COVID Supplemental Appropriations Act, 2022

H.R. 8800, Supporting Medicare Providers Act of 2022; Issues related to physician payment cuts, including APM bonuses; Inflation Reduction Act of 2022 - Part B drug negotiation and impact on physician reimbursement; H.R. 2617, Consolidated Appropriations Act, 2023 - increasing Medicare Physician Fee Schedule payments and extending all Medicare telehealth flexibilities extended in the Consolidated Appropriations Act of 2022 through December 31, 2024; Health disparities; Issues related to the Public Health Emergency; S. 368/H.R. 1332, Telehealth Modernization Act; H.R. 7007, COVID Supplemental Appropriations Act, 2022; Issues related to the implementation of the No Surprises Act; H.R. 2163/S. 464, Safe Step Act of 2021; S. 4293, Pharmacy Benefit Manager Transparency Act of 2022

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Inflation Reduction Act of 2022 (PL 117-169) - extending enhanced premium assistance for ACA marketplace plans through 2025; H.R. 2617, Consolidated Appropriations Act, 2023 - extending all Medicare telehealth flexibilities extended in the Consolidated Appropriations Act of 2022 through December 31, 2024 and possible changes to Medicare provider directory policies; Committee Print 117-1 - Improvements to Medicare Inpatient and Outpatient Mental Health Services (H.R. 8879, Inpatient Psychiatric Facility Improvement Act; H.R. 8878, To amend title XVIII of the Social Security Act to ensure adequate coverage of outpatient mental health services under the Medicare program); Committee Print 117-2 - Improvements to the Medicare Program Related to Physician Services and Education (H.R. 432, Mental Health Access Improvement Act of 2021; H.R. 8910, Behavioral Health Integration Awareness Act of 2022; H.R. 8884, To direct the Secretary of Health and Human Services to provide outreach and reporting on opioid use disorder treatment services furnished by opioid treatment programs under the Medicare program; H.R. 8890, Physician Wellness Program Act of 2022; H.R. 8908, Fighting Stimulant and other Substance Use Disorders Act); Committee Print 117-3 - Requiring Coverage of Forensic Medical Exams with No Cost Sharing (H.R. 8891, No Surprises for Survivors Act of 2022); Committee Print 117-4 - Improved Information in Provider Directories, Plan Definitions and Crisis Services for Private Insurance Plans (H.R. 8885, Better Health Care Directories Act; H.R. 8886, Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act; 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); Committee Print 117-5 - Improved Information for Network Coverage and Plan Documents in Private Insurance Plans (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; H.R. 8889, Readable Insurance Coverage Explanations Act (RICE Act)); Telehealth issues related to COVID-19; S. 150/H.R. 2166, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; HELP Committee bipartisan efforts to improve public health and medical preparedness/response programs; Over the Counter Covid Testing Guidance; Test to Treat Initiative; Issues related to the implementation of the No Surprises Act; S. 3799, PREVENT Pandemics Act; S. 3700/H.R. 6833, Affordable Insulin Now Act; Issues related to the Senate Finance report on mental health and mental health legislation; Senate Finance Committee bipartisan Discussion Draft: Ensuring Access to Telemental Health Services; Senate Finance Committee bipartisan Discussion Draft: Improving Access to Physical and Mental Health Care for Children and Youth under Medicaid and CHIP; Senate Finance Committee bipartisan Discussion Draft: Mental Health Workforce; Bipartisan Safer Communities Act, P.L. 117-159, specifically policy related to access to mental health services for youth and families through Medicaid and CHIP and telehealth; H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022; Issues related to FDA user fee reauthorization bills (H.R. 7667, Food and Drug Amendments of 2022; S. 4348, Food and Drug Administration Safety and Landmark Advancements Act of 2022 (FDSLA Act of 2022), including accelerated approval, reimportation, and orphan drugs; Issues related to the Public Health Emergency; H.R. 7007, COVID Supplemental Appropriations Act, 2022; S. 4293, Pharmacy Benefit Manager Transparency Act of 2022; Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act; Executive Order Directing HHS to Explore Additional Actions to Lower Prescription Drug Costs

Client expense: Not reported · Firm income: $80,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medical Economic Index (MEI) in the 2023 Physician Fee Schedule Rule; H.R. 8800, The Supporting Medicare Providers Act of 2022; Issues related to physician payment cuts, including APM bonuses; Telehealth issues related to COVID-19; Health disparities; H.R. 2617, Consolidated Appropriations Act, 2023 - increasing Medicare Physician Fee Schedule payments and extending all Medicare telehealth flexibilities extended in the Consolidated Appropriations Act of 2022 through December 31, 2024; Issues related to the implementation of the No Surprises Act; S. 3799, PREVENT Pandemics Act; S. 3700/H.R. 6833, Affordable Insulin Now Act; Issues related to the Senate Finance report on mental health and mental health legislation; Senate Finance Committee bipartisan Discussion Draft: Ensuring Access to Telemental Health Services; Senate Finance Committee bipartisan Discussion Draft: Improving Access to Physical and Mental Health Care for Children and Youth under Medicaid and CHIP; Senate Finance Committe bipartisan Discussion Draft: Mental Health Workforce H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022; Committee Print 117-1 - Improvements to Medicare Inpatient and Outpatient Mental Health Services (H.R. 8879, Inpatient Psychiatric Facility Improvement Act; H.R. 8878, To amend title XVIII of the Social Security Act to ensure adequate coverage of outpatient mental health services under the Medicare program); Committee Print 117-2 - Improvements to the Medicare Program Related to Physician Services and Education (H.R. 432, Mental Health Access Improvement Act of 2021; H.R. 8910, Behavioral Health Integration Awareness Act of 2022; H.R. 8884, To direct the Secretary of Health and Human Services to provide outreach and reporting on opioid use disorder treatment services furnished by opioid treatment programs under the Medicare program; H.R. 8890, Physician Wellness Program Act of 2022; H.R. 8908, Fighting Stimulant and other Substance Use Disorders Act); Committee Print 117-3 - Requiring Coverage of Forensic Medical Exams with No Cost Sharing (H.R. 8891, No Surprises for Survivors Act of 2022); Committee Print 117-4 - Improved Information in Provider Directories, Plan Definitions and Crisis Services for Private Insurance Plans (H.R. 8885, Better Health Care Directories Act; H.R. 8886, Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act; 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); Committee Print 117-5 - Improved Information for Network Coverage and Plan Documents in Private Insurance Plans (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; H.R. 8889, Readable Insurance Coverage Explanations Act (RICE Act)); Issues related to reauthorization of FDA user fee bills (H.R. 7667, Food and Drug Amendments of 2022; S. 4348 Food and Drug Administration Safety and Landmark Advancements Act of 2022 (FDSLA Act of 2022)); Issues related to the Public Health Emergency; S. 368/H.R. 1332, Telehealth Modernization Act; H.R. 7007, COVID Supplemental Appropriations Act, 2022; Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act; H.R.6087, Improving Access to Workers Compensation for Injured Federal Workers Act; Issues related to medical student federal loan forgiveness; Executive Order Directing HHS to Explore Additional Actions to Lower Prescription Drug Costs

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Departments of Labor, Health and Human Services, Education and Related Agencies Appropriations for Fiscal Year (FY) 2023 (H.R. 8295): Provisions pertaining to appropriations for the Social Security Administrations (SSA) operating budget including support for the funding level requested by the SSA to the Office of Management and Budget (OMB), support for the Presidents funding level, restoration of statement mailings to all workers, providing sufficient funds for field offices, concerns regarding SSA administering the paid family leave program and prohibition of funding for implementation of SSA regulations regarding the use of Administrative Appeals Judges in the hearing process, Older Americans Act programs, State Health Insurance Assistance Program funding, the Community Service Employment Program, the Social Services Block Grant, the Community Services Block Grant, and the Low-Income Home Energy Assistance Program. Consolidated Appropriations Act, 2023 (H.R. 2617, Public Law 117-73): Pertaining to Division H, Title IV: Social Security Administration - Limitation on Administrative Expenses; Division T: Security 2.0 Act of 2022: Expansion of Savers Credit, provision of paper benefit statements, expansion of eligibility for retirement plan participation for part-time workers, establishment of a Retirement Savings Lost Plan Registry. Pertaining to Division H, Title II: Provisions to fund Older Americans Act programs, the State Health Insurance Assistance Program, the Social Services Block Grant, the Community Services Block Grant and the Low-Income Home Energy Assistance Program. Pertaining to Division FF: Proposals for supplemental appropriations to respond to the ongoing COVID-19 pandemic; proposals to extend Money Follows the Person, a Medicaid program that funds states to allow seniors to stay in their homes, and to extend spousal protection programs for home and community-based services. Proposals to extend COVID telehealth flexibilities; proposals to authorize Medicare Part B coverage of Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs), improving access to clinical social worker services, and establishing coverage of intensive outpatient (IOP) services. Bipartisan COVID Supplemental Appropriations Act, 2022: the Coronavirus Supplemental Appropriations Act (H.R. 7007): Proposals for supplemental appropriations to respond to the ongoing COVID-19 pandemic.

Client expense: Not reported · Firm income: $37,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of

Issues related to drug pricing; implementation of H.R.5376, Inflation Reduction Act of 2022 (P.L.117-169). Issues related to COVID-19 response including vaccines and anti-viral therapies; H.R.7007, COVID Supplemental Appropriations Act, 2022. Issues related to the FY2023 Appropriations Process. Issues related to drug supply chain; H.R.3927/S.2082, MADE in America Act. Issues related to PDUFA Reauthorization; H.R.7667, Food and Drug Amendments of 2022; S.4348, FDASLA Act of 2022. 340B drug discount program policy issues. Antimicrobial Resistance; H.R.3932, PASTEUR Act. Discussions regarding health package in Year-End Omnibus; H.R.2617, Consolidated Appropriations Act, 2023.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Departments of Labor, Health and Human Services, Education and Related Agencies Appropriations for Fiscal Year (FY) 2023 (H.R. 8295): Provisions pertaining to appropriations for the Social Security Administrations (SSA) operating budget including support for the funding level requested by the SSA to the Office of Management and Budget (OMB), support for the Presidents funding level, restoration of statement mailings to all workers, providing sufficient funds for field offices, concerns regarding SSA administering the paid family leave program and prohibition of funding for implementation of SSA regulations regarding the use of Administrative Appeals Judges in the hearing process, Older Americans Act programs, State Health Insurance Assistance Program funding, the Community Service Employment Program, the Social Services Block Grant, the Community Services Block Grant, and the Low-Income Home Energy Assistance Program. Consolidated Appropriations Act, 2023 (H.R. 2617, Public Law 117-73): Pertaining to Division H, Title IV: Social Security Administration - Limitation on Administrative Expenses; Division T: Security 2.0 Act of 2022: Expansion of Savers Credit, provision of paper benefit statements, expansion of eligibility for retirement plan participation for part-time workers, establishment of a Retirement Savings Lost Plan Registry. Pertaining to Division H, Title II: Provisions to fund Older Americans Act programs, the State Health Insurance Assistance Program, the Social Services Block Grant, the Community Services Block Grant and the Low-Income Home Energy Assistance Program. Pertaining to Division FF: Proposals for supplemental appropriations to respond to the ongoing COVID-19 pandemic; proposals to extend Money Follows the Person, a Medicaid program that funds states to allow seniors to stay in their homes, and to extend spousal protection programs for home and community-based services. Proposals to extend COVID telehealth flexibilities; proposals to authorize Medicare Part B coverage of Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs), improving access to clinical social worker services, and establishing coverage of intensive outpatient (IOP) services. Bipartisan COVID Supplemental Appropriations Act, 2022: the Coronavirus Supplemental Appropriations Act (H.R. 7007): Proposals for supplemental appropriations to respond to the ongoing COVID-19 pandemic.

Client expense: $190,000 · Firm income: Not reported

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

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

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

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

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

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

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

H.R. 7007 - COVID Supplemental Appropriations Act of 2022; H.R.5376 - Inflation Reduction Act; H.R.6833

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Affordable prescription drugs; 340B Drug pricing program; Health care privacy; Patient privacy issues; Issues related to the American Rescue Plan Act, PL 117-2; Issues related to expanding health care coverage, including in non-Medicaid expansion states; Issues related to improving social determinants of health; Issues related to extending and expanding flexibilities for virtual care; Financial support for providers for diagnosis and treatment related to COVID-19, coverage of COVID-19 related conditions, access to PPE and other materials and equipment related to the treatment of patients with COVID-19, including funding for the Provider Relief Fund; Issues related to affordable health care coverage; H.R. 2228 - Rural Behavioral Health Access Act; Issues related to drug pricing; Issues related to Bipartisan Infrastructure Framework; Issues related to telehealth; Efforts to extend Medicare sequester delay, including H.R.1868; Issues related to Medicare policy on virtual care; Issues related to vaccine mandates; S. 168/H.R. 708 - Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act; S. 346/H.R. 959 - Black Maternal Health Momnibus Act; S. 773/H.R. 3203 - Legislation related to 340B eligibility; S. 834/H.R. 2256 - Resident Physician Shortage Reduction Act; S. 834/H.R. 2256 - Healthcare Workforce Resilience Act; S. 368/H.R. 1332 - Telehealth Modernization Act ; S. 1512/H.R. 2903 - CONNECT for Health Act; S. 1988 - Protecting Rural Telehealth Access Act; H.R. 3 - Elijah E. Cummings Lower Drug Costs Now Act; S.773/H.R. 3203 - A bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; H.R. 4943 - Childrens Mental Health Infrastructure Act; H.R. 4944 - Helping Kids Cope Act; H.R. 5376 - Build Back Better Act; H.R. 1667 - Dr. Lorna Breen Health Care Provider Protection Act; Issues related to workforce retention; H.R. 2471 - Consolidated Appropriations Act (FY 2022 Omnibus); H.R. 7007 - Covid-19 Supplemental Appropriations Act; H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act; issues related to the Acute Hospital Care at Home (AHCAH) waiver; H.R. 4407/S. 1568 - Technical Reset to Advance the Instruction of Nurses (TRAIN) Act; S. 3493 - Telehealth Extension and Evaluation Act; H.R. 6202 - Telehealth Extension Act; H.R. 5376 - Inflation Reduction Act (Public Law 117-169); H.R. 6833 - Continuing Resolution; Issues related to adequate financing for hospitals and providers; H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act; Issues related to extending the Medicare Dependent Hospital and Low Volume Hospital programs; Issues related to extending bonus payments for Advanced Alternative Payment models; H.R. 4587 - Value in Health Care Act; Issues related to coding and coverage of spiritual care through chaplain services; Issues related to value-based care programs, including the Bundled Payments for Care Improvement (BPCI) Advanced Model

Client expense: $660,000 · Firm income: Not reported

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

Issues related to Medicare and Medicaid coverage and Medicaid disproportionate share program; Financial support for providers for diagnosis and treatment related to COVID-19; coverage of COVID-19 related conditions; access to PPE and other materials and equipment related to the treatment of patients with COVID-19, including funding for the Provider Relief Fund; PL 117-2; Issues related to Bipartisan Infrastructure Framework; Issues related to telehealth; Efforts to extend Medicare sequester delay, including H.R.1868; Issues related to Medicare policy on virtual care; Childrens Health Graduate Medical Education; issues related to drug pricing; Issues related to hospital DSH eligibility; Issues related to Home and Community Based Services (HCBS); Medicaid waiver-related issues; Childrens transplant program issues; S. 346/H.R. 959 - Black Maternal Health Momnibus Act; S.773/H.R. 3203 - legislation to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; S. 834/H.R. 2256 - Resident Physician Shortage Reduction Act; S. 1024/H.R. 2255 - Healthcare Workforce Resilience Act; S. 368/H.R. 1332 - Telehealth Modernization Act; S. 1512/H.R. 2903 - CONNECT for Health Act ; S. 1988 - Protecting Rural Telehealth Access Act; H.R. 3 - Elijah E. Cummings Lower Drug Costs Now Act; H.R. 5376 - Build Back Better Act; Efforts to delay statutory PAYGO payment reductions; Efforts to offset physician payment reductions; Efforts to improve hospital reimbursement; Issues related to cuts to Medicaid DSH; Issues related to cuts to uncompensated care pools; Issues related to hospital at home programs; H.R. 2471 - Consolidated Appropriations Act (FY 2022 Omnibus); H.R. 7007 - Covid-19 Supplemental Appropriations Act; H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act; issues related to the Acute Hospital Care at Home (AHCAH) waiver; S. 3493 - Telehealth Extension and Evaluation Act; H.R. 6202 - Telehealth Extension Act; H.R. 5376 - Inflation Reduction Act (Public Law 117-169); H.R. 6833 - Continuing Resolution; Issues related to adequate financing for hospitals and providers; H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act; Issues related to extending the Medicare Dependent Hospital and Low Volume Hospital programs; Issues related to extending bonus payments for Advanced Alternative Payment models; H.R. 4587 - Value in Health Care Act; Issues related to coding and coverage of spiritual care through chaplain services; Issues related to value-based care programs, including the Bundled Payments for Care Improvement (BPCI) Advanced Model

Client expense: $660,000 · Firm income: Not reported

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

340B Drug Pricing Program; Issues related to 340B contract pharmacies; Financial support for providers for diagnosis and treatment related to COVID-19, including funding for the Provider Relief Fund; coverage of COVID-19 related conditions; S. 168/H.R. 708 - Temporary; Reciprocity to Ensure Access to Treatment (TREAT) Act; S. 346/H.R. 959 - Black Maternal Health Momnibus Act; S. 773/H.R. 3203 - Legislation related to 340B eligibility; S. 368/H.R. 1332 - Telehealth Modernization Act; S. 1512/H.R. 2903 - CONNECT for Health Act; S. 1988 -Protecting Rural Telehealth Access Act; H.R. 3 - Elijah E. Cummings Lower Drug Costs Now Act; S.773/H.R. 3203 - A bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; - S.773/H.R. 3203; H.R. 5376 - Build Back Better Act; H.R. 853 - Closing Loopholes for Orphan Drugs Act; H.R. 2471 - Consolidated Appropriations Act (FY 2022 Omnibus); H.R. 7007 - Covid-19 Supplemental Appropriations Act; H.R. 5376 - Inflation Reduction Act (Public Law 117-169); H.R. 6833 - Continuing Resolution

Client expense: $660,000 · 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

Funding for HRSA Uninsured Fund. H.R. 7007 - COVID-19 Supplemental Appropriations Act of 2022.

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

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

Issue: Support unique mission of academic medicine. P.L. 117-180, Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023 Issues: Support temporary extension of federal funding levels. Support supplemental funding for COVID-19 and Monkeypox response efforts, including testing. Oppose inclusion of policies that would increase burdensome regulations and negatively impact patients access to care by allowing Food and Drug Administration regulation of the development of Laboratory Developed Tests at academic medical centers. Presidents FY 2023 Budget Request H.R. 8295, S. 4659, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2023 Issues: Support increased funding for National Institutes of Health (NIH), Agency for Healthcare Research and Quality (AHRQ), Childrens Hospitals Graduate Medical Education (CHGME), Centers for Disease Control and Prevention (CDC), Hospital Preparedness Program, and biodefense, emerging special pathogens and public health preparedness programs. Support mandatory funding for public health preparedness. Oppose limitations on facilities and administrative reimbursement and on salary support. Maintain NIH salary cap at Executive Level II. Support animal research and oppose efforts to increase burden on researchers unnecessarily. Ensure investment in Advanced Research Projects Agency for Health does not supplant NIH funding. Oppose arbitrary restrictions on specific types and sites of research. Support funding for Health Resources and Services Administration (HRSA) workforce programs. Support funding for CDC Racial and Ethnic Approaches to Community Health program (REACH), Prevention Research Centers, hospital-based and community violence interventions, data modernization, outbreak forecasting, and climate and health, and for research on gun violence. Support funding for Department of Education and federal student aid. Support funding to combat opioid epidemic. Support ongoing investment in public health infrastructure. Support funding for maternal health and mortality improvement initiatives. Support expansion of CDC-supported genomic sequencing. Support increased funding for Telehealth Resource Centers. Issue: Support investment in nondefense discretionary spending, including ample funding allocations for Labor-HHS-Education. Presidents FY 2023 Budget Request H.R. 8256, S. 4664, Commerce, Justice, Science, and Related Agencies Appropriations Act, 2023 Issues: Support funding for the National Science Foundation (NSF) Presidents FY 2023 Budget Request H.R. 8238, S. 4759, Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2023 Issues: Support funding for Veterans Affairs medical research, research infrastructure, information technology, and community care. Oppose restrictions on use of canines in VA medical research. Oppose VA research funding rescissions. Support removing VA health funding from discretionary caps. P.L. 117-2, American Rescue Plan Issue: Encourage agencies to implement funding relief for federal research agencies, new COVID-19 research, funding for data science, CDC-supported genomic sequencing, public health data modernization, investment in public health infrastructure, testing, contact tracing, vaccine development and distribution. Support funding for provider relief fund. Support supplemental funding for HRSA workforce programs and programs addressing the mental health and well-being of health care providers. Support funding for increased FMAP for new states to expand Medicaid. Support funding for COBRA premium assistance. Support expanded subsidies in the ACA marketplaces. Support extension of postpartum Medicaid and CHIP coverage for 12 months. Support extension of Medicare sequester. P.L. 117-169, Inflation Reduction Act of 2022 Issue: Support funding for pandemic resilience, funding for research and development, and VA hospital infrastructure. Support increased Medicare and VA support for physician training and the physician workforce. Support maximum funding for public health and health care preparedness. Support funding for research infrastructure and research recovery. Support funding for broadband access and other physical infrastructure. Support funding for capital projects at hospitals to enhance preparedness and expand ICU capacity. Support funding for grants between public health departments and academic medical centers. Support funding for Teaching Health Center Graduate Medical Education and Childrens Hospital Graduate Medical Education. Support funding for maternal health. Support policies allowing teaching hospitals, medical schools, and other non-profit or public entities to access sustainable infrastructure investments. Support policies to reduce prescription drug prices H.R.7007, Making emergency supplemental appropriations for coronavirus response and relief for the fiscal year ending September 30, 2022, and for other purposes. Draft Senate Supplemental Administration's emergency supplemental funding request to address COVID. Issue: Support emergency funding for HHS to address COVID.

Client expense: $912,077 · 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), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Economic Council (NEC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE, Veterans Affairs, Dept of (VA), White House Office

Issues related to the implementation of the Inflation Reduction Act of 2022, PL 117-169; Issues related to the Continuing Resolution, H.R.6833; Issues related to reauthorization of FDA user fee bills (H.R. 7667, Food and Drug Amendments of 2022; S. 4348, Food and Drug Administration Safety and Landmark Advancements Act of 2022 (FDSLA Act of 2022)), including accelerated approval and reimportation; Issues related to the Public Health Emergency; Issues related to COVID-19 vaccines, manufacturing, and distribution; H.R. 7007, COVID Supplemental Appropriations Act, 2022; Consolidated Appropriations Act, 2022 (PL 117-103); S. 3799, PREVENT Pandemics Act; H.R. 5585, The Advanced Research Project Agency-Health (ARPA-H) Act; Issues related to the FY 2023 President's Budget; H.R. 6007, To amend title XVIII of the Social Security Act to provide for the expansion of coverage of vaccines under part B of the Medicare program, and for other purposes

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Discussions related to genomics, sequencing and the applications for sequencing including in rare disease and related reimbursement; S. 2022, Ending the Diagnostic Odyssey Act; H.R. 6000, Cures 2.0 Act; Ongoing monitoring of CDC surveillance funding; Chips and Science Act (PL 117-167); H.R. 791/S. 236, Tracking COVID-19 Variants Act; H.R. 5376, Inflation Reduction Act of 2022; H.R. 5585, Advanced Research Project Agency-Health (ARPA-H) Act; S. 3819, Advanced Research Project Authority for Health (ARPA-H) Act; Issues related to the White House Cancer Moonshot initiative; H.R. 7007, COVID Supplemental Appropriations Act, 2022; S. 3799, PREVENT Pandemics Act; Issues related to the FY 2023 President's Budget; S.3534/H.R.7152, Tracking Pathogens Act; Issues related to reauthorization of FDA user fee bills (H.R. 7667, Food and Drug Amendments of 2022; S. 4348 Food and Drug Administration Safety and Landmark Advancements Act of 2022 (FDSLA Act of 2022)), including H.R. 4281/S. 2209, VALID Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to program integrity, health insurance, Medicare, Medicaid, population health; Issues related to H.R. 5376, Inflation Reduction Act of 2022 (now PL 117-169) and implementation; S.3799, PREVENT Pandemics Act, with specific focus on Section 213 (public health data availability and access; S. 3700/H.R. 6833, Affordable Insulin Now Act; Issues related to the Senate Finance report on mental health and mental health legislation; Senate Finance Committee bipartisan Discussion Draft: Ensuring Access to Telemental Health Services; Senate Finance Committee bipartisan Discussion Draft: Improving Access to Physical and Mental Health Care for Children and Youth under Medicaid and CHIP; Bipartisan Safer Communities Act, P.L. 117-159, specifically policy related to access to mental health services for youth and families through Medicaid and CHIP and telehealth; H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022; Issues related to reauthorization of FDA user fee bills (H.R.7667, Food and Drug Amendments of 2022; S.4348 Food and Drug Administration Safety and Landmark Advancements Act of 2022 (FDSLA Act of 2022)); Issues related to the Public Health Emergency; H.R. 550, Immunization Infrastructure Modernization Act; H.R. 6000, Cures 2.0 Act; Issues related to modernizing Immunization Information Systems (IIS); H.R. 7007, COVID Supplemental Appropriations Act, 2022; Issues related to the FY 2023 Presidents Budget

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 8800, Supporting Medicare Providers Act of 2022; Issues related to physician payment cuts, including APM bonuses; Issues related to H.R. 5376, Inflation Reduction Act of 2022 (now PL 117-169) and implementation; Issues related to the Continuing Resolution, H.R.6833; Health disparities; Issues related to the Public Health Emergency; S. 368/H.R. 1332, Telehealth Modernization Act; H.R. 7007, COVID Supplemental Appropriations Act, 2022; Issues related to the implementation of the No Surprises Act; Issues related to the FY 2023 President's Budget; H.R. 2163/S. 464, Safe Step Act of 2021; S. 4293, Pharmacy Benefit Manager Transparency Act of 2022

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to H.R. 5376, Inflation Reduction Act of 2022 (now PL 117-169) and implementation; Issues related to H.R. 6833, the Continuing Resolution; Committee Print 117-1 - Improvements to Medicare Inpatient and Outpatient Mental Health Services (H.R. 8879, Inpatient Psychiatric Facility Improvement Act; H.R. 8878, To amend title XVIII of the Social Security Act to ensure adequate coverage of outpatient mental health services under the Medicare program); Committee Print 117-2 - Improvements to the Medicare Program Related to Physician Services and Education (H.R. 432, Mental Health Access Improvement Act of 2021; H.R. 8910, Behavioral Health Integration Awareness Act of 2022; H.R. 8884, To direct the Secretary of Health and Human Services to provide outreach and reporting on opioid use disorder treatment services furnished by opioid treatment programs under the Medicare program; H.R. 8890, Physician Wellness Program Act of 2022; H.R. 8908, Fighting Stimulant and other Substance Use Disorders Act); Committee Print 117-3 - Requiring Coverage of Forensic Medical Exams with No Cost Sharing (H.R. 8891, No Surprises for Survivors Act of 2022); Committee Print 117-4 - Improved Information in Provider Directories, Plan Definitions and Crisis Services for Private Insurance Plans (H.R. 8885, Better Health Care Directories Act; H.R. 8886, Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act; 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); Committee Print 117-5 - Improved Information for Network Coverage and Plan Documents in Private Insurance Plans (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; H.R. 8889, Readable Insurance Coverage Explanations Act (RICE Act)); Telehealth issues related to COVID-19; S. 150/H.R. 2166, Ensuring Parity in MA for Audio-Only Telehealth Act of 2021; HELP Committee bipartisan efforts to improve public health and medical preparedness/response programs; Over the Counter Covid Testing Guidance; Test to Treat Initiative; Issues related to the implementation of the No Surprises Act; S. 3799, PREVENT Pandemics Act; S. 3700/H.R. 6833, Affordable Insulin Now Act; Issues related to the Senate Finance report on mental health and mental health legislation; Senate Finance Committee bipartisan Discussion Draft: Ensuring Access to Telemental Health Services; Senate Finance Committee bipartisan Discussion Draft: Improving Access to Physical and Mental Health Care for Children and Youth under Medicaid and CHIP; Senate Finance Committee bipartisan Discussion Draft: Mental Health Workforce; Bipartisan Safer Communities Act, P.L. 117-159, specifically policy related to access to mental health services for youth and families through Medicaid and CHIP and telehealth; H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022; Issues related to FDA user fee reauthorization bills (H.R. 7667, Food and Drug Amendments of 2022; S. 4348, Food and Drug Administration Safety and Landmark Advancements Act of 2022 (FDSLA Act of 2022), including accelerated approval, reimportation, and orphan drugs; Issues related to the Public Health Emergency; H.R. 7007, COVID Supplemental Appropriations Act, 2022; Issues related to the FY 2023 President's Budget; S. 4293, Pharmacy Benefit Manager Transparency Act of 2022; Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act

Client expense: Not reported · Firm income: $80,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medical Economic Index (MEI) in the 2023 Physician Fee Schedule Rule; H.R. 8800, The Supporting Medicare Providers Act of 2022; Issues related to physician payment cuts, including APM bonuses; Telehealth issues related to COVID-19; Health disparities; Issues related to H.R. 5376, Inflation Reduction Act of 2022 (now PL 117-169) and implementation; Issues related to the Continuing Resolution, H.R.6833; Issues related to the implementation of the No Surprises Act; S. 3799, PREVENT Pandemics Act; S. 3700/H.R. 6833, Affordable Insulin Now Act; Issues related to the Senate Finance report on mental health and mental health legislation; Senate Finance Committee bipartisan Discussion Draft: Ensuring Access to Telemental Health Services; Senate Finance Committee bipartisan Discussion Draft: Improving Access to Physical and Mental Health Care for Children and Youth under Medicaid and CHIP; Senate Finance Committe bipartisan Discussion Draft: Mental Health Workforce H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022; Committee Print 117-1 - Improvements to Medicare Inpatient and Outpatient Mental Health Services (H.R. 8879, Inpatient Psychiatric Facility Improvement Act; H.R. 8878, To amend title XVIII of the Social Security Act to ensure adequate coverage of outpatient mental health services under the Medicare program); Committee Print 117-2 - Improvements to the Medicare Program Related to Physician Services and Education (H.R. 432, Mental Health Access Improvement Act of 2021; H.R. 8910, Behavioral Health Integration Awareness Act of 2022; H.R. 8884, To direct the Secretary of Health and Human Services to provide outreach and reporting on opioid use disorder treatment services furnished by opioid treatment programs under the Medicare program; H.R. 8890, Physician Wellness Program Act of 2022; H.R. 8908, Fighting Stimulant and other Substance Use Disorders Act); Committee Print 117-3 - Requiring Coverage of Forensic Medical Exams with No Cost Sharing (H.R. 8891, No Surprises for Survivors Act of 2022); Committee Print 117-4 - Improved Information in Provider Directories, Plan Definitions and Crisis Services for Private Insurance Plans (H.R. 8885, Better Health Care Directories Act; H.R. 8886, Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act; 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); Committee Print 117-5 - Improved Information for Network Coverage and Plan Documents in Private Insurance Plans (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; H.R. 8889, Readable Insurance Coverage Explanations Act (RICE Act)); Issues related to reauthorization of FDA user fee bills (H.R. 7667, Food and Drug Amendments of 2022; S. 4348 Food and Drug Administration Safety and Landmark Advancements Act of 2022 (FDSLA Act of 2022)); Issues related to the Public Health Emergency; S. 368/H.R. 1332, Telehealth Modernization Act; H.R. 7007, COVID Supplemental Appropriations Act, 2022; Issues related to the FY 2023 President's Budget; Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act; H.R.6087, Improving Access to Workers Compensation for Injured Federal Workers Act; Issues related to medical student federal loan forgiveness

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

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

Issues related to drug pricing; H.R.5376, Inflation Reduction Act of 2022 (P.L.117-169). Issues related to COVID-19 response including vaccines and anti-viral therapies; H.R.7007, COVID Supplemental Appropriations Act, 2022. Issues related to the FY2023 Appropriations Process. Issues related to drug supply chain; H.R.3927/S.2082, MADE in America Act. Issues related to PDUFA Reauthorization; H.R.7667, Food and Drug Amendments of 2022; S.4348, FDASLA Act of 2022; H.R.6833, Making continuing appropriations for fiscal year 2023, and for other purposes (P.L.117-180). 340B drug discount program policy issues. Antimicrobial Resistance; H.R.3932, PASTEUR Act.

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

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

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

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

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

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

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

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

Departments of Labor, Health and Human Services, Education and Related Agencies Appropriations for Fiscal Year (FY) 2023 (H.R. 8295): Provisions pertaining to appropriations for the Social Security Administrations (SSA) operating budget including support for the funding level requested by the SSA to the Office of Management and Budget (OMB), support for the Presidents funding level, restoration of statement mailings to all workers, providing sufficient funds for field offices, concerns regarding SSA administering the paid family leave program and prohibition of funding for implementation of SSA regulations regarding the use of Administrative Appeals Judges in the hearing process, Older Americans Act programs, State Health Insurance Assistance Program funding, the Community Service Employment Program, and the Low-Income Home Energy Assistance Program. Making Continuing Appropriations for Fiscal Year 2023, and for other purposes (H.R. 6833, Public Law No: 117-180), Pertaining to Division A, Section 148: Social Security Administration - Limitation on Administrative Expenses. Budget: A concurrent resolution setting forth the congressional budget for the U.S. government for FY 2022 and setting forth appropriate budgetary levels for FY 2023-2031 (S. Con. Res 14): provisions pertaining to the debt limit, Social Security Income Restoration Act of 2021, and the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3): Legislation providing for reconciliation pursuant to Title II of S. Con. Res 14 (H.R. 5376 also known as the Build Back Better Act): Provisions relating to the Social Security Income Restoration Act of 2021, Paid Family and Medical Leave, expanding Medicare, drug pricing reform, and Medicaid expansion. Bipartisan COVID Supplemental Appropriations Act, 2022: the Coronavirus Supplemental Appropriations Act (H.R. 7007): Proposals for supplemental appropriations to respond to the ongoing COVID-19 pandemic.

Client expense: Not reported · Firm income: $23,000

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of

Departments of Labor, Health and Human Services, Education and Related Agencies Appropriations for Fiscal Year (FY) 2023 (H.R. 8295): Provisions pertaining to appropriations for the Social Security Administrations (SSA) operating budget including support for the funding level requested by the SSA to the Office of Management and Budget (OMB), support for the Presidents funding level, restoration of statement mailings to all workers, providing sufficient funds for field offices, concerns regarding SSA administering the paid family leave program and prohibition of funding for implementation of SSA regulations regarding the use of Administrative Appeals Judges in the hearing process, Older Americans Act programs, State Health Insurance Assistance Program funding, the Community Service Employment Program, and the Low-Income Home Energy Assistance Program. Making Continuing Appropriations for Fiscal Year 2023, and for other purposes (H.R. 6833, Public Law No: 117-180), Pertaining to Division A, Section 148: Social Security Administration - Limitation on Administrative Expenses. Budget: A concurrent resolution setting forth the congressional budget for the U.S. government for FY 2022 and setting forth appropriate budgetary levels for FY 2023-2031 (S. Con. Res 14): provisions pertaining to the debt limit, Social Security Income Restoration Act of 2021, and the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3): Legislation providing for reconciliation pursuant to Title II of S. Con. Res 14 (H.R. 5376 also known as the Build Back Better Act): Provisions relating to the Social Security Income Restoration Act of 2021, Paid Family and Medical Leave, expanding Medicare, drug pricing reform, and Medicaid expansion. Bipartisan COVID Supplemental Appropriations Act, 2022: the Coronavirus Supplemental Appropriations Act (H.R. 7007): Proposals for supplemental appropriations to respond to the ongoing COVID-19 pandemic.

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Treasury, Dept of

H.R. 7007 - COVID Supplemental Appropriations Act of 2022; H.R.5376 - Inflation Reduction Act; H.R.6833

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Regulation and oversight of clinical laboratories, including laboratory developed test services; commercial laboratory surge capacity issues for response to COVID-19 pandemic/epidemic/public health crises; HRSA COVID-19 Uninsured Test and Vaccine Fund; issues related to validation, deployment, and reimbursement for testing to address 2022 Monkeypox outbreak. VALID Act H.R. 4128/S. 2209, Food and Drug Administration Safety and Landmark Advancements Act S. 4348, Food and Drug Amendments of 2022 H.R. 7667, American Data Privacy and Protection Act H.R. 8152, COVID Supplemental Appropriations Act 2022 H.R. 7007, PREVENT Pandemics Act S. 3799.

Client expense: $516,655 · 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), SENATE, White House Office

Reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, COVID-19 test coverage and reimbursement, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); regulation and oversight of clinical laboratories, including laboratory developed test services; commercial laboratory surge capacity issues for response to COVID-19 pandemic/epidemic/public health crises; HRSA COVID-19 Uninsured Test and Vaccine Fund; impact of data privacy proposals on HIPAA compliance and laboratory operations; issues related to validation, deployment, and reimbursement for testing to address 2022 Monkeypox outbreak. Saving Access to Laboratory Services Act H.R. 8188/S. 4449, VALID Act H.R. 4128/S. 2209, Food and Drug Administration Safety and Landmark Advancements Act S. 4348, Food and Drug Amendments of 2022 H.R. 7667, American Data Privacy and Protection Act H.R. 8152, COVID Supplemental Appropriations Act 2022 H.R. 7007, Telehealth Extension and Evaluation Act S. 3593, PREVENT Pandemics Act S. 3799.

Client expense: $1,144,727 · 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), SENATE, White House Office

Regulation and oversight of clinical laboratories, including laboratory developed test services; commercial laboratory surge capacity issues for response to COVID-19 pandemic/epidemic/public health crises; HRSA COVID-19 Uninsured Test and Vaccine Fund; issues related to validation, deployment, and reimbursement for testing to address 2022 Monkeypox outbreak. VALID Act H.R. 4128/S. 2209, Food and Drug Administration Safety and Landmark Advancements Act S. 4348, Food and Drug Amendments of 2022 H.R. 7667, American Data Privacy and Protection Act H.R. 8152, COVID Supplemental Appropriations Act 2022 H.R. 7007, PREVENT Pandemics Act S. 3799.

Client expense: $1,144,727 · 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), SENATE, White House Office

Regulation and oversight of clinical laboratories, including laboratory developed test services; commercial laboratory surge capacity issues for response to COVID-19 pandemic/epidemic/public health crises; HRSA COVID-19 Uninsured Test and Vaccine Fund; issues related to validation, deployment, and reimbursement for testing to address 2022 Monkeypox outbreak. VALID Act H.R. 4128/S. 2209, Food and Drug Administration Safety and Landmark Advancements Act S. 4348, Food and Drug Amendments of 2022 H.R. 7667, American Data Privacy and Protection Act H.R. 8152, COVID Supplemental Appropriations Act 2022 H.R. 7007, PREVENT Pandemics Act S. 3799.

Client expense: $1,144,727 · Firm income: Not reported

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

Reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, COVID-19 test coverage and reimbursement, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); regulation and oversight of clinical laboratories, including laboratory developed test services; commercial laboratory surge capacity issues for response to COVID-19 pandemic/epidemic/public health crises; HRSA COVID-19 Uninsured Test and Vaccine Fund; impact of data privacy proposals on HIPAA compliance and laboratory operations; issues related to validation, deployment, and reimbursement for testing to address 2022 Monkeypox outbreak. Saving Access to Laboratory Services Act H.R. 8188/S. 4449, VALID Act H.R. 4128/S. 2209, Food and Drug Administration Safety and Landmark Advancements Act S. 4348, Food and Drug Amendments of 2022 H.R. 7667, American Data Privacy and Protection Act H.R. 8152, COVID Supplemental Appropriations Act 2022 H.R. 7007, Telehealth Extension and Evaluation Act S. 3593, PREVENT Pandemics Act S. 3799.

Client expense: $1,144,727 · 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), SENATE, White House Office

Regulation and oversight of clinical laboratories, including laboratory developed test services; commercial laboratory surge capacity issues for response to COVID-19 pandemic/epidemic/public health crises; HRSA COVID-19 Uninsured Test and Vaccine Fund; issues related to validation, deployment, and reimbursement for testing to address 2022 Monkeypox outbreak. VALID Act H.R. 4128/S. 2209, Food and Drug Administration Safety and Landmark Advancements Act S. 4348, Food and Drug Amendments of 2022 H.R. 7667, American Data Privacy and Protection Act H.R. 8152, COVID Supplemental Appropriations Act 2022 H.R. 7007, PREVENT Pandemics Act S. 3799.

Client expense: $1,144,727 · Firm income: Not reported

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

Reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, COVID-19 test coverage and reimbursement, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); regulation and oversight of clinical laboratories, including laboratory developed test services; commercial laboratory surge capacity issues for response to COVID-19 pandemic/epidemic/public health crises; HRSA COVID-19 Uninsured Test and Vaccine Fund; impact of data privacy proposals on HIPAA compliance and laboratory operations; issues related to validation, deployment, and reimbursement for testing to address 2022 Monkeypox outbreak. Saving Access to Laboratory Services Act H.R. 8188/S. 4449, VALID Act H.R. 4128/S. 2209, Food and Drug Administration Safety and Landmark Advancements Act S. 4348, Food and Drug Amendments of 2022 H.R. 7667, American Data Privacy and Protection Act H.R. 8152, COVID Supplemental Appropriations Act 2022 H.R. 7007, Telehealth Extension and Evaluation Act S. 3593, PREVENT Pandemics Act S. 3799.

Client expense: $1,144,727 · 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), SENATE, White House Office

Regulation and oversight of clinical laboratories, including laboratory developed test services; commercial laboratory surge capacity issues for response to COVID-19 pandemic/epidemic/public health crises; HRSA COVID-19 Uninsured Test and Vaccine Fund; issues related to validation, deployment, and reimbursement for testing to address 2022 Monkeypox outbreak. VALID Act H.R. 4128/S. 2209, Food and Drug Administration Safety and Landmark Advancements Act S. 4348, Food and Drug Amendments of 2022 H.R. 7667, American Data Privacy and Protection Act H.R. 8152, COVID Supplemental Appropriations Act 2022 H.R. 7007, PREVENT Pandemics Act S. 3799.

Client expense: $1,144,727 · 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), SENATE, White House Office

Reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, COVID-19 test coverage and reimbursement, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); regulation and oversight of clinical laboratories, including laboratory developed test services; commercial laboratory surge capacity issues for response to COVID-19 pandemic/epidemic/public health crises; HRSA COVID-19 Uninsured Test and Vaccine Fund; impact of data privacy proposals on HIPAA compliance and laboratory operations; issues related to validation, deployment, and reimbursement for testing to address 2022 Monkeypox outbreak. Saving Access to Laboratory Services Act H.R. 8188/S. 4449, VALID Act H.R. 4128/S. 2209, Food and Drug Administration Safety and Landmark Advancements Act S. 4348, Food and Drug Amendments of 2022 H.R. 7667, American Data Privacy and Protection Act H.R. 8152, COVID Supplemental Appropriations Act 2022 H.R. 7007, Telehealth Extension and Evaluation Act S. 3593, PREVENT Pandemics Act S. 3799.

Client expense: $1,144,727 · 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), SENATE, White House Office

Issue: Support unique mission of academic medicine. Presidents FY 2023 Budget Request H.R. 8295, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2023 Draft Senate Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2023 Issues: Support increased funding for National Institutes of Health (NIH), Agency for Healthcare Research and Quality (AHRQ), Childrens Hospitals Graduate Medical Education (CHGME), Centers for Disease Control and Prevention (CDC), Hospital Preparedness Program, and biodefense, emerging special pathogens and public health preparedness programs. Support mandatory funding for public health preparedness. Oppose limitations on facilities and administrative reimbursement and on salary support. Maintain NIH salary cap at Executive Level II. Support animal research and oppose efforts to increase burden on researchers unnecessarily. Ensure investment in Advanced Research Projects Agency for Health does not supplant NIH funding. Oppose arbitrary restrictions on specific types and sites of research. Support funding for Health Resources and Services Administration (HRSA) workforce programs. Support funding for CDC Racial and Ethnic Approaches to Community Health program (REACH), Prevention Research Centers, hospital-based and community violence interventions, data modernization, outbreak forecasting, and climate and health, and for research on gun violence. Support funding for Department of Education and federal student aid. Support funding to combat opioid epidemic. Support ongoing investment in public health infrastructure. Support funding for maternal health and mortality improvement initiatives. Support expansion of CDC-supported genomic sequencing. Support increased funding for Telehealth Resource Centers. Issue: Support investment in nondefense discretionary spending, including ample funding allocations for Labor-HHS-Education. Presidents FY 2023 Budget Request H.R. 8256, Commerce, Justice, Science, and Related Agencies Appropriations Act, 2023 Issues: Support funding for the National Science Foundation (NSF) Presidents FY 2023 Budget Request H.R. 8238, Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2023 Issues: Support funding for Veterans Affairs medical research, research infrastructure, information technology, and community care. Oppose restrictions on use of canines in VA medical research. Oppose VA research funding rescissions. Support removing VA health funding from discretionary caps. P.L. 117-2, American Rescue Plan Issue: Encourage agencies to implement funding relief for federal research agencies, new COVID-19 research, funding for data science, CDC-supported genomic sequencing, public health data modernization, investment in public health infrastructure, testing, contact tracing, vaccine development and distribution. Support funding for provider relief fund. Support supplemental funding for HRSA workforce programs and programs addressing the mental health and well-being of health care providers. Support funding for increased FMAP for new states to expand Medicaid. Support expanded subsidies in the ACA marketplaces. Support extension of postpartum Medicaid and CHIP coverage for 12 months. Support extension of Medicare sequester. H.R. 5376, Build Back Better Act Draft Senate Reconciliation Legislation Issue: Support funding for pandemic resilience, funding for research and development, and VA hospital infrastructure. Support increased Medicare and VA support for physician training and the physician workforce. Support maximum funding for public health and health care preparedness. Support funding for research infrastructure and research recovery. Support funding for broadband access and other physical infrastructure. Support funding for capital projects at hospitals to enhance preparedness and expand ICU capacity. Support funding for grants between public health departments and academic medical centers. Support funding for Teaching Health Center Graduate Medical Education and Childrens Hospital Graduate Medical Education. Support funding for maternal health. H.R.7007, Making emergency supplemental appropriations for coronavirus response and relief for the fiscal year ending September 30, 2022, and for other purposes. Draft Senate Supplemental Administration's emergency supplemental funding request to address COVID. Issue: Support emergency funding for HHS to address COVID.

Client expense: $1,090,000 · 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), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Economic Council (NEC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE, Veterans Affairs, Dept of (VA), White House Office

Reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, COVID-19 test coverage and reimbursement, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); regulation and oversight of clinical laboratories, including laboratory developed test services; commercial laboratory surge capacity issues for response to COVID-19 pandemic/epidemic/public health crises; HRSA COVID-19 Uninsured Test and Vaccine Fund; impact of data privacy proposals on HIPAA compliance and laboratory operations; issues related to validation, deployment, and reimbursement for testing to address 2022 Monkeypox outbreak. Saving Access to Laboratory Services Act H.R. 8188/S. 4449, VALID Act H.R. 4128/S. 2209, Food and Drug Administration Safety and Landmark Advancements Act S. 4348, Food and Drug Amendments of 2022 H.R. 7667, American Data Privacy and Protection Act H.R. 8152, COVID Supplemental Appropriations Act 2022 H.R. 7007, Telehealth Extension and Evaluation Act S. 3593, PREVENT Pandemics Act S. 3799.

Client expense: $1,144,727 · 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), SENATE, White House Office

Reimbursement and coverage issues for and related to clinical laboratory services, including the Medicare clinical laboratory fee schedule, physician fee schedule, new test coding and pricing, COVID-19 test coverage and reimbursement, and implementation of the Protecting Access to Medicare Act (P.L. 113-93); regulation and oversight of clinical laboratories, including laboratory developed test services; commercial laboratory surge capacity issues for response to COVID-19 pandemic/epidemic/public health crises; HRSA COVID-19 Uninsured Test and Vaccine Fund; impact of data privacy proposals on HIPAA compliance and laboratory operations; issues related to validation, deployment, and reimbursement for testing to address 2022 Monkeypox outbreak. Saving Access to Laboratory Services Act H.R. 8188/S. 4449, VALID Act H.R. 4128/S. 2209, Food and Drug Administration Safety and Landmark Advancements Act S. 4348, Food and Drug Amendments of 2022 H.R. 7667, American Data Privacy and Protection Act H.R. 8152, COVID Supplemental Appropriations Act 2022 H.R. 7007, Telehealth Extension and Evaluation Act S. 3593, PREVENT Pandemics Act S. 3799.

Client expense: $1,144,727 · 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), SENATE, White House Office

Regulation and oversight of clinical laboratories, including laboratory developed test services; commercial laboratory surge capacity issues for response to COVID-19 pandemic/epidemic/public health crises; HRSA COVID-19 Uninsured Test and Vaccine Fund; issues related to validation, deployment, and reimbursement for testing to address 2022 Monkeypox outbreak. VALID Act H.R. 4128/S. 2209, Food and Drug Administration Safety and Landmark Advancements Act S. 4348, Food and Drug Amendments of 2022 H.R. 7667, American Data Privacy and Protection Act H.R. 8152, COVID Supplemental Appropriations Act 2022 H.R. 7007, PREVENT Pandemics Act S. 3799.

Client expense: $1,144,727 · 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), SENATE, White House Office

Regulation and oversight of clinical laboratories, including laboratory developed test services; commercial laboratory surge capacity issues for response to COVID-19 pandemic/epidemic/public health crises; HRSA COVID-19 Uninsured Test and Vaccine Fund; issues related to validation, deployment, and reimbursement for testing to address 2022 Monkeypox outbreak. VALID Act H.R. 4128/S. 2209, Food and Drug Administration Safety and Landmark Advancements Act S. 4348, Food and Drug Amendments of 2022 H.R. 7667, American Data Privacy and Protection Act H.R. 8152, COVID Supplemental Appropriations Act 2022 H.R. 7007, PREVENT Pandemics Act S. 3799.

Client expense: $1,144,727 · Firm income: Not reported

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

HR 7666 Restoring Hope for Mental Health and Well Being Act S 3799 PREVENT Pandemics Act HR 2471 Consolidated Appropriations Act of 2022 HR 7007 Coronavirus Supplemental Appropriations Act of 2022 HR 6000 Cures 2.0 Act (drugs/pharmaceuticals) HR 4026 Social Determinants of Health Data Analysis Act of 2021 HR 5376 Build Back Better Act, to provide for Budget Reconciliation HR 3947 Justice for Patients Act (arbitration) HR 2903 and S 1512 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) of 2021 Act HR 3076 Postal Service Reform Act of 2022 S 386 Medicare-X Choice Act of 2021 HR 1976 Medicare for All Act of 2021 HR 1848 Leading Infrastructure for Tomorrows America (LIFT) Act

Client expense: $2,170,000 · Firm income: Not reported

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

Issues related to COVID-19 vaccines, manufacturing, and distribution; H.R. 7007, COVID Supplemental Appropriations Act, 2022; Consolidated Appropriations Act, 2022 (PL 117-103); S. 3799, PREVENT Pandemics Act; H.R. 5585, The Advanced Research Project Agency-Health (ARPA-H) Act; Issues related to the FY 2023 Presidents Budget; HR 6007, To amend title XVIII of the Social Security Act to provide for the expansion of coverage of vaccines under part B of the Medicare program, and for other purposes

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE