Entirety Education and training for health practitioners who deliver medication s and treatment for individuals with Substance Abuse Disorders (SUDs) H.R. 2067, Medication Access and Training Expansion Act Public Law 117-328, Conslidated Appropriations Act, FY2023, Health and Mental Health related issues Monitor the following: H.R.8454/S.253, Medical Marijuana and Cannabidiol Research Expansion Act, Entirety S.4839, State Opioid Response Grant Authorization Act, Entirety Mental Health Substance Use Disorder related issues H.R.5218, Collaborate in an Orderly and Cohesive Manner Act, Entirety S.4591, Cannabis Administration and Opportunity Act, generally H.R.1384/S.445, Mainstreaming Addiction Treatment Act S.987, CARA 3.0 Act of 2021

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.6279/S.3629, Opioid Treatment Access Act, Entirety H.R.7666, Restoring Hope for Mental Health and Well-Being Act of 2022, Entirety Education and training for health practitioners who deliver medication s and treatment for individuals with Substance Abuse Disorders (SUDs) H.R. 2067, Medication Access and Training Expansion Act Public Law 117-328, Conslidated Appropriations Act, FY2023, Health and Mental Health related issues Monitor the following: H.R.8454/S.253, Medical Marijuana and Cannabidiol Research Expansion Act, Entirety S.4839, State Opioid Response Grant Authorization Act, Entirety Mental Health Substance Use Disorder related issues H.R.5218, Collaborate in an Orderly and Cohesive Manner Act, Entirety S.4591, Cannabis Administration and Opportunity Act, generally H.R.1384/S.445, Mainstreaming Addiction Treatment Act S.987, CARA 3.0 Act of 2021

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.1475/S.1795, Pursuing Equity in Mental Health Act H.R.2955/S.4448, Suicide Prevention Act H.R.3259/S.586, NOPAIN Act H.R.3467/S.4332, Improving Data Collection for Adverse Childhood Experiences Act H.R.4040, Advancing Telehealth Beyond COVID-19 Act H.R.5611/S.1902 Behavioral Health Crisis Services Expansion Act H.R. 6302, The Protecting the Health of Americas Older Adults Act H.R.7116, 9-8-8 Implementation 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.8800, Supporting Medicare Providers Act of 2022 S. 5272 / H.R. 9577, Increasing Mental Health Options Act S.2086, RISE from Trauma Act S.2425, Suicide Prevention Lifeline Improvement Act of 2021 S. 3257 A bill to lengthen the period of time during which certain controlled substances must be administered S.4170, Mental Health Reform Reauthorization Act S.4301, Substance Use Prevention, Treatment, and Recovery Act S.4306, Improving Access to Behavioral Health Integration Act S.4472, Health Care Capacity for Pediatric Mental Health Act S.4616, Behavioral Health Coverage Transparency Act of 2022 S.4804, Parity Enforcement Act of 2022 S. 5310 Helping Kids Through Trauma Act H.R. 7644, Pride in Mental Health Act S. 4747, Invest in Kids' Mental Health Now Act H.R. 5218, Collaborate in an Orderly and Cohesive Manner Act S. 4306, Improving Access to Behavioral Health Integration Act H.R.8391, the CONtinuity in Necessary Evaluative Crisis Treatment (CONNECT) Act H.R. 9109, GRIEF Act H.R. 2617, Consolidated Appropriations Act, 2023 Discussion of population health-based approaches - Rep. Smith (WA) General population health and rural mental health access solutions Grass-tops summit on year-end mental health package Response to RFI re: No Surprises Act Response to RFI re: provider directory

Client expense: $480,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to public mental health programs, Medicare, Medicaid, substance-use disorder care, healthcare workforce and integrated care models. Issues regarding telehealth and legislation pertaining to collaborative care and mental health parity. Working for passage of the Collaborate in an Orderly and Cohesive Manner Act (H.R. 5218).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.1475/S.1795, Pursuing Equity in Mental Health Act H.R.2955/S.4448, Suicide Prevention Act H.R.3259/S.586, NOPAIN Act H.R.3467/S.4332, Improving Data Collection for Adverse Childhood Experiences Act H.R.4040, Advancing Telehealth Beyond COVID-19 Act H.R.5611/S.1902 Behavioral Health Crisis Services Expansion Act H.R. 6302, The Protecting the Health of Americas Older Adults Act H.R.7116, 9-8-8 Implementation 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.8800, Supporting Medicare Providers Act of 2022 S. 5272 / H.R. 9577, Increasing Mental Health Options Act S.2086, RISE from Trauma Act S.2425, Suicide Prevention Lifeline Improvement Act of 2021 S. 3257 A bill to lengthen the period of time during which certain controlled substances must be administered S.4170, Mental Health Reform Reauthorization Act S.4301, Substance Use Prevention, Treatment, and Recovery Act S.4306, Improving Access to Behavioral Health Integration Act S.4472, Health Care Capacity for Pediatric Mental Health Act S.4616, Behavioral Health Coverage Transparency Act of 2022 S.4804, Parity Enforcement Act of 2022 S. 5310 Helping Kids Through Trauma Act H.R. 7644, Pride in Mental Health Act S. 4747, Invest in Kids' Mental Health Now Act H.R. 5218, Collaborate in an Orderly and Cohesive Manner Act S. 4306, Improving Access to Behavioral Health Integration Act H.R.8391, the CONtinuity in Necessary Evaluative Crisis Treatment (CONNECT) Act H.R. 9109, GRIEF Act H.R. 2617, Consolidated Appropriations Act, 2023 Discussion of population health-based approaches - Rep. Smith (WA) General population health and rural mental health access solutions Grass-tops summit on year-end mental health package Response to RFI re: No Surprises Act Response to RFI re: provider directory

Client expense: $480,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Issues/Topics Public health funding  Behavioral health and crisis intervention Healthcare Workforce Rural health care and rural hospitals Telehealth  Medicare   Medicaid  Dual Medicare and Medicaid Eligibility Hospital Consolidation  Nutrition Services and Food Security  Obesity in older adults School meals Child nutrition Opioids and Substance Use Disorders Caregiving and Aging Home and Community Based Services Pandemic Preparedness Bills S. 3799, PREVENT Pandemics Act H.R. 6613, Keeping School Meals Flexible Act S. 1536 / H.R. 3108, Medical Nutrition Therapy Act of 2021 H.R. 5218, Collaborate in an Orderly and Cohesive Manner H.R. 7232, 9-8-8 and Parity Assistance Act of 2022 H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022 H.R. 1887 / S. 4009, Rural Hospital Support Act S. 2089, Keep Kids Fed Act S. 3913 / H.R. 8481, Improving DATA in Public Health Act S.4264, Advancing Integration in Medicare and Medicaid (AIM) Act S.3534 / H.R.7152, Tracking Pathogens Act S. 1162 / H.R. 6770, PACE Plus Act S.3626, PACE Expanded Act S. 569 / H.R. 1577, Treat and Reduce Obesity Act H.R. 4040, Advancing Telehealth Beyond COVID-19 Act of 2021

Client expense: $860,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.5218, Collaborate in an Orderly and Cohesive Manner Act, Collaborative care model Funding for mental health treatment H.R.7666, Restoring Hope for Mental Health and Well-Being Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.800/H.R. 4870 - Promoting Access to Diabetic Shoes Act H.R. 1956/S. 1986 - Increasing Access to Quality Cardiac Rehabilitation Care Act of 2021 H.R. 2067/S. 2235 - Medication Access and Training Expansion (MATE) Act S. 987 - Comprehensive Addiction and Recovery Act (CARA) 3.0 H.R. 1319 - American Rescue Plan Act [Public Law No: 117-2] H.R. 1716 - COVID-19 Mental Health Research Act H.R. 1195 - the Workplace Violence Prevention for Health Care and Social Service Workers Act S. 54 - Strengthening Americas Health Care Readiness Act H.R. 851/S. 246 - the Future Advancement of Academic Nursing (FAAN) Act H.R. 959/S.346 - Black Maternal Health Momnibus Act of 2021 H.R. 1384 - the Mainstreaming Addiction Treatment Act of 2021 H.R. 955 - the Medicaid Reentry Act of 2021 H.R. 1025 - the Kids Access to Primary Care Act of 2021 S. 1315/H.R. 3630 - the Lymphedema Treatment Act S. 1833 - the Ensuring Access to Primary Care for Women & Children Act H.R. 3550/S. 4905 - the Primary and Behavioral Health Care Access Act S. 1512/H.R. 2903 - the CONNECT for Health Act of 2021 S. 287/H.R. 945 - the Perinatal Workforce Act S. 1536/H.R. 3108 - the Medical Nutrition Therapy Act of 2021 H.R. 1667/S. 610 - the Dr. Lorna Breen Health Care Provider Protection Act H.R. 736 - the Community Immunity During COVID-19 Act of 2021 H.R. 3087/S. 2051 - Breast Cancer Patient Equity Act H.R. 6000 - the Cures 2.0 Act S. 2652/H.R. 5067 - the Preserving Patient Access to Home Infusion Act S. 3149/H.R. 5848 - the Rural Health Equity Act H.R. 6308 - the ACO Assignment Improvement Act of 2021 H.R. 5248 - the Temporary Responders for Immediate Aid in Grave Emergencies (TRIAGE) Act of 2021 H.R. 5376 - the Build Back Better Act H.R.3925 - the Reducing Barriers to Substance Use Treatment Act S. Res. 626 and H. Res. 1100 - honoring and recognizing May 6 through 12, 2022 as National Nurses Week S.3098/H.R. 7617 - Preventive Care Awareness Act S.4182 - the Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 7236 - the Strengthen Kids Mental Health Now Act of 2022 H.R. 2376 - the Excellence in Recovery Housing Act H.R. 4944 - the Helping Kids Cope Act of 2021 H.R. 5218 - the Collaborate in an Orderly and Cohesive Manner Act H.R. 7076 - the Supporting Childrens Mental Health Care Access Act of 2022 H.R. 7232 - the 9-8-8 and Parity Assistance Act of 2022 H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 S.4170 - the Mental Health Reform Reauthorization Act H.R. 8812 - Improving Care and Access to Nurses (ICAN) Act H.R. 8454 - Medical Marijuana and Cannabidiol Research Expansion Act H.R. 3352/S. 1697 - Midwives for MOMs Act Issues pertaining to White House Hunger, Nutrition, and Health Conference Issues surrounding federal Monkeypox response Clinical Laboratory Improvement Amendments (CLIA) Replenish the COVID-19 Uninsured Relief Fund Nursing faculty shortage Nursing Education Use of telehealth to prescribe controlled substances under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 [Public Law No: 110-425] Rural health care issues, including rural workforce, COVID-19 vaccination, and reimbursement Medicare sequestration Medicare restrictions pertaining to telehealth Include nurses, APRNs, and nursing students in all National Public Health Plans Provide resources to support nurses, APRNs, and nursing students mental health needs, especially for those responding to the pandemic Funding to ensure childcare coverage Increased Federal Medical Assistance Percentage (FMAP) funding to states Access to personal protective equipment Extension of CMS waivers beyond public health emergency Skilled Nursing Facility admitting examination and assessment requirements COVID-19 Pandemic relief: funding, removal of barriers, telehealth, mental health, personal protective equipment, and testing Telehealth, remote patient monitoring and other forms of health technology COVID-19 Pandemic Reducing Regulatory Burdens, including those relating to home infusion therapy, Medicare Conditions of Participation, and hospice certification Medication-Assisted Treatment (MATs) Opioid Abuse Epidemic Documentation of medical records Health plan coverage and program requirements including provider non-discrimination Issues relating to Mental and Substance Use Disorder Workforce Addressing Health Equity Medicare Provider Reimbursement Clinical labor pricing update Tobacco flavors and menthol Site specific restrictions on providers under DEA controlled substances policy

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Nuclear Regulatory Commission (NRC), Office of Special Counsel, SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Implementation of funding provided for in Consolidated Appropriations Act, 2021 (P.L. 116-260) to address substance use disorder; Mainstreaming Addiction Treatment Act (H.R. 1384/S. 445); Medication Access and Training Expansion Act (H.R. 2067/S. 2235); Medicaid Reentry Act of 2021 (H.R. 955/S. 285); Collaborate in an Orderly and Cohesive Manner Act (H.R.5218); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Synthetic Opioid Danger Awareness Act (H.R. 2364); FENTANYL Results Act (H.R. 2538/S. 1160); issues related to fentanyl.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Care Act (ACA); Transparency; Surprise Billing, Telehealth; COVID-19; Extending ARPA Subsidies; Health Equity Issues; Mental Health Parity; Affordability; Inflation Reduction Act; No Surprises Act; Covid transition/PH. COVID-19 response in P.L. 117-103, The Consolidated Appropriations Act; Health care policies contained in P.L. 117-2, The American Rescue Plan Act; P.L. 117-169, Inflation Reduction Act of 2022 H.R. 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 To amend the Public Health Service Act to reauthorize certain programs relating to mental health and substance use disorders, and for other purposes Sponsor: Rep. Frank Pallone (D-NJ-06) H.R. 5218 Collaborate in an Orderly and Cohesive Manner Act H.R. 7767 - Strengthening Behavioral Health Benefits Act To amend the Employee Retirement Income Security Act of 1974 to provide for the enforcement of mental health and substance abuse disorder parity requirements, and for other purposes. Sponsor: Rep. Joe Courtney (D-CT-02) H.R. 959 - Black Maternal Health Momnibus Act of 2021 To end preventable maternal mortality and severe maternal morbidity in the United States and close disparities in maternal health outcomes, and for other purposes. Sponsor: Rep. Lauren Underwood (D-IL-14) H.R. 5376 Inflation Reduction Act Sponsor: John Yarmuth (D-KY) H.R. 3 - Lower Drug Costs Now Act Sponsor: Rep. Frank Pallone (D-NJ-06) Insulin -the Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act

Client expense: $1,050,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to public mental health programs, Medicare, Medicaid, substance-use disorder care, healthcare workforce and integrated care models. Issues regarding telehealth and legislation pertaining to collaborative care and mental health parity. Working for passage of the Collaborate in an Orderly and Cohesive Manner Act (H.R. 5218).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Increasing access to mental health and substance use treatment; Mental Health Parity implementation; H.R. 1384/S. 445 - Mainstreaming Addiction and Treatment Act; S. 4306 - Improving Access to Behavioral Health Integration Act; S. 2938 - Bipartisan Safer Communities Act; H.R. 5218 - Collaborate in an Orderly and Cohesive Manner Act; H.R. 1364 Parity Enforcement Act; S. 4461 Expanding Access to Mental Health Training Act; H.R. 2955/S. 4448 Suicide Prevention Act; H.R. 7666 Restoring Hope for Mental Health and Well-Being Act; H.R. 8637/S. 4003 Law Enforcement De-Escalation Act; H.R. 8512/S. 4616 Behavioral Health Coverage Transparency Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health Insurance Coverage (general); Health Equity (general); Breastfeeding (general); Assisted Reproductive Technology (general); Substance Use Disorder (general); Gynecologic Cancer (general); Reproductive Health (general); Intimate Partner Violence (general); Gun Violence (general); Immunization (general); Breast Cancer (general); Medical Liability Reform (general); Health IT (general); Patient-Physician Relationship (general); Child Welfare (general); Maternal Mortality and Morbidity (general); Graduate Medical Education (general); Contraception (general); Abortion (general); Indian Health (general); Teaching Health Centers Graduate Medical Education (general); Community Health Centers (general); National Health Service Corps (general); Health care workforce (general); Title VII Health Workforce Programs (general); Title VIII Health Workforce Programs (general); Sexuality Education (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); COVID-19 Vaccines (general); Pandemic Preparedness (general); Risk Evaluation and Mitigation Strategies (general); Data Collection (general); Social Determinants of Health (General); Maternal Mental Health (general); Online misinformation (general); EMTALA (general); H.R. 3755/S. 1975, Womens Health Protection Act; implementation of P.L. 115-320, Improving Access to Maternity Care Act; implementation of Maternal Health Quality Improvement Act contained in P.L. 117-103; H.R. 959/ S. 346, Black Maternal Health Momnibus Act; 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. 1065/S. 1486, Pregnant Workers Fairness Act; implementation of P.L. 117-105, Lorna Breen Health Care Provider Protection Act H.R. 1350/ S.408, Supporting Best Practices for Healthy Moms Act; H.R. 3407/S. 411, MOMMAs Act; implementation of P.L. 117-2, the American Rescue Plan Act of 2021; H.R. 2007/S. 2444, Stephanie Tubbs Jones Uterine Fibroid Research and Education Act of 2021; H.R. 3110/S. 1658, PUMP for Nursing Mothers Act; H.R. 2903/S.1515, CONNECT for Health Act; H.R. 3671/S.1958, Doctors of Community (DOC) Act; Implementation of P.L. 114-255, the 21st Century Cures Act; Implementation of the No Surprises Act contained in P.L. 116-260H.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; Advanced Research Projects Agency for Health (ARPA-H); H.R. 5376, Build Back Better Act, H.R. 5376, Inflation Reduction Act of 2022; H.R. 5218, Collaborate in an Orderly and Cohesive Manner Act; H.R. 5239/ S. 2941, Good Samaritan Health Professionals Act of 2021; H.R. 7073/S.3824, Into the Light for MMH and SUD Act of 2022; H.R.5487/S.3972, SHINE for Autumn Act of 2021; Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) (general); Disclosure of Ingredients in Menstrual Products (general); H.R.7011/S.3797, Maternal and Child Health Stillbirth Prevention Act of 2022; H.R. 2234/S. 1021, Equal Access to Abortion Coverage (EACH) Act; S. 4467, Protecting Access to Medication Abortion Act; S.Res.664, A resolution expressing opposition to the criminalization of essential healthcare, including the full range of sexual and reproductive healthcare such as abortion, gender-affirming care, and contraceptive care, and disapproving of the criminalization of pregnancy outcomes; H.Res.589, Expressing the sense of the House of Representatives that policies governing access to medication abortion care in the United States should be equitable and based on science; H.R. 7894/S. 4347, Affordability is Access Act (AAA); H.R. 6005/S. 3223, Access to Birth Control Act; H.R. 7845, NIH Clinical Trial Diversity Act of 2022; H.R. 4217/S. 2779, TRIUMPH for New Moms Act of 2021; H.R. 7974, Endometriosis CARE Act of 2022; H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022; 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; Safety and efficacy of noninvasive prenatal screening tests (FDA/CMS); COVID-19 public health emergency unwinding (general); ; Implementation of the Maternal Health Quality Improvement Act and Rural MOMS Act included in P.L. 117-103; Implementation of P.L. 117-103, Consolidated Appropriations Act, 2022;; health care provider conscience protections (general); Access to prenatal telehealth services (general) ; H.R. ____, Abortion Care Awareness Act; Consent for use of human reproductive material in assisted reproductive technology or intrauterine insemination (general); H.R. ____, Informing New Factors and Options for Reproductive Care Act; H.R. 8834, EQUIP Act; S. 4688, Reproductive Freedom for All Act; S. 4748, Protecting National Access to Reproductive Care Act; H.R. 4040, Advancing Telehealth Beyond COVID-19 Act of 2021; Reproductive health care workforce (general); S.4467, Protecting Access to Medication Abortion Act; S.4723, Let Doctors Provide Reproductive Health Care Act; H.R. 8373, Right to Contraception Act; S.4764, Reproductive Health Care Accessibility Act

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

H.R. 432 - Mental Health Access Improvement Act H.R. 1358 - Mental Health Parity Justice Act of 2021 H.R. 1475/ S. 1795 - Pursuing Equity in Mental Health Act H.R. 2754 - COVID-19 Long Haulers Act H.R. 3173 - Improving Seniors Timely Access to Care Act of 2021 H.R. 3467 - Improving Data Collection for Adverse Childhood Experiences (ACES) Act H.R. 3541 / S. 1810 - Conrad State 30 and Physician Access Reauthorization Act H.R. 3753/ S. 1962 - Parity Implementation Assistance Act H.R. 4058 / S. 2061 - Telemental Health Care Access Act H.R. 4122 / S. 3658 - Resident Education Deferred Interest (REDI) Act H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act H.R. 4770 - Evaluating Disparities and Outcomes of Telehealth (EDOT) Act of 2021 H.R. 5218 - Collaborate in an Orderly and Cohesive Manner Act H.R. 6000 - Cures 2.0 Act H.R. 7116 - 988 Implementation Act of 2022 H.R. 7180 / S. 4014 - Brycen Gray and Bren Price COVID-19 Cognitive Research Act H.R. 7232 - 988 and Parity Assistance Act of 2022 H.R. 7254 - Mental Health Justice and Parity Act of 2022 H.R. 7482 / S. 4015 - TREAT Act H.R. 7649 - To direct the Secretary of Health and Human Services to open a public docket for the submission of public comments regarding factors that should be taken into consideration when reviewing a proposed modification to an approved risk evaluation and mitigation strategy, and for other purposes. H.R. 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 H.R. 7667 - Food and Drug Amendments of 2022 H.R. 8180 - Undertaking Needed Investments in Therapy, Education, and De-Escalation (UNITED) Act of 2022 H.R. 8229 - Telemental Health Parity Act H.R. 8391 - CONNECT Act H.R. 8487 - Improving Seniors Timely Access to Care Act of 2022 H.R. 8512 - Behavioral Health Coverage Transparency Act H.R. 8542 - Mental Health Justice Act of 2022 H.R. 8637/ S. 4003 - Law Enforcement De-Escalation Training Act of 2022 H.R. 8800 - Supporting Medicare Providers Act of 2022 H.R. 8878 - Intensive Outpatient Policy H.R. 8879 - Inpatient Psychiatric Facility Improvement Act H.R. 8881 - Mental Health Transparency Act H.R. 8884 - Medicare Opioid Use Disorder Outreach Act H.R. 8885 - Better Health Care Directories Act H.R. 8886 - Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act H.R. 8889 - RICE (Readable Insurance Coverage Enhancement) Act H.R. 8890 - Physician Wellness Program Act H.R. 8891 - No Surprises for Survivors Act H.R. 8892 - Access to Mental Health Services Act H.R. 8908 - Fighting Stimulant and other Substance Use Disorders Act H.R. 8910 - Behavioral Health Integration Awareness Act H.R. 9201 - Community Mental Wellness and Resilience Act S. 2086 - RISE from Trauma Act S. 2938 - Bipartisan Safer Communities Act S. 3726 - CARE for Long COVID Act S. 4132 - Womens Health Protection Act S. 4170 - Mental Health Reform Reauthorization Act of 2022 S. 4306 - Improving Access to Behavioral Health Integration Act S. 4348 - Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act of 2022 S. 4448 - Suicide Prevention Act S. 4461 - Expanding Access to Mental Health Training Act S. 4472 - Health Care Capacity for Pediatric Behavioral Health Act S. 4804 - Parity Enforcement Act of 2022 S. 4839 - State Opioid Response Grant Authorization Act S.5041 - A bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions in psychiatry and subspecialties S.5042 - A bill to amend title XVIII of the Social Security Act to expand eligibility for incentives under the Medicare health professional shortage area bonus program to practitioners furnishing mental health and substance use disorder services S.5043 - A bill to require the Secretary of Health and Human Services to issue guidance to States on strategies under Medicaid and CHIP to increase mental health and substance use disorder care provider education, training, recruitment, and retention S.5061 - A bill to amend title XVIII of the Social Security Act to provide for Medicare coverage and coding for qualified psychologist services furnished by advanced psychology trainees S.5062 - A bill to amend title XVIII of the Social Security Act to increase access to mental health programs for physicians

Client expense: $192,727 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE

Legislation to amend the definition of physician in Medicare to provide for treatment of clinical psychologists as physicians, for purposes of providing clinical psychologist services under Medicare; issues related to reimbursement of psychologists in Medicare; issues related to integration of behavorial health services in primary care, including Improving Access to Behavioral Health Integration Act (S. 4306) and Collaborate in an Orderly and Cohesive Manner Act (HR 5218).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.8454/S.253, Medical Marijuana and Cannabidiol Research Expansion Act, Entirety H.R.6279/S.3629, Opioid Treatment Access Act, Entirety H.R.7666, Restoring Hope for Mental Health and Well-Being Act of 2022, Entirety S.4839, State Opioid Response Grant Authorization Act, Entirety Mental Health Substance Use Disorder related issues H.R.5218, Collaborate in an Orderly and Cohesive Manner Act, Entirety S.4591, Cannabis Administration and Opportunity Act, generally Education and training for health practitioners who deliver medication s and treatment for individuals with Substance Abuse Disorders (SUDs) H.R.1384/S.445, Mainstreaming Addiction Treatment Act H.R. 2067, Medication Access and Training Expansion Act Monitor S.987, CARA 3.0 Act of 2021

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Education and training for health practitioners who deliver medications and treatment for individuals with Substance Abuse Disorders (SUDs) H.R.1384/S.445, Mainstreaming Addiction Treatment Act H.R. 2067, Medication Access and Training Expansion Act H.R.6279/S.3629, Opioid Treatment Access Act H.R.7666, Restoring Hope for Mental Health and Well-Being Act of 2022, Entirety H.R.8454/S.253, Cannabidiol & Marijuana Research Expansion Act, Cannabis research related issues S.4839, State Opioid Response Grant Authorization Act, Entirety Mental Health Substance Use Disorder related issues H.R.5218, Collaborate in an Orderly and Cohesive Manner Act, Entirety

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases. Regarding CMS Medicare Physician Fee Schedule and Quality Payment Program (QPP) rules, expressed support for extending some of the services and increased flexibility for telehealth through the end of 2023, namely some audio-only services that were allowed during the COVID-19 public health emergency (PHE), support for collecting additional data on health equity issues to analyze disparities that occur across their programs, support for including chronic care management as one of the seven MIPS Value Pathways (MVPs) for 2023. Urged CMS to discontinue its split/shared visits policy and not move forward with the transition set to take effect in 2023. Urged Congress to support inclusion in must-pass legislation this year provisions to provide financial stability through a baseline positive annual update to the physician fee schedule reflecting inflation in practice costs, and eliminate, replace or revise budget neutrality requirements to allow for appropriate changes in spending growth; Extend the moratoriums on sequester and PAYGO cuts that were approved by Congress at the end of last year. FY2023 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Preventions programs in the FY 2023 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ). COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP); urged support for administering COVID-19 vaccinations to all eligible immigrants in Customs and Border Protection (CBP) custody. Urged CMS to support increasing COVID-19 vaccine uptake by ensuring clinicians are appropriately paid for vaccine counseling for beneficiaries of Medicaid and Medicare. Urged that telehealth services should remain in place for at least two years after the end of the PHE to ensure that our physicians are able to continue to use this modality to enhance patient care. Urged Congress to support the concept of a congressionally-mandated bipartisan commission to examine the U.S. preparations for and response to the COVID-19 pandemic, in order to inform future public policy and health systems preparedness. Urged that any uses of technology in the U.S. in the context of the pandemic should be demonstrated to be effective, be temporary, and ensure that safeguards for privacy and confidentiality are in place. Womens Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Urged support for mandatory, permanent extension of postpartum Medicaid coverage, from 60 days to 12 months after delivery. Urged support for the Womens Health Protection Act of 2021 and 2022 (H.R. 3755/S. 1975), bills that would protect a persons ability to determine whether to continue or end a pregnancy and to protect the health care clinicians ability to provide abortion services free from medically unnecessary restrictions such as waiting periods, biased counselling and admitting privilege requirements for clinicians. Access to Care: Urged members of Congress to cosponsor and pass H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place: Cosponsor and pass H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the Affordable Care Act. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots to 14,000 over seven years for specialties facing shortages, including internal medicine; Cosponsor and pass S. 1024, the Healthcare Workforce Resilience Act, to recapture 40,000 unused visas and use them to provide additional green cards to 15,000 physicians and 25,000 professional nurses; Cosponsor and pass H.R. 3541/S. 1810, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R.4122/S.3658, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2023 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Public Health and Pandemic Preparedness: Urged members of Congress to support funding in FY2023 appropriations - $11 billion total for the CDC, $35 million for the CDCs Injury Prevention and Control, Firearm Injury and Mortality Prevention Research; $49 billion in total for the NIH, $25 million for the Office of the Director, Firearm Injury and Mortality Prevention Research; Cosponsor and pass the COVID Supplemental Appropriations Act, 2022, H.R. 7007, or a similar supplemental funding package, to provide $15.6 billion in additional funding for COVID relief; Cosponsor and pass the CONNECT for Health Act (H.R. 2903/S. 1512) and the Telehealth Extension Act of 2021 (H.R. 6202/S. 3593), to remove arbitrary restrictions on where a patient must be located to utilize telehealth services; enable patients to continue to receive telehealth services in their homes; ensure federally-qualified health centers and rural health centers can furnish telehealth services and improve data collection and analysis for at least two years. Prescription Drug Reform: Urged members of Congress to cosponsor and pass S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; Cosponsor and pass S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; Cosponsor and pass S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Telehealth Services: Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends; H.R. 8487, the Improving Seniors Timely Access to Care Act that would help protect patients from unnecessary delays in care and reduce administrative burdens on physicians by standardizing and streamlining the prior authorization approval process in the Medicare Advantage (MA) program. Mental and Behavioral Health: Urged members of Congress to cosponsor and pass H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs.

Client expense: $302,378 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Continued advocacy with Congress in support of expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases. Regarding CMS Medicare Physician Fee Schedule and Quality Payment Program (QPP) rules, expressed support for extending some of the services and increased flexibility for telehealth through the end of 2023, namely some audio-only services that were allowed during the COVID-19 public health emergency (PHE), support for collecting additional data on health equity issues to analyze disparities that occur across their programs, support for including chronic care management as one of the seven MIPS Value Pathways (MVPs) for 2023. Urged CMS to discontinue its split/shared visits policy and not move forward with the transition set to take effect in 2023. Urged Congress to support inclusion in must-pass legislation this year provisions to provide financial stability through a baseline positive annual update to the physician fee schedule reflecting inflation in practice costs, and eliminate, replace or revise budget neutrality requirements to allow for appropriate changes in spending growth; Extend the moratoriums on sequester and PAYGO cuts that were approved by Congress at the end of last year. FY2023 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Preventions programs in the FY 2023 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ). COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP); urged support for administering COVID-19 vaccinations to all eligible immigrants in Customs and Border Protection (CBP) custody. Urged CMS to support increasing COVID-19 vaccine uptake by ensuring clinicians are appropriately paid for vaccine counseling for beneficiaries of Medicaid and Medicare. Urged that telehealth services should remain in place for at least two years after the end of the PHE to ensure that our physicians are able to continue to use this modality to enhance patient care. Urged Congress to support the concept of a congressionally-mandated bipartisan commission to examine the U.S. preparations for and response to the COVID-19 pandemic, in order to inform future public policy and health systems preparedness. Urged that any uses of technology in the U.S. in the context of the pandemic should be demonstrated to be effective, be temporary, and ensure that safeguards for privacy and confidentiality are in place. Womens Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Urged support for mandatory, permanent extension of postpartum Medicaid coverage, from 60 days to 12 months after delivery. Urged support for the Womens Health Protection Act of 2021 and 2022 (H.R. 3755/S. 1975), bills that would protect a persons ability to determine whether to continue or end a pregnancy and to protect the health care clinicians ability to provide abortion services free from medically unnecessary restrictions such as waiting periods, biased counselling and admitting privilege requirements for clinicians. Access to Care: Urged members of Congress to cosponsor and pass H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place: Cosponsor and pass H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the Affordable Care Act. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots to 14,000 over seven years for specialties facing shortages, including internal medicine; Cosponsor and pass S. 1024, the Healthcare Workforce Resilience Act, to recapture 40,000 unused visas and use them to provide additional green cards to 15,000 physicians and 25,000 professional nurses; Cosponsor and pass H.R. 3541/S. 1810, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R.4122/S.3658, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2023 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Public Health and Pandemic Preparedness: Urged members of Congress to support funding in FY2023 appropriations - $11 billion total for the CDC, $35 million for the CDCs Injury Prevention and Control, Firearm Injury and Mortality Prevention Research; $49 billion in total for the NIH, $25 million for the Office of the Director, Firearm Injury and Mortality Prevention Research; Cosponsor and pass the COVID Supplemental Appropriations Act, 2022, H.R. 7007, or a similar supplemental funding package, to provide $15.6 billion in additional funding for COVID relief; Cosponsor and pass the CONNECT for Health Act (H.R. 2903/S. 1512) and the Telehealth Extension Act of 2021 (H.R. 6202/S. 3593), to remove arbitrary restrictions on where a patient must be located to utilize telehealth services; enable patients to continue to receive telehealth services in their homes; ensure federally-qualified health centers and rural health centers can furnish telehealth services and improve data collection and analysis for at least two years. Prescription Drug Reform: Urged members of Congress to cosponsor and pass S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; Cosponsor and pass S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; Cosponsor and pass S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Telehealth Services: Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends; H.R. 8487, the Improving Seniors Timely Access to Care Act that would help protect patients from unnecessary delays in care and reduce administrative burdens on physicians by standardizing and streamlining the prior authorization approval process in the Medicare Advantage (MA) program. Mental and Behavioral Health: Urged members of Congress to cosponsor and pass H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act, to provide grants through the Department of Health and Human Services to primary care physicians who choose to deliver behavioral health care through the Collaborate Care Model (CoCM); Support enhanced reimbursement for CoCM payment codes under Medicare to more appropriately reflect the value of services provided to patients with mental health and substance use disorder needs.

Client expense: $68,579 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

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

Issues generally in the Affordable Care Act; issues related to insurance markets and stabilization, transparency, surprise billing, access to and payment for mental health care, and COVID-19 response in P.L. 117-103, the Consolidated Appropriations Act, 2022; H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022; and health care policies contained in and amendments offered to P.L. 117-2, the American Rescue Plan Act of 2021; P.L. 117-169, Inflation Reduction Act of 2021; H.R. 5218, Collaborate in an Orderly and Cohesive Manner Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1475/S.1795 Pursuing Equity in Mental Health Act S. 660/H.R. 2264: Tele-Mental Health Improvement Act H.R. 1364: Parity Enforcement Act S. 2086: The Resilience Investment, Support and Expansion (RISE) from Trauma Act S. 1927: Child Abuse Prevention and Treatment Act (CAPTA) Reauthorization of 2021 H.R 3467: Improving Data Collection for Adverse Childhood Experiences (ACEs) Act H.R. 1385: Behavioral Health Coordination and Communication Act S. 445: Mainstreaming Addiction Treatment Act S. 854: Methamphetamine Response Act S. 1457: STOP Fentanyl Act S. 1962/H.R. 3753: Parity Implementation Assistance Act Draft Global Enhancement of Mental Health and Psychosocial Support Access Act of 2021 H.R. 5218: Collaborate in an Orderly and Cohesive Manner Act S.2873 - Preventing and Addressing Trauma with Health Services (PATHS) Act Draft Reconciliation package Future Senate Finance Committee mental health legislation Future Cures 2.0 legislation from Rep. DeGette and Rep. Upton Draft Child Abuse and Neglect Data Collection and Improvement Act of 2021 Draft Legislation to award grants to 10 eligible crisis centers to provide follow-up services to individuals receiving suicide prevention and crisis intervention services (Rep. Trone) Coalition letter to state governors re: emergency temporary licensure waivers for out-of-state practitioners H.R. 5848 / S. 3149: Rural Health Equity Act Draft legislation to support reimbursement for psychology interns and residents in Medicare Draft legislation to support the reauthorization of Title VII programs H.R. 4026 Social Determinants of Health Data Analysis Act of 2021 H.R. 3894 CARING for Social Determinants Act of 2021 H.R. 3173 / S. 3018 Improving Seniors Access to Timely Care Act H.R. 7116 988 Implementation Act Draft bereavement care bill Letter to CDC re: Office of Rural Health Coalition thank-you letter to Congressional leadership and White House re: omnibus package S. 4301 Substance Use Prevention, Treatment, and Recovery Act S. 4306 Improving Access to Behavioral Health Integration Act S.4170 Mental Health Reform Reauthorization Act S.3824/H.R. 7073 Into the Light for MMH and SUD Act of 2022 H.R. 7666 Restoring Hope for Mental Health and Well-Being Act of 2022 H.R. 2955/ S. 4448 Suicide Prevention Act

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

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

H.R. 1475/S.1795 Pursuing Equity in Mental Health Act S. 660/H.R. 2264: Tele-Mental Health Improvement Act H.R. 1364: Parity Enforcement Act S. 2086: The Resilience Investment, Support and Expansion (RISE) from Trauma Act S. 1927: Child Abuse Prevention and Treatment Act (CAPTA) Reauthorization of 2021 H.R 3467: Improving Data Collection for Adverse Childhood Experiences (ACEs) Act H.R. 1385: Behavioral Health Coordination and Communication Act S. 445: Mainstreaming Addiction Treatment Act S. 854: Methamphetamine Response Act S. 1457: STOP Fentanyl Act S. 1962/H.R. 3753: Parity Implementation Assistance Act Draft Global Enhancement of Mental Health and Psychosocial Support Access Act of 2021 H.R. 5218: Collaborate in an Orderly and Cohesive Manner Act S.2873 - Preventing and Addressing Trauma with Health Services (PATHS) Act Draft Reconciliation package Future Senate Finance Committee mental health legislation Future Cures 2.0 legislation from Rep. DeGette and Rep. Upton Draft Child Abuse and Neglect Data Collection and Improvement Act of 2021 Draft Legislation to award grants to 10 eligible crisis centers to provide follow-up services to individuals receiving suicide prevention and crisis intervention services (Rep. Trone) Coalition letter to state governors re: emergency temporary licensure waivers for out-of-state practitioners H.R. 5848 / S. 3149: Rural Health Equity Act Draft legislation to support reimbursement for psychology interns and residents in Medicare Draft legislation to support the reauthorization of Title VII programs H.R. 4026 Social Determinants of Health Data Analysis Act of 2021 H.R. 3894 CARING for Social Determinants Act of 2021 H.R. 3173 / S. 3018 Improving Seniors Access to Timely Care Act H.R. 7116 988 Implementation Act Draft bereavement care bill Letter to CDC re: Office of Rural Health Coalition thank-you letter to Congressional leadership and White House re: omnibus package S. 4301 Substance Use Prevention, Treatment, and Recovery Act S. 4306 Improving Access to Behavioral Health Integration Act S.4170 Mental Health Reform Reauthorization Act S.3824/H.R. 7073 Into the Light for MMH and SUD Act of 2022 H.R. 7666 Restoring Hope for Mental Health and Well-Being Act of 2022 H.R. 2955/ S. 4448 Suicide Prevention Act

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, SENATE, White House Office

Issues/Topics Public health funding  Behavioral health and crisis intervention Healthcare Workforce Rural health care and rural hospitals Telehealth  Medicare   Medicaid  Dual Medicare and Medicaid Eligibility Hospital Consolidation     Nutrition Services and Food Security  Obesity in older adults School meals Child nutrition Opioids and Substance Use Disorders Caregiving and Aging Home and Community Based Services Pandemic Preparedness Bills S3799 PREVENT Pandemics Act H.R. 6613 - Keeping School Meals Flexible Act S1536/HR3108 - Medical Nutrition Therapy Act of 2021 HR 5218 - Collaborate in an Orderly and Cohesive Manner HR 7232 - 9-8-8 and Parity Assistance Act of 2022 HR 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 H.R.1887/ S.4009 - Rural Hospital Support Act S.2089 - Keep Kids Fed Act H.R.6613 - Keeping School Meals Flexible Act S.3913 - Improving DATA in Public Health Act S.4264 - Advancing Integration in Medicare and Medicaid (AIM) Act S.3534/HR.7152 - Tracking Pathogens Act

Client expense: $720,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation to amend the definition of physician in Medicare to provide for treatment of clinical psychologists as physicians, for purposes of providing clinical psychologist services under Medicare; issues related to reimbursement of psychologists in Medicare; issues related to integration of behavorial health services in primary care, including Improving Access to Behavioral Health Integration Act (S. 4306) and Collaborate in an Orderly and Cohesive Manner Act (HR 5218).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to public mental health programs, Medicare, Medicaid, substance-use disorder care, healthcare workforce and integrated care models. Issues regarding telehealth and legislation pertaining to collaborative care and mental health parity. Working for passage of the Collaborate in an Orderly and Cohesive Manner Act (H.R. 5218).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE