Opioid Treatment Access Act of 2022

Substance Use Disorders, Training related issues Medication Assisted Treatment (MAT) delivery related issues H.R.6279/S.3629, Opioid Treatment Access Act, Entirety H.R.1384/S.445, Mainstreaming Addiction Treatment Act of 2021, Entirety H.R.2067, Medication Access and Training Expansion Act, Entirety H.R.7666, Restoring Hope for Mental Health and Well-Being Act of 2022, Entirety Public Law 117-328, Consolidated Appropriations Act, FY2023, Health; Mental Health; and Substance Use Disorder (SUD) related issues Monitor Telehealth for providing Medication Assisted Treatment (MAT)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Substance Use Disorders, Training related issues Medication Assisted Treatment (MAT) delivery related issues H.R.6279/S.3629, Opioid Treatment Access Act, Entirety H.R.1384/S.445, Mainstreaming Addiction Treatment Act of 2021, Entirety H.R.2067, Medication Access and Training Expansion Act, Entirety H.R.7666, Restoring Hope for Mental Health and Well-Being Act of 2022, Entirety Public Law 117-328, Consolidated Appropriations Act, FY2023, Health; Mental Health; and Substance Use Disorder (SUD) related issues Monitor Telehealth for providing Medication Assisted Treatment (MAT)

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

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.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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S.2697/H.R.6636 - the Due Process Continuity of Care Act: This legislation would amend the Medicaid Inmate Exclusion Policy to allow these otherwise eligible individuals to receive their full Medicaid benefits while incarcerated at the option of the state. Advocated for the DEA and SAMHSA to grant continued telehealth flexibilities for buprenorphine for OUD during the national public health emergency declared in response to the opioid crisis and work to make those telehealth flexibilities permanent, as appropriate, based on findings of further studies. Advocated for the Office of National Drug Control Policy (ONDCP) to clear policy barriers to sustainable implementation of contingency management (CM) interventions. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for issuance of a NPRM regarding further alignment of 42 CFR Part 2 with HIPAA, as called for by the CARES Act. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements and inclusion of S. 1927, the Child Abuse Prevention and Treatment (CAPTA) Reauthorization Act of 2021, in an end-of-the-year legislative package. ASAM joined a letter addressed to the Chairs and Ranking Members of the Labor, Health and Human Services, Education, and Related Agencies Subcommittees of the U.S. Senate and House Committees on Appropriations, urging the committees to fund the Centers for Disease Control and Preventions (CDC) Office of Smoking and Health (OSH) at $261.5 million, as was delineated in the U.S. Senate Appropriations Committees Chairmans mark from July 2022 ASAM submitted comments in a letter to the U.S. Senators Patty Murray and Richard Burr, Chair and Ranking Member of the Committee on Health, Education, Labor and Pensions (HELP), containing policy recommendations for inclusion in a possible Senate mental health and substance use disorder (MH/SUD) legislative package. The comments were based on HR 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022, which has already passed the U.S. House on a bipartisan basis. The letter voices ASAM's support for many provisions of the Restoring Hope Act, that would, among other things, reauthorize key Substance Abuse and Mental Health Administration (SAMHSA) and Health Resources and Services Administration (HRSA) programs to address the national MH and SUD crisis. ASAM joined a letter to the U.S. Senate Finance Committee in response to the committees Enhancing the Mental Health Workforce discussion draft. The letter thanks the committee for its ongoing efforts to address the MH and SUD workforce crisis and makes several key recommendations. The letters recommendations focus on two key areas: (1) clarifications to the bills language to ensure that Medicare beneficiaries with a primary diagnosis of SUD or no co-occurring MH condition can access the critical services they need and (2) resolving other barriers that prevent the MH and SUD workforce from meeting its full potential. ASAM joined a letter to SAMHSA supporting continuation of the PCSS program

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S.2697/H.R.6636 - the Due Process Continuity of Care Act: This legislation would amend the Medicaid Inmate Exclusion Policy to allow these otherwise eligible individuals to receive their full Medicaid benefits while incarcerated at the option of the state. Advocated for the DEA and SAMHSA to grant continued telehealth flexibilities for buprenorphine for OUD during the national public health emergency declared in response to the opioid crisis and work to make those telehealth flexibilities permanent, as appropriate, based on findings of further studies. Advocated for the Office of National Drug Control Policy (ONDCP) to clear policy barriers to sustainable implementation of contingency management (CM) interventions. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for issuance of a NPRM regarding further alignment of 42 CFR Part 2 with HIPAA, as called for by the CARES Act. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements and inclusion of S. 1927, the Child Abuse Prevention and Treatment (CAPTA) Reauthorization Act of 2021, in an end-of-the-year legislative package. ASAM joined a letter addressed to the Chairs and Ranking Members of the Labor, Health and Human Services, Education, and Related Agencies Subcommittees of the U.S. Senate and House Committees on Appropriations, urging the committees to fund the Centers for Disease Control and Preventions (CDC) Office of Smoking and Health (OSH) at $261.5 million, as was delineated in the U.S. Senate Appropriations Committees Chairmans mark from July 2022 ASAM submitted comments in a letter to the U.S. Senators Patty Murray and Richard Burr, Chair and Ranking Member of the Committee on Health, Education, Labor and Pensions (HELP), containing policy recommendations for inclusion in a possible Senate mental health and substance use disorder (MH/SUD) legislative package. The comments were based on HR 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022, which has already passed the U.S. House on a bipartisan basis. The letter voices ASAM's support for many provisions of the Restoring Hope Act, that would, among other things, reauthorize key Substance Abuse and Mental Health Administration (SAMHSA) and Health Resources and Services Administration (HRSA) programs to address the national MH and SUD crisis. ASAM joined a letter to the U.S. Senate Finance Committee in response to the committees Enhancing the Mental Health Workforce discussion draft. The letter thanks the committee for its ongoing efforts to address the MH and SUD workforce crisis and makes several key recommendations. The letters recommendations focus on two key areas: (1) clarifications to the bills language to ensure that Medicare beneficiaries with a primary diagnosis of SUD or no co-occurring MH condition can access the critical services they need and (2) resolving other barriers that prevent the MH and SUD workforce from meeting its full potential. ASAM joined a letter to SAMHSA supporting continuation of the PCSS program

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S.2697/H.R.6636 - the Due Process Continuity of Care Act: This legislation would amend the Medicaid Inmate Exclusion Policy to allow these otherwise eligible individuals to receive their full Medicaid benefits while incarcerated at the option of the state. Advocated for the DEA and SAMHSA to grant continued telehealth flexibilities for buprenorphine for OUD during the national public health emergency declared in response to the opioid crisis and work to make those telehealth flexibilities permanent, as appropriate, based on findings of further studies. Advocated for the Office of National Drug Control Policy (ONDCP) to clear policy barriers to sustainable implementation of contingency management (CM) interventions. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for issuance of a NPRM regarding further alignment of 42 CFR Part 2 with HIPAA, as called for by the CARES Act. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements and inclusion of S. 1927, the Child Abuse Prevention and Treatment (CAPTA) Reauthorization Act of 2021, in an end-of-the-year legislative package. ASAM joined a letter addressed to the Chairs and Ranking Members of the Labor, Health and Human Services, Education, and Related Agencies Subcommittees of the U.S. Senate and House Committees on Appropriations, urging the committees to fund the Centers for Disease Control and Preventions (CDC) Office of Smoking and Health (OSH) at $261.5 million, as was delineated in the U.S. Senate Appropriations Committees Chairmans mark from July 2022 ASAM submitted comments in a letter to the U.S. Senators Patty Murray and Richard Burr, Chair and Ranking Member of the Committee on Health, Education, Labor and Pensions (HELP), containing policy recommendations for inclusion in a possible Senate mental health and substance use disorder (MH/SUD) legislative package. The comments were based on HR 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022, which has already passed the U.S. House on a bipartisan basis. The letter voices ASAM's support for many provisions of the Restoring Hope Act, that would, among other things, reauthorize key Substance Abuse and Mental Health Administration (SAMHSA) and Health Resources and Services Administration (HRSA) programs to address the national MH and SUD crisis. ASAM joined a letter to the U.S. Senate Finance Committee in response to the committees Enhancing the Mental Health Workforce discussion draft. The letter thanks the committee for its ongoing efforts to address the MH and SUD workforce crisis and makes several key recommendations. The letters recommendations focus on two key areas: (1) clarifications to the bills language to ensure that Medicare beneficiaries with a primary diagnosis of SUD or no co-occurring MH condition can access the critical services they need and (2) resolving other barriers that prevent the MH and SUD workforce from meeting its full potential. ASAM joined a letter to SAMHSA supporting continuation of the PCSS program

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S.2697/H.R.6636 - the Due Process Continuity of Care Act: This legislation would amend the Medicaid Inmate Exclusion Policy to allow these otherwise eligible individuals to receive their full Medicaid benefits while incarcerated at the option of the state. Advocated for the DEA and SAMHSA to grant continued telehealth flexibilities for buprenorphine for OUD during the national public health emergency declared in response to the opioid crisis and work to make those telehealth flexibilities permanent, as appropriate, based on findings of further studies. Advocated for the Office of National Drug Control Policy (ONDCP) to clear policy barriers to sustainable implementation of contingency management (CM) interventions. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for issuance of a NPRM regarding further alignment of 42 CFR Part 2 with HIPAA, as called for by the CARES Act. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements and inclusion of S. 1927, the Child Abuse Prevention and Treatment (CAPTA) Reauthorization Act of 2021, in an end-of-the-year legislative package. ASAM joined a letter addressed to the Chairs and Ranking Members of the Labor, Health and Human Services, Education, and Related Agencies Subcommittees of the U.S. Senate and House Committees on Appropriations, urging the committees to fund the Centers for Disease Control and Preventions (CDC) Office of Smoking and Health (OSH) at $261.5 million, as was delineated in the U.S. Senate Appropriations Committees Chairmans mark from July 2022 ASAM submitted comments in a letter to the U.S. Senators Patty Murray and Richard Burr, Chair and Ranking Member of the Committee on Health, Education, Labor and Pensions (HELP), containing policy recommendations for inclusion in a possible Senate mental health and substance use disorder (MH/SUD) legislative package. The comments were based on HR 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022, which has already passed the U.S. House on a bipartisan basis. The letter voices ASAM's support for many provisions of the Restoring Hope Act, that would, among other things, reauthorize key Substance Abuse and Mental Health Administration (SAMHSA) and Health Resources and Services Administration (HRSA) programs to address the national MH and SUD crisis. ASAM joined a letter to the U.S. Senate Finance Committee in response to the committees Enhancing the Mental Health Workforce discussion draft. The letter thanks the committee for its ongoing efforts to address the MH and SUD workforce crisis and makes several key recommendations. The letters recommendations focus on two key areas: (1) clarifications to the bills language to ensure that Medicare beneficiaries with a primary diagnosis of SUD or no co-occurring MH condition can access the critical services they need and (2) resolving other barriers that prevent the MH and SUD workforce from meeting its full potential. ASAM joined a letter to SAMHSA supporting continuation of the PCSS program

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S.2697/H.R.6636 - the Due Process Continuity of Care Act: This legislation would amend the Medicaid Inmate Exclusion Policy to allow these otherwise eligible individuals to receive their full Medicaid benefits while incarcerated at the option of the state. Advocated for the DEA and SAMHSA to grant continued telehealth flexibilities for buprenorphine for OUD during the national public health emergency declared in response to the opioid crisis and work to make those telehealth flexibilities permanent, as appropriate, based on findings of further studies. Advocated for the Office of National Drug Control Policy (ONDCP) to clear policy barriers to sustainable implementation of contingency management (CM) interventions. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for issuance of a NPRM regarding further alignment of 42 CFR Part 2 with HIPAA, as called for by the CARES Act. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements and inclusion of S. 1927, the Child Abuse Prevention and Treatment (CAPTA) Reauthorization Act of 2021, in an end-of-the-year legislative package. ASAM joined a letter addressed to the Chairs and Ranking Members of the Labor, Health and Human Services, Education, and Related Agencies Subcommittees of the U.S. Senate and House Committees on Appropriations, urging the committees to fund the Centers for Disease Control and Preventions (CDC) Office of Smoking and Health (OSH) at $261.5 million, as was delineated in the U.S. Senate Appropriations Committees Chairmans mark from July 2022 ASAM submitted comments in a letter to the U.S. Senators Patty Murray and Richard Burr, Chair and Ranking Member of the Committee on Health, Education, Labor and Pensions (HELP), containing policy recommendations for inclusion in a possible Senate mental health and substance use disorder (MH/SUD) legislative package. The comments were based on HR 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022, which has already passed the U.S. House on a bipartisan basis. The letter voices ASAM's support for many provisions of the Restoring Hope Act, that would, among other things, reauthorize key Substance Abuse and Mental Health Administration (SAMHSA) and Health Resources and Services Administration (HRSA) programs to address the national MH and SUD crisis. ASAM joined a letter to the U.S. Senate Finance Committee in response to the committees Enhancing the Mental Health Workforce discussion draft. The letter thanks the committee for its ongoing efforts to address the MH and SUD workforce crisis and makes several key recommendations. The letters recommendations focus on two key areas: (1) clarifications to the bills language to ensure that Medicare beneficiaries with a primary diagnosis of SUD or no co-occurring MH condition can access the critical services they need and (2) resolving other barriers that prevent the MH and SUD workforce from meeting its full potential. ASAM joined a letter to SAMHSA supporting continuation of the PCSS program

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S.2697/H.R.6636 - the Due Process Continuity of Care Act: This legislation would amend the Medicaid Inmate Exclusion Policy to allow these otherwise eligible individuals to receive their full Medicaid benefits while incarcerated at the option of the state. Advocated for the DEA and SAMHSA to grant continued telehealth flexibilities for buprenorphine for OUD during the national public health emergency declared in response to the opioid crisis and work to make those telehealth flexibilities permanent, as appropriate, based on findings of further studies. Advocated for the Office of National Drug Control Policy (ONDCP) to clear policy barriers to sustainable implementation of contingency management (CM) interventions. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for issuance of a NPRM regarding further alignment of 42 CFR Part 2 with HIPAA, as called for by the CARES Act. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements and inclusion of S. 1927, the Child Abuse Prevention and Treatment (CAPTA) Reauthorization Act of 2021, in an end-of-the-year legislative package. ASAM joined a letter addressed to the Chairs and Ranking Members of the Labor, Health and Human Services, Education, and Related Agencies Subcommittees of the U.S. Senate and House Committees on Appropriations, urging the committees to fund the Centers for Disease Control and Preventions (CDC) Office of Smoking and Health (OSH) at $261.5 million, as was delineated in the U.S. Senate Appropriations Committees Chairmans mark from July 2022 ASAM submitted comments in a letter to the U.S. Senators Patty Murray and Richard Burr, Chair and Ranking Member of the Committee on Health, Education, Labor and Pensions (HELP), containing policy recommendations for inclusion in a possible Senate mental health and substance use disorder (MH/SUD) legislative package. The comments were based on HR 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022, which has already passed the U.S. House on a bipartisan basis. The letter voices ASAM's support for many provisions of the Restoring Hope Act, that would, among other things, reauthorize key Substance Abuse and Mental Health Administration (SAMHSA) and Health Resources and Services Administration (HRSA) programs to address the national MH and SUD crisis. ASAM joined a letter to the U.S. Senate Finance Committee in response to the committees Enhancing the Mental Health Workforce discussion draft. The letter thanks the committee for its ongoing efforts to address the MH and SUD workforce crisis and makes several key recommendations. The letters recommendations focus on two key areas: (1) clarifications to the bills language to ensure that Medicare beneficiaries with a primary diagnosis of SUD or no co-occurring MH condition can access the critical services they need and (2) resolving other barriers that prevent the MH and SUD workforce from meeting its full potential. ASAM joined a letter to SAMHSA supporting continuation of the PCSS program

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

COVID services & COVID services for the uninsured S. 3799PREVENT Pandemics Act S. Amdt to H.R. 2471 Consolidated Appropriations Act of 2022 S. 1536Medical Nutrition Therapy Act of 2021 S. 4293Pharmacy Benefit Manager Transparency Act H.R. 7666 Restoring Hope for Mental Health and Wellbeing Act H.R. 2355 Opioid Prescription Verification Act H.R. 1384 Mainstreaming Addiction Treatment Act H.R. 7007 COVID Supplemental Appropriations Act of 2022 H.R. 3108 Medical Nutrition Therapy Act of 2021 H.R. 5585 Advanced Research Project Agency-Health H.R. 6279 Opioid Treatment Access Act H.R. 7559 Prescription Information Modernization Act H.R. 5376 Inflation Reduction Act H.R. 2617 Consolidated Appropriations Act of 2023

Client expense: $280,000 · Firm income: Not reported

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

Issues related to opioid addiction recovery and drug treatment programs - no specific legislation. H.R.1384 - Mainstreaming Addiction Treatment Act of 2021; H.R. 6279 and S. 3629, Opioid Treatment Access Act of 2022 - entire bill.

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

Government targets: HOUSE OF REPRESENTATIVES, Substance Abuse & Mental Health Services Administration (SAMHSA)

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

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

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

Healthcare Supply Chain - Highlighted the important role played by hospital group purchasing organizations in promoting resiliency and value in healthcare purchasing. Provided information on ongoing efforts to reduce greenhouse gas emissions and support environmentally preferred sourcing for healthcare supplies. Engaged to support policies to ensure greater transparency and mitigate or limit shortages of prescription drugs. Supported policies that would expedite critical cargo, including cargo necessary for medical care, during a public health emergency or disaster. Food and Drug Administration User Fee Amendments - Supported passage of legislation to extend user-fee authorities ((S. 4348, H.R.7667, H.R. 6833). Advocated for greater transparency in the health care supply chain for drugs and medical devices. Supported updating language related to the Unapproved Drugs Initiative, and incorporating the PASTUER Act (S.2076) and the PATCH Act (H.R. 7084) in final passage. Inflation Reduction Act (H.R. 5376) - Supported extension of enhanced subsidies through the health insurance marketplace. Supported provisions that would increase reimbursement for biosimilar medications and monitored impact of other policies impacting prices of prescription drugs. Public Health Emergency - Advocated for HHS to further extend the declared Public Health Emergency. Telehealth - Supported efforts to make telehealth flexibilities offered during COVID-19 Public Health Emergency permanent. Supported CONNECT for Health Act (S. 1512/H.R. 2903) and the Extending Telehealth Beyond COVID-19 Act (H.R. 4040). Encouraged reimbursement parity for certain telehealth services and support for audio-only telehealth services. Health Care Workforce - Urged passage of the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708; S. 168); The Health Care Workforce Resilience Act (S. 1024/H.R. 2255); The Resident Physician Shortage Reduction Act (S.834/H.R. 2256). The Opioid Workforce Act (S. 1438/H.R. 3441). Urged administration to examine practices of health care staffing agencies. Supported passage of the Travel Nursing Agency Transparency Study Act (S. 4352). Supported passage of the Safety from Violence for Healthcare Employees Act (H.R. 7961). Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act (S. 3799) - monitored PREVENT Pandemics Act and supported inclusion of provisions to improve supply chain transparency and extend shelf life of prescription drugs. Supported passage of the Integrity, Notification, Fairness in Online Retail Marketplaces (INFORM) Consumers Act (S. 963/H.R. 5502). 340B Drug Pricing Program - Urged HHS to enforce guidance that would allow 340B Covered Entities to utilize contract pharmacies. Social Determinants of Health and Health Equity - Shared insights and offered suggestions to CMS regarding health equity measurement, indices and data collection. Supported the Social Determinants Accelerator Act (H.R. 2503; S. 3039); The LINC to Address Social Needs Act (S. 509). Antimicrobial resistance (S. 2076) - Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act. Supported passage of Opioid Treatment Access Act (S. 3629/H.R. 6279). Supported passage of Drug Shortage Shelf Life Extension Act (S. 3493). Supported passage of the Hospital Inpatient Services Modernization Act (S. 3792/H.R. 7053).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

H.R. 6072, Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act of 2021, provisions relating to social determinants of health, mental health, and social services S. 509, LINC to Address Social Needs Act of 2021, provisions relating to social determinants of health, 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 H.R. 1218, Data Mapping to Save Moms Lives Act, all provisions S. 198, Data Mapping to Save Moms' Lives Act, all provisions S. 1675, Maternal Health Quality Improvement Act, all provisions H.R. 1384, Mainstreaming Addiction Treatment (MAT) Act of 2021, all provisions S. 445, MAT Act of 2021, 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. 5602, Bolstering Infectious Outbreaks (BIO) Preparedness Workforce Act of 2021, all provisions S. 3244, BIO Preparedness Workforce 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. 3753, Parity Implementation Assistance Act, all provisions S. 1962, Parity Implementation Assistance Act, all provisions H.R. 7232, 9-8-8 and Parity Assistance Act of 2022, all provisions H.R. 2067, Medication Access and Training Expansion (MATE) Act of 2021, all provisions S. 2235, MATE Act of 2021, all provisions S. 2938, Bipartisan Safer Communities Act, all provisions S. 4090, Dietary Supplement Listing Act of 2022, all provisions H.R. 8296, Womens Health Protection Act of 2022, all provisions H.R. 8373, Right to Contraception Act, all provisions H.R. 8318, To restrict limitations on the possession, sale, purchase, transportation or use of any contraceptive that relates to interstate commerce, all provisions H.R. 8454, Medical Marijuana and Cannabidiol Research Expansion Act S. 253, Cannabidiol and Marihuana Research Expansion Act, all provisions S. 2866, Treatment Restoration for Emergency Antibody Therapeutics (TREAT) 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 S. 1675, Maternal Health Quality Improvement 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, VALID Act of 2021, all provisions H.R. 8152, American Data Privacy and Protection Act, 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, Protecting Our Kids 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. 8297, Ensuring Womens Right to Reproductive Freedom Act, all provisions H.R. 1235, Charlotte Woodward Organ Transplant Discrimination Prevention Act, all provisions S. 3301, Charlotte Woodward Organ Transplant Discrimination Prevention Act, all provisions H.R. 708, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions S. 168, TREAT Act, all provisions H.R. 4480, Telehealth Coverage and Payment Parity 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. 3778, Nullifying Opportunities for Variants to Infect and Decimate (NOVID) Act, all provisions S. 1976, NOVID Act, all provisions H.R. 6904, Patients Before Profits Act of 2022, all provisions H.R. 7116, 9-8-8 Implementation Act of 2022, all provisions H.R. 8890, Physician Wellness Program Act of 2022, all provisions H.R. 8908, Fighting Stimulant and other Substance Use Disorders Act, all provisions H.R. 8891, No Surprises for Survivors Act of 2022, all provisions H.R. 8885, Better Health Care Directories Act, all provisions H.R. 8886, Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act, all provisions H.R. 8892, To direct the Secretary of Health and Human Services to conduct a public outreach campaign to inform individuals covered under a group health plan or group or individual health insurance coverage of Federal requirements relating to mental health and substance use disorder crisis services, and for other purposes, all provisions H.R. 8881, To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require group health plans and health insurance issuers offering group or individual health insurance coverage to disclose the percentage of in-network participation for certain provider types, and for other purposes, all provisions H.R. 8889, Readable Insurance Coverage Explanations (RICE) Act, all provisions H.R. 7780, Mental Health Matters Act, all provisions H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, 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. 925, Data to Save Moms Act, all provisions H.R. 3352, Midwives for MOMS Act of 2021, all provisions H.R. 847, Promoting Digital Privacy Technologies Act, all provisions S. 224, Promoting Digital Privacy Technologies Act, all provisions H.R. 3771, South Asian Heart Health Awareness and Research Act of 2022, 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 Emergency Room Hero and Patient Safety Act No Surprises Act/implementation Global health security/pandemics Digital Health/AI/Digital Therapeutics Privacy/non-HIPAA covered health apps Abortion/Dobbs decision Drug overdose epidemic Telehealth Scope of practice/patient safety Prior authorization Physician burnout/mental health stigma Health equity/COVID-19 COVID-19 Provider Relief Fund COVID-91/testing/misinformation/vaccine issues/therapeutics Section 1557/nondiscrimination/limited English proficiency Maternal Mortality Modifier 25, Impossible Day Hunger, Nutrition and Health WIC/SNAP/Nutrition Strengthening primary health care Data privacy Physician-led aerospace medicine teams Men who have sex with men/blood donations Federally qualified health centers and clinical trials

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

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Federal Aviation Administration (FAA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, White House Office

American Rescue Plan Act of 2021 (H.R. 1319), all provisions related to relief to address the continued impact of COVID-19. Mainstreaming Addiction Treatment Act (S. 445/H.R. 1384), all provisions related to removing the waiver requirement for health care providers to prescribe buprenorphine for opioid use disorder. Improving Access to Remote Behavioral Health Treatment Act of 2019, all provisions related to amending regulations for the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 and allowing community mental health centers to register to practice telemedicine. Medication Access and Training Expansion Act (H.R. 2067), all provisions related to requiring physicians and other prescribers of controlled substances to complete training on treating and managing patients with substance use disorders. CONNECT for Health Act of 2021 (H.R. 2903/S. 1512), all provisions related to expanding access to telehealth services. Telemental Health Care Access Act of 2021 (S. 2061), all provisions related to ensuring coverage of mental health services furnished through telehealth. HELP Act of 2021 (S. 1570), all provisions related to the accessibility and coordination of 211 services and 988 services. Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708/S. 168), all provisions related to temporary authorization of in-person and telehealth services. Behavioral Health Crisis Services Expansion Act (S. 1902), all provisions related to empowering communities to establish a continuum of care for individuals experiencing a behavioral health crisis. Preventing Overdoses and Saving Lives Act of 2021 (H.R. 5442), all provisions related to authorizing grants to develop strategic response plans with respect to the opioid crisis, and to require practitioners prescribing an opioid for certain patients to also prescribe an opioid overdose reversal drug. Coronavirus Mental Health and Addiction Assistance Act of 2021 (H.R. 593/S. 135), all provisions related to providing grants to entities that provide mental health and substance use disorder programs during the COVID-19 pandemic. Mental Health Services for Students Act of 2021 (H.R. 721/S. 1841), all provisions related to school-based mental health services. Stopping the Mental Health Pandemic Act (H.R. 7080/S. 4059), all provisions related to grants to support behavioral health treatment and services during the COVID-19 pandemic. Emergency Support for Substance Use Disorders Act (S. 4058), all provisions related to grants for harm reduction activities during the COVID-19 pandemic. Elementary and Secondary School Counseling Act (H.R. 6214/S. 3356), all provisions related to awarding grants to increase access to school-based, mental health services. Campus Prevention and Recovery Services for Students Act of 2019 (H.R. 3591), all provisions related to expanding the illicit drug and alcohol abuse prevention program to include campus efforts to prevent substance misuse. Opioid Treatment Access Act of 2022 (H.R. 6279), all provisions related to authorizing a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs. 9-8-8 Implementation Act of 2022 (H.R. 7116), all provisions related to providing for improvements in the implementation of the National Suicide Prevention Lifeline, and for other purposes. 9-8-8 and Parity Assistance Act of 2022 (H.R.7232), all provisions related to providing for improvements in the implementation of the National Suicide Prevention Lifeline, and for other purposes. Into the Light for MMH and SUD Act of 2022 (H.R. 7073), all provisions related to reauthorizing a grant program for screening, assessment, and treatment services for maternal mental health and substance use disorders, and for other purposes. Anna Westin Legacy Act (H.R. 7249/S. 3686), all provisions related to providing education and training on eating disorders for health care providers and communities, and for other purposes. Behavioral Health Information Technology Act, (H.R.7427), all provisions related to CMI testing of incentive payments for behavioral health providers and certain other providers for adoption and use of certified electronic health record technology, and for other purposes Safe Step Act (H.R. 2163/S. 464), all provisions related to creating an exception for medication step-therapy. Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act (S. 586), all provisions related to establishing separate payments for certain non-opioid treatments under the Medicare prospective payment system for hospital outpatient department services and the payment system for ambulatory surgical center services Food and Drug Administration Safety and Landmark Advancements Act of 2022 (S.4348), all provisions related to addressing substance use disorders and the safe disposal of opioids. Telemental Health Access to Care Act (S.2061/H.R. 4058), all provisions related to intended to increase access to tele-mental health care and telehealth. Stop Pills That Kill Act (S.4151), all provisions related to penalizing the manufacture and/or facilitation of manufacturing counterfeit pills that contain fentanyl, an analogue of fentanyl, or a counterfeit substance. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R. 7666), all provisions related to reauthorizations, expansions, and modifications of programs, grants, and activities that focus on mental and behavioral health. CONNECT Act of 2022 (H.R.8391), all provisions related to awarding grants for crisis centers to provide follow-up services to individuals receiving suicide prevention and crisis intervention services. BENEFIT Act of 2021 (H.R.4472), all provisions related to strengthen the use of patient-experience data within the benefit-risk framework for approval of new drugs. Advancing Telehealth Beyond COVID-19 Act of 2021 (H.R.4040), all provisions related to extending telehealth flexibilities under the Medicare program

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Communications Commission (FCC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

Substance Use Disorders, Training related issues Medication Assisted Treatment (MAT) delivery related issues Telehealth for providing Medication Assisted Treatment (MAT) H.R.6279/S.3629, Opioid Treatment Access Act, Entirety H.R.1384/S.445, Mainstreaming Addiction Treatment Act of 2021, Entirety H.R.2067, Medication Access and Training Expansion Act, Entirety H.R.7666, Restoring Hope for Mental Health and Well-Being Act of 2022, Entirety

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Substance Use Disorders, Training related issues Medication Assisted Treatment (MAT) delivery related issues Telehealth for providing Medication Assisted Treatment (MAT) H.R.6279/S.3629, Opioid Treatment Access Act, Entirety H.R.1384/S.445, Mainstreaming Addiction Treatment Act of 2021, Entirety H.R.2067, Medication Access and Training Expansion Act, Entirety H.R.7666, Restoring Hope for Mental Health and Well-Being Act of 2022, Entirety

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

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

Issues related to opioid addiction recovery and drug treatment programs - no specific legislation. H.R.1384 - Mainstreaming Addiction Treatment Act of 2021; H.R. 6279 and S. 3629, Opioid Treatment Access Act of 2022 - entire bill.

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

Government targets: HOUSE OF REPRESENTATIVES, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for legislation that would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. ASAM wrote a letter to the U.S. House Ways and Means Committee regarding the Committees markup of worker and family support and health legislation aimed to expand access to mental health and substance use disorder (SUD) care under Medicare. ASAM requested several, specific clarifications to be made to ensure that Medicare beneficiaries with a primary diagnosis of SUD or with no co-occurring mental health condition can access critical SUD services under Medicare. ASAM wrote a comment letter to the Centers for Medicare and Medicaid Services (CMS) on the proposed 2023 Medicare Physician Fee Schedule (MPFS) covering revisions to opioid treatment program (OTP) services, a proposal to establish physician payment for the management of chronic pain, and a request for information on intensive outpatient (IOP) services, among other items. ASAM joined a coalition of public health, medical, and professional organizations in a letter to the Food and Drug Administration (FDA), supporting its intention to issue a proposed rule to reduce the nicotine level in cigarettes to non-addictive or minimally addictive levels. ASAM joined a letter addressed to Senator Schumer, requesting support of civil monetary penalty authority for the U.S. Department of Labor (USDOL) to enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). ASAM joined a letter to Congressional leadership regarding additional investments in the health care workforce, in particular Medicare-supported GME. ASAM joined a letter to Senate HELP leadership requesting support for funding to enhance the Collaborative Care Model (CoCM), which integrates behavioral health with primary care. Specifically, the letter recommended inclusion of bipartisan language found in Title III, Subtitle A, Section 301 of H.R. 7666 that provides grants to primary care to implement the CoCM. ASAM joined a letter to HHS, supporting the elevating of the Office of the Assistant Secretary for Preparedness and Response into a separate division, the Administration for Strategic Preparedness and Response (ASPR) and urging proactive steps to integrate mental health and substance use throughout the operations of ASPR. ASAM joined a letter to CMS, providing input on the Conditions of Participation for Rural Emergency Hospitals and recommending that CMS increase access to evidence-based treatment by clarifying in the Conditions of Participation that emergency departments operated by Rural Emergency Hospitals must meet the existing standard of care when treating patients with an opioid use disorder. ASAM joined a letter to bill sponsors supporting S. 4472, the Health Care Capacity for Pediatric Mental Health Act, which would make investments in mental health and substance use disorder care for kids and teens while providing support to the pediatric health professionals who serve. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for release of implementation rules regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for legislation that would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. ASAM wrote a letter to the U.S. House Ways and Means Committee regarding the Committees markup of worker and family support and health legislation aimed to expand access to mental health and substance use disorder (SUD) care under Medicare. ASAM requested several, specific clarifications to be made to ensure that Medicare beneficiaries with a primary diagnosis of SUD or with no co-occurring mental health condition can access critical SUD services under Medicare. ASAM wrote a comment letter to the Centers for Medicare and Medicaid Services (CMS) on the proposed 2023 Medicare Physician Fee Schedule (MPFS) covering revisions to opioid treatment program (OTP) services, a proposal to establish physician payment for the management of chronic pain, and a request for information on intensive outpatient (IOP) services, among other items. ASAM joined a coalition of public health, medical, and professional organizations in a letter to the Food and Drug Administration (FDA), supporting its intention to issue a proposed rule to reduce the nicotine level in cigarettes to non-addictive or minimally addictive levels. ASAM joined a letter addressed to Senator Schumer, requesting support of civil monetary penalty authority for the U.S. Department of Labor (USDOL) to enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). ASAM joined a letter to Congressional leadership regarding additional investments in the health care workforce, in particular Medicare-supported GME. ASAM joined a letter to Senate HELP leadership requesting support for funding to enhance the Collaborative Care Model (CoCM), which integrates behavioral health with primary care. Specifically, the letter recommended inclusion of bipartisan language found in Title III, Subtitle A, Section 301 of H.R. 7666 that provides grants to primary care to implement the CoCM. ASAM joined a letter to HHS, supporting the elevating of the Office of the Assistant Secretary for Preparedness and Response into a separate division, the Administration for Strategic Preparedness and Response (ASPR) and urging proactive steps to integrate mental health and substance use throughout the operations of ASPR. ASAM joined a letter to CMS, providing input on the Conditions of Participation for Rural Emergency Hospitals and recommending that CMS increase access to evidence-based treatment by clarifying in the Conditions of Participation that emergency departments operated by Rural Emergency Hospitals must meet the existing standard of care when treating patients with an opioid use disorder. ASAM joined a letter to bill sponsors supporting S. 4472, the Health Care Capacity for Pediatric Mental Health Act, which would make investments in mental health and substance use disorder care for kids and teens while providing support to the pediatric health professionals who serve. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for release of implementation rules regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for legislation that would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. ASAM wrote a letter to the U.S. House Ways and Means Committee regarding the Committees markup of worker and family support and health legislation aimed to expand access to mental health and substance use disorder (SUD) care under Medicare. ASAM requested several, specific clarifications to be made to ensure that Medicare beneficiaries with a primary diagnosis of SUD or with no co-occurring mental health condition can access critical SUD services under Medicare. ASAM wrote a comment letter to the Centers for Medicare and Medicaid Services (CMS) on the proposed 2023 Medicare Physician Fee Schedule (MPFS) covering revisions to opioid treatment program (OTP) services, a proposal to establish physician payment for the management of chronic pain, and a request for information on intensive outpatient (IOP) services, among other items. ASAM joined a coalition of public health, medical, and professional organizations in a letter to the Food and Drug Administration (FDA), supporting its intention to issue a proposed rule to reduce the nicotine level in cigarettes to non-addictive or minimally addictive levels. ASAM joined a letter addressed to Senator Schumer, requesting support of civil monetary penalty authority for the U.S. Department of Labor (USDOL) to enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). ASAM joined a letter to Congressional leadership regarding additional investments in the health care workforce, in particular Medicare-supported GME. ASAM joined a letter to Senate HELP leadership requesting support for funding to enhance the Collaborative Care Model (CoCM), which integrates behavioral health with primary care. Specifically, the letter recommended inclusion of bipartisan language found in Title III, Subtitle A, Section 301 of H.R. 7666 that provides grants to primary care to implement the CoCM. ASAM joined a letter to HHS, supporting the elevating of the Office of the Assistant Secretary for Preparedness and Response into a separate division, the Administration for Strategic Preparedness and Response (ASPR) and urging proactive steps to integrate mental health and substance use throughout the operations of ASPR. ASAM joined a letter to CMS, providing input on the Conditions of Participation for Rural Emergency Hospitals and recommending that CMS increase access to evidence-based treatment by clarifying in the Conditions of Participation that emergency departments operated by Rural Emergency Hospitals must meet the existing standard of care when treating patients with an opioid use disorder. ASAM joined a letter to bill sponsors supporting S. 4472, the Health Care Capacity for Pediatric Mental Health Act, which would make investments in mental health and substance use disorder care for kids and teens while providing support to the pediatric health professionals who serve. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for release of implementation rules regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for legislation that would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. ASAM wrote a letter to the U.S. House Ways and Means Committee regarding the Committees markup of worker and family support and health legislation aimed to expand access to mental health and substance use disorder (SUD) care under Medicare. ASAM requested several, specific clarifications to be made to ensure that Medicare beneficiaries with a primary diagnosis of SUD or with no co-occurring mental health condition can access critical SUD services under Medicare. ASAM wrote a comment letter to the Centers for Medicare and Medicaid Services (CMS) on the proposed 2023 Medicare Physician Fee Schedule (MPFS) covering revisions to opioid treatment program (OTP) services, a proposal to establish physician payment for the management of chronic pain, and a request for information on intensive outpatient (IOP) services, among other items. ASAM joined a coalition of public health, medical, and professional organizations in a letter to the Food and Drug Administration (FDA), supporting its intention to issue a proposed rule to reduce the nicotine level in cigarettes to non-addictive or minimally addictive levels. ASAM joined a letter addressed to Senator Schumer, requesting support of civil monetary penalty authority for the U.S. Department of Labor (USDOL) to enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). ASAM joined a letter to Congressional leadership regarding additional investments in the health care workforce, in particular Medicare-supported GME. ASAM joined a letter to Senate HELP leadership requesting support for funding to enhance the Collaborative Care Model (CoCM), which integrates behavioral health with primary care. Specifically, the letter recommended inclusion of bipartisan language found in Title III, Subtitle A, Section 301 of H.R. 7666 that provides grants to primary care to implement the CoCM. ASAM joined a letter to HHS, supporting the elevating of the Office of the Assistant Secretary for Preparedness and Response into a separate division, the Administration for Strategic Preparedness and Response (ASPR) and urging proactive steps to integrate mental health and substance use throughout the operations of ASPR. ASAM joined a letter to CMS, providing input on the Conditions of Participation for Rural Emergency Hospitals and recommending that CMS increase access to evidence-based treatment by clarifying in the Conditions of Participation that emergency departments operated by Rural Emergency Hospitals must meet the existing standard of care when treating patients with an opioid use disorder. ASAM joined a letter to bill sponsors supporting S. 4472, the Health Care Capacity for Pediatric Mental Health Act, which would make investments in mental health and substance use disorder care for kids and teens while providing support to the pediatric health professionals who serve. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for release of implementation rules regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for legislation that would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. ASAM wrote a letter to the U.S. House Ways and Means Committee regarding the Committees markup of worker and family support and health legislation aimed to expand access to mental health and substance use disorder (SUD) care under Medicare. ASAM requested several, specific clarifications to be made to ensure that Medicare beneficiaries with a primary diagnosis of SUD or with no co-occurring mental health condition can access critical SUD services under Medicare. ASAM wrote a comment letter to the Centers for Medicare and Medicaid Services (CMS) on the proposed 2023 Medicare Physician Fee Schedule (MPFS) covering revisions to opioid treatment program (OTP) services, a proposal to establish physician payment for the management of chronic pain, and a request for information on intensive outpatient (IOP) services, among other items. ASAM joined a coalition of public health, medical, and professional organizations in a letter to the Food and Drug Administration (FDA), supporting its intention to issue a proposed rule to reduce the nicotine level in cigarettes to non-addictive or minimally addictive levels. ASAM joined a letter addressed to Senator Schumer, requesting support of civil monetary penalty authority for the U.S. Department of Labor (USDOL) to enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). ASAM joined a letter to Congressional leadership regarding additional investments in the health care workforce, in particular Medicare-supported GME. ASAM joined a letter to Senate HELP leadership requesting support for funding to enhance the Collaborative Care Model (CoCM), which integrates behavioral health with primary care. Specifically, the letter recommended inclusion of bipartisan language found in Title III, Subtitle A, Section 301 of H.R. 7666 that provides grants to primary care to implement the CoCM. ASAM joined a letter to HHS, supporting the elevating of the Office of the Assistant Secretary for Preparedness and Response into a separate division, the Administration for Strategic Preparedness and Response (ASPR) and urging proactive steps to integrate mental health and substance use throughout the operations of ASPR. ASAM joined a letter to CMS, providing input on the Conditions of Participation for Rural Emergency Hospitals and recommending that CMS increase access to evidence-based treatment by clarifying in the Conditions of Participation that emergency departments operated by Rural Emergency Hospitals must meet the existing standard of care when treating patients with an opioid use disorder. ASAM joined a letter to bill sponsors supporting S. 4472, the Health Care Capacity for Pediatric Mental Health Act, which would make investments in mental health and substance use disorder care for kids and teens while providing support to the pediatric health professionals who serve. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for release of implementation rules regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for legislation that would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. ASAM wrote a letter to the U.S. House Ways and Means Committee regarding the Committees markup of worker and family support and health legislation aimed to expand access to mental health and substance use disorder (SUD) care under Medicare. ASAM requested several, specific clarifications to be made to ensure that Medicare beneficiaries with a primary diagnosis of SUD or with no co-occurring mental health condition can access critical SUD services under Medicare. ASAM wrote a comment letter to the Centers for Medicare and Medicaid Services (CMS) on the proposed 2023 Medicare Physician Fee Schedule (MPFS) covering revisions to opioid treatment program (OTP) services, a proposal to establish physician payment for the management of chronic pain, and a request for information on intensive outpatient (IOP) services, among other items. ASAM joined a coalition of public health, medical, and professional organizations in a letter to the Food and Drug Administration (FDA), supporting its intention to issue a proposed rule to reduce the nicotine level in cigarettes to non-addictive or minimally addictive levels. ASAM joined a letter addressed to Senator Schumer, requesting support of civil monetary penalty authority for the U.S. Department of Labor (USDOL) to enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). ASAM joined a letter to Congressional leadership regarding additional investments in the health care workforce, in particular Medicare-supported GME. ASAM joined a letter to Senate HELP leadership requesting support for funding to enhance the Collaborative Care Model (CoCM), which integrates behavioral health with primary care. Specifically, the letter recommended inclusion of bipartisan language found in Title III, Subtitle A, Section 301 of H.R. 7666 that provides grants to primary care to implement the CoCM. ASAM joined a letter to HHS, supporting the elevating of the Office of the Assistant Secretary for Preparedness and Response into a separate division, the Administration for Strategic Preparedness and Response (ASPR) and urging proactive steps to integrate mental health and substance use throughout the operations of ASPR. ASAM joined a letter to CMS, providing input on the Conditions of Participation for Rural Emergency Hospitals and recommending that CMS increase access to evidence-based treatment by clarifying in the Conditions of Participation that emergency departments operated by Rural Emergency Hospitals must meet the existing standard of care when treating patients with an opioid use disorder. ASAM joined a letter to bill sponsors supporting S. 4472, the Health Care Capacity for Pediatric Mental Health Act, which would make investments in mental health and substance use disorder care for kids and teens while providing support to the pediatric health professionals who serve. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for release of implementation rules regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

COVID services & COVID services for the uninsured S. 3799PREVENT Pandemics Act S. Amdt to H.R. 2471 Consolidated Appropriations Act of 2022 S. 1536Medical Nutrition Therapy Act of 2021 S. 4293Pharmacy Benefit Manager Transparency Act H.R. 7666 Restoring Hope for Mental Health and Wellbeing Act H.R. 2355 Opioid Prescription Verification Act H.R. 1384 Mainstreaming Addiction Treatment Act H.R. 7007 COVID Supplemental Appropriations Act of 2022 H.R. 3108 Medical Nutrition Therapy Act of 2021 H.R. 5585 Advanced Research Project Agency-Health H.R. 6279 Opioid Treatment Access Act H.R. 7559 Prescription Information Modernization Act H.R. 5376 Inflation Reduction Act

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

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

Health Care Supply Chain - Advocated for the importance of hospital group purchasing organizations, and highlighted role in supporting supply chain resiliency to secure essential, authentic medical supplies for hospitals throughout the course of the COVID-19 pandemic. Supported adoption of effort to reduce greenhouse gas emissions and environmentally preferred sourcing for health care supplies. Engaged to support policies to limit shortages of prescription drugs. Advocated for greater transparency in the health care supply chain for drugs and medical devices. Build Back Better Act (H.R. 5376) - Supported policies to encourage health care coverage and close the Medicaid coverage gap. Public Health Emergency - Advocated for HHS to further extend the declared Public Health Emergency. Telehealth - Supported efforts to make telehealth flexibilities offered during COVID-19 Public Health Emergency permanent. Supported CONNECT for Health Act (S. 1512/H.R. 2903) and encouraged reimbursement parity for certain telehealth services and support for audio-only telehealth services. Health Care Workforce - Urged passage of the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708; S. 168); The Health Care Workforce Resilience Act (S. 1024/H.R. 2255); The Dr. Lorna Breen Health Care Provider Protection Act (S.610/H.R. 1667); The Resident Physician Shortage Reduction Act (S.834/H.R. 2256). The Opioid Workforce Act (S. 1438/H.R. 3441). Urged administration to examine practices of health care staffing agencies. Supported passage of the Travel Nursing Agency Transparency Study Act (S. 4352). Supported passage of the Safety from Violence for Healthcare Employees Act (H.R. 7961). Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act (S. 3799) - monitored Senate Committee adoption of PREVENT Pandemics Act. Supported inclusion of provisions to improve supply chain transparency and extend shelf life of prescription drugs. Supported passage of the Integrity, Notification, Fairness in Online Retail Marketplaces (INFORM) Consumers Act (S. 963/H.R. 5502). 340B Drug Pricing Program - Urged HHS to enforce guidance that would allow 340B Covered Entities to utilize contract pharmacies. Food and Drug Administration User Fees (S. 4348, H.R.7667) - Urged inclusion of provisions in FDA user fee legislation to provide greater authorities for the FDA to promote supply chain transparency, clarifying language related to the Unapproved Drugs Initiative, the PASTUER Act (S.2076) and the PATCH Act (H.R. 7084). Social Determinants of Health and Health Equity - Shared insights and offered suggestions to CMS regarding health equity measurement, indices and data collection. Supported the Social Determinants Accelerator Act (H.R. 2503; S. 3039); The LINC to Address Social Needs Act (S. 509). Antimicrobial resistance (S. 2076) - Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act. Supported passage of Opioid Treatment Access Act (S. 3629/H.R. 6279). Supported passage of Drug Shortage Shelf Life Extension Act (S. 3493).

Client expense: $210,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA), White House Office

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

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

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

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

COVID services & COVID services for the uninsured S. 3799PREVENT Pandemics Act S. Amdt to H.R. 2471 Consolidated Appropriations Act of 2022 S. 1536Medical Nutrition Therapy Act of 2021 S. 4293Pharmacy Benefit Manager Transparency Act H.R. 7666 Restoring Hope for Mental Health and Wellbeing Act H.R. 2355 Opioid Prescription Verification Act H.R. 1384 Mainstreaming Addiction Treatment Act H.R. 7007 COVID Supplemental Appropriations Act of 2022 H.R. 3108 Medical Nutrition Therapy Act of 2021 H.R. 5585 Advanced Research Project Agency-Health H.R. 6279 Opioid Treatment Access Act H.R. 7559 Prescription Information Modernization Act

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

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

Substance Use Disorders, Training related issues Medication Assisted Treatment (MAT) delivery related issues Telehealth for providing Medication Assisted Treatment (MAT) H.R.6279/S.3629, Opioid Treatment Access Act, Entirety H.R.3284/S.4445, Mainstreaming Addiction Treatment Act, Entirety H.R.2067, Medication Access and Training Expansion Act, Entirety H.R.7666, Restoring Hope for Mental Health and Well-Being Act of 2022, Entirety

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Substance Use Disorders, Training related issues Medication Assisted Treatment (MAT) delivery related issues Telehealth for providing Medication Assisted Treatment (MAT) H.R.6279/S.3629, Opioid Treatment Access Act, Entirety H.R.3284/S.4445, Mainstreaming Addiction Treatment Act, Entirety H.R.2067, Medication Access and Training Expansion Act, Entirety H.R.7666, Restoring Hope for Mental Health and Well-Being Act of 2022, Entirety

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

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 S.253, Cannabidiol & Marijuana Research Expansion Act, Cannabis research related issues H.R.5657, Medical Marijuana Research Act, Cannabis research related issues

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.4521, America COMPETES Act of 2022, Secure and Fair Enforcement (SAFE) Banking Act H.R.7666, Restoring Hope for Mental Health and Well-Being Act of 2022, Entirety Monitor the following: 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 CARA 3.0 Act of 2021 Public Law 117-103, Consolidated Appropriations Act, FY2022

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Advocated for closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Advocated for closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Advocated for closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Advocated for closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Advocated for closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Advocated for closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Issues related to opioid addiction recovery and drug treatment programs - no specific legislation. H.R.1384 - Mainstreaming Addiction Treatment Act of 2021; H.R. 6279 and S. 3629, Opioid Treatment Access Act of 2022 - entire bill.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), White House Office

American Rescue Plan Act of 2021 (H.R. 1319), all provisions related to relief to address the continued impact of COVID-19. Mainstreaming Addiction Treatment Act (S. 445/H.R. 1384), all provisions related to removing the waiver requirement for health care providers to prescribe buprenorphine for opioid use disorder. Improving Access to Remote Behavioral Health Treatment Act of 2019, all provisions related to amending regulations for the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 and allowing community mental health centers to register to practice telemedicine. Medication Access and Training Expansion Act (H.R. 2067), all provisions related to requiring physicians and other prescribers of controlled substances to complete training on treating and managing patients with substance use disorders. CONNECT for Health Act of 2021 (H.R. 2903/S. 1512), all provisions related to expanding access to telehealth services. Telemental Health Care Access Act of 2021 (S. 2061), all provisions related to ensuring coverage of mental health services furnished through telehealth. HELP Act of 2021 (S. 1570), all provisions related to the accessibility and coordination of 211 services and 988 services. Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708/S. 168), all provisions related to temporary authorization of in-person and telehealth services. Behavioral Health Crisis Services Expansion Act (S. 1902), all provisions related to empowering communities to establish a continuum of care for individuals experiencing a behavioral health crisis. Ensuring Medicaid Continuity for Children in Foster Care Act of 2021 (H.R. 5414/S. 2689), all provisions related to ensuring children in foster care who are placed in a qualified residential treatment program are eligible for Medicaid. Preventing Overdoses and Saving Lives Act of 2021 (H.R. 5442), all provisions related to authorizing grants to develop strategic response plans with respect to the opioid crisis, and to require practitioners prescribing an opioid for certain patients to also prescribe an opioid overdose reversal drug. Coronavirus Mental Health and Addiction Assistance Act of 2021 (H.R. 593/S. 135), all provisions related to providing grants to entities that provide mental health and substance use disorder programs during the COVID-19 pandemic. Mental Health Services for Students Act of 2021 (H.R. 721/S. 1841), all provisions related to school-based mental health services. Stopping the Mental Health Pandemic Act (H.R. 7080/S. 4059), all provisions related to grants to support behavioral health treatment and services during the COVID-19 pandemic. Emergency Support for Substance Use Disorders Act (S. 4058), all provisions related to grants for harm reduction activities during the COVID-19 pandemic. Elementary and Secondary School Counseling Act (H.R. 6214/S. 3356), all provisions related to awarding grants to increase access to school-based, mental health services. Campus Prevention and Recovery Services for Students Act of 2019 (H.R. 3591), all provisions related to expanding the illicit drug and alcohol abuse prevention program to include campus efforts to prevent substance misuse. Opioid Treatment Access Act of 2022 (H.R. 6279), all provisions related to authorizing a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs. 9-8-8 Implementation Act of 2022 (H.R. 7116), all provisions related to providing for improvements in the implementation of the National Suicide Prevention Lifeline, and for other purposes. 9-8-8 and Parity Assistance Act of 2022 (H.R.7232), all provisions related to providing for improvements in the implementation of the National Suicide Prevention Lifeline, and for other purposes. Into the Light for MMH and SUD Act of 2022 (H.R. 7073), all provisions related to reauthorizing a grant program for screening, assessment, and treatment services for maternal mental health and substance use disorders, and for other purposes. Anna Westin Legacy Act (H.R. 7249/S. 3686), all provisions related to providing education and training on eating disorders for health care providers and communities, and for other purposes. Behavioral Health Information Technology Act, (H.R.7427), all provisions related to CMI testing of incentive payments for behavioral health providers and certain other providers for adoption and use of certified electronic health record technology, and for other purposes Safe Step Act (H.R. 2163/S. 464), all provisions related to creating an exception for medication step-therapy. Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act (S. 586), all provisions related to establishing separate payments for certain non-opioid treatments under the Medicare prospective payment system for hospital outpatient department services and the payment system for ambulatory surgical center services Food and Drug Administration Safety and Landmark Advancements Act of 2022 (S.4348), all provisions related to addressing substance use disorders and the safe disposal of opioids. Telemental Health Access to Care Act (S.2061/H.R. 4058), all provisions related to intended to increase access to tele-mental health care and telehealth. Stop Pills That Kill Act (S.4151), all provisions related to penalizing the manufacture and/or facilitation of manufacturing counterfeit pills that contain fentanyl, an analogue of fentanyl, or a counterfeit substance. Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R. 7666), all provisions related to reauthorizations, expansions, and modifications of programs, grants, and activities that focus on mental and behavioral health.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Communications Commission (FCC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

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

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

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