Anti-Racism in Public Health Act of 2021

S. 346/H.R. 959, Black Maternal Health Momnibus Act of 2021, In support of maternal health and closing disparities in maternal health outcomes for women of color; S. 162/H.R. 666, Anti-Racism in Public Health Act of 2021, In support of strengthening anti-racist health policy; S. Res. 172/H. Res. 344, A resolution declaring racism a public health crisis, In support of declaring racism a public health crisis; H.R. 1475, Pursuing Equity in Mental Health Act, In support of additional resources and guidance to identify mental health, social-emotional, and behavioral health problems; S. 1948/H.R. 3673, National ACERT Grant Program Authorization Act, In support of strengthening and expanding the National ACERT Grant Program Authorization Act; In support of increasing mental health access for women and girls of color.

Client expense: $87,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

Childcare Issues related to childcare - no specific bill General Advocacy on COVID-19 relief, response, and pandemic preparedness, including issues related to: Additional COVID-19 relief funding Assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response Health disparities and protecting vulnerable populations Mental and behavioral health Expanding internet connectivity/broadband Grant program for childcare Food assistance programs Small business loans Reducing health care premiums for low- and middle-income families Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. S.3799 PREVENT Pandemics Act (Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act) Gun Safety S. 2325/H.R.4238 - Making America Safe and Secure (MASS) Act Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care Health Care Workforce S.3828/ H.R. 2418 - Student Loan Forgiveness for Frontline Health Workers Act S. 54 - Strengthening America's Health Care Readiness Act S. 834/ H.R.2256 - Resident Physician Shortage Reduction Act of 2021 S.610/ H.R.1667 - Dr. Lorna Breen Health Care Provider Protection Act S.3244/ H.R.5602 - BIO Preparedness Workforce Act of 2021 Issues related to health care workforce shortages Issues related to the affordability of medical education and federal loan programs Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 - Healthcare Workforce Resilience Act Infrastructure Issues related to broadband access Issues related to the Build Back Better framework Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition H.R.5370 - Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 - Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Issues related to equitable policies around blood, tissue donations Maternal Health S. 411/ H.R. 3407 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education S.3658 /H.R. 4122 - Resident Education Deferred Interest (REDI) Act Medicare/Medicaid Issues related to Medicare physician payment H.R. 1587/ S. 1731 - Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill S.3018/ H.R.3173 - Improving Seniors Timely Access to Care Act of 2021 Issues related to Medicare Advantage risk adjustment HR8800 Supporting Medicare Providers Act of 2022 Opioids/ Substance Use Disorder H.R.6311/ S.3418 - Comprehensive Addiction Resources Emergency (CARE) Act S. 2354 - Safer Prescribing of Controlled Substances Act H.R.1026 / S.2353 - LABEL Opioids Act of 2021 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 H.R.4521 - America COMPETES Act of 2022 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 - Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill Regulatory Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to health equity Comment letter to OSTP Request for Information To Support the Development of a Federal Scientific Integrity Policy Framework

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

Government targets: 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), Labor, Dept of (DOL), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Childcare Issues related to childcare - no specific bill General Advocacy on COVID-19 relief, response, and pandemic preparedness, including issues related to: Additional COVID-19 relief funding Assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response Health disparities and protecting vulnerable populations Mental and behavioral health Expanding internet connectivity/broadband Grant program for childcare Food assistance programs Small business loans Reducing health care premiums for low- and middle-income families Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. S.3799 PREVENT Pandemics Act (Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act) Gun Safety S. 2325/H.R.4238 - Making America Safe and Secure (MASS) Act Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care Health Care Workforce S.3828/ H.R. 2418 - Student Loan Forgiveness for Frontline Health Workers Act S. 54 - Strengthening America's Health Care Readiness Act S. 834/ H.R.2256 - Resident Physician Shortage Reduction Act of 2021 S.610/ H.R.1667 - Dr. Lorna Breen Health Care Provider Protection Act S.3244/ H.R.5602 - BIO Preparedness Workforce Act of 2021 Issues related to health care workforce shortages Issues related to the affordability of medical education and federal loan programs Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 - Healthcare Workforce Resilience Act Infrastructure Issues related to broadband access Issues related to the Build Back Better framework Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition H.R.5370 - Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 - Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Issues related to equitable policies around blood, tissue donations Maternal Health S. 411/ H.R. 3407 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education S.3658 /H.R. 4122 - Resident Education Deferred Interest (REDI) Act Medicare/Medicaid Issues related to Medicare physician payment H.R. 1587/ S. 1731 - Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill S.3018/ H.R.3173 - Improving Seniors Timely Access to Care Act of 2021 Issues related to Medicare Advantage risk adjustment HR8800 Supporting Medicare Providers Act of 2022 Opioids/ Substance Use Disorder H.R.6311/ S.3418 - Comprehensive Addiction Resources Emergency (CARE) Act S. 2354 - Safer Prescribing of Controlled Substances Act H.R.1026 / S.2353 - LABEL Opioids Act of 2021 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 H.R.4521 - America COMPETES Act of 2022 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 - Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill Regulatory Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to health equity

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

Government targets: 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), Labor, Dept of (DOL), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Childcare Issues related to childcare - no specific bill General Advocacy on COVID-19 relief, response, and pandemic preparedness, including issues related to: Additional COVID-19 relief funding Assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response Health disparities and protecting vulnerable populations Mental and behavioral health Expanding internet connectivity/broadband Grant program for childcare Food assistance programs Small business loans Reducing health care premiums for low- and middle-income families Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. S.3799 PREVENT Pandemics Act (Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act) Gun Safety S. 2325/H.R.4238 - Making America Safe and Secure (MASS) Act Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care Health Care Workforce S.3828/ H.R. 2418 - Student Loan Forgiveness for Frontline Health Workers Act S. 54 - Strengthening America's Health Care Readiness Act S. 834/ H.R.2256 - Resident Physician Shortage Reduction Act of 2021 S.610/ H.R.1667 - Dr. Lorna Breen Health Care Provider Protection Act S.3244/ H.R.5602 - BIO Preparedness Workforce Act of 2021 Issues related to health care workforce shortages Issues related to the affordability of medical education and federal loan programs Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 - Healthcare Workforce Resilience Act Infrastructure Issues related to broadband access Issues related to the Build Back Better framework Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition H.R.5370 - Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 - Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Issues related to equitable policies around blood, tissue donations Maternal Health S. 411/ H.R. 3407 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education S.3658 /H.R. 4122 - Resident Education Deferred Interest (REDI) Act Medicare/Medicaid Issues related to Medicare physician payment H.R. 1587/ S. 1731 - Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill S.3018/ H.R.3173 - Improving Seniors Timely Access to Care Act of 2021 Issues related to Medicare Advantage risk adjustment Opioids/ Substance Use Disorder H.R.6311/ S.3418 - Comprehensive Addiction Resources Emergency (CARE) Act S. 2354 - Safer Prescribing of Controlled Substances Act H.R.1026 / S.2353 - LABEL Opioids Act of 2021 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 H.R.4521 - America COMPETES Act of 2022 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 - Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill Regulatory Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to health equity

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

Government targets: 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), Labor, Dept of (DOL), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Childcare Issues related to childcare - no specific bill General Advocacy on COVID-19 relief, response, and pandemic preparedness, including issues related to: Additional COVID-19 relief funding Assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response Health disparities and protecting vulnerable populations Mental and behavioral health Expanding internet connectivity/broadband Grant program for childcare Food assistance programs Small business loans Reducing health care premiums for low- and middle-income families Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. S.3799 PREVENT Pandemics Act (Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act) Gun Safety S. 2325/H.R.4238 - Making America Safe and Secure (MASS) Act Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care Health Care Workforce S.3828/ H.R. 2418 - Student Loan Forgiveness for Frontline Health Workers Act S. 54 - Strengthening America's Health Care Readiness Act S. 834/ H.R.2256 - Resident Physician Shortage Reduction Act of 2021 S.610/ H.R.1667 - Dr. Lorna Breen Health Care Provider Protection Act S.3244/ H.R.5602 - BIO Preparedness Workforce Act of 2021 Issues related to health care workforce shortages Issues related to the affordability of medical education and federal loan programs Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 - Healthcare Workforce Resilience Act Infrastructure Issues related to broadband access Issues related to the Build Back Better framework Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition H.R.5370 - Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 - Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Issues related to equitable policies around blood, tissue donations Maternal Health S. 411/ H.R. 3407 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education S.3658 /H.R. 4122 - Resident Education Deferred Interest (REDI) Act Medicare/Medicaid Issues related to Medicare physician payment H.R. 1587/ S. 1731 - Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill S.3018/ H.R.3173 - Improving Seniors Timely Access to Care Act of 2021 Issues related to Medicare Advantage risk adjustment Opioids/ Substance Use Disorder H.R.6311/ S.3418 - Comprehensive Addiction Resources Emergency (CARE) Act S. 2354 - Safer Prescribing of Controlled Substances Act H.R.1026 / S.2353 - LABEL Opioids Act of 2021 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 H.R.4521 - America COMPETES Act of 2022 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 - Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill Regulatory Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to health equity Comment letter to OSTP Request for Information To Support the Development of a Federal Scientific Integrity Policy Framework

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

Government targets: 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), Labor, Dept of (DOL), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

S. 346/H.R. 959, Black Maternal Health Momnibus Act of 2021, In support of maternal health and closing disparities in maternal health outcomes for women of color; S. 162/H.R. 666, Anti-Racism in Public Health Act of 2021, In support of strengthening anti-racist health policy; S. Res. 172/H. Res. 344, A resolution declaring racism a public health crisis, In support of declaring racism a public health crisis; H.R. 1475, Pursuing Equity in Mental Health Act, In support of additional resources and guidance to identify mental health, social-emotional, and behavioral health problems; S. 1948/H.R. 3673, National ACERT Grant Program Authorization Act, In support of strengthening and expanding the National ACERT Grant Program Authorization Act; In support of increasing mental health access for women and girls of color.

Client expense: $115,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 253, Cannabidiol and Marihuana Research Expansion Act, all provisions H.R. 6087, Improving Access to Workers Compensation for Injured Federal Workers Act of 2022, all provisions H.R. 3085, Equity in Neuroscience and Alzheimers Clinical Trials (ENACT) Act of 2021, all provisions H.R. 5030, Diversifying Investigations Via Equitable Research Studies for Everyone (DIVERSE) Trials Act, all provisions H.R. 1384, Mainstreaming Addiction Treatment (MAT) Act of 2021, all provisions S. 445, Mainstreaming Addiction Treatment (MAT) Act of 2021, all provisions H.R. 2067, Medication Access and Training Expansion (MATE) Act of 2021, all provisions S. 2235, Medication Access and Training Expansion (MATE) Act of 2021, all provisions H.R. 6072, Leveraging Integrated Networks in Communities (LINC) To Address Social Needs Act of 2021, provisions relating to social determinants of health, impact on mental health and social services S. 509, Leveraging Integrated Networks in Communities (LINC) To Address Social Needs Act of 2021, provisions relating to social determinants of health, impact on mental health and social services H.R. 379, Improving Social Determinants of Health Act of 2021, all provisions S. 104, Improving Social Determinants of Health Act of 2021, all provisions S. 3799, Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act, all provisions H.R. 8, Bipartisan Background Checks Act of 2021, all provisions H.R. 1446, Enhanced Background Checks Act of 2021, all provisions S. 1675, Maternal Health Quality Improvement Act, all provisions H.R. 2163, Safe Step Act, all provisions S. 464, Safe Step Act, all provisions H.R. 666, Anti-Racism in Public Health Act of 2021, all provisions S. 162, Anti-Racism in Public Health Act of 2021, all provisions H.R. 5248, Temporary Responders for Immediate Aid in Grave Emergencies (TRIAGE) Act of 2021, all provisions H.R. 6311, Comprehensive Addiction Resources Emergency Act of 2021, all provisions S. 3418, Comprehensive Addiction Resources Emergency Act of 2021, all provisions H.R. 1364, Parity Enforcement Act of 2021, all provisions H.R. 3735, Parity Implementation Assistance Act, all provisions H.R. 7232, 9-8-8 and Parity Assistance Act of 2022, all provisions H.R. 7116, 9-8-8 Implementation Act of 2022, all provisions S. 2938, Bipartisan Safer Communities Act, all provisions S. 4090, Dietary Supplement Listing Act of 2022, all provisions S. 1675, Maternal Health Quality Improvement Act, all provisions H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, all provisions S. 610, Dr. Lorna Breen Health Care Provider Protection Act, all provisions H.R. 3753, Parity Implementation Assistance Act, all provisions S. 1962, Parity Implementation Assistance Act, all provisions S. 3904, Healthcare Cybersecurity Act of 2022, all provisions H.R. 4128, Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021, all provisions S. 2209, Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021, all provisions H.R. 6000, Cures 2.0 Act, all provisions S. 2416, New Opportunities for Value that Extend Lives (NOVEL) Act of 2021, all provisions H.R. 8152, To provide consumers with foundational data privacy rights, create strong oversight mechanisms, and establish meaningful enforcement, all provisions H.R. 2377, Federal Extreme Risk Protection Order Act of 2022, all provisions H.R. 7910, Protecting Our Kids Act, all provisions S. 2938, Bipartisan Safer Communities Act, all provisions H.R. 7667, Food and Drug Amendments of 2022, all provisions H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022, all provisions H.R. 2503, Social Determinants Accelerator Act of 2021, all provisions S. 3039, Social Determinants Accelerator Act of 2021, all provisions H.R. 7192, Diagnostic Device Advisory Committee Act, all provisions H.R. 3085, Equity in Neuroscience and Alzheimers Clinical Trials (ENACT) Act of 2021, all provisions H.R. 5218, Collaborate in an Orderly and Cohesive Manner Act, all provisions H.R. 7845, NIH Clinical Trial Diversity Act of 2022, all provisions H.R. 708, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions H.R. 4480, Telehealth Coverage and Payment Parity Act, all provisions H.R. 7573, Telehealth Extension and Evaluation Act, all provisions S. 3593, Telehealth Extension and Evaluation Act, all provisions H.R. 5541, Primary and Virtual Care Affordability Act, all provisions H.R. 1306, National Coronavirus Commission Act of 2021, all provisions S. 412, National Coronavirus Commission Act of 2021, all provisions H.R. 1843, COVID-19 Hate Crimes Act, all provisions S. 937, COVID-19 Hate Crimes Act, all provisions H.R. 3778, Nullifying Opportunities for Variants to Infect and Decimate (NOVID) Act, all provisions S. 1976, Nullifying Opportunities for Variants to Infect and Decimate (NOVID) Act, all provisions H.R. 6904, Patients Before Profits Act of 2022, all provisions H.R. 7053, Hospital Inpatient Services Modernization Act, all provisions S. 3792, Hospital Inpatient Services Modernization Act, all provisions H.R. 1364, Parity Enforcement Act of 2021, all provisions H.R. 5224, Preventing Overdoses and Saving Lives Act of 2021, all provisions H.R. 6279, Opioid Treatment Access Act of 2022, all provisions H.R. 7234, Summer Barrow Prevention, Treatment, and Recovery Act, all provisions H.R. 3352, Midwives for MOMS Act of 2021, all provisions H.R. 847, Promoting Digital Privacy Technologies Act, all provisions S. 224, Promoting Digital Privacy Technologies Act, all provisions H.R. 3771, South Asian Heart Health Awareness and Research Act of 2021, all provisions H.R. 7559, Prescription Information Modernization Act of 2022, all provisions H.R. 8289, Banning Misleading Drug Ads Act of 2022, all provisions H.R. 3614, Menstrual Equity For All Act of 2021, all provisions No Surprises Act/implementation Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions 21st Century Cures Act/implementation Maternal mortality Maternal health and inequities/FY 2023 funding Prior Authorization AMA Recovery Plan for Americas Physicians/telehealth/prior authorization/physician burnout/scope Section 2527(b) of the U.S. Innovation and Competition Act (USICA)/Open Access Language Retired Physician Re-entry COVID-19 telehealth flexibilities COVID-19/Vaccine distribution/Vaccines in physician offices Physician burnout and suicide COVID-19/Health Equity/vaccines COVID-19 response/testing/misinformation/therapeutics/Paxlovid Public Health Emergency COVID-19 Health Equity/Men who have sex with men/3-month blood donation use deferral Health Equity/Federally qualified health centers and clinical trials Womens Reproductive Health Medication Abortion Access Diabetes Provider Relief Fund/COVID-19 Electronic Health Records (EHR) Certification Data Privacy Hunger, Nutrition, and Health Digital Health/AI/Digital Therapeutics Monkeypox/testing/vaccination

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

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

Childcare Issues related to childcare - no specific bill General Advocacy on COVID-19 relief, response, and pandemic preparedness, including issues related to: Additional COVID-19 relief funding Assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response Health disparities and protecting vulnerable populations Mental and behavioral health Expanding internet connectivity/broadband Grant program for childcare Food assistance programs Small business loans Reducing health care premiums for low- and middle-income families Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. S.3799 PREVENT Pandemics Act (Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act) Gun Safety S. 2325/H.R.4238 - Making America Safe and Secure (MASS) Act Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care Health Care Workforce S.3828/ H.R. 2418 - Student Loan Forgiveness for Frontline Health Workers Act S. 54 - Strengthening America's Health Care Readiness Act S. 834/ H.R.2256 - Resident Physician Shortage Reduction Act of 2021 S.610/ H.R.1667 - Dr. Lorna Breen Health Care Provider Protection Act S.3244/ H.R.5602 - BIO Preparedness Workforce Act of 2021 Issues related to health care workforce shortages Issues related to the affordability of medical education and federal loan programs Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 - Healthcare Workforce Resilience Act Infrastructure Issues related to broadband access Issues related to the Build Back Better framework Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition H.R.5370 - Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 - Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Issues related to equitable policies around blood, tissue donations Maternal Health S. 411/ H.R. 3407 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education S.3658 /H.R. 4122 - Resident Education Deferred Interest (REDI) Act Medicare/Medicaid Issues related to Medicare physician payment H.R. 1587/ S. 1731 - Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill S.3018/ H.R.3173 - Improving Seniors Timely Access to Care Act of 2021 Issues related to Medicare Advantage risk adjustment Opioids/ Substance Use Disorder H.R.6311/ S.3418 - Comprehensive Addiction Resources Emergency (CARE) Act S. 2354 - Safer Prescribing of Controlled Substances Act H.R.1026 / S.2353 - LABEL Opioids Act of 2021 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 H.R.4521 - America COMPETES Act of 2022 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 - Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill Regulatory Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to health equity

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

Government targets: 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), Labor, Dept of (DOL), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Childcare Issues related to childcare - no specific bill General Advocacy on COVID-19 relief, response, and pandemic preparedness, including issues related to: Additional COVID-19 relief funding Assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response Health disparities and protecting vulnerable populations Mental and behavioral health Expanding internet connectivity/broadband Grant program for childcare Food assistance programs Small business loans Reducing health care premiums for low- and middle-income families Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. S.3799 PREVENT Pandemics Act (Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act) Gun Safety S. 2325/H.R.4238 - Making America Safe and Secure (MASS) Act Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care Health Care Workforce S.3828/ H.R. 2418 - Student Loan Forgiveness for Frontline Health Workers Act S. 54 - Strengthening America's Health Care Readiness Act S. 834/ H.R.2256 - Resident Physician Shortage Reduction Act of 2021 S.610/ H.R.1667 - Dr. Lorna Breen Health Care Provider Protection Act S.3244/ H.R.5602 - BIO Preparedness Workforce Act of 2021 Issues related to health care workforce shortages Issues related to the affordability of medical education and federal loan programs Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 - Healthcare Workforce Resilience Act Infrastructure Issues related to broadband access Issues related to the Build Back Better framework Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition H.R.5370 - Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 - Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Issues related to equitable policies around blood, tissue donations Maternal Health S. 411/ H.R. 3407 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education S.3658 /H.R. 4122 - Resident Education Deferred Interest (REDI) Act Medicare/Medicaid Issues related to Medicare physician payment H.R. 1587/ S. 1731 - Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill S.3018/ H.R.3173 - Improving Seniors Timely Access to Care Act of 2021 Issues related to Medicare Advantage risk adjustment Opioids/ Substance Use Disorder H.R.6311/ S.3418 - Comprehensive Addiction Resources Emergency (CARE) Act S. 2354 - Safer Prescribing of Controlled Substances Act H.R.1026 / S.2353 - LABEL Opioids Act of 2021 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 H.R.4521 - America COMPETES Act of 2022 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 - Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill Regulatory Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to health equity Comment letter to OSTP RFI - Public Access to Peer-Reviewed Scholarly Publications, Data and Code Resulting from Federally Funded Research

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

Government targets: 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), Labor, Dept of (DOL), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH) has demonstrated value in meeting the policy objectives suggested above. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases. Regarding CMS Medicare Physician Fee Schedule and Quality Payment Program (QPP) rules, expressed support for extending some of the services and increased flexibility for telehealth through the end of 2023, namely some audio-only services that were allowed during the COVID-19 public health emergency (PHE), support for collecting additional data on health equity issues to analyze disparities that occur across their programs, support for including chronic care management as one of the seven MIPS Value Pathways (MVPs) for 2023. Urged CMS to discontinue its split/shared visits policy and not move forward with the transition set to take effect in 2023. FY2023 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Preventions programs in the FY 2023 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ). COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP); urged support for administering COVID-19 vaccinations to all eligible immigrants in Customs and Border Protection (CBP) custody. Urged CMS to support increasing COVID-19 vaccine uptake by ensuring clinicians are appropriately paid for vaccine counseling for beneficiaries of Medicaid and Medicare. Urged that telehealth services should remain in place for at least two years after the end of the PHE to ensure that our physicians are able to continue to use this modality to enhance patient care. Urged Congress to support the concept of a congressionally-mandated bipartisan commission to examine the U.S. preparations for and response to the COVID-19 pandemic, in order to inform future public policy and health systems preparedness. Urged that any uses of technology in the U.S. in the context of the pandemic should be demonstrated to be effective, be temporary, and ensure that safeguards for privacy and confidentiality are in place. American Rescue Plan (ARP) Act (H.R. 1319): Urged support for various provisions within the ARP to provide incentives for states to expand Medicaid by temporarily increasing the states base FMAP by five percentage points for two years for states that newly expand Medicaid. Urged support for allowing states, for five years, to extend Medicaid eligibility (and CHIP eligibility) to women for 12 months postpartum. Urged support to require Medicaid coverage of COVID-19 vaccines and treatment without beneficiary cost sharing with vaccines matched at a 100 percent federal medical assistance percentage (FMAP) through one year after the end of the PHE. Urged support for $46 billion to HHS to detect, diagnose, trace, and monitor COVID-19 infections, and for other activities necessary to mitigate the spread of COVID-19. Urged support to subsidize the health coverage of people earning up to 150 percent of the federal poverty level (FPL) under the ACA and those on unemployment insurance for a period of two years. Womens Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Urged support for mandatory, permanent extension of postpartum Medicaid coverage, from 60 days to 12 months after delivery. Urged support for the Womens Health Protection Act of 2021 and 2022 (H.R. 3755/S. 1975), bills that would protect a persons ability to determine whether to continue or end a pregnancy and to protect the health care clinicians ability to provide abortion services free from medically unnecessary restrictions such as waiting periods, biased counselling and admitting privilege requirements for clinicians. Expand Health Coverage and Affordability: Urged Congress to support H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place. Introduce and pass the companion bill in the Senate and H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the ACA. Urged Congress to support H.R. 3173, the Improving Seniors Timely Access to Care Act of 2021, which would help protect patients from unnecessary delays in care and reduce administrative burdens on physicians by standardizing and streamlining the prior authorization approval process in the Medicare Advantage program. Urged passage of H.R. 3563, the Chronic Disease Management Act, which will allow high deductible health plans (HDHPs) to provide patients with access to certain chronic care services and treatments with no cost sharing before meeting their deductible; H.R. 5541, the Primary and Virtual Care Affordability Act, which gives employers and health plan sponsors the flexibility to waive the deductible for primary care and telehealth services through December 31, 2023, for patients covered by HDHPs. Support the Physician Workforce: Urged Congress to support H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots by at least 2,000 per year over seven years (14,000 slots) for specialties facing shortages, including internal medicine; H.R. 1554 (116th Congress), the Resident Education Deferred Interest Act, to allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program; Urged support for the Conrad State 30 and Physician Access Reauthorization Act (H.R. 3541, S. 1810), which would extend the authorization for the program for three years and would simplify the process for obtaining a visa, enhance important workplace protections for physicians, and increase the number of waivers available to states beyond the current allotment of thirty waivers, if certain requirements are met. Support the Value of Primary and Comprehensive Care: Urged Congress to continue to fund the 3.00 percent increase to all physicians services that was approved by Congress at the end of last year to prevent CY2023 budget neutrality cuts for physician services, including primary care visits and other evaluation and management services; Ensure that any legislation that addresses budget neutrality treats all services fairly and equitably; Pass H.R. 1025, the Kids Access to Primary Care Act, to increase access to health coverage for Medicaid patients by achieving payment parity for primary care services under Medicaid and Medicare; Extend the five percent bonus that physicians receive if they meet performance expectations in Advanced APMs that is set to expire at the end of 2022; Urged support to prevent scheduled cuts for physician services, including primary care, resulting from budget sequestration and pay-as-you go budget rules. Improve Access to Prescription Drugs and Reduce Costs: Urged Congress to support S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; S. 141, the End Taxpayer Subsidies for Drug Ads Act, to end the federal tax deduction that pharmaceutical companies use to pay for drug advertising; S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Urged support for the reauthorization of prescription drug user fee agreements. Promote Health Equity, Social Justice, and Eliminate Disparities: Urged Congress to support H.R. 1280, the George Floyd Justice in Policing Act of 2021, to overhaul qualified immunity for law enforcement, prohibit racial profiling on the part of law enforcement and ban no-knock warrants in federal drug cases and chokeholds and carotid holds at the federal level; H.R. 5, the Equality Act, to prohibit discrimination based on sex, sexual orientation and gender identity in public accommodations and facilities, education, federal housing credit and the jury system; H.R. 666/S. 162, the Anti-Racism in Public Health Act of 2021, to establish within the CDC a National Center on Anti-racism and Health for data collection and research and a law enforcement violence prevention program. Expand Access to Telehealth Services and Promote Patient Safety/Privacy; Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends. Substance Use Disorders: Urged Congress to support for the Comprehensive Addiction Resources Emergency (CARE) Act in the 117th Congress, which offers increased access to treatment and will improve care for individuals with substance use disorders (SUDs), specifically $1 billion per year to expand access to overdose reversal drugs (Naloxone) and provide this life-saving medicine to states to distribute to first responders, public health departments, and the public. The Build Back Better Act (H.R. 5376): Urged support in Congress for the following provisions: provide temporary enhanced ACA Marketplace cost-sharing reduction assistance to individuals with household incomes below 138 percent of the federal poverty level (FPL) for calendar years (CY) 2022 through 2025 and specify that individuals with household incomes below 138 percent of the FPL with access to employer-sponsored coverage or a qualified small employer health reimbursement arrangement can still receive credits; the 400 percent federal poverty level premium tax credit eligibility cap should be eliminated, and the amount of premium tax credits for all income levels should be enhanced; establish a health insurance affordability fund, with $10 billion made available annually for states to establish a state reinsurance program or use the funds to provide financial assistance to reduce out-of-pocket costs; permanently reauthorize CHIP and provide states the option to increase Medicaid and CHIP eligibility levels for children up to 300 percent of FPL without receiving a waiver. Mental and Behavioral Health: Urged Congress to support H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act (CoCM) that would provide grants through the Department of Health and Human Services to primary care physicians that choose to deliver behavioral health care through the Collaborative Care Model (CoCM). CoCM involves a primary care physician working collaboratively with a psychiatric consultant and a care manager to manage the clinical care of behavioral health patient caseloads. Urged support for retaining all services added to the Medicare telehealth services list on a temporary, Category 3 basis until the end of CY23. CMS should maintain coverage of audio-only mental health visits even after the PHE is lifted. This extension should last at least through the end of 2023 with an option to extend it even further or consider making it permanent, based on the experience and learnings of patients and physicians who utilize these visits. Urged support for expanding access to mental and behavioral health services, including allowing beneficiaries to access services from home, or if the technology is not available at home, from a rural health clinic or hospital. Regulate Tobacco: Urged the Food and Drug Administration (FDA) to use its authority under the Family Smoking Prevention and Tobacco Control Act (TCA) to issue product standards ending the manufacture and sale of flavored tobacco products; Urged the FDA to fulfill its commitment to issue a rule prohibiting characterizing flavors in cigars and to prohibit menthol as a characterizing flavor in cigarettes.

Client expense: $407,792 · Firm income: Not reported

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

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH) has demonstrated value in meeting the policy objectives suggested above. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases. Regarding CMS Medicare Physician Fee Schedule and Quality Payment Program (QPP) rules, expressed support for extending some of the services and increased flexibility for telehealth through the end of 2023, namely some audio-only services that were allowed during the COVID-19 public health emergency (PHE), support for collecting additional data on health equity issues to analyze disparities that occur across their programs, support for including chronic care management as one of the seven MIPS Value Pathways (MVPs) for 2023. Urged CMS to discontinue its split/shared visits policy and not move forward with the transition set to take effect in 2023. FY2023 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Preventions programs in the FY 2023 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ). COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP); urged support for administering COVID-19 vaccinations to all eligible immigrants in Customs and Border Protection (CBP) custody. Urged CMS to support increasing COVID-19 vaccine uptake by ensuring clinicians are appropriately paid for vaccine counseling for beneficiaries of Medicaid and Medicare. Urged that telehealth services should remain in place for at least two years after the end of the PHE to ensure that our physicians are able to continue to use this modality to enhance patient care. Urged Congress to support the concept of a congressionally-mandated bipartisan commission to examine the U.S. preparations for and response to the COVID-19 pandemic, in order to inform future public policy and health systems preparedness. Urged that any uses of technology in the U.S. in the context of the pandemic should be demonstrated to be effective, be temporary, and ensure that safeguards for privacy and confidentiality are in place. American Rescue Plan (ARP) Act (H.R. 1319): Urged support for various provisions within the ARP to provide incentives for states to expand Medicaid by temporarily increasing the states base FMAP by five percentage points for two years for states that newly expand Medicaid. Urged support for allowing states, for five years, to extend Medicaid eligibility (and CHIP eligibility) to women for 12 months postpartum. Urged support to require Medicaid coverage of COVID-19 vaccines and treatment without beneficiary cost sharing with vaccines matched at a 100 percent federal medical assistance percentage (FMAP) through one year after the end of the PHE. Urged support for $46 billion to HHS to detect, diagnose, trace, and monitor COVID-19 infections, and for other activities necessary to mitigate the spread of COVID-19. Urged support to subsidize the health coverage of people earning up to 150 percent of the federal poverty level (FPL) under the ACA and those on unemployment insurance for a period of two years. Womens Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Urged support for mandatory, permanent extension of postpartum Medicaid coverage, from 60 days to 12 months after delivery. Urged support for the Womens Health Protection Act of 2021 and 2022 (H.R. 3755/S. 1975), bills that would protect a persons ability to determine whether to continue or end a pregnancy and to protect the health care clinicians ability to provide abortion services free from medically unnecessary restrictions such as waiting periods, biased counselling and admitting privilege requirements for clinicians. Expand Health Coverage and Affordability: Urged Congress to support H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place. Introduce and pass the companion bill in the Senate and H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the ACA. Urged Congress to support H.R. 3173, the Improving Seniors Timely Access to Care Act of 2021, which would help protect patients from unnecessary delays in care and reduce administrative burdens on physicians by standardizing and streamlining the prior authorization approval process in the Medicare Advantage program. Urged passage of H.R. 3563, the Chronic Disease Management Act, which will allow high deductible health plans (HDHPs) to provide patients with access to certain chronic care services and treatments with no cost sharing before meeting their deductible; H.R. 5541, the Primary and Virtual Care Affordability Act, which gives employers and health plan sponsors the flexibility to waive the deductible for primary care and telehealth services through December 31, 2023, for patients covered by HDHPs. Support the Physician Workforce: Urged Congress to support H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots by at least 2,000 per year over seven years (14,000 slots) for specialties facing shortages, including internal medicine; H.R. 1554 (116th Congress), the Resident Education Deferred Interest Act, to allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program; Urged support for the Conrad State 30 and Physician Access Reauthorization Act (H.R. 3541, S. 1810), which would extend the authorization for the program for three years and would simplify the process for obtaining a visa, enhance important workplace protections for physicians, and increase the number of waivers available to states beyond the current allotment of thirty waivers, if certain requirements are met. Support the Value of Primary and Comprehensive Care: Urged Congress to continue to fund the 3.00 percent increase to all physicians services that was approved by Congress at the end of last year to prevent CY2023 budget neutrality cuts for physician services, including primary care visits and other evaluation and management services; Ensure that any legislation that addresses budget neutrality treats all services fairly and equitably; Pass H.R. 1025, the Kids Access to Primary Care Act, to increase access to health coverage for Medicaid patients by achieving payment parity for primary care services under Medicaid and Medicare; Extend the five percent bonus that physicians receive if they meet performance expectations in Advanced APMs that is set to expire at the end of 2022; Urged support to prevent scheduled cuts for physician services, including primary care, resulting from budget sequestration and pay-as-you go budget rules. Improve Access to Prescription Drugs and Reduce Costs: Urged Congress to support S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; S. 141, the End Taxpayer Subsidies for Drug Ads Act, to end the federal tax deduction that pharmaceutical companies use to pay for drug advertising; S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Urged support for the reauthorization of prescription drug user fee agreements. Promote Health Equity, Social Justice, and Eliminate Disparities: Urged Congress to support H.R. 1280, the George Floyd Justice in Policing Act of 2021, to overhaul qualified immunity for law enforcement, prohibit racial profiling on the part of law enforcement and ban no-knock warrants in federal drug cases and chokeholds and carotid holds at the federal level; H.R. 5, the Equality Act, to prohibit discrimination based on sex, sexual orientation and gender identity in public accommodations and facilities, education, federal housing credit and the jury system; H.R. 666/S. 162, the Anti-Racism in Public Health Act of 2021, to establish within the CDC a National Center on Anti-racism and Health for data collection and research and a law enforcement violence prevention program. Expand Access to Telehealth Services and Promote Patient Safety/Privacy; Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends. Substance Use Disorders: Urged Congress to support for the Comprehensive Addiction Resources Emergency (CARE) Act in the 117th Congress, which offers increased access to treatment and will improve care for individuals with substance use disorders (SUDs), specifically $1 billion per year to expand access to overdose reversal drugs (Naloxone) and provide this life-saving medicine to states to distribute to first responders, public health departments, and the public. The Build Back Better Act (H.R. 5376): Urged support in Congress for the following provisions: provide temporary enhanced ACA Marketplace cost-sharing reduction assistance to individuals with household incomes below 138 percent of the federal poverty level (FPL) for calendar years (CY) 2022 through 2025 and specify that individuals with household incomes below 138 percent of the FPL with access to employer-sponsored coverage or a qualified small employer health reimbursement arrangement can still receive credits; the 400 percent federal poverty level premium tax credit eligibility cap should be eliminated, and the amount of premium tax credits for all income levels should be enhanced; establish a health insurance affordability fund, with $10 billion made available annually for states to establish a state reinsurance program or use the funds to provide financial assistance to reduce out-of-pocket costs; permanently reauthorize CHIP and provide states the option to increase Medicaid and CHIP eligibility levels for children up to 300 percent of FPL without receiving a waiver. Mental and Behavioral Health: Urged Congress to support H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act (CoCM) that would provide grants through the Department of Health and Human Services to primary care physicians that choose to deliver behavioral health care through the Collaborative Care Model (CoCM). CoCM involves a primary care physician working collaboratively with a psychiatric consultant and a care manager to manage the clinical care of behavioral health patient caseloads. Urged support for retaining all services added to the Medicare telehealth services list on a temporary, Category 3 basis until the end of CY23. CMS should maintain coverage of audio-only mental health visits even after the PHE is lifted. This extension should last at least through the end of 2023 with an option to extend it even further or consider making it permanent, based on the experience and learnings of patients and physicians who utilize these visits. Urged support for expanding access to mental and behavioral health services, including allowing beneficiaries to access services from home, or if the technology is not available at home, from a rural health clinic or hospital. Regulate Tobacco: Urged the Food and Drug Administration (FDA) to use its authority under the Family Smoking Prevention and Tobacco Control Act (TCA) to issue product standards ending the manufacture and sale of flavored tobacco products; Urged the FDA to fulfill its commitment to issue a rule prohibiting characterizing flavors in cigars and to prohibit menthol as a characterizing flavor in cigarettes.

Client expense: $106,554 · Firm income: Not reported

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

Childcare Issues related to childcare - no specific bill General Advocacy on COVID-19 relief, response, and pandemic preparedness, including issues related to: Additional COVID-19 relief funding Assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response Health disparities and protecting vulnerable populations Mental and behavioral health Expanding internet connectivity/broadband Grant program for childcare Food assistance programs Small business loans Reducing health care premiums for low- and middle-income families Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. Gun Safety S. 2325/H.R.4238 - Making America Safe and Secure (MASS) Act Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care Health Care Workforce S.3828/ H.R. 2418 - Student Loan Forgiveness for Frontline Health Workers Act S. 54 - Strengthening America's Health Care Readiness Act S. 834/ H.R.2256 - Resident Physician Shortage Reduction Act of 2021 S.610/ H.R.1667 - Dr. Lorna Breen Health Care Provider Protection Act S.3244/ H.R.5602 - BIO Preparedness Workforce Act of 2021 Issues related to health care workforce shortages Issues related to the affordability of medical education and federal loan programs Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 - Healthcare Workforce Resilience Act Infrastructure Issues related to broadband access Issues related to the Build Back Better framework Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition H.R.5370 - Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 - Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Issues related to equitable policies around blood, tissue donations Maternal Health S. 411/ H.R. 3407 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education Medicare/Medicaid Issues related to Medicare physician payment H.R. 1587/ S. 1731 - Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill S.3018/ H.R.3173 - Improving Seniors Timely Access to Care Act of 2021 Issues related to Medicare Advantage risk adjustment Opioids/ Substance Use Disorder H.R.6311/ S.3418 - Comprehensive Addiction Resources Emergency (CARE) Act S. 2354 - Safer Prescribing of Controlled Substances Act H.R.1026 / S.2353 - LABEL Opioids Act of 2021 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 H.R.4521 - America COMPETES Act of 2022 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 - Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill Regulatory Proposed Collection and Comment Request - Requirements Related to Surprise Billing; Part II (CMS-10791); issues related to provider burden and price transparency rules Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to health equity

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

Government targets: 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), Labor, Dept of (DOL), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Childcare Issues related to childcare - no specific bill General Advocacy on COVID-19 relief, response, and pandemic preparedness, including issues related to: Additional COVID-19 relief funding Assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response Health disparities and protecting vulnerable populations Mental and behavioral health Expanding internet connectivity/broadband Grant program for childcare Food assistance programs Small business loans Reducing health care premiums for low- and middle-income families Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. Gun Safety S. 2325/H.R.4238 - Making America Safe and Secure (MASS) Act Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care Health Care Workforce S.3828/ H.R. 2418 - Student Loan Forgiveness for Frontline Health Workers Act S. 54 - Strengthening America's Health Care Readiness Act S. 834/ H.R.2256 - Resident Physician Shortage Reduction Act of 2021 S.610/ H.R.1667 - Dr. Lorna Breen Health Care Provider Protection Act S.3244/ H.R.5602 - BIO Preparedness Workforce Act of 2021 Issues related to health care workforce shortages Issues related to the affordability of medical education and federal loan programs Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 - Healthcare Workforce Resilience Act Infrastructure Issues related to broadband access Issues related to the Build Back Better framework Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition H.R.5370 - Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 - Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Issues related to equitable policies around blood, tissue donations Maternal Health S. 411/ H.R. 3407 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education Medicare/Medicaid Issues related to Medicare physician payment H.R. 1587/ S. 1731 - Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill S.3018/ H.R.3173 - Improving Seniors Timely Access to Care Act of 2021 Issues related to Medicare Advantage risk adjustment Opioids/ Substance Use Disorder H.R.6311/ S.3418 - Comprehensive Addiction Resources Emergency (CARE) Act S. 2354 - Safer Prescribing of Controlled Substances Act H.R.1026 / S.2353 - LABEL Opioids Act of 2021 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 H.R.4521 - America COMPETES Act of 2022 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 - Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill Regulatory Proposed Collection and Comment Request - Requirements Related to Surprise Billing; Part II (CMS-10791); issues related to provider burden and price transparency rules Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to health equity

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

Government targets: 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), Labor, Dept of (DOL), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Anti-Racism in Public Health Act (H.R.666/S.162)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medical Center related issues as follows: H.R.4502/S.3062, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, FY2022 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, FY2023 Psychedelic research related issues H.R.2256/S.834, Resident Physician Shortage Reduction Act of 2021 H.R.666/S.162, Anti-Racism in Public Health Act of 2021 H.R.1332/S.368, Telehealth Modernization Act Monitor Medical Center related issues as follows: 340B Drug Pricing related issues Medicare reimbursement issues, generally Organ transplant issues Prescription drug pricing, generally H.R.6000, Cures 2.0 Act, generally H.R.5376, Build Back Better Act, Hospital related issues

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 346/H.R. 959, Black Maternal Health Momnibus Act of 2021, In support of maternal health and closing disparities in maternal health outcomes for women of color; S. 162/H.R. 666, Anti-Racism in Public Health Act of 2021, In support of strengthening anti-racist health policy; S. Res. 172/H. Res. 344, A resolution declaring racism a public health crisis, In support of declaring racism a public health crisis; H.R. 1475, Pursuing Equity in Mental Health Act, In support of additional resources and guidance to identify mental health, social-emotional, and behavioral health problems; S. 1948/H.R. 3673, National ACERT Grant Program Authorization Act, In support of strengthening and expanding the National ACERT Grant Program Authorization Act; S. 1975/H.R. 3755, Women's Health Protection Act of 2021, In support of equal access to safe, legal abortion care; In support of increasing mental health access for women and girls of color.

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

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

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH) has demonstrated value in meeting the policy objectives suggested above. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged support for H.R. 8505, a bill to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule; Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases, along with GPC1X codes to go into effect. Regarding CMS 2022 Medicare Physician Fee Schedule and Quality Payment Program (QPP) rules, expressed support for extending some of the services and increased flexibility for telehealth through the end of 2023, namely some audio-only services that were allowed during the COVID-19 public health emergency (PHE), support for collecting additional data on health equity issues to analyze disparities that occur across their programs, support for including chronic care management as one of the seven MIPS Value Pathways (MVPs) for 2023. Urged CMS to discontinue its split/shared visits policy and not move forward with the transition set to take effect in 2023. FY2022 Appropriations: Urged Congress to support $10 billion for the Centers for Disease Control and Preventions programs in the FY 2022 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as $50 million in funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for: Health Resources Services Administration (HRSA), $9.2 billion; Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA), $71 million; National Health Service Corps (NHSC), $860 million in total program funding; Agency for Healthcare Research and Quality (AHRQ), $500 million; Centers for Medicare and Medicaid Services (CMS), Program Operations for Federal Exchanges, $296.5 million. Also, urged support for the VA, Veterans Health Administration (VHA), $103.1 billion, which includes the following within the VHA -- VA, VHA, Medical Services, $66.2 billion, VA, VHA, Medical Community Care, $20.7 billion, VA, VHA, Medical and Prosthetic Research; $902 million. COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Urged the administration to explore regulatory and other actions that would make COVID-19 testing free-of-charge to patients covered by both public and private insurance plans, including ACA-compliant plans offered through the insurance exchanges, and to waive co-pays and deductibles for patients seeing physicians for symptoms that may be indicative of COVID-19 or who are hospitalized for treatment. Urged CMS to utilize a national disaster recovery program that would pay doctors 110% of Medicare rates for caring for uninsured patients who have been infected with SARS-CoV-2. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for the Student Loan Forgiveness for Frontline Health Workers Act, H.R. 6720, introduced May 5, 2020 by Representative Carolyn B. Maloney (D-NY) which would eliminate graduate school debt for healthcare workers, including physicians and medical students, who are providing direct patient care in response to the COVID-19 pandemic; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP); urged support for administering COVID-19 vaccinations to all eligible immigrants in Customs and Border Protection (CBP) custody. Urged CMS to support increasing COVID-19 vaccine uptake by ensuring clinicians are appropriately paid for vaccine counseling for beneficiaries of Medicaid and Medicare. Urged that telehealth services should remain in place for at least two years after the end of the PHE to ensure that our physicians are able to continue to use this modality to enhance patient care. Urged Congress to support the concept of a congressionally-mandated bipartisan commission to examine the U.S. preparations for and response to the COVID-19 pandemic, in order to inform future public policy and health systems preparedness. Urged that any uses of technology in the U.S. in the context of the pandemic should be demonstrated to be effective, be temporary, and ensure that safeguards for privacy and confidentiality are in place. American Rescue Plan (ARP) Act (H.R. 1319): Urged support for various provisions within the ARP to provide incentives for states to expand Medicaid by temporarily increasing the states base FMAP by five percentage points for two years for states that newly expand Medicaid. Urged support for allowing states, for five years, to extend Medicaid eligibility (and CHIP eligibility) to women for 12 months postpartum. Urged support to require Medicaid coverage of COVID-19 vaccines and treatment without beneficiary cost sharing with vaccines matched at a 100 percent federal medical assistance percentage (FMAP) through one year after the end of the PHE. Urged support for $46 billion to HHS to detect, diagnose, trace, and monitor COVID-19 infections, and for other activities necessary to mitigate the spread of COVID-19. Urged support to subsidize the health coverage of people earning up to 150 percent of the federal poverty level (FPL) under the ACA and those on unemployment insurance for a period of two years. Womens Health: Urged Congress to support, H.R. 958, the Protecting Moms Who Served Act, which would provide critical support for maternity care coordination programs to address the clinical and nonclinical perinatal needs of veterans and ensure effective coordination between VA and non-VA facilities in the delivery of maternity care and other health care services. Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Urged support for mandatory, permanent extension of postpartum Medicaid coverage, from 60 days to 12 months after delivery. Urged support for the Womens Health Protection Act of 2021 (H.R. 3755 and S. 1975), bills that would protect a persons ability to determine whether to continue or end a pregnancy and to protect the health care clinicians ability to provide abortion services free from medically unnecessary restrictions such as waiting periods, biased counselling and admitting privilege requirements for clinicians. Expand Health Coverage and Affordability: Urged Congress to support H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place. Introduce and pass the companion bill in the Senate and H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the ACA. Urged Congress to support H.R. 3173, the Improving Seniors Timely Access to Care Act of 2021, which would help protect patients from unnecessary delays in care and reduce administrative burdens on physicians by standardizing and streamlining the prior authorization approval process in the Medicare Advantage program. Urged passage of H.R. 3563, the Chronic Disease Management Act, which will allow high deductible health plans (HDHPs) to provide patients with access to certain chronic care services and treatments with no cost sharing before meeting their deductible; H.R. 5541, the Primary and Virtual Care Affordability Act, which gives employers and health plan sponsors the flexibility to waive the deductible for primary care and telehealth services through December 31, 2023, for patients covered by HDHPs. Train and Support Frontline Physicians during and after COVID-19: Urged Congress to support H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots by at least 2,000 per year over seven years (14,000 slots) for specialties facing shortages, including internal medicine; H.R. 1554 (116th Congress), the Resident Education Deferred Interest Act, to allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program; S. 948, the Conrad State 30 and Physician Access Reauthorization Act (116th Congress) and S. 3599 (116th Congress), the Healthcare Workforce Resilience Act, to support the COVID-19 response workforce by expediting visas for international medical graduates (IMGs) to enter the U.S. for training and patient care, permanently authorizing the Conrad 30 Program, and providing a pathway for IMGs and their families already in the U.S to obtain permanent residency status; H.R. 2418, the Student Loan Forgiveness for Frontline Health Workers Act, to forgive student loans for physicians and other clinicians who are on the frontlines of providing care to COVID-19 patients or helping the health care system cope with the COVID-19 public health emergency; H.R. 1667/S. 610, the Dr. Lorna Breen Health Care Provider Protection Act, to address the behavioral health and well-being of physicians, including depression, suicides and burnout. Urged support for the Conrad State 30 and Physician Access Reauthorization Act (H.R. 3541, S. 1810), which would extend the authorization for the program for three years and would simplify the process for obtaining a visa, enhance important workplace protections for physicians, and increase the number of waivers available to states beyond the current allotment of thirty waivers, if certain requirements are met. Support the Value of Primary and Comprehensive Care: Urged Congress to continue to fund the 3.00 percent increase to all physicians services that was approved by Congress at the end of last year to prevent CY2023 budget neutrality cuts for physician services, including primary care visits and other evaluation and management services; Ensure that any legislation that addresses budget neutrality treats all services fairly and equitably; Pass H.R. 1025, the Kids Access to Primary Care Act, to increase access to health coverage for Medicaid patients by achieving payment parity for primary care services under Medicaid and Medicare; Extend the five percent bonus that physicians receive if they meet performance expectations in Advanced APMs that is set to expire at the end of 2022; Urged support to prevent scheduled cuts for physician services, including primary care, resulting from budget sequestration and pay-as-you go budget rules. Improve Access to Prescription Drugs and Reduce Costs: Urged Congress to support S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; S. 141, the End Taxpayer Subsidies for Drug Ads Act, to end the federal tax deduction that pharmaceutical companies use to pay for drug advertising; S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Urged support for the reauthorization of prescription drug user fee agreements. Promote Health Equity, Social Justice, and Eliminate Disparities: Urged Congress to support H.R. 1280, the George Floyd Justice in Policing Act of 2021, to overhaul qualified immunity for law enforcement, prohibit racial profiling on the part of law enforcement and ban no-knock warrants in federal drug cases and chokeholds and carotid holds at the federal level; H.R. 5, the Equality Act, to prohibit discrimination based on sex, sexual orientation and gender identity in public accommodations and facilities, education, federal housing credit and the jury system; H.R. 666/S. 162, the Anti-Racism in Public Health Act of 2021, to establish within the CDC a National Center on Anti-racism and Health for data collection and research and a law enforcement violence prevention program; H.R. 959/S. 346, the Black Maternal Health Momnibus Act of 2021, to reduce preventable maternal mortality and severe maternal morbidity in the U.S. and close disparities in maternal health outcomes, particularly among pregnant minority women. Expand Access to Telehealth Services and Promote Patient Safety/Privacy; Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends; Urged appropriators to include adequate funding in FY2022 to support expansion of broadband capabilities nationwide, especially to rural and underserved communities, and to remove the ban on adoption of a national unique health identifier standard. Surprise Medical Billing: Voiced support for the decision of CMS to provide protections for patients from surprise bills in situations where they need an ambulance, especially in a perceived emergency; voiced support for CMS approach that emergency services provided by out-of-network emergency facilities and out-of-network provider organizations, and certain non-emergency services furnished by out-of-network provider organizations at certain in-network facilities, must be calculated based on a recognized amount which is generally the lesser of the Qualifying Payment Amount (QPA) - the plans median in-network rate for the item or service, or an all-payer model agreement between CMS and the state; urged CMS to include in the Independent Dispute Resolution process described in future sub-regulatory guidance that health plans have an affirmative obligation to pay fairly and appropriately for services provided in and out of network. Substance Use Disorders: Urged Congress to support for the Comprehensive Addiction Resources Emergency (CARE) Act in the 117th Congress, which offers increased access to treatment and will improve care for individuals with substance use disorders (SUDs), specifically $1 billion per year to expand access to overdose reversal drugs (Naloxone) and provide this life-saving medicine to states to distribute to first responders, public health departments, and the public. The Build Back Better Act (H.R. 5376): Urged support in Congress for the following provisions: provide temporary enhanced ACA Marketplace cost-sharing reduction assistance to individuals with household incomes below 138 percent of the federal poverty level (FPL) for calendar years (CY) 2022 through 2025 and specify that individuals with household incomes below 138 percent of the FPL with access to employer-sponsored coverage or a qualified small employer health reimbursement arrangement can still receive credits; the 400 percent federal poverty level premium tax credit eligibility cap should be eliminated, and the amount of premium tax credits for all income levels should be enhanced; establish a health insurance affordability fund, with $10 billion made available annually for states to establish a state reinsurance program or use the funds to provide financial assistance to reduce out-of-pocket costs; permanently reauthorize CHIP and provide states the option to increase Medicaid and CHIP eligibility levels for children up to 300 percent of FPL without receiving a waiver. Mental and Behavioral Health: Urged Congress to support H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act (CoCM) that would provide grants through the Department of Health and Human Services to primary care physicians that choose to deliver behavioral health care through the Collaborative Care Model (CoCM). CoCM involves a primary care physician working collaboratively with a psychiatric consultant and a care manager to manage the clinical care of behavioral health patient caseloads. Urged support for retaining all services added to the Medicare telehealth services list on a temporary, Category 3 basis until the end of CY23. CMS should maintain coverage of audio-only mental health visits even after the PHE is lifted. This extension should last at least through the end of 2023 with an option to extend it even further or consider making it permanent, based on the experience and learnings of patients and physicians who utilize these visits. Urged support for expanding access to mental and behavioral health services, including allowing beneficiaries to access services from home, or if the technology is not available at home, from a rural health clinic or hospital.

Client expense: $253,972 · Firm income: Not reported

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

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH) has demonstrated value in meeting the policy objectives suggested above. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged support for H.R. 8505, a bill to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule; Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases, along with GPC1X codes to go into effect. Regarding CMS 2022 Medicare Physician Fee Schedule and Quality Payment Program (QPP) rules, expressed support for extending some of the services and increased flexibility for telehealth through the end of 2023, namely some audio-only services that were allowed during the COVID-19 public health emergency (PHE), support for collecting additional data on health equity issues to analyze disparities that occur across their programs, support for including chronic care management as one of the seven MIPS Value Pathways (MVPs) for 2023. Urged CMS to discontinue its split/shared visits policy and not move forward with the transition set to take effect in 2023. FY2022 Appropriations: Urged Congress to support $10 billion for the Centers for Disease Control and Preventions programs in the FY 2022 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as $50 million in funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for: Health Resources Services Administration (HRSA), $9.2 billion; Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA), $71 million; National Health Service Corps (NHSC), $860 million in total program funding; Agency for Healthcare Research and Quality (AHRQ), $500 million; Centers for Medicare and Medicaid Services (CMS), Program Operations for Federal Exchanges, $296.5 million. Also, urged support for the VA, Veterans Health Administration (VHA), $103.1 billion, which includes the following within the VHA -- VA, VHA, Medical Services, $66.2 billion, VA, VHA, Medical Community Care, $20.7 billion, VA, VHA, Medical and Prosthetic Research; $902 million. COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Urged the administration to explore regulatory and other actions that would make COVID-19 testing free-of-charge to patients covered by both public and private insurance plans, including ACA-compliant plans offered through the insurance exchanges, and to waive co-pays and deductibles for patients seeing physicians for symptoms that may be indicative of COVID-19 or who are hospitalized for treatment. Urged CMS to utilize a national disaster recovery program that would pay doctors 110% of Medicare rates for caring for uninsured patients who have been infected with SARS-CoV-2. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for the Student Loan Forgiveness for Frontline Health Workers Act, H.R. 6720, introduced May 5, 2020 by Representative Carolyn B. Maloney (D-NY) which would eliminate graduate school debt for healthcare workers, including physicians and medical students, who are providing direct patient care in response to the COVID-19 pandemic; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP); urged support for administering COVID-19 vaccinations to all eligible immigrants in Customs and Border Protection (CBP) custody. Urged CMS to support increasing COVID-19 vaccine uptake by ensuring clinicians are appropriately paid for vaccine counseling for beneficiaries of Medicaid and Medicare. Urged that telehealth services should remain in place for at least two years after the end of the PHE to ensure that our physicians are able to continue to use this modality to enhance patient care. Urged Congress to support the concept of a congressionally-mandated bipartisan commission to examine the U.S. preparations for and response to the COVID-19 pandemic, in order to inform future public policy and health systems preparedness. Urged that any uses of technology in the U.S. in the context of the pandemic should be demonstrated to be effective, be temporary, and ensure that safeguards for privacy and confidentiality are in place. American Rescue Plan (ARP) Act (H.R. 1319): Urged support for various provisions within the ARP to provide incentives for states to expand Medicaid by temporarily increasing the states base FMAP by five percentage points for two years for states that newly expand Medicaid. Urged support for allowing states, for five years, to extend Medicaid eligibility (and CHIP eligibility) to women for 12 months postpartum. Urged support to require Medicaid coverage of COVID-19 vaccines and treatment without beneficiary cost sharing with vaccines matched at a 100 percent federal medical assistance percentage (FMAP) through one year after the end of the PHE. Urged support for $46 billion to HHS to detect, diagnose, trace, and monitor COVID-19 infections, and for other activities necessary to mitigate the spread of COVID-19. Urged support to subsidize the health coverage of people earning up to 150 percent of the federal poverty level (FPL) under the ACA and those on unemployment insurance for a period of two years. Womens Health: Urged Congress to support, H.R. 958, the Protecting Moms Who Served Act, which would provide critical support for maternity care coordination programs to address the clinical and nonclinical perinatal needs of veterans and ensure effective coordination between VA and non-VA facilities in the delivery of maternity care and other health care services. Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Urged support for mandatory, permanent extension of postpartum Medicaid coverage, from 60 days to 12 months after delivery. Urged support for the Womens Health Protection Act of 2021 (H.R. 3755 and S. 1975), bills that would protect a persons ability to determine whether to continue or end a pregnancy and to protect the health care clinicians ability to provide abortion services free from medically unnecessary restrictions such as waiting periods, biased counselling and admitting privilege requirements for clinicians. Expand Health Coverage and Affordability: Urged Congress to support H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place. Introduce and pass the companion bill in the Senate and H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the ACA. Urged Congress to support H.R. 3173, the Improving Seniors Timely Access to Care Act of 2021, which would help protect patients from unnecessary delays in care and reduce administrative burdens on physicians by standardizing and streamlining the prior authorization approval process in the Medicare Advantage program. Urged passage of H.R. 3563, the Chronic Disease Management Act, which will allow high deductible health plans (HDHPs) to provide patients with access to certain chronic care services and treatments with no cost sharing before meeting their deductible; H.R. 5541, the Primary and Virtual Care Affordability Act, which gives employers and health plan sponsors the flexibility to waive the deductible for primary care and telehealth services through December 31, 2023, for patients covered by HDHPs. Train and Support Frontline Physicians during and after COVID-19: Urged Congress to support H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots by at least 2,000 per year over seven years (14,000 slots) for specialties facing shortages, including internal medicine; H.R. 1554 (116th Congress), the Resident Education Deferred Interest Act, to allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program; S. 948, the Conrad State 30 and Physician Access Reauthorization Act (116th Congress) and S. 3599 (116th Congress), the Healthcare Workforce Resilience Act, to support the COVID-19 response workforce by expediting visas for international medical graduates (IMGs) to enter the U.S. for training and patient care, permanently authorizing the Conrad 30 Program, and providing a pathway for IMGs and their families already in the U.S to obtain permanent residency status; H.R. 2418, the Student Loan Forgiveness for Frontline Health Workers Act, to forgive student loans for physicians and other clinicians who are on the frontlines of providing care to COVID-19 patients or helping the health care system cope with the COVID-19 public health emergency; H.R. 1667/S. 610, the Dr. Lorna Breen Health Care Provider Protection Act, to address the behavioral health and well-being of physicians, including depression, suicides and burnout. Urged support for the Conrad State 30 and Physician Access Reauthorization Act (H.R. 3541, S. 1810), which would extend the authorization for the program for three years and would simplify the process for obtaining a visa, enhance important workplace protections for physicians, and increase the number of waivers available to states beyond the current allotment of thirty waivers, if certain requirements are met. Support the Value of Primary and Comprehensive Care: Urged Congress to continue to fund the 3.00 percent increase to all physicians services that was approved by Congress at the end of last year to prevent CY2023 budget neutrality cuts for physician services, including primary care visits and other evaluation and management services; Ensure that any legislation that addresses budget neutrality treats all services fairly and equitably; Pass H.R. 1025, the Kids Access to Primary Care Act, to increase access to health coverage for Medicaid patients by achieving payment parity for primary care services under Medicaid and Medicare; Extend the five percent bonus that physicians receive if they meet performance expectations in Advanced APMs that is set to expire at the end of 2022; Urged support to prevent scheduled cuts for physician services, including primary care, resulting from budget sequestration and pay-as-you go budget rules. Improve Access to Prescription Drugs and Reduce Costs: Urged Congress to support S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; S. 141, the End Taxpayer Subsidies for Drug Ads Act, to end the federal tax deduction that pharmaceutical companies use to pay for drug advertising; S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Urged support for the reauthorization of prescription drug user fee agreements. Promote Health Equity, Social Justice, and Eliminate Disparities: Urged Congress to support H.R. 1280, the George Floyd Justice in Policing Act of 2021, to overhaul qualified immunity for law enforcement, prohibit racial profiling on the part of law enforcement and ban no-knock warrants in federal drug cases and chokeholds and carotid holds at the federal level; H.R. 5, the Equality Act, to prohibit discrimination based on sex, sexual orientation and gender identity in public accommodations and facilities, education, federal housing credit and the jury system; H.R. 666/S. 162, the Anti-Racism in Public Health Act of 2021, to establish within the CDC a National Center on Anti-racism and Health for data collection and research and a law enforcement violence prevention program; H.R. 959/S. 346, the Black Maternal Health Momnibus Act of 2021, to reduce preventable maternal mortality and severe maternal morbidity in the U.S. and close disparities in maternal health outcomes, particularly among pregnant minority women. Expand Access to Telehealth Services and Promote Patient Safety/Privacy; Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends; Urged appropriators to include adequate funding in FY2022 to support expansion of broadband capabilities nationwide, especially to rural and underserved communities, and to remove the ban on adoption of a national unique health identifier standard. Surprise Medical Billing: Voiced support for the decision of CMS to provide protections for patients from surprise bills in situations where they need an ambulance, especially in a perceived emergency; voiced support for CMS approach that emergency services provided by out-of-network emergency facilities and out-of-network provider organizations, and certain non-emergency services furnished by out-of-network provider organizations at certain in-network facilities, must be calculated based on a recognized amount which is generally the lesser of the Qualifying Payment Amount (QPA) - the plans median in-network rate for the item or service, or an all-payer model agreement between CMS and the state; urged CMS to include in the Independent Dispute Resolution process described in future sub-regulatory guidance that health plans have an affirmative obligation to pay fairly and appropriately for services provided in and out of network. Substance Use Disorders: Urged Congress to support for the Comprehensive Addiction Resources Emergency (CARE) Act in the 117th Congress, which offers increased access to treatment and will improve care for individuals with substance use disorders (SUDs), specifically $1 billion per year to expand access to overdose reversal drugs (Naloxone) and provide this life-saving medicine to states to distribute to first responders, public health departments, and the public. The Build Back Better Act (H.R. 5376): Urged support in Congress for the following provisions: provide temporary enhanced ACA Marketplace cost-sharing reduction assistance to individuals with household incomes below 138 percent of the federal poverty level (FPL) for calendar years (CY) 2022 through 2025 and specify that individuals with household incomes below 138 percent of the FPL with access to employer-sponsored coverage or a qualified small employer health reimbursement arrangement can still receive credits; the 400 percent federal poverty level premium tax credit eligibility cap should be eliminated, and the amount of premium tax credits for all income levels should be enhanced; establish a health insurance affordability fund, with $10 billion made available annually for states to establish a state reinsurance program or use the funds to provide financial assistance to reduce out-of-pocket costs; permanently reauthorize CHIP and provide states the option to increase Medicaid and CHIP eligibility levels for children up to 300 percent of FPL without receiving a waiver. Mental and Behavioral Health: Urged Congress to support H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act (CoCM) that would provide grants through the Department of Health and Human Services to primary care physicians that choose to deliver behavioral health care through the Collaborative Care Model (CoCM). CoCM involves a primary care physician working collaboratively with a psychiatric consultant and a care manager to manage the clinical care of behavioral health patient caseloads. Urged support for retaining all services added to the Medicare telehealth services list on a temporary, Category 3 basis until the end of CY23. CMS should maintain coverage of audio-only mental health visits even after the PHE is lifted. This extension should last at least through the end of 2023 with an option to extend it even further or consider making it permanent, based on the experience and learnings of patients and physicians who utilize these visits. Urged support for expanding access to mental and behavioral health services, including allowing beneficiaries to access services from home, or if the technology is not available at home, from a rural health clinic or hospital.

Client expense: $107,807 · Firm income: Not reported

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

Reproductive Rights and Roe v. Wade; State abortion bans and abortion access in the United States; Access to abortion, contraception, and maternity care for veterans, servicemembers, and dependents; H.R. 2709 and S. 1238, Access to Contraception for Servicemembers and Dependents Act, regarding access to affordable contraception; H.R.239, Equal Access to Contraception for Veterans Act, regarding access to affordable contraception Access to the contraceptive coverage benefit under the Affordable Care Act; Trump administration refusal of care rule; Denials of healthcare; Maternal health outcomes and care options; Treatment of pregnant incarcerated people and detainees; COVID-19 response efforts, including federal relief response, paid family leave, and restrictions on insurance coverage of abortion; H.R. 2234 and S. 1021, EACH Act, regarding access to affordable health insurance plans that cover abortion; H.R.804 and S.248, FAMILY Act, regarding paid family leave; H.R.959, the Momnibus Act, regarding maternal health outcomes; H.R. 666 and S. 162, Anti-Racism in Public Health Act, regarding strengthening the federal governments ability to develop anti-racist health policy; H.R. 1065 the Pregnant Workers Fairness Act, regarding discrimination against pregnant workers; H.J.Res. 17, Resolution to remove the deadline for ratification of the Equal Rights Amendment; H.R. 1378, Do No Harm Act, regarding denials of care; H.R. 5 and S. 393, the Equality Act, regarding ending discrimination for LGBTQIA+ individuals. H.R. 3312 and S. 1689, the Real Education and Access for Healthy Youth Act, regarding young peoples access to sex education; H.R. 3755 and S. 1975, the Women's Health Protection Act, regarding access to abortion care; Access to evidence-based medication abortion care; S. 1260, the Endless Frontier Act, regarding medical research Lee amendment #1891 to S.1260, regarding scientific research using fetal tissue

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

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

Reproductive Rights and Roe v. Wade; Access to the full spectrum of abortion care options; State abortion bans and abortion access in the United States; Access to abortion and contraception for veterans, servicemembers, and dependents; Access to the contraceptive coverage benefit under the Affordable Care Act; Trump administration refusal of care rule; Maternal health outcomes and care options; Treatment of pregnant incarcerated people and detainees; COVID-19 response efforts, including federal relief response, paid family leave, and restrictions on insurance coverage of abortion; H.R. 2234 and S. 1021, EACH Act, regarding access to affordable health insurance plans that cover abortion; H.R.804 and S.248, FAMILY Act, regarding paid family leave; H.R.959, the Momnibus Act, regarding maternal health outcomes; H.R. 666 and S. 162, Anti-Racism in Public Health Act, regarding strengthening the federal governments ability to develop anti-racist health policy; H.R. 1065 the Pregnant Workers Fairness Act, regarding discrimination against pregnant workers; H.J.Res. 17, Resolution to remove the deadline for ratification of the Equal Rights Amendment; H.R. 1378, Do No Harm Act, regarding denials of care; H.R. 5 and S. 393, the Equality Act, regarding ending discrimination for LGBTQIA+ individuals.

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

Government targets: Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

S. 346/H.R. 959, Black Maternal Health Momnibus Act of 2021, In support of maternal health and closing disparities in maternal health outcomes for women of color; S. 162/H.R. 666, Anti-Racism in Public Health Act of 2021, In support of strengthening anti-racist health policy; S. Res. 172/H. Res. 344, A resolution declaring racism a public health crisis, In support of declaring racism a public health crisis; H.R. 1475, Pursuing Equity in Mental Health Act, In support of additional resources and guidance to identify mental health, social-emotional, and behavioral health problems; S. 1948/H.R. 3673, National ACERT Grant Program Authorization Act, In support of strengthening and expanding the National ACERT Grant Program Authorization Act; S. 1875/H.R. 3755, Women's Health Protection Act of 2021, In support of equal access to safe, legal abortion care.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6000, CURES 2.0 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. 4217, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act of 2021, all provisions S. 2779, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act of 2021, all provisions H.R. 708, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, provisions related to fraud, waste, and abuse In telehealth S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, provisions related to fraud, waste, and abuse In telehealth H.R. 4480, Telehealth Coverage and Payment Parity Act, all provisions H.R. 6202, Telehealth Extension Act of 2021, 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. 379, Improving Social Determinants of Health Act of 2021, all provisions S. 104, Improving Social Determinants of Health Act of 2021, 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. 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. 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 S. 2448, Health Misinformation Act of 2021, all provisions H.R. 5963, Provider Relief Fund Improvement Act, all provisions H.R. 6072, Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act of 2021, all provisions S. 509, Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act of 2021, all provisions H.R. 3614, Menstrual Equity For All Act of 2021, all provisions H.R. 1384, Mainstreaming Addiction Treatment Act of 2021, all provisions S. 445, Mainstreaming Addiction Treatment Act of 2021, all provisions H.R. 5224, Preventing Overdoses and Saving Lives Act of 2021, all provisions H.R. 3755, Women's Health Protection Act of 2021, provisions relating to parental notification and consent laws for unemancipated youth S. 1975, Women's Health Protection Act of 2021, provisions relating to parental notification and consent laws for unemancipated youth S. 253, Cannabidiol and Marihuana Research Expansion Act, 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. 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 21st Century Cures Act/implementation Primary Care Physician Reentry Act COVID-19/Vaccine distributions/vaccines in physician offices COVID-19/Vaccine/Health Equity COVID-19/monoclonal antibodies/therapeutics/testing/counseling reimbursement VOCID-19/PPE/misinformation COVID-19/retail pharmacies/HIPAA Health equity/race corrections in clinical algorithms Surprise billing Electronic Health Records (EHR) Certification Maternal health/mortality Maternal health/bias Pharmacy Benefit Managers/Rx drug price transparency Drug overdose epidemic Biometrics Telemedicine/HIPAA Social determinants of health Information blocking/privacy Human cell donating/men who have had sex with men PL 115-271, Section 3204/harmful interpretation Naloxone/over-the-counter/standing orders Menstrual products/poverty/medical necessities Abortion/mandatory parent notification/consent Coding - CPT Panel Risk Evaluation and Mitigation Strategies (REMS) - Accutane Opioids Physical therapy Digital Health/AI/Digital Therapeutics Precision Medicine/Diagnostics

Client expense: $4,770,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Office of Science & Technology Policy (OSTP), SENATE, Veterans Affairs, Dept of (VA), White House Office

Childcare Issues related to childcare - no specific bill COVID-19 Pandemic & Pandemic Preparedness H.R. 1319 - American Rescue Plan Act - including provisions on: Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response State and local funding Health disparities and protecting vulnerable populations Behavioral and mental health services Expanding internet connectivity Grant program for childcare Food assistance programs Small business loans/Paycheck Protection Program Reducing health care premiums for low- and middle-income families by increasing the Affordable Care Acts (ACA) premium tax credits for 2021 and 2022 The continuation of employer-based health coverage by subsidizing COBRA coverage through the end of the fiscal year. Health care subsidies for unemployed workers who are ineligible for COBRA. Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. General advocacy on COVID-19 relief and related policies: Financial assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Issues related to pandemic preparedness Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Mental and behavioral health H.R. 2418 - Student Loan Forgiveness for Frontline Health Workers Act Pandemic Production Act (PPA) (no bill number) Gun Safety S. 2325/H.R.4238 - Making America Safe and Secure (MASS) Act Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care Health Care Workforce S. 54 - Strengthening America's Health Care Readiness Act S. 834/ H.R.2256 - Resident Physician Shortage Reduction Act of 2021 S.610/ H.R.1667 - Dr. Lorna Breen Health Care Provider Protection Act S.3244/ H.R.5602 - BIO Preparedness Workforce Act of 2021 Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 - Healthcare Workforce Resilience Act Infrastructure H.R.3684 - Infrastructure Investment and Jobs Act Issues related to broadband access Issues related to the Build Back Better framework Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition H.R.5370 - Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 - Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Maternal Health S. 411/ H.R. 3407 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education - no specific bill Medicare/Medicaid S. 610 - Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 315 - Medicare Sequester COVID Moratorium Act S. 748 - Medicare Sequester Relief Act Issues related to Medicare physician payment H.R. 1587/ S. 1731 - Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill H.R.3173 - Improving Seniors Timely Access to Care Act of 2021 Issues related to Medicare Advantage risk adjustment Opioids/ Substance Use Disorder H.R.6311/ S.3418 - Comprehensive Addiction Resources Emergency (CARE) Act S. 2354 - Safer Prescribing of Controlled Substances Act H.R.1026 / S.2353 - LABEL Opioids Act of 2021 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 - Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill Regulatory Medicare Program; CY 2022 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Provider Enrollment Regulation Updates; Provider and Supplier Prepayment and Post-payment Medical Review Requirements. Interim Final Rule (IFR) - Requirements Related to Surprise Billing; Part I IFR - Requirements Related to Surprise Billing; Part II These are regulations implementing provisions of Title I (No Surprises Act) of Division BB of the Consolidated Appropriations Act, 2021

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Childcare Issues related to childcare - no specific bill COVID-19 Pandemic & Pandemic Preparedness H.R. 1319 - American Rescue Plan Act - including provisions on: Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response State and local funding Health disparities and protecting vulnerable populations Behavioral and mental health services Expanding internet connectivity Grant program for childcare Food assistance programs Small business loans/Paycheck Protection Program Reducing health care premiums for low- and middle-income families by increasing the Affordable Care Acts (ACA) premium tax credits for 2021 and 2022 The continuation of employer-based health coverage by subsidizing COBRA coverage through the end of the fiscal year. Health care subsidies for unemployed workers who are ineligible for COBRA. Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. General advocacy on COVID-19 relief and related policies: Financial assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Issues related to pandemic preparedness Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Mental and behavioral health H.R. 2418 - Student Loan Forgiveness for Frontline Health Workers Act Pandemic Production Act (PPA) (no bill number) Gun Safety S. 2325/H.R.4238 - Making America Safe and Secure (MASS) Act Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care Health Care Workforce S. 54 - Strengthening America's Health Care Readiness Act S. 834/ H.R.2256 - Resident Physician Shortage Reduction Act of 2021 S.610/ H.R.1667 - Dr. Lorna Breen Health Care Provider Protection Act S.3244/ H.R.5602 - BIO Preparedness Workforce Act of 2021 Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 - Healthcare Workforce Resilience Act Infrastructure H.R.3684 - Infrastructure Investment and Jobs Act Issues related to broadband access Issues related to the Build Back Better framework Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition H.R.5370 - Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 - Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Maternal Health S. 411/ H.R. 3407 - Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education - no specific bill Medicare/Medicaid S. 610 - Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 315 - Medicare Sequester COVID Moratorium Act S. 748 - Medicare Sequester Relief Act Issues related to Medicare physician payment H.R. 1587/ S. 1731 - Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill H.R.3173 - Improving Seniors Timely Access to Care Act of 2021 Issues related to Medicare Advantage risk adjustment Opioids/ Substance Use Disorder H.R.6311/ S.3418 - Comprehensive Addiction Resources Emergency (CARE) Act S. 2354 - Safer Prescribing of Controlled Substances Act H.R.1026 / S.2353 - LABEL Opioids Act of 2021 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 - Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill Regulatory Medicare Program; CY 2022 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Provider Enrollment Regulation Updates; Provider and Supplier Prepayment and Post-payment Medical Review Requirements. Interim Final Rule (IFR) - Requirements Related to Surprise Billing; Part I IFR - Requirements Related to Surprise Billing; Part II These are regulations implementing provisions of Title I (No Surprises Act) of Division BB of the Consolidated Appropriations Act, 2021

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Health Insurance Coverage (general); Health Disparities (general); Breastfeeding (general); Assisted Reproductive Technology (general); Smoking Cessation (general); Substance Use Disorder (general); Gynecologic Cancer (general); Gynecologic Devices (general); Reproductive Health (general); Intimate Partner Violence (general); Gun Violence (general); Immunization (general); Breast Cancer (general); Medical Liability Reform (general); Health IT (general); Patient-Physician Relationship (general); Child Welfare (general); Prematurity (general); Maternal Mortality and Morbidity (general); Graduate Medical Education (general); Contraception (general); Abortion (general); Indian Health (general); Teaching Health Centers Graduate Medical Education (general); Community Health Centers (general); National Health Service Corps (general); Health care workforce (general); Title VII Health Workforce Programs (general); Special Diabetes Program (general); Special Diabetes Program for Indians (general); Sexuality Education (general); Teen Pregnancy Prevention Program (general); Personal Responsibility Education Program (general); Sexually Transmitted Infections (general); Tobacco Cessation (general); Access and Provision of Medication-based Opioid Use Disorder Treatment (HHS); Research in Pregnant and Breastfeeding Women (general); Health Care Reform (general); Title X Family Planning Program (general); Womens Preventive Services (general); Administrative Burden (general); COVID-19 Response (general); Risk Evaluation and Mitigation Strategies (general); Data Collection (general); Health Equity (general); Pregnancy Risk Assessment Monitoring System (CDC); Provider Relief Fund (general); Maternal Mental Health (general); Violence Against Women Act (general); COVID-19 Vaccine (general); H.R. 3755/S. 1975, Womens Health Protection Act; H.R. _/S. _, VACCINES Act; implementation of P.L. 115-344, Preventing Maternal Deaths Act; implementation of P.L. 115-320, Improving Access to Maternity Care Act; H.R. 4387/S.1675, Maternal Health Quality Improvement Act; H.R. 959/ S. 346, the Black Maternal Health Momnibus Act of 2021; implementation of P.L. 116-123, the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020; implementation of P.L. 116-127, the Families First Coronavirus Response Act; implementation of P.L. 116-136, the Coronavirus Aid, Relief, and Economic Security Act; implementation of P.L. 116-139, Paycheck Protection Program and Health Care Enhancement Act; H.R. 3021 the Coronavirus Provider Protection Act; H.R. 1065/S. 1486, the Pregnant Workers Fairness Act; H.R. _/S._, the Maternal Health Pandemic Response Act; H.R.1667/S. 610, Lorna Breen Health Care Provider Protection Act; S, 176, Ensuring Understanding of COVID-19 to Protect Public Health Act; H.R. 736/S. 167, Community Immunity During COVID-19 Act; H.R. 1350/ S.408, Supporting Best Practices for Healthy Moms Act; H.R. 3407/S. 411; MOMMAs Act; H.R. 769/S.1491, Rural MOMS Act; Implementation of P.L. 117-2, the American Rescue Plan Act of 2021; H.R. 2216 /S.1063, the Jeanette Acosta Invest in Womens Health Act; H.R. 2007, Stephanie Tubbs Jones Uterine Fibroid Research and Education Act of 2021; H.R. 3110/S. 1658, PUMP for Nursing Mothers Act; H.R. 2903/S.1515, CONNECT for Health Act; H.R. 3671/S.1958, Doctors of Community (DOC) Act; H.Res.375, Supporting the goals and ideals of the month of May as Sex Ed For All Month: Equity and Access for All; Implementation of P.L. 114-255, the 21st Century Cures Act; Implementation of the No Surprises Act contained in P.L. 116-260, Consolidated Appropriations Act, 2021; S.Res.172/H.Res.344, a Resolution Declaring Racism a Public Health Crisis; H.R. 666/S. 162, the Anti-Racism in Public Health Act; S. 1234/H.R. 2556, the Maternal CARE Act; S. 1333, the MOMS Act; S. 198/H.R. 1218, the Data Mapping to Save Moms Lives Act; H.R. 1439, Expanded Genetic Screening Act of 2021; S. 1622, the HEALTH for MOM Act of 2021; H.R. 482/S. 350, Newborn Screening Saves Lives Reauthorization Act; H.R. 5/S. 393, Equality Act

Client expense: $167,084 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Indian Health Service, Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), U.S. Agency for International Development (USAID), Veterans Affairs, Dept of (VA), White House Office

COVID-19 data collection and reporting, Centers for Disease Control and Prevention's Data Modernization Initiative, and proposals that address health disparities and inequities in the healthcare system, including the Anti-Racism in Public Health Act (H.R. 666 / S.162) and Equitable Data Collection and Disclosure on COVID-19 Act (H.R. 1370 / S.512).

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged support for H.R. 8505, a bill to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule; Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases, along with GPC1X codes to go into effect. Regarding CMS 2022 Medicare Physician Fee Schedule and Quality Payment Program (QPP) rules, expressed support for extending some of the services and increased flexibility for telehealth through the end of 2023, namely some audio-only services that were allowed during the COVID-19 public health emergency (PHE), support for collecting additional data on health equity issues to analyze disparities that occur across their programs, support for including chronic care management as one of the seven MIPS Value Pathways (MVPs) for 2023. FY2022 Appropriations: Urged Congress to support $10 billion for the Centers for Disease Control and Preventions programs in the FY 2022 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as $50 million in funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for: Health Resources Services Administration (HRSA), $9.2 billion; Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA), $71 million; National Health Service Corps (NHSC), $860 million in total program funding; Agency for Healthcare Research and Quality (AHRQ), $500 million; Centers for Medicare and Medicaid Services (CMS), Program Operations for Federal Exchanges, $296.5 million. Also, urged support for the VA, Veterans Health Administration (VHA), $103.1 billion, which includes the following within the VHA -- VA, VHA, Medical Services, $66.2 billion, VA, VHA, Medical Community Care, $20.7 billion, VA, VHA, Medical and Prosthetic Research; $902 million. COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Urged the administration to explore regulatory and other actions that would make COVID-19 testing free-of-charge to patients covered by both public and private insurance plans, including ACA-compliant plans offered through the insurance exchanges, and to waive co-pays and deductibles for patients seeing physicians for symptoms that may be indicative of COVID-19 or who are hospitalized for treatment. Urged CMS to utilize a national disaster recovery program that would pay doctors 110% of Medicare rates for caring for uninsured patients who have been infected with SARS-CoV-2. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for the Student Loan Forgiveness for Frontline Health Workers Act, H.R. 6720, introduced May 5, 2020 by Representative Carolyn B. Maloney (D-NY) which would eliminate graduate school debt for healthcare workers, including physicians and medical students, who are providing direct patient care in response to the COVID-19 pandemic; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. This extension-either continued by CMS or mandated by Congress-should last at least through the end of 2021, or until such a time when effective vaccines and treatments are widely available, with an option to extend it even further, or consider making permanent, based on the experience and learnings of patients and physicians who are utilizing these visits. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP); urged support for administering COVID-19 vaccinations to all eligible immigrants in Customs and Border Protection (CBP) custody. Urged CMS to support increasing COVID-19 vaccine uptake by ensuring clinicians are appropriately paid for vaccine counseling for beneficiaries of Medicaid and Medicare. American Rescue Plan (ARP) Act (H.R. 1319): Urged support for various provisions within the ARP to provide incentives for states to expand Medicaid by temporarily increasing the states base FMAP by five percentage points for two years for states that newly expand Medicaid. Urged support for allowing states, for five years, to extend Medicaid eligibility (and CHIP eligibility) to women for 12 months postpartum. Urged support to require Medicaid coverage of COVID-19 vaccines and treatment without beneficiary cost sharing with vaccines matched at a 100 percent federal medical assistance percentage (FMAP) through one year after the end of the PHE. Urged support for $46 billion to HHS to detect, diagnose, trace, and monitor COVID-19 infections, and for other activities necessary to mitigate the spread of COVID-19. Urged support to subsidize the health coverage of people earning up to 150 percent of the federal poverty level (FPL) under the ACA and those on unemployment insurance for a period of two years. Urged support for waiving VA cost sharing and copayments for medical treatment until September 30, 2021. Womens Health: Urged Congress to support, H.R. 958, the Protecting Moms Who Served Act, which would provide critical support for maternity care coordination programs to address the clinical and nonclinical perinatal needs of veterans and ensure effective coordination between VA and non-VA facilities in the delivery of maternity care and other health care services. Urged HHS to promptly finalize new Title X regulations that ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminates medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protects funding for and ensures consistent treatment of qualified service sites. Urged support for mandatory, permanent extension of postpartum Medicaid coverage, from 60 days to 12 months after delivery. Urged support for the Womens Health Protection Act of 2021 (H.R. 3755 and S. 1975), bills that would protect a persons ability to determine whether to continue or end a pregnancy and to protect the health care clinicians ability to provide abortion services free from medically unnecessary restrictions such as waiting periods, biased counselling and admitting privilege requirements for clinicians. Expand Health Coverage and Affordability: Urged Congress to support H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place. Introduce and pass the companion bill in the Senate and H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the ACA. Train and Support Frontline Physicians during and after COVID-19: Urged Congress to support H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots by at least 2,000 per year over seven years (14,000 slots) for specialties facing shortages, including internal medicine; H.R. 1554 (116th Congress), the Resident Education Deferred Interest Act, to allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program; S. 948, the Conrad State 30 and Physician Access Reauthorization Act (116th Congress) and S. 3599 (116th Congress), the Healthcare Workforce Resilience Act, to support the COVID-19 response workforce by expediting visas for international medical graduates (IMGs) to enter the U.S. for training and patient care, permanently authorizing the Conrad 30 Program, and providing a pathway for IMGs and their families already in the U.S to obtain permanent residency status; H.R. 2418, the Student Loan Forgiveness for Frontline Health Workers Act, to forgive student loans for physicians and other clinicians who are on the frontlines of providing care to COVID-19 patients or helping the health care system cope with the COVID-19 public health emergency; H.R. 1667/S. 610, the Dr. Lorna Breen Health Care Provider Protection Act, to address the behavioral health and well-being of physicians, including depression, suicides and burnout. Support the Value of Primary and Comprehensive Care: Urged Congress to Continue to fund the 3.75 percent increase to all physicians services that was approved by Congress at the end of last year to prevent CY2022 budget neutrality cuts for physician services, including primary care visits and other evaluation and management services; Ensure that any legislation that addresses budget neutrality treats all services fairly and equitably; Pass H.R. 1025, the Kids Access to Primary Care Act, to increase access to health coverage for Medicaid patients by achieving payment parity for primary care services under Medicaid and Medicare; Extend the five percent bonus that physicians receive if they meet performance expectations in Advanced APMs that is set to expire at the end of 2022; Act before the end of CY2021 to prevent scheduled cuts for physician services, including primary care, resulting from budget sequestration and pay-as-you go budget rules. Voiced support for H.R. 6020, bipartisan legislation to extend the 3.75 percent update to the conversion factor for an additional year. Improve Access to Prescription Drugs and Reduce Costs: Urged Congress to support S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; S. 141, the End Taxpayer Subsidies for Drug Ads Act, to end the federal tax deduction that pharmaceutical companies use to pay for drug advertising; S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Promote Health Equity, Social Justice, and Eliminate Disparities: Urged Congress to support H.R. 1280, the George Floyd Justice in Policing Act of 2021, to overhaul qualified immunity for law enforcement, prohibit racial profiling on the part of law enforcement and ban no-knock warrants in federal drug cases and chokeholds and carotid holds at the federal level; H.R. 5, the Equality Act, to prohibit discrimination based on sex, sexual orientation and gender identity in public accommodations and facilities, education, federal housing credit and the jury system; H.R. 666/S. 162, the Anti-Racism in Public Health Act of 2021, to establish within the CDC a National Center on Anti-racism and Health for data collection and research and a law enforcement violence prevention program; H.R. 959/S. 346, the Black Maternal Health Momnibus Act of 2021, to reduce preventable maternal mortality and severe maternal morbidity in the U.S. and close disparities in maternal health outcomes, particularly among pregnant minority women. Expand Access to Telehealth Services and Promote Patient Safety/Privacy; Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends; Urged appropriators to include adequate funding in FY2022 to support expansion of broadband capabilities nationwide, especially to rural and underserved communities, and to remove the ban on adoption of a national unique health identifier standard. Veterans Administration: Expressed concerns to the VA about its efforts to develop National Standards of Practice for physicians and other health professionals that supersede state scope of practice and licensure laws; expressed that the VA has not provided a transparent process by which public stakeholders are provided an adequate opportunity to review and provide meaningful input into the standards of practice. Expressed concern that the VA is moving forward too quickly and with too little stakeholder input on the VA supremacy Project. Urged support for provisions in any final FY2022 National Defense Authorization Act to prevent cuts to the military medical workforce without requiring appropriate congressional oversight and review. Surprise Medical Billing: Voiced support for the decision of CMS to provide protections for patients from surprise bills in situations where they need an ambulance, especially in a perceived emergency; voiced support for CMS approach that emergency services provided by out-of-network emergency facilities and out-of-network provider organizations, and certain non-emergency services furnished by out-of-network provider organizations at certain in-network facilities, must be calculated based on a recognized amount which is generally the lesser of the Qualifying Payment Amount (QPA) - the plans median in-network rate for the item or service, or an all-payer model agreement between CMS and the state; urged CMS to include in the Independent Dispute Resolution process described in future sub-regulatory guidance that health plans have an affirmative obligation to pay fairly and appropriately for services provided in and out of network. Substance Use Disorders: Urged Congress to support for the Comprehensive Addiction Resources Emergency (CARE) Act in the 117th Congress, which offers increased access to treatment and will improve care for individuals with substance use disorders (SUDs), specifically $1 billion per year to expand access to overdose reversal drugs (Naloxone) and provide this life-saving medicine to states to distribute to first responders, public health departments, and the public. The Build Back Better Act (H.R. 5376): Urged support in Congress for the following provisions: provide temporary enhanced ACA Marketplace cost-sharing reduction assistance to individuals with household incomes below 138 percent of the federal poverty level (FPL) for calendar years (CY) 2022 through 2025 and specify that individuals with household incomes below 138 percent of the FPL with access to employer-sponsored coverage or a qualified small employer health reimbursement arrangement can still receive credits; the 400 percent federal poverty level premium tax credit eligibility cap should be eliminated, and the amount of premium tax credits for all income levels should be enhanced; establish a health insurance affordability fund, with $10 billion made available annually for states to establish a state reinsurance program or use the funds to provide financial assistance to reduce out-of-pocket costs; permanently reauthorize CHIP and provide states the option to increase Medicaid and CHIP eligibility levels for children up to 300 percent of FPL without receiving a waiver. Mental and Behavioral Health: Urged Congress to support H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act (CoCM) that would provide grants through the Department of Health and Human Services to primary care physicians that choose to deliver behavioral health care through the Collaborative Care Model (CoCM). CoCM involves a primary care physician working collaboratively with a psychiatric consultant and a care manager to manage the clinical care of behavioral health patient caseloads. Urged support for retaining all services added to the Medicare telehealth services list on a temporary, Category 3 basis until the end of CY23. CMS should maintain coverage of audio-only mental health visits even after the PHE is lifted. This extension should last at least through the end of 2023 with an option to extend it even further or consider making it permanent, based on the experience and learnings of patients and physicians who utilize these visits. Urged support for expanding access to mental and behavioral health services, including allowing beneficiaries to access services from home, or if the technology is not available at home, from a rural health clinic or hospital.

Client expense: $257,285 · Firm income: Not reported

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

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged support for H.R. 8505, a bill to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule; Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases, along with GPC1X codes to go into effect. Regarding CMS 2022 Medicare Physician Fee Schedule and Quality Payment Program (QPP) rules, expressed support for extending some of the services and increased flexibility for telehealth through the end of 2023, namely some audio-only services that were allowed during the COVID-19 public health emergency (PHE), support for collecting additional data on health equity issues to analyze disparities that occur across their programs, support for including chronic care management as one of the seven MIPS Value Pathways (MVPs) for 2023. FY2022 Appropriations: Urged Congress to support $10 billion for the Centers for Disease Control and Preventions programs in the FY 2022 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as $50 million in funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for: Health Resources Services Administration (HRSA), $9.2 billion; Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA), $71 million; National Health Service Corps (NHSC), $860 million in total program funding; Agency for Healthcare Research and Quality (AHRQ), $500 million; Centers for Medicare and Medicaid Services (CMS), Program Operations for Federal Exchanges, $296.5 million. Also, urged support for the VA, Veterans Health Administration (VHA), $103.1 billion, which includes the following within the VHA -- VA, VHA, Medical Services, $66.2 billion, VA, VHA, Medical Community Care, $20.7 billion, VA, VHA, Medical and Prosthetic Research; $902 million. COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Urged the administration to explore regulatory and other actions that would make COVID-19 testing free-of-charge to patients covered by both public and private insurance plans, including ACA-compliant plans offered through the insurance exchanges, and to waive co-pays and deductibles for patients seeing physicians for symptoms that may be indicative of COVID-19 or who are hospitalized for treatment. Urged CMS to utilize a national disaster recovery program that would pay doctors 110% of Medicare rates for caring for uninsured patients who have been infected with SARS-CoV-2. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for the Student Loan Forgiveness for Frontline Health Workers Act, H.R. 6720, introduced May 5, 2020 by Representative Carolyn B. Maloney (D-NY) which would eliminate graduate school debt for healthcare workers, including physicians and medical students, who are providing direct patient care in response to the COVID-19 pandemic; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. This extension-either continued by CMS or mandated by Congress-should last at least through the end of 2021, or until such a time when effective vaccines and treatments are widely available, with an option to extend it even further, or consider making permanent, based on the experience and learnings of patients and physicians who are utilizing these visits. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP); urged support for administering COVID-19 vaccinations to all eligible immigrants in Customs and Border Protection (CBP) custody. Urged CMS to support increasing COVID-19 vaccine uptake by ensuring clinicians are appropriately paid for vaccine counseling for beneficiaries of Medicaid and Medicare. American Rescue Plan (ARP) Act (H.R. 1319): Urged support for various provisions within the ARP to provide incentives for states to expand Medicaid by temporarily increasing the states base FMAP by five percentage points for two years for states that newly expand Medicaid. Urged support for allowing states, for five years, to extend Medicaid eligibility (and CHIP eligibility) to women for 12 months postpartum. Urged support to require Medicaid coverage of COVID-19 vaccines and treatment without beneficiary cost sharing with vaccines matched at a 100 percent federal medical assistance percentage (FMAP) through one year after the end of the PHE. Urged support for $46 billion to HHS to detect, diagnose, trace, and monitor COVID-19 infections, and for other activities necessary to mitigate the spread of COVID-19. Urged support to subsidize the health coverage of people earning up to 150 percent of the federal poverty level (FPL) under the ACA and those on unemployment insurance for a period of two years. Urged support for waiving VA cost sharing and copayments for medical treatment until September 30, 2021. Womens Health: Urged Congress to support, H.R. 958, the Protecting Moms Who Served Act, which would provide critical support for maternity care coordination programs to address the clinical and nonclinical perinatal needs of veterans and ensure effective coordination between VA and non-VA facilities in the delivery of maternity care and other health care services. Urged HHS to promptly finalize new Title X regulations that ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminates medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protects funding for and ensures consistent treatment of qualified service sites. Urged support for mandatory, permanent extension of postpartum Medicaid coverage, from 60 days to 12 months after delivery. Urged support for the Womens Health Protection Act of 2021 (H.R. 3755 and S. 1975), bills that would protect a persons ability to determine whether to continue or end a pregnancy and to protect the health care clinicians ability to provide abortion services free from medically unnecessary restrictions such as waiting periods, biased counselling and admitting privilege requirements for clinicians. Expand Health Coverage and Affordability: Urged Congress to support H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place. Introduce and pass the companion bill in the Senate and H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the ACA. Train and Support Frontline Physicians during and after COVID-19: Urged Congress to support H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots by at least 2,000 per year over seven years (14,000 slots) for specialties facing shortages, including internal medicine; H.R. 1554 (116th Congress), the Resident Education Deferred Interest Act, to allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program; S. 948, the Conrad State 30 and Physician Access Reauthorization Act (116th Congress) and S. 3599 (116th Congress), the Healthcare Workforce Resilience Act, to support the COVID-19 response workforce by expediting visas for international medical graduates (IMGs) to enter the U.S. for training and patient care, permanently authorizing the Conrad 30 Program, and providing a pathway for IMGs and their families already in the U.S to obtain permanent residency status; H.R. 2418, the Student Loan Forgiveness for Frontline Health Workers Act, to forgive student loans for physicians and other clinicians who are on the frontlines of providing care to COVID-19 patients or helping the health care system cope with the COVID-19 public health emergency; H.R. 1667/S. 610, the Dr. Lorna Breen Health Care Provider Protection Act, to address the behavioral health and well-being of physicians, including depression, suicides and burnout. Support the Value of Primary and Comprehensive Care: Urged Congress to Continue to fund the 3.75 percent increase to all physicians services that was approved by Congress at the end of last year to prevent CY2022 budget neutrality cuts for physician services, including primary care visits and other evaluation and management services; Ensure that any legislation that addresses budget neutrality treats all services fairly and equitably; Pass H.R. 1025, the Kids Access to Primary Care Act, to increase access to health coverage for Medicaid patients by achieving payment parity for primary care services under Medicaid and Medicare; Extend the five percent bonus that physicians receive if they meet performance expectations in Advanced APMs that is set to expire at the end of 2022; Act before the end of CY2021 to prevent scheduled cuts for physician services, including primary care, resulting from budget sequestration and pay-as-you go budget rules. Voiced support for H.R. 6020, bipartisan legislation to extend the 3.75 percent update to the conversion factor for an additional year. Improve Access to Prescription Drugs and Reduce Costs: Urged Congress to support S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; S. 141, the End Taxpayer Subsidies for Drug Ads Act, to end the federal tax deduction that pharmaceutical companies use to pay for drug advertising; S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Promote Health Equity, Social Justice, and Eliminate Disparities: Urged Congress to support H.R. 1280, the George Floyd Justice in Policing Act of 2021, to overhaul qualified immunity for law enforcement, prohibit racial profiling on the part of law enforcement and ban no-knock warrants in federal drug cases and chokeholds and carotid holds at the federal level; H.R. 5, the Equality Act, to prohibit discrimination based on sex, sexual orientation and gender identity in public accommodations and facilities, education, federal housing credit and the jury system; H.R. 666/S. 162, the Anti-Racism in Public Health Act of 2021, to establish within the CDC a National Center on Anti-racism and Health for data collection and research and a law enforcement violence prevention program; H.R. 959/S. 346, the Black Maternal Health Momnibus Act of 2021, to reduce preventable maternal mortality and severe maternal morbidity in the U.S. and close disparities in maternal health outcomes, particularly among pregnant minority women. Expand Access to Telehealth Services and Promote Patient Safety/Privacy; Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends; Urged appropriators to include adequate funding in FY2022 to support expansion of broadband capabilities nationwide, especially to rural and underserved communities, and to remove the ban on adoption of a national unique health identifier standard. Veterans Administration: Expressed concerns to the VA about its efforts to develop National Standards of Practice for physicians and other health professionals that supersede state scope of practice and licensure laws; expressed that the VA has not provided a transparent process by which public stakeholders are provided an adequate opportunity to review and provide meaningful input into the standards of practice. Expressed concern that the VA is moving forward too quickly and with too little stakeholder input on the VA supremacy Project. Urged support for provisions in any final FY2022 National Defense Authorization Act to prevent cuts to the military medical workforce without requiring appropriate congressional oversight and review. Surprise Medical Billing: Voiced support for the decision of CMS to provide protections for patients from surprise bills in situations where they need an ambulance, especially in a perceived emergency; voiced support for CMS approach that emergency services provided by out-of-network emergency facilities and out-of-network provider organizations, and certain non-emergency services furnished by out-of-network provider organizations at certain in-network facilities, must be calculated based on a recognized amount which is generally the lesser of the Qualifying Payment Amount (QPA) - the plans median in-network rate for the item or service, or an all-payer model agreement between CMS and the state; urged CMS to include in the Independent Dispute Resolution process described in future sub-regulatory guidance that health plans have an affirmative obligation to pay fairly and appropriately for services provided in and out of network. Substance Use Disorders: Urged Congress to support for the Comprehensive Addiction Resources Emergency (CARE) Act in the 117th Congress, which offers increased access to treatment and will improve care for individuals with substance use disorders (SUDs), specifically $1 billion per year to expand access to overdose reversal drugs (Naloxone) and provide this life-saving medicine to states to distribute to first responders, public health departments, and the public. The Build Back Better Act (H.R. 5376): Urged support in Congress for the following provisions: provide temporary enhanced ACA Marketplace cost-sharing reduction assistance to individuals with household incomes below 138 percent of the federal poverty level (FPL) for calendar years (CY) 2022 through 2025 and specify that individuals with household incomes below 138 percent of the FPL with access to employer-sponsored coverage or a qualified small employer health reimbursement arrangement can still receive credits; the 400 percent federal poverty level premium tax credit eligibility cap should be eliminated, and the amount of premium tax credits for all income levels should be enhanced; establish a health insurance affordability fund, with $10 billion made available annually for states to establish a state reinsurance program or use the funds to provide financial assistance to reduce out-of-pocket costs; permanently reauthorize CHIP and provide states the option to increase Medicaid and CHIP eligibility levels for children up to 300 percent of FPL without receiving a waiver. Mental and Behavioral Health: Urged Congress to support H.R. 5218, the Collaborate in an Orderly and Cohesive Manner Act (CoCM) that would provide grants through the Department of Health and Human Services to primary care physicians that choose to deliver behavioral health care through the Collaborative Care Model (CoCM). CoCM involves a primary care physician working collaboratively with a psychiatric consultant and a care manager to manage the clinical care of behavioral health patient caseloads. Urged support for retaining all services added to the Medicare telehealth services list on a temporary, Category 3 basis until the end of CY23. CMS should maintain coverage of audio-only mental health visits even after the PHE is lifted. This extension should last at least through the end of 2023 with an option to extend it even further or consider making it permanent, based on the experience and learnings of patients and physicians who utilize these visits. Urged support for expanding access to mental and behavioral health services, including allowing beneficiaries to access services from home, or if the technology is not available at home, from a rural health clinic or hospital.

Client expense: $101,390 · Firm income: Not reported

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

S. 346/H.R. 959, Black Maternal Health Momnibus Act of 2021, In support of maternal health and closing disparities in maternal health outcomes for women of color; S. 162/H.R. 666, Anti-Racism in Public Health Act of 2021, In support of strengthening anti-racist health policy; S. Res. 172/H. Res. 344, A resolution declaring racism a public health crisis, In support of declaring racism a public health crisis; H.R. 1475, Pursuing Equity in Mental Health Act, In support of additional resources and guidance to identify mental health, social-emotional, and behavioral health problems; S. 1948/H.R. 3673, National ACERT Grant Program Authorization Act, In support of strengthening and expanding the National ACERT Grant Program Authorization Act; H.R. 3755, Women's Health Protection Act of 2021, In support of equal access to safe, legal abortion care.

Client expense: $60,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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. 4058, Telemental Health Care Access Act of 2021 S. 2061, Telemental Health Care Access Act of 2021, all provisions H.R. 4480, Telehealth Coverage and Payment Parity 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. 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. 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. 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 S. 2448, Health Misinformation Act of 2021, all provisions H.R. 2503, Social Determinants Accelerator Act of 2021, all provisions S. 509, Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act of 2021, all provisions H.R. 2163, Safe Step Act, all provisions S. 464, Safe Step Act, all provisions H.R. 1384, Mainstreaming Addiction Treatment Act of 2021, all provisions S. 445, Mainstreaming Addiction Treatment Act of 2021, all provisions H.R. 925, Data to Save Moms Act, all provisions H.R. 2547, Comprehensive Debt Collection Improvement Act, provisions relating to medical debt H.R. 3755, Women's Health Protection Act of 2021, all provisions S. 1975, Womens Health Protection Act of 2021, all provisions H.R. 1816, Information Transparency & Personal Data Control Act, all provisions H.R. 4217, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act of 2021, provision relating to physician representation S. 2779, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act of 2021, provision relating to physician representation S. 253, Cannabidiol and Marihuana Research Expansion Act, all provisions H.R. 379, Improving Social Determinants of Health Act of 2021, all provisions S. 104, Improving Social Determinants of Health Act of 2021, all provisions 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 Act of 2021, all provisions S. 445, Mainstreaming Addiction Treatment Act of 2021, 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 Comprehensive Addiction Resources Emergency (CARE) Act of 2019 21st Century Cures 2.0 Affordable Care Act Tax Credits Primary and Virtual Health Care Affordability Act Affordable Care Act family glitch Waste, fraud, and abuse in telehealth Digital Therapeutics Digital Health/Artificial Intelligence (AI) regulation Telehealth studies Dialysis Centers/COVID-19 telehealth flexibilities continuation Physician burnout and suicide issues Vaccine distribution/vaccines in physician offices/health equity Provider Relief Fund Prior Authorization/attachment standards ERISA Plans/prior authorization requirements Health equity/race corrections in clinical algorithms Maternal mortality Prescription drug pricing Data Privacy Information blocking Drug overdose epidemic Social Determinants of Health Cybersecurity and HIPAA Clinical and administrative data COVID-19/health equity/testing/PPE/misinformation/vaccine issues COVID-19/OSHA/emergency temporary standard (ETS) Precision Medicine/Diagnostics/Coding Nomination of Rahul Gupta, MD, to be Director of White House Office of National Drug Control Policy Mental health parity Prior authorization Physician health programs

Client expense: $3,490,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institute of Standards & Technology (NIST), Office of Science & Technology Policy (OSTP), SENATE, U.S. Customs & Border Protection, Veterans Affairs, Dept of (VA), White House Office

Reproductive Rights and Roe v. Wade; State abortion bans and abortion access in the United States; Access to abortion, contraception, and maternity care for veterans, servicemembers, and dependents; H.R. 2709 and S. 1238, Access to Contraception for Servicemembers and Dependents Act, regarding access to affordable contraception; H.R.239, Equal Access to Contraception for Veterans Act, regarding access to affordable contraception H.R. 4350, FY22 National Defense Authorization Act Access to the contraceptive coverage benefit under the Affordable Care Act; Title X family planning program; Trump administration refusal of care rule; Denials of and nondiscrimination in healthcare; Treatment of pregnant incarcerated people and detainees; Infrastructure bills, including the Build Back Better legislative package, and programs to support women and families; S.Con.Res.14, access to healthcare, paid family and medical leave, and programs to support women and families; Lankford amendment #3792, restrictions on abortion access; Inhofe amendment #3331, restrictions on abortion access; Kennedy amendment #3758, restrictions on abortion access; Marshall amendment #2706, restrictions on abortion access; Marshall amendment #2707, restrictions on abortion access; Marshall amendment #2715, restrictions on contraception access; Hawley amendment #2740, restrictions on abortion access; Hawley amendment #2741, restrictions on abortion access; Moran amendment #3050, restrictions on abortion access; Hawley amendment #3077, restrictions on abortion access; Hawley amendment #3078, restrictions on abortion access; Marshall amendment #3080, restrictions on reproductive healthcare access; Sasse amendment #3094, restrictions on abortion access; Maternal health outcomes and care options; Paid family and medical leave; H.R.804 and S.248, FAMILY Act, regarding paid family leave; H.R.959, the Momnibus Act, regarding maternal health outcomes; H.R. 666 and S. 162, Anti-Racism in Public Health Act, regarding strengthening the federal governments ability to develop anti-racist health policy; H.R. 1065 the Pregnant Workers Fairness Act, regarding discrimination against pregnant workers; H.J.Res. 17, Resolution to remove the deadline for ratification of the Equal Rights Amendment; H.R. 1378, Do No Harm Act, regarding denials of care; H.R. 5 and S. 393, the Equality Act, regarding ending discrimination for LGBTQIA+ individuals. H.R. 3312 and S. 1689, the Real Education and Access for Healthy Youth Act, regarding young peoples access to sex education; H.R. 2234 and S. 1021, EACH Act, regarding access to affordable health insurance plans that cover abortion; H.R. 3755 and S. 1975, the Women's Health Protection Act, regarding access to abortion care; Access to evidence-based medication abortion care; H.Res.589, Expressing the sense of the House of Representatives that policies governing access to medication abortion care in the United States should be equitable and based on science;

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Office of Management & Budget (OMB), SENATE, White House Office

COVID-19 data collection and reporting, Centers for Disease Control and Prevention's Data Modernization Initiative, and proposals that address health disparities and inequities in the healthcare system, including the Anti-Racism in Public Health Act (H.R. 666 / S.162) and Equitable Data Collection and Disclosure on COVID-19 Act (H.R. 1370 / S.512).

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Childcare Issues related to childcare - no specific bill COVID-19 Pandemic & Pandemic Preparedness H.R. 1319, American Rescue Plan Act - including provisions on: Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response State and local funding Health disparities and protecting vulnerable populations Behavioral and mental health services Expanding internet connectivity Grant program for childcare Food assistance programs Small business loans/Paycheck Protection Program Reducing health care premiums for low- and middle-income families by increasing the Affordable Care Acts (ACA) premium tax credits for 2021 and 2022 The continuation of employer-based health coverage by subsidizing COBRA coverage through the end of the fiscal year. Health care subsidies for unemployed workers who are ineligible for COBRA. Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. General advocacy on COVID-19 relief: Financial assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Issues related to pandemic preparedness Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Mental and behavioral health H.R. 2418 Student Loan Forgiveness for Frontline Health Workers Act Pandemic Production Act (PPA) (no bill number) Gun Safety S. 2325/H.R.4238 - Making America Safe and Secure (MASS) Act Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Health Care Workforce S. 54 - Strengthening America's Health Care Readiness Act S. 834/ H.R.2256 - Resident Physician Shortage Reduction Act of 2021 S.610/ H.R.1667 - Dr. Lorna Breen Health Care Provider Protection Act Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 Healthcare Workforce Resilience Act Infrastructure Issues related to broadband access Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Maternal Health S. 411/ H.R. 3407, Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education - no specific bill Medicare/Medicaid H.R. 315, Medicare Sequester COVID Moratorium Act S. 748, Medicare Sequester Relief Act Issues related to Medicare physician payment H.R. 1587/ S. 1731 Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill H.R.3173 - Improving Seniors Timely Access to Care Act of 2021 Opioids/ Substance Use Disorder Comprehensive Addiction Resources Emergency (CARE) Act (no bill number) S. 2354 Safer Prescribing of Controlled Substances Act H.R.1026 / S.2353 LABEL Opioids Act of 2021 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill Regulatory Medicare Program; CY 2022 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Provider Enrollment Regulation Updates; Provider and Supplier Prepayment and Post-payment Medical Review Requirements. Interim Final Rule (IFC) - Requirements Related to Surprise Billing; Part I. This is the first regulation implementing provisions of Title I (No Surprises Act) of Division BB of the Consolidated Appropriations Act, 2021

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Childcare Issues related to childcare - no specific bill COVID-19 Pandemic & Pandemic Preparedness H.R. 1319, American Rescue Plan Act - including provisions on: Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response State and local funding Health disparities and protecting vulnerable populations Behavioral and mental health services Expanding internet connectivity Grant program for childcare Food assistance programs Small business loans/Paycheck Protection Program Reducing health care premiums for low- and middle-income families by increasing the Affordable Care Acts (ACA) premium tax credits for 2021 and 2022 The continuation of employer-based health coverage by subsidizing COBRA coverage through the end of the fiscal year. Health care subsidies for unemployed workers who are ineligible for COBRA. Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. General advocacy on COVID-19 relief: Financial assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Issues related to pandemic preparedness Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Mental and behavioral health H.R. 2418 Student Loan Forgiveness for Frontline Health Workers Act Pandemic Production Act (PPA) (no bill number) Gun Safety S. 2325/H.R.4238 - Making America Safe and Secure (MASS) Act Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Health Care Workforce S. 54 - Strengthening America's Health Care Readiness Act S. 834/ H.R.2256 - Resident Physician Shortage Reduction Act of 2021 S.610/ H.R.1667 - Dr. Lorna Breen Health Care Provider Protection Act Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 Healthcare Workforce Resilience Act Infrastructure Issues related to broadband access Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Maternal Health S. 411/ H.R. 3407, Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education - no specific bill Medicare/Medicaid H.R. 315, Medicare Sequester COVID Moratorium Act S. 748, Medicare Sequester Relief Act Issues related to Medicare physician payment H.R. 1587/ S. 1731 Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Issues related to prior authorization and administrative simplification - no specific bill H.R.3173 - Improving Seniors Timely Access to Care Act of 2021 Opioids/ Substance Use Disorder Comprehensive Addiction Resources Emergency (CARE) Act (no bill number) S. 2354 Safer Prescribing of Controlled Substances Act H.R.1026 / S.2353 LABEL Opioids Act of 2021 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill Regulatory Medicare Program; CY 2022 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Provider Enrollment Regulation Updates; Provider and Supplier Prepayment and Post-payment Medical Review Requirements. Interim Final Rule (IFC) - Requirements Related to Surprise Billing; Part I. This is the first regulation implementing provisions of Title I (No Surprises Act) of Division BB of the Consolidated Appropriations Act, 2021

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged support for H.R. 8505, a bill to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule; Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases, along with GPC1X codes to go into effect. Regarding CMS proposed 2022 Medicare Physician Fee Schedule and Quality Payment Program (QPP) rules, expressed support for extending some of the services and increased flexibility for telehealth through the end of 2023, namely some audio-only services that were allowed during the COVID-19 public health emergency (PHE), support for collecting additional data on health equity issues to analyze disparities that occur across their programs, support for including chronic care management as one of the seven MIPS Value Pathways (MVPs) for 2023. FY2022 Appropriations: Urged Congress to support $10 billion for the Centers for Disease Control and Preventions programs in the FY 2022 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as $50 million in funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for: Health Resources Services Administration (HRSA), $9.2 billion; Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA), $71 million; National Health Service Corps (NHSC), $860 million in total program funding; Agency for Healthcare Research and Quality (AHRQ), $500 million; Centers for Medicare and Medicaid Services (CMS), Program Operations for Federal Exchanges, $296.5 million. Also, urged support for the VA, Veterans Health Administration (VHA), $103.1 billion, which includes the following within the VHA -- VA, VHA, Medical Services, $66.2 billion, VA, VHA, Medical Community Care, $20.7 billion, VA, VHA, Medical and Prosthetic Research; $902 million. COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Urged the administration to explore regulatory and other actions that would make COVID-19 testing free-of-charge to patients covered by both public and private insurance plans, including ACA-compliant plans offered through the insurance exchanges, and to waive co-pays and deductibles for patients seeing physicians for symptoms that may be indicative of COVID-19 or who are hospitalized for treatment. Urged CMS to utilize a national disaster recovery program that would pay doctors 110% of Medicare rates for caring for uninsured patients who have been infected with SARS-CoV-2. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for the Student Loan Forgiveness for Frontline Health Workers Act, H.R. 6720, introduced May 5, 2020 by Representative Carolyn B. Maloney (D-NY) which would eliminate graduate school debt for healthcare workers, including physicians and medical students, who are providing direct patient care in response to the COVID-19 pandemic; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. This extension-either continued by CMS or mandated by Congress-should last at least through the end of 2021, or until such a time when effective vaccines and treatments are widely available, with an option to extend it even further, or consider making permanent, based on the experience and learnings of patients and physicians who are utilizing these visits. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP); urged support for administering COVID-19 vaccinations to all eligible immigrants in Customs and Border Protection (CBP) custody. American Rescue Plan (ARP) Act (H.R. 1319): Urged support for various provisions within the ARP to provide incentives for states to expand Medicaid by temporarily increasing the states base FMAP by five percentage points for two years for states that newly expand Medicaid. Urged support for allowing states, for five years, to extend Medicaid eligibility (and CHIP eligibility) to women for 12 months postpartum. Urged support to require Medicaid coverage of COVID-19 vaccines and treatment without beneficiary cost sharing with vaccines matched at a 100 percent federal medical assistance percentage (FMAP) through one year after the end of the PHE. Urged support for $46 billion to HHS to detect, diagnose, trace, and monitor COVID-19 infections, and for other activities necessary to mitigate the spread of COVID-19. Urged support to subsidize the health coverage of people earning up to 150 percent of the federal poverty level (FPL) under the ACA and those on unemployment insurance for a period of two years. Urged support for waiving VA cost sharing and copayments for medical treatment until September 30, 2021. Womens Health: Urged Congress to support, H.R. 958, the Protecting Moms Who Served Act, which would provide critical support for maternity care coordination programs to address the clinical and nonclinical perinatal needs of veterans and ensure effective coordination between VA and non-VA facilities in the delivery of maternity care and other health care services. Urged HHS to promptly finalize new Title X regulations that ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminates medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protects funding for and ensures consistent treatment of qualified service sites. Urged support for mandatory, permanent extension of postpartum Medicaid coverage, from 60 days to 12 months after delivery. Urged support for the Womens Health Protection Act of 2021 (H.R. 3755 and S. 1975), bills that would protect a persons ability to determine whether to continue or end a pregnancy and to protect the health care clinicians ability to provide abortion services free from medically unnecessary restrictions such as waiting periods, biased counselling and admitting privilege requirements for clinicians. Expand Health Coverage and Affordability: Urged Congress to support H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place. Introduce and pass the companion bill in the Senate and H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the ACA. Train and Support Frontline Physicians during and after COVID-19: Urged Congress to support H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots by at least 2,000 per year over seven years (14,000 slots) for specialties facing shortages, including internal medicine; H.R. 1554 (116th Congress), the Resident Education Deferred Interest Act, to allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program; S. 948, the Conrad State 30 and Physician Access Reauthorization Act (116th Congress) and S. 3599 (116th Congress), the Healthcare Workforce Resilience Act, to support the COVID-19 response workforce by expediting visas for international medical graduates (IMGs) to enter the U.S. for training and patient care, permanently authorizing the Conrad 30 Program, and providing a pathway for IMGs and their families already in the U.S to obtain permanent residency status; H.R. 2418, the Student Loan Forgiveness for Frontline Health Workers Act, to forgive student loans for physicians and other clinicians who are on the frontlines of providing care to COVID-19 patients or helping the health care system cope with the COVID-19 public health emergency; H.R. 1667/S. 610, the Dr. Lorna Breen Health Care Provider Protection Act, to address the behavioral health and well-being of physicians, including depression, suicides and burnout. Support the Value of Primary and Comprehensive Care: Urged Congress to Continue to fund the 3.75 percent increase to all physicians services that was approved by Congress at the end of last year to prevent CY2022 budget neutrality cuts for physician services, including primary care visits and other evaluation and management services; Ensure that any legislation that addresses budget neutrality treats all services fairly and equitably; Pass H.R. 1025, the Kids Access to Primary Care Act, to increase access to health coverage for Medicaid patients by achieving payment parity for primary care services under Medicaid and Medicare; Extend the five percent bonus that physicians receive if they meet performance expectations in Advanced APMs that is set to expire at the end of 2022; Act before the end of CY2021 to prevent scheduled cuts for physician services, including primary care, resulting from budget sequestration and pay-as-you go budget rules. Improve Access to Prescription Drugs and Reduce Costs: Urged Congress to support S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; S. 141, the End Taxpayer Subsidies for Drug Ads Act, to end the federal tax deduction that pharmaceutical companies use to pay for drug advertising; S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Support Essential Public Health and Research Initiatives: Urged Congress to support H.R. 8, the Bipartisan Background Checks Act that would establish new background check requirements for firearm transfers between private parties; H.R. 3076/S. 506, the Extreme Risk Protection Order Act from the 116th Congress, to establish a grant program to help states and Indian tribes implement extreme risk protection order laws and expands categories of individuals who are prohibited from receiving, possessing, shipping, or transporting a firearm; H.R. 3271/S. 1702, the Climate Change Health Protection and Promotion Act that would take important steps to mitigate the harmful impact of climate change on health. Promote Health Equity, Social Justice, and Eliminate Disparities: Urged Congress to support H.R. 1280, the George Floyd Justice in Policing Act of 2021, to overhaul qualified immunity for law enforcement, prohibit racial profiling on the part of law enforcement and ban no-knock warrants in federal drug cases and chokeholds and carotid holds at the federal level; H.R. 5, the Equality Act, to prohibit discrimination based on sex, sexual orientation and gender identity in public accommodations and facilities, education, federal housing credit and the jury system; H.R. 666/S. 162, the Anti-Racism in Public Health Act of 2021, to establish within the CDC a National Center on Anti-racism and Health for data collection and research and a law enforcement violence prevention program; H.R. 959/S. 346, the Black Maternal Health Momnibus Act of 2021, to reduce preventable maternal mortality and severe maternal morbidity in the U.S. and close disparities in maternal health outcomes, particularly among pregnant minority women. Expand Access to Telehealth Services and Promote Patient Safety/Privacy; Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends; Urged appropriators to include adequate funding in FY2022 to support expansion of broadband capabilities nationwide, especially to rural and underserved communities, and to remove the ban on adoption of a national unique health identifier standard. Veterans Administration: Expressed concerns to the VA about its efforts to develop National Standards of Practice for physicians and other health professionals that supersede state scope of practice and licensure laws; expressed that the VA has not provided a transparent process by which public stakeholders are provided an adequate opportunity to review and provide meaningful input into the standards of practice. Infrastructure Investment: Expressed support with Congress for several provisions in the bipartisan Infrastructure Investment and Jobs Act, legislation that makes sweeping and historic investments in this nations infrastructure; Applauded provisions that would improve public health specifically to ensure all Americans have access to safe drinking water, broadband services that provide vital access to telehealth services, as well as investment in clean energy to reverse the negative health effects associated with climate change. Surprise Medical Billing: Voiced support for the decision of CMS to provide protections for patients from surprise bills in situations where they need an ambulance, especially in a perceived emergency; voiced support for CMS approach that emergency services provided by out-of-network emergency facilities and out-of-network provider organizations, and certain non-emergency services furnished by out-of-network provider organizations at certain in-network facilities, must be calculated based on a recognized amount which is generally the lesser of the Qualifying Payment Amount (QPA) - the plans median in-network rate for the item or service, or an all-payer model agreement between CMS and the state; urged CMS to include in the Independent Dispute Resolution process described in future sub-regulatory guidance that health plans have an affirmative obligation to pay fairly and appropriately for services provided in and out of network.

Client expense: $287,346 · Firm income: Not reported

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

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged support for H.R. 8505, a bill to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule; Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases, along with GPC1X codes to go into effect. Regarding CMS proposed 2022 Medicare Physician Fee Schedule and Quality Payment Program (QPP) rules, expressed support for extending some of the services and increased flexibility for telehealth through the end of 2023, namely some audio-only services that were allowed during the COVID-19 public health emergency (PHE), support for collecting additional data on health equity issues to analyze disparities that occur across their programs, support for including chronic care management as one of the seven MIPS Value Pathways (MVPs) for 2023. FY2022 Appropriations: Urged Congress to support $10 billion for the Centers for Disease Control and Preventions programs in the FY 2022 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as $50 million in funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for: Health Resources Services Administration (HRSA), $9.2 billion; Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA), $71 million; National Health Service Corps (NHSC), $860 million in total program funding; Agency for Healthcare Research and Quality (AHRQ), $500 million; Centers for Medicare and Medicaid Services (CMS), Program Operations for Federal Exchanges, $296.5 million. Also, urged support for the VA, Veterans Health Administration (VHA), $103.1 billion, which includes the following within the VHA -- VA, VHA, Medical Services, $66.2 billion, VA, VHA, Medical Community Care, $20.7 billion, VA, VHA, Medical and Prosthetic Research; $902 million. COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Urged the administration to explore regulatory and other actions that would make COVID-19 testing free-of-charge to patients covered by both public and private insurance plans, including ACA-compliant plans offered through the insurance exchanges, and to waive co-pays and deductibles for patients seeing physicians for symptoms that may be indicative of COVID-19 or who are hospitalized for treatment. Urged CMS to utilize a national disaster recovery program that would pay doctors 110% of Medicare rates for caring for uninsured patients who have been infected with SARS-CoV-2. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for the Student Loan Forgiveness for Frontline Health Workers Act, H.R. 6720, introduced May 5, 2020 by Representative Carolyn B. Maloney (D-NY) which would eliminate graduate school debt for healthcare workers, including physicians and medical students, who are providing direct patient care in response to the COVID-19 pandemic; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. This extension-either continued by CMS or mandated by Congress-should last at least through the end of 2021, or until such a time when effective vaccines and treatments are widely available, with an option to extend it even further, or consider making permanent, based on the experience and learnings of patients and physicians who are utilizing these visits. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP); urged support for administering COVID-19 vaccinations to all eligible immigrants in Customs and Border Protection (CBP) custody. American Rescue Plan (ARP) Act (H.R. 1319): Urged support for various provisions within the ARP to provide incentives for states to expand Medicaid by temporarily increasing the states base FMAP by five percentage points for two years for states that newly expand Medicaid. Urged support for allowing states, for five years, to extend Medicaid eligibility (and CHIP eligibility) to women for 12 months postpartum. Urged support to require Medicaid coverage of COVID-19 vaccines and treatment without beneficiary cost sharing with vaccines matched at a 100 percent federal medical assistance percentage (FMAP) through one year after the end of the PHE. Urged support for $46 billion to HHS to detect, diagnose, trace, and monitor COVID-19 infections, and for other activities necessary to mitigate the spread of COVID-19. Urged support to subsidize the health coverage of people earning up to 150 percent of the federal poverty level (FPL) under the ACA and those on unemployment insurance for a period of two years. Urged support for waiving VA cost sharing and copayments for medical treatment until September 30, 2021. Womens Health: Urged Congress to support, H.R. 958, the Protecting Moms Who Served Act, which would provide critical support for maternity care coordination programs to address the clinical and nonclinical perinatal needs of veterans and ensure effective coordination between VA and non-VA facilities in the delivery of maternity care and other health care services. Urged HHS to promptly finalize new Title X regulations that ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminates medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protects funding for and ensures consistent treatment of qualified service sites. Urged support for mandatory, permanent extension of postpartum Medicaid coverage, from 60 days to 12 months after delivery. Urged support for the Womens Health Protection Act of 2021 (H.R. 3755 and S. 1975), bills that would protect a persons ability to determine whether to continue or end a pregnancy and to protect the health care clinicians ability to provide abortion services free from medically unnecessary restrictions such as waiting periods, biased counselling and admitting privilege requirements for clinicians. Expand Health Coverage and Affordability: Urged Congress to support H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place. Introduce and pass the companion bill in the Senate and H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the ACA. Train and Support Frontline Physicians during and after COVID-19: Urged Congress to support H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots by at least 2,000 per year over seven years (14,000 slots) for specialties facing shortages, including internal medicine; H.R. 1554 (116th Congress), the Resident Education Deferred Interest Act, to allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program; S. 948, the Conrad State 30 and Physician Access Reauthorization Act (116th Congress) and S. 3599 (116th Congress), the Healthcare Workforce Resilience Act, to support the COVID-19 response workforce by expediting visas for international medical graduates (IMGs) to enter the U.S. for training and patient care, permanently authorizing the Conrad 30 Program, and providing a pathway for IMGs and their families already in the U.S to obtain permanent residency status; H.R. 2418, the Student Loan Forgiveness for Frontline Health Workers Act, to forgive student loans for physicians and other clinicians who are on the frontlines of providing care to COVID-19 patients or helping the health care system cope with the COVID-19 public health emergency; H.R. 1667/S. 610, the Dr. Lorna Breen Health Care Provider Protection Act, to address the behavioral health and well-being of physicians, including depression, suicides and burnout. Support the Value of Primary and Comprehensive Care: Urged Congress to Continue to fund the 3.75 percent increase to all physicians services that was approved by Congress at the end of last year to prevent CY2022 budget neutrality cuts for physician services, including primary care visits and other evaluation and management services; Ensure that any legislation that addresses budget neutrality treats all services fairly and equitably; Pass H.R. 1025, the Kids Access to Primary Care Act, to increase access to health coverage for Medicaid patients by achieving payment parity for primary care services under Medicaid and Medicare; Extend the five percent bonus that physicians receive if they meet performance expectations in Advanced APMs that is set to expire at the end of 2022; Act before the end of CY2021 to prevent scheduled cuts for physician services, including primary care, resulting from budget sequestration and pay-as-you go budget rules. Improve Access to Prescription Drugs and Reduce Costs: Urged Congress to support S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; S. 141, the End Taxpayer Subsidies for Drug Ads Act, to end the federal tax deduction that pharmaceutical companies use to pay for drug advertising; S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Support Essential Public Health and Research Initiatives: Urged Congress to support H.R. 8, the Bipartisan Background Checks Act that would establish new background check requirements for firearm transfers between private parties; H.R. 3076/S. 506, the Extreme Risk Protection Order Act from the 116th Congress, to establish a grant program to help states and Indian tribes implement extreme risk protection order laws and expands categories of individuals who are prohibited from receiving, possessing, shipping, or transporting a firearm; H.R. 3271/S. 1702, the Climate Change Health Protection and Promotion Act that would take important steps to mitigate the harmful impact of climate change on health. Promote Health Equity, Social Justice, and Eliminate Disparities: Urged Congress to support H.R. 1280, the George Floyd Justice in Policing Act of 2021, to overhaul qualified immunity for law enforcement, prohibit racial profiling on the part of law enforcement and ban no-knock warrants in federal drug cases and chokeholds and carotid holds at the federal level; H.R. 5, the Equality Act, to prohibit discrimination based on sex, sexual orientation and gender identity in public accommodations and facilities, education, federal housing credit and the jury system; H.R. 666/S. 162, the Anti-Racism in Public Health Act of 2021, to establish within the CDC a National Center on Anti-racism and Health for data collection and research and a law enforcement violence prevention program; H.R. 959/S. 346, the Black Maternal Health Momnibus Act of 2021, to reduce preventable maternal mortality and severe maternal morbidity in the U.S. and close disparities in maternal health outcomes, particularly among pregnant minority women. Expand Access to Telehealth Services and Promote Patient Safety/Privacy; Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends; Urged appropriators to include adequate funding in FY2022 to support expansion of broadband capabilities nationwide, especially to rural and underserved communities, and to remove the ban on adoption of a national unique health identifier standard. Veterans Administration: Expressed concerns to the VA about its efforts to develop National Standards of Practice for physicians and other health professionals that supersede state scope of practice and licensure laws; expressed that the VA has not provided a transparent process by which public stakeholders are provided an adequate opportunity to review and provide meaningful input into the standards of practice. Infrastructure Investment: Expressed support with Congress for several provisions in the bipartisan Infrastructure Investment and Jobs Act, legislation that makes sweeping and historic investments in this nations infrastructure; Applauded provisions that would improve public health specifically to ensure all Americans have access to safe drinking water, broadband services that provide vital access to telehealth services, as well as investment in clean energy to reverse the negative health effects associated with climate change. Surprise Medical Billing: Voiced support for the decision of CMS to provide protections for patients from surprise bills in situations where they need an ambulance, especially in a perceived emergency; voiced support for CMS approach that emergency services provided by out-of-network emergency facilities and out-of-network provider organizations, and certain non-emergency services furnished by out-of-network provider organizations at certain in-network facilities, must be calculated based on a recognized amount which is generally the lesser of the Qualifying Payment Amount (QPA) - the plans median in-network rate for the item or service, or an all-payer model agreement between CMS and the state; urged CMS to include in the Independent Dispute Resolution process described in future sub-regulatory guidance that health plans have an affirmative obligation to pay fairly and appropriately for services provided in and out of network.

Client expense: $102,561 · Firm income: Not reported

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

H. Res. 349 - In support the goals of Overdose Awareness Day by lowering the United States flag to half-staff on all Federal buildings on August 31st of each year H.Res 538 - Bebe Moore Campbell BIPOC Mental Health Awareness Month H.R. 586/S. 1543- The STANDUP Act H.R. 588 - Stopping the Mental Health Pandemic Act H.R. 593 - Coronavirus Mental Health and Addiction Assistance Act of 2021 H.R. 654/S. 26 - Drug-Free Communities Pandemic Relief Act H.R. 666/ S. 162 - the Anti-Racism in Public Health Act H.R. 721/S. 1841 - Mental Health Services for Students Act H.R. 909/S. 484 - Moms Matter Act H.R. 912 - American Indian and Alaska Native Veterans Mental Health Act H.R. 925/S. 327 - Data to Save Moms Act H.R. 955/S. 285 - Medicaid Reentry Act H.R. 959/ S. 346 - the Black Maternal Health Momnibus Act H.R. 1025 - Kids Access to Primary Care Act of 2021 H.R. 1195 - the Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 1205/S. 2157 - Improving Mental Health Access from the Emergency Department Act H.R. 1324/S. 467 - Effective Suicide Screening and Assessment in the Emergency Department Act H.R. 1331 - the Strengthening Mental Health Supports for BIPOC Communities Act H.R. 1400 - the COVID-19 Health Disparities Action Act of 2021 H.R. 1475/S. 1795 - Pursuing Equity in Mental Health Act H.R. 1480 - Helping Emergency Responders Overcome (HERO) Act H.R. 1551/S.584 - Nutrition CARE Act H.R. 1554 - grants for community-based mental health and substance use disorder services H.R. 1587/S. 1731 - Medicare Audiologist Access and Services Act of 2021 H.R. 1667/S. 610 - Dr. Lorna Breen Health Care Provider Protection Act H.R. 1716/ S. 631 - the Covid-19 Mental Health Research Act H.R. 1738/S. 646 - Stabilize Medicaid and CHIP Act H.R. 2051/S. 854 - Methamphetamine Response Act of 2021 H.R. 2161/S. 971 - CAMRA Act Support Letter H.R. 2255/S. 1024 -the Healthcare Workforce Resilience Act H.R. 2256/S. 834 - the Resident Physician Shortage Reduction Act of 2021 H.R. 2264/ S. 660 - the Telemental Health Improvement Act H.R. 2364 - Synthetic Opioid Danger Awareness Act H.R. 2379 - State Opioid Response Grant Authorization Act of 2021 H.R. 2503 - Social Determinants Accelerator Act of 2021 H.R. 2591/S.957 - DUMP Opioids Act H.R. 2611 - Increasing Behavioral Health Treatment Act H.R. 2767/ S. 2144 - the Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act H.R. 2862 -the Campaign to Prevent Suicide Act H.R. 2874/S. 1576 - Behavioral Health Coverage Transparency Act of 2021 H.R. 2903/S. 1512 - the CONNECT for Health Act of 2021 H.R. 2929/ S. 157 - The Virtual Peer Support Act H.R. 2955 -the Suicide Prevention Act H.R. 2973 - the Strengthening Americas Families Act (SAFA) of 2021 H.R. 2981, the Suicide Prevention Lifeline Improvement Act of 2021 H.R. 3150/S. 1578 - the Mental Health Professionals Workforce Shortage Loan Repayment Act of 2021 H.R. 3407/S. 411 - Mothers and Offspring Mortality and Morbidity Awareness Act MOMMAs Act H.R. 3441 - The Substance Use Disorder Workforce Act of 2021 H.R. 3447 - Permanency for Audio-Only Telehealth Act H.R. 3450/S. 1727, the Medicaid Bump Act H.R. 3541/S. 1810 - Conrad State 30 and Physician Access Reauthorization Act H.R.3467 - the Improving Data Collection for Adverse Childhood Experiences Act H.R. 3753/S. 1962 - Parity Implementation Assistance Act H.R. 3755/S. 1975 - the Womens Health Protection Act H.R. 3894 - Collecting and Analyzing Resources Integral and Necessary for Guidance (CARING) for Social Determinants Act of 2021 H.R. 3931 / S. 2069 - Excellence in Mental Health and Addiction Treatment Expansion Act H.R. 4026 - Social Determinants of Health Data Analysis Act of 2021 H.R. 4058/S. 2061- The Telemental Health Care Access Act H.R. 4146 - Therapeutic Fraud Prevention Act of 2021 H.R. 4151/S. 2238 - FASD Respect Act H.R.4217 - TRIUMPH for New Moms Act of 2021 H.R. 4305, the Crisis Care Enhancement Act H.R. 4351/S. 981 - CARA 3.0 Act of 2021 H.R. 4387/S. 1675 - Maternal Health Quality Improvement Act of 2021 H.R. 4406 - Supporting Medicaid in the U.S. Territories Act of 2021 H.R. 4510 - Health Enterprise Zones Act of 2021 H.R. 4554 - Care That's Fair Act H.R. 4631- Protecting Our Students by Terminating Graduate Rates that Add to Debt (POST GRAD) Act H.R. 4649 - Supporting Underserved Populations by Placing Our Resources in Trusts (SUPPORT) for Mental Health Act H.R. 4770- Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act of 2021 (EDOT Act) H.R. 4943 - the Childrens Mental Health Infrastructure Act of 2021 H.R. 4944, the Helping Kids Cope Act of 2021 H.R. 4970 - Rural Medical Residency Expansion Act of 2021 H.R. 5035 - Child Suicide Prevention and Lethal Means Safety Act H.R. 5218 - Collaborate in an Orderly and Cohesive Manner Act H.R. 5224 - Preventing Overdoses and Saving Lives Act of 2021 S. 674 - Public Health Infrastructure Saves Lives Act S. 1024 - Healthcare Workforce Resilience Act S. 1902 - Behavioral Health Crisis Services Expansion Act S. 2086/ - Resilience Investment, Support, and Expansion from Trauma Act (RISE from Trauma Act) (Bill # TBD) - LAI Buprenorphine Access Act (No legislation) Amend Section 1834(m) of the Social Security Act to ensure that the Secretary has the tools to transition following the end of the public health emergency and ensure telehealth is regulated the same as in-person services.    (No legislation)_Retain the 3.75% increase to conversion factor for FY 22 and 23 in the MPFS

Client expense: $236,825 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

Reproductive Rights and Roe v. Wade; State abortion bans and abortion access in the United States; Access to abortion, contraception, and maternity care for veterans, servicemembers, and dependents; H.R. 2709 and S. 1238, Access to Contraception for Servicemembers and Dependents Act, regarding access to affordable contraception; H.R.239, Equal Access to Contraception for Veterans Act, regarding access to affordable contraception Access to the contraceptive coverage benefit under the Affordable Care Act; Trump administration refusal of care rule; Denials of healthcare; Maternal health outcomes and care options; Treatment of pregnant incarcerated people and detainees; COVID-19 response efforts, including federal relief response, paid family leave, and restrictions on insurance coverage of abortion; H.R. 2234 and S. 1021, EACH Act, regarding access to affordable health insurance plans that cover abortion; H.R.804 and S.248, FAMILY Act, regarding paid family leave; H.R.959, the Momnibus Act, regarding maternal health outcomes; H.R. 666 and S. 162, Anti-Racism in Public Health Act, regarding strengthening the federal governments ability to develop anti-racist health policy; H.R. 1065 the Pregnant Workers Fairness Act, regarding discrimination against pregnant workers; H.J.Res. 17, Resolution to remove the deadline for ratification of the Equal Rights Amendment; H.R. 1378, Do No Harm Act, regarding denials of care; H.R. 5 and S. 393, the Equality Act, regarding ending discrimination for LGBTQIA+ individuals. H.R. 3312 and S. 1689, the Real Education and Access for Healthy Youth Act, regarding young peoples access to sex education; H.R. 3755 and S. 1975, the Women's Health Protection Act, regarding access to abortion care; Access to evidence-based medication abortion care; S. 1260, the Endless Frontier Act, regarding medical research Lee amendment #1891 to S.1260, regarding scientific research using fetal tissue

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

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

S. 346/H.R. 959, Black Maternal Health Momnibus Act of 2021, In support of maternal health and closing disparities in maternal health outcomes for women of color; S. 162/H.R. 666, Anti-Racism in Public Health Act of 2021, In support of strengthening anti-racist health policy; S. Res. 172/H. Res. 344, A resolution declaring racism a public health crisis, In support of declaring racism a public health crisis; H.R. 1475, Pursuing Equity in Mental Health Act, In support of additional resources and guidance to identify mental health, social-emotional, and behavioral health problems; S. 1948/H.R. 3673, National ACERT Grant Program Authorization Act, In support of strengthening and expanding the National ACERT Grant Program Authorization Act.

Client expense: $130,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2503, Social Determinants Accelerator Act of 2021, all provisions H. R. 379, Improving Social Determinants of Health Act of 2021, all provisions S. 104, Improving Social Determinants of Health Act of 2021, all provisions S. 509, Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act of 2021, all provisions H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, all provisions S. 610, Dr. Lorna Breen Health Care Provider Protection Act, all provisions H.R. 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 Act of 2021, all provisions S. 445, Mainstreaming Addiction Treatment (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. 1783, Accessible, Affordable Internet for All Act, all provisions S. 745, Accessible, Affordable Internet for All Act, 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. 4058, To amend title XVIII of the Social Security Act to ensure coverage of mental and behavioral health services furnished through telehealth, all provisions S. 2061, Telemental Health Care Access Act of 2021, 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 S. 987, CARA 3.0 Act of 2021, all provisions H.R. 925, Data to Save Moms Act, all provisions H.R. 2547, Comprehensive Debt Collection Improvement Act, all provisions H.R. 831, Health STATISTICS Act of 2021, all provisions S. 346, Black Maternal Health Momnibus Act of 2021, all provisions S. 253, Cannabidiol and Marihuana Research Expansion Act, all provisions Assistant Physician Parity Act Energy Employees Occupational Illness Compensation Act/physician assistants and nurse practitioners/telehealth flexibilities AMA Prior Authorization Physician Survey Telehealth Physician Practice Benchmark Survey Digital Therapeutics Digital Health/AI regulations Digital vaccine credential services Vaccine Hesitancy Vaccine distribution/vaccines in physician offices Fraud, waste, and abuse in telehealth Physician burnout and suicide issues Provider Relief Fund Health Equity/race corrections in clinical algorithms Health Equity/Black Men White Coats screenings Drug pricing Health Insurance Portability and Accountability Act (HIPAA)/Information Blocking Remote Patient Monitoring COVID-19 Coding Opioid use disorder 21st Century Cures Act Electronic Health Records (EHR) certification Data Privacy Nomination of Melanie Egorin to serve as HHS Assistant Secretary for Legislation Nomination of Andrea Palm for HHS Deputy Secretary Social Determinants of Health

Client expense: $4,220,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA), White House Office

Childcare Issues related to childcare - no specific bill COVID-19 Pandemic H.R. 1319, American Rescue Plan Act - including provisions on: Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response State and local funding Health disparities and protecting vulnerable populations Behavioral and mental health services Expanding internet connectivity Grant program for childcare Food assistance programs Small business loans/Paycheck Protection Program Reducing health care premiums for low- and middle-income families by increasing the Affordable Care Acts (ACA) premium tax credits for 2021 and 2022 The continuation of employer-based health coverage by subsidizing COBRA coverage through the end of the fiscal year. Health care subsidies for unemployed workers who are ineligible for COBRA. Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. General advocacy on COVID-19 relief: Financial assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Issues related to pandemic preparedness Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Mental and behavioral health H.R. 2418 Student Loan Forgiveness for Frontline Health Workers Act Pandemic Production Act (PPA) (no bill number) S. 54, Strengthening America's Health Care Readiness Act Gun Safety Making America Safe and Secure (MASS) Act (no bill number) Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill S.610/ H.R.1667 - the Dr. Lorna Breen Health Care Provider Protection Act Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 Healthcare Workforce Resilience Act Infrastructure Issues related to broadband access Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Maternal Health S. 411/ H.R. 3407, Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education - no specific bill Medicare/Medicaid H.R. 315, Medicare Sequester COVID Moratorium Act S. 748, Medicare Sequester Relief Act Issues related to Medicare physician payment H.R. 1587/ S. 1731 Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Opioids/ Substance Use Disorder Comprehensive Addiction Resources Emergency (CARE) Act (no bill number) Safer Prescribing of Controlled Substances Act (no bill number) LABEL Opioids Act (no bill number) Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act of 2020 Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill

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

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

Childcare Issues related to childcare - no specific bill COVID-19 Pandemic H.R. 1319, American Rescue Plan Act - including provisions on: Vaccines Testing, contact tracing, and mitigation Hiring additional public health workers to support COVID-19 response State and local funding Health disparities and protecting vulnerable populations Behavioral and mental health services Expanding internet connectivity Grant program for childcare Food assistance programs Small business loans/Paycheck Protection Program Reducing health care premiums for low- and middle-income families by increasing the Affordable Care Acts (ACA) premium tax credits for 2021 and 2022 The continuation of employer-based health coverage by subsidizing COBRA coverage through the end of the fiscal year. Health care subsidies for unemployed workers who are ineligible for COBRA. Incentives and federal funding to expand Medicaid and CHIP eligibility Allowing states to extend Medicaid and CHIP eligibility to women for 12 months postpartum. General advocacy on COVID-19 relief: Financial assistance for health care providers (Provider Relief Fund) Issues related to personal protective equipment (PPE) and medical supplies Issues related to pandemic preparedness Support for resident physicians and medical students Student loan forgiveness/debt relief Federal Medicaid Match State and local funding Demographic data collection Telemedicine/Telehealth Mental and behavioral health H.R. 2418 Student Loan Forgiveness for Frontline Health Workers Act Pandemic Production Act (PPA) (no bill number) S. 54, Strengthening America's Health Care Readiness Act Gun Safety Making America Safe and Secure (MASS) Act (no bill number) Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill S.610/ H.R.1667 - the Dr. Lorna Breen Health Care Provider Protection Act Immigration Issues related to Immigration - no specific bill S. 1024/H.R. 2255 Healthcare Workforce Resilience Act Infrastructure Issues related to broadband access Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Nutrition Issues related to nutrition and food security Racial Justice/Health Equity S. 162/H.R. 666 Anti-Racism in Public Health Act of 2021 Issues related to racial justice/health care equity Maternal Health S. 411/ H.R. 3407, Mothers and Offspring Mortality and Morbidity Awareness (MOMMA's) Act Medical Education Issues related to the affordability of medical education - no specific bill Medicare/Medicaid H.R. 315, Medicare Sequester COVID Moratorium Act S. 748, Medicare Sequester Relief Act Issues related to Medicare physician payment H.R. 1587/ S. 1731 Medicare Audiologist Access and Services Act of 2021 Issues related to Medicare/Medicaid - no specific bill Opioids/ Substance Use Disorder Comprehensive Addiction Resources Emergency (CARE) Act (no bill number) Safer Prescribing of Controlled Substances Act (no bill number) LABEL Opioids Act (no bill number) Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill Publications Open access to information based on publicly funded research Issues related to scholarly and scientific publishing and public access S.1260 - United States Innovation and Competition Act of 2021 Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act of 2020 Telehealth Issues related to telehealth Issues related to telebehavioral health access Issues related to physician licensing S. 368/H.R. 1332 Telehealth Modernization Act Vaccines Issues related to vaccines - no specific bill

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

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

Health Insurance Coverage (general); Health Disparities (general); Breastfeeding (general); Assisted Reproductive Technology (general); Smoking Cessation (general); Substance Use Disorder (general); Gynecologic Cancer (general); Gynecologic Devices (general); Reproductive Health (general); Intimate Partner Violence (general); Gun Violence (general); Immunization (general); Breast Cancer (general); Medical Liability Reform (general); Health IT (general); Patient-Physician Relationship (general); Child Welfare (general); Prematurity (general); Maternal Mortality and Morbidity (general); Graduate Medical Education (general); Contraception (general); Abortion (general); Indian Health (general); Teaching Health Centers Graduate Medical Education (general); Community Health Centers (general); National Health Service Corps (general); Health care workforce (general); Title VII Health Workforce Programs (general); Special Diabetes Program (general); Special Diabetes Program for Indians (general); Sexuality Education (general); Teen Pregnancy Prevention Program (general); Personal Responsibility Education Program (general); Sexually Transmitted Infections (general); Tobacco Cessation (general); Access and Provision of Medication-based Opioid Use Disorder Treatment (HHS); Research in Pregnant and Breastfeeding Women (general); Health Care Reform (general); Title X Family Planning Program (general); Womens Preventive Services (general); Administrative Burden (general); COVID-19 Response (general); Risk Evaluation and Mitigation Strategies (general); Data Collection (general); Health Equity (general); Pregnancy Risk Assessment Monitoring System (CDC); Provider Relief Fund (general); Maternal Mental Health (general); Violence Against Women Act (general); COVID-19 Vaccine (general); H.R. 3755/S. 1975, Womens Health Protection Act; H.R. _/S. _, VACCINES Act; implementation of P.L. 115-344, Preventing Maternal Deaths Act; implementation of P.L. 115-320, Improving Access to Maternity Care Act; H.R. 4387/S.1675, Maternal Health Quality Improvement Act; H.R. 959/ S. 346, the Black Maternal Health Momnibus Act of 2021; implementation of P.L. 116-123, the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020; implementation of P.L. 116-127, the Families First Coronavirus Response Act; implementation of P.L. 116-136, the Coronavirus Aid, Relief, and Economic Security Act; implementation of P.L. 116-139, Paycheck Protection Program and Health Care Enhancement Act; H.R. 3021 the Coronavirus Provider Protection Act; H.R. 1065/S. 1486, the Pregnant Workers Fairness Act; H.R. _/S._, the Maternal Health Pandemic Response Act; H.R.1667/S. 610, Lorna Breen Health Care Provider Protection Act; S, 176, Ensuring Understanding of COVID-19 to Protect Public Health Act; H.R. 736/S. 167, Community Immunity During COVID-19 Act; H.R. 1350/ S.408, Supporting Best Practices for Healthy Moms Act; H.R. 3407/S. 411; MOMMAs Act; H.R. 769/S.1491, Rural MOMS Act; Implementation of P.L. 117-2, the American Rescue Plan Act of 2021; H.R. 2216 /S.1063, the Jeanette Acosta Invest in Womens Health Act; H.R. 2007, Stephanie Tubbs Jones Uterine Fibroid Research and Education Act of 2021; H.R. 3110/S. 1658, PUMP for Nursing Mothers Act; H.R. 2903/S.1515, CONNECT for Health Act; H.R. 3671/S.1958, Doctors of Community (DOC) Act; H.Res.375, Supporting the goals and ideals of the month of May as Sex Ed For All Month: Equity and Access for All; Implementation of P.L. 114-255, the 21st Century Cures Act; Implementation of the No Surprises Act contained in P.L. 116-260, Consolidated Appropriations Act, 2021; S.Res.172/H.Res.344, a Resolution Declaring Racism a Public Health Crisis; H.R. 666/S. 162, the Anti-Racism in Public Health Act; S. 1234/H.R. 2556, the Maternal CARE Act; S. 1333, the MOMS Act; S. 198/H.R. 1218, the Data Mapping to Save Moms Lives Act; H.R. 1439, Expanded Genetic Screening Act of 2021; S. 1622, the HEALTH for MOM Act of 2021; H.R. 482/S. 350, Newborn Screening Saves Lives Reauthorization Act; H.R. 5/S. 393, Equality Act

Client expense: $167,084 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Indian Health Service, Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), U.S. Agency for International Development (USAID), Veterans Affairs, Dept of (VA), White House Office

COVID-19 data collection and reporting, Centers for Disease Control and Prevention's Data Modernization Initiative, and proposals that address health disparities and inequities in the healthcare system, including the Anti-Racism in Public Health Act (H.R. 666 / S.162) and Equitable Data Collection and Disclosure on COVID-19 Act (H.R. 1370 / S.512).

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE