Moms Matter Act

Momnibus Legislation Medicaid Postpartum Coverage Extension MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act H.R. 3352, Midwives for Maximizing Optimal Maternity Services

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation Medicaid Postpartum Coverage Extension MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act H.R. 3352, Midwives for Maximizing Optimal Maternity Services

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

HR 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 and S 4170 - Mental Health Reform Reauthorization Act of 2022: Advocated to add doctoral occupational therapy programs to the list of programs eligible for Mental and Behavioral Health Education and Training Grants. HR 2461/S 1089 - Access to Assistive Technology and Devices for Americans Study Act (Triple A Study): Support passage HR 3320/S 1679 - The Allied Health Workforce Diversity Act: Support passage. HR 3150/S 1578 - Mental Health Professionals Workforce Shortage Loan Repayment Act of 2021: Support passage. HR 909/S 484 - Moms Matter Act: Support passage. HR 7116 - 9-8-8 Implementation Act of 2022: Support passage. S. 3799 - PREVENT Pandemics Act: Support passage. S 4306 - Improving Access to Behavioral Health Integration Act: Support passage. HR 6770-PACE Plus Act and S 3626-PACE Expanded Act: Support passage. HR 7667 - Food and Drug Amendments of 2022: Support for Section 811. Bans of Devices for One or More Intended Uses. S. 4348-FDASLA Act of 2022: Support for Sen. Chris Murphy's amendment banning the use of electric skin shock devices. HR 2617 - Consolidated Appropriations Act of 2023: Support inclusion of all above provisions in end of year Omnibus bill.

Client expense: $180,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies relating to: Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention H.R. 909/S. 484, Moms Matter Act H.R. 959/S. 346, Black Maternal Health Momnibus Act of 2021 H.R. 1620, Violence Against Women Act Reauthorization Act of 2021 H.R. 2347/S. 2691, Strengthening the Vaccines for Children Program Act of 2021 H.R. 3407/S. 411, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act H.R. 3655, Vaccine Injury Compensation Modernization Act of 2021 H.R. 4217/S. 2779, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act H.R. 5376, Inflation Reduction Act - provisions related to health equity and mental and behavioral health for patients and health care providers H.R. 5585, Advanced Research Projects Agency-Health (ARPA-H) Act H.R. 7236, Strengthen Kids Mental Health Now Act of 2022 H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022 H.R. 7780, Mental Health Matters Act H.R. 8296, Womens Health Protection Act of 2022 H.R. 8391, Continuity in Necessary Evaluative Crisis Treatment (CONNECT) Act of 2022 S. 104/H.R. 379, Improving Social Determinants of Health Act of 2021 S. 674, Public Health Infrastructure Saves Lives Act S. 3479/H.R. 8151, Building a Sustainable Workforce for Healthy Communities Act S. 3623, Violence Against Women Act Reauthorization Act of 2022 S. 4170, Mental Health Reform Reauthorization Act of 2022

Client expense: Not reported · Firm income: $26,600

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

Legislation and policies relating to: Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention H.R. 66, Comprehensive Access to Robust Insurance Now Guaranteed for Kids (CARING for Kids) Act H.R. 482/S. 350, Newborn Screening Saves Lives Reauthorization Act of 2021 H.R. 485, Stronger Child Abuse Prevention and Treatment Act H.R. 550, Immunization Infrastructure Modernization Act of 2021 H.R. 909/S. 484, Moms Matter Act H.R. 959/S. 346, Black Maternal Health Momnibus Act of 2021 H.R. 1065/S. 1486, Pregnant Workers Fairness Act H.R. 1324/S/ 467, Effective Suicide Screening and Assessment in the Emergency Department Act of 2021 H.R. 1390, Childrens Health Insurance Program Pandemic Enhancement and Relief (CHIPPER) Act H.R. 1620, Violence Against Women Act Reauthorization Act of 2021 H.R. 1791, Childrens Health Insurance Program Permanency (CHIPP) Act H.R. 2094/S. 1301, Promoting Physical Activity for Americans Act H.R. 2347/S. 2691, Strengthening the Vaccines for Children Program Act of 2021 H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act of 2021 H.R. 3182, Safe Sleep for Babies Act of 2021 H.R. 3407/S. 411, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act H.R. 3655, Vaccine Injury Compensation Modernization Act of 2021 H.R. 4217/S. 2779, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act H.R. 5376, Inflation Reduction Act - provisions related to health equity and mental and behavioral health for patients and health care providers H.R. 5487/S. 3972, Stillbirth Health Improvement and Education (SHINE) for Autumn Act of 2021 H.R. 5585, Advanced Research Projects Agency-Health (ARPA-H) Act H.R. 7076, Supporting Childrens Mental Health Care Access Act of 2022 H.R. 7236, Strengthen Kids Mental Health Now Act of 2022 H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022 H.R. 7780, Mental Health Matters Act H.R. 8296, Womens Health Protection Act of 2022 H.R. 8391, Continuity in Necessary Evaluative Crisis Treatment (CONNECT) Act of 2022 H.R. 8450, Healthy Meals, Healthy Kids Act S. 104/H.R. 379, Improving Social Determinants of Health Act of 2021 S. 248/H.R. 804, Family and Medical Insurance Leave (FAMILY) Act S. 499/H.R. 369, Improving Health Insurance Affordability Act of 2021 S. 674, Public Health Infrastructure Saves Lives Act S. 844/H.R. 3109, PHIT Act of 2021 S. 1259, Safe Cribs Act S. 1275/H.R. 2119, Family Violence Prevention and Services Improvement Act of 2021 S. 1658/H.R. 3110, Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act S. 2069/H.R. 4323, Excellence in Mental Health and Addiction Treatment Act S. 3479/H.R. 8151, Building a Sustainable Workforce for Healthy Communities Act S. 3623, Violence Against Women Act Reauthorization Act of 2022 S. 3799, Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act) S. 4170, Mental Health Reform Reauthorization Act of 2022

Client expense: Not reported · Firm income: $24,000

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

Draft, Hospital Competition Act of 2021 (no bill number) - procedural changes around The Mental Health Parity and Addiction Equity Act (MHPEA) litigation H.R. 19 - Lower Costs, More Cures Act of 2021- Rep. McMorris, Rodgers - prescription drug prices for Medicare and Medicaid H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc - Medicaid expansion H.R. 379 - Improving Social Determinants of Health Act of 2021 - Rep. Barragan, Nanette Diaz - Social Determinants of Health H.R. 432 - Mental Health Access Improvement Act of 2021- Rep. Thompson, Mike - mental health services under Medicare H.R. 778 - Secure Data and Privacy for Contact Tracing Act of 2021 - Rep. Speier, Jackie - digital contact tracing for COVID-19 H.R. 908 - MORE Health Education Act - Rep. Blunt Rochester, Lisa - federally facilitated exchanges H.R. 909 - Moms Matter Act - Rep. Blunt Rochester, Lisa - maternal mental health conditions and SUD H.R. 943 - Social Determinants for Moms Act - Rep. McBath, Lucy -SDOH and maternal health H.R. 959 - Black Maternal Health Momnibus Act of 2021 - Rep. Underwood, Lauren - maternal health including in Medicaid and CHIP H.R. 1212 - Kira Johnson Act - Rep. Adams, Alma - maternal health outcomes H.R. 1218 - Data Mapping to Save Moms Lives Act - Rep. Butterfield, G. K. -maternal health data H.R. 1268 - Building COVID-19 Vaccine Confidence Act of 2021 - Rep. Velazquez, Nydia - COVID-19 H.R. 1319 - American Rescue Plan Act of 2021 - Rep. Yarmuth, John - COVID-19 relief H.R. 1350 - Supporting Best Practices for Healthy Moms Act - Rep. Kelly, Robin - maternal health outcomes H.R. 1364 - Parity Enforcement Act of 2021 - Rep. Norcross, Donald - mental health and SUD H.R. 1400 - COVID-19 Health Disparities Action Act of 2021 - Rep. Cardenas, Tony -COVID-19 and health disparities H.R. 1406 - COVID-19 Emergency Telehealth Impact Reporting Act of 2021 - Rep. Curtis, John - telehealth and COVID-19 H.R. 1544 - Virtual Community Support Act of 2021 - Rep. Cardenas, Tony - mental health and SUD grants for community peer support H.R. 1647 - TREATS Act - Rep. McKinley, David - increase use of telehealth for SUD treatment H.R. 1721 - To amend the Consolidated Appropriations Act, 2021 to authorize additional funds for the Emergency Broadband Connectivity Fund, to provide grants to States and Tribal Entities to strengthen the National Lifeline Eligibility Verifier, to provide for Federal coordination between the National Lifeline Eligibility Verifier and the National Accuracy Clearinghouse - Rep. Veasey, Marc - Broadband H.R. 1835 - COVID Community Care Act - Rep. Lee, Barbara - COVID-19 response H.R. 1848 - LIFT America Act - Rep. Pallone, Frank, Jr. - broadband and public health infrastructure H.R. 1872 - MORE Health Education Act - Rep. Blunt Rochester, Lisa - Federal Exchange outreach and educational activities H.R. 1976 - Medicare for All Act of 2021 - Rep. Jayapal, Pramila - public option H.R. 1985 - Nursing Home Reform Modernization Act of 2021 - Rep. Pascrell, Bill, Jr. - quality and transparency H.R. 2010 - Public Option Deficit Reduction Act- Rep. DeFazio, Peter - public option H.R. 2163 - Safe Step Act - Rep. Ruiz, Raul - commercial plans and medication step-therapy requirements H.R. 3173 - Improving Seniors Timely Access to Care Act of 2021 - Rep. DelBene, Suzan - prior authorization in Medicare Advantage H.R. 3753 - Parity Implementation Assistance Act - Rep. Cardenas, Tony - mental health parity H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act of 2021- Rep. Cheney, Liz - telehealth H.R. 4595 - Medicaid Saves Lives Act - Rep. Bourdeaux, Carolyn - Medicaid expansion H.R. 7236 - Strengthen Kids Mental Health Now Act of 2022 - Rep. Eshoo, Anna - mental health and Medicaid H.R. 7427 - To amend title XI of the Social Security Act to require CMI testing of incentive payments for behavioral health providers and certain other providers for adoption and use of certified electronic health record technology, and for other purposes. - Rep. Matsui, Doris - behavioral health and electronic health records H.R. 7512 - Protecting Patients from Deceptive Health Plans Act - Rep. Hayes, Jahana - excepted benefits coverage H.R. 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 - Rep. Pallone, Frank - reauthorization of several behavioral health programs H.R. 7667 - Food and Drug Amendments of 2022 - Rep. Eshoo, Anna - reauthorization of user fee programs H.R. 7780 - Mental Health Matters Act - Rep. DeSaulnier, Mark - changes to the procedure around MHPEA litigation H.R. 8152 - American Data Privacy and Protection Act - Rep. Pallone, Frank, Jr. - data privacy H.R. 8594 - Restore Protections for Dialysis Patients Act - Rep. Clarke, Yvette - reform of the Medicare Secondary Payer act H.R. 8876 - The Jackie Walorski Maternal and Child Home Visiting Reauthorization Act of 2022 - Rep. Davis, Danny - funding for maternal and early childhood health programs 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. - Rep. Chu, Judy - mental health and Medicare H.R. 8879 - Inpatient Psychiatric Facility Improvement Act - Rep. Evans, Dwight - mental health and Medicare 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. - Rep. Horsford, Steven - commercial plans 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. - Rep. Kelly, Mike - mental health and Medicare H.R. 8885 - Better Health Care Directories Act - Rep. Kildee, Daniel - commercial plans H.R. 8886 - Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act - Rep. Moore, Gwen - commercial plans H.R. 8889 - RICE Act - Rep. Plaskett, Stacey - commercial plans H.R. 8890 - Physician Wellness Program Act of 2022 - Rep. Ruiz, Raul - mental health and Medicare H.R. 8891 - No Surprises for Survivors Act of 2022 - Rep. Sanchez, Linda - requirements for group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for forensic medical exams with no cost sharing 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. - Rep. Sewell, Terri - commercial plans H.R. 8908 - Fighting Stimulant and other Substance Use Disorders Act - Rep. Estes, Ron - mental health and Medicare H.R. 8910 - Behavioral Health Integration Awareness Act of 2022 - Rep. Smith, Jason - mental health and Medicare S. 24 - Protecting Personal Health Data Act - Sen. Klobuchar, Amy - privacy S. 104 - Improving Social Determinants of Health Act of 2021- Sen. Smith, Tina - health disparities S. 199 - Secure Data and Privacy for Contact Tracing Act of 2021 - Sen. Schatz, Brian - digital contact tracing for COVID-19 S. 201 - Improving Access to Health Care in Rural and Underserved Areas Act - Sen. Rosen, Jacky - rural health S. 334 - IMPACT to Save Moms Act - Sen. Casey, Robert - maternal health S. 340 - TREATS Act - Sen. Portman, Rob - telehealth, SUD and mental health S. 345 - Maternal Vaccinations Act - Sen. Kaine, Tim - maternal health S. 346 - Black Maternal Health Momnibus Act of 2021 - Sen. Booker, Cory - maternal health and health disparities S. 347 - Data to Save Moms Act - Sen. Smith, Tina - maternal health data S. 352 - Health Care Improvement Act of 2021 - Sen. Warner, Mark - health care costs and coverage S. 408 - Supporting Best Practices for Healthy Moms Act - Sen. Toomey, Pat - maternal health S. 411 - MOMMAs Act - Sen. Durbin, Richard - maternal health S. 464 - Safe Step Act - Sen. Murkowski, Lisa - commercial plans and medication step-therapy requirements S. 512 - Equitable Data Collection and Disclosure on COVID-19 Act of 2021- Sen. Warren, Elizabeth - COVID-19 Data Collection S. 586 - NOPAIN Act - Sen. Capito, Shelley Moore - non-opioid treatment S. 674 - Public Health Infrastructure Saves Lives Act- Sen. Murray, Patty - public health infrastructure S. 708 - Preventing Mental Health and Substance Use Crises During Emergencies Act - Sen. Kelly, Mark - mental health and SUD national strategy S. 745 - Accessible, Affordable Internet for All Act - Sen. Klobuchar, Amy - broadband S. 779 - Protecting Americans with Pre-Existing Conditions Act of 2021- Sen. Warner, Mark R. - state innovation waivers S. 782 - Nursing Home Reform Modernization Act of 2021- Sen. Casey, Robert P., Jr. - nursing home quality and transparency S. 783 - COVID Community Care Act - Sen. Warren, Elizabeth - COVID-19 response S. 851 - Social Determinants for Moms Act- Sen. Blumenthal, Richard - SDOH and maternal health S. 893 - Tech to Save Moms Act- Sen. Menendez, Robert - maternal health S. 983 - CHOICE Act - Sen. Whitehouse, Sheldon - public option S. 987 - TREATS Act - Sen. Portman, Rob - SUD prevention and treatment S. 1010 - Turn the Tide Act - Sen. Shaheen, Jeanne - Substance Use Disorder S. 1042 - Kira Johnson Act - Sen. Warnock, Raphael - maternal health S. 1512 - CONNECT for Health Act of 2021 - Sen. Schatz, Brian - expansion of telehealth for Medicare S. 1873 - Medicare Multi-Cancer Early Detection Screening Coverage Act of 2021 - Sen. Crapo, Mike - Cancer screening in Medicare S. 1962 - Parity Implementation Assistance Act - Sen. Murphy, Christopher - mental health parity S. 2164 - Lower Costs, More Cures Act of 2021 - Sen. Crapo, Mike - prescription drug prices for Medicare and Medicaid S. 2315 - Medicaid Saves Lives Act - Sen. Warnock, Raphael - Medicaid expansion S. 2499 - SAFE DATA Act - Sen. Wicker, Roger - consumer data privacy and data transparency and security S. 3018 - Improving Seniors Timely Access to Care Act of 2021 - Sen. Marshall, Roger - prior authorization in Medicare Advantage S. 3195 - Consumer Online Privacy Rights Act - Sen. Cantwell, Maria - data privacy S. 3799 - Prevent Pandemics Act - Sen. Murray, Patty - pandemic preparedness S. 3983 - PATCH Act - Sen. Cassidy, Bill - data privacy S. 4264 - Advancing Integration in Medicare and Medicaid (AIM) Act - Sen. Scott, Tim - coordinating full-benefits for dual eligible individuals S. 4293 - Pharmacy Benefit Manager Transparency Act of 2022 - Sen. Cantwell, Maria and Sen. Grassley, Chuck - scope of PBM practices S. 4306 - Improving Access to Behavioral Health Integration Act - Sen. Smith, Tina - behavioral health S. 4750 - Restore Protections for Dialysis Patients Act - Sen. Menendez, Robert - reform of MSP Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers, enforcement; cybersecurity; issues related to Medicare Secondary Payer requirements; issues related to health care price transparency; issues related to all payor claims databases; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital and provider consolidation; issues related to medical management; issues relating to quality improvement; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; issues related to health equity; issues related to vaccination; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; prescription drug pricing; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; rural health; issues related to behavioral health benefits; issues related to Managed Long Term Services and Supports (MLTSS); issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; issues relating to surprise medical bills; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage and reproductive health; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues related to health insurance tax; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; reinsurance, risk corridors, and risk adjustment; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters; essential health benefits, actuarial value, and accreditation; NQF reauthorization; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations; issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to short term limited duration products; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); issues related to association health plans; issues related to cost-sharing reductions (CSRs); issues related to the refundable credit for coverage under a qualified health plan and enhancements included in the American Rescue Plan Act (ARPA); issues related to Medicaid coverage gap; issues related to small employer group size; issues related to Certificate of Public Advantage; issues relating to veterans health care; issues relating to caregivers; and other issues relating to health care reform implementation.

Client expense: $3,230,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

HR 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 and S 4170 - Mental Health Reform Reauthorization Act of 2022: Advocated to add doctoral occupational therapy programs to the list of programs eligible for Mental and Behavioral Health Education and Training Grants. HR 2461/S 1089 - Access to Assistive Technology and Devices for Americans Study Act (Triple A Study): Support passage HR 3320/S 1679 - The Allied Health Workforce Diversity Act: Support passage. HR 3150/S 1578 - Mental Health Professionals Workforce Shortage Loan Repayment Act of 2021: Support passage. HR 909/S 484 - Moms Matter Act: Support passage. HR 7116 - 9-8-8 Implementation Act of 2022: Support passage. S. 3799 - PREVENT Pandemics Act: Support passage. S 4306 - Improving Access to Behavioral Health Integration Act: Support passage. HR 6770-PACE Plus Act and S 3626-PACE Expanded Act: Support passage. HR 7667 - Food and Drug Amendments of 2022: Support for Section 811. Bans of Devices for One or More Intended Uses. S. 4348-FDASLA Act of 2022: Support for Sen. Chris Murphy's amendment banning the use of electric skin shock devices.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation Medicaid Postpartum Coverage Extension MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act H.R. 3352, Midwives for Maximizing Optimal Maternity Services

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies relating to: Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Implementation of the Dr. Lorna Breen Health Care Provider Protection Act (P.L. 117-105) H.R. 66, Comprehensive Access to Robust Insurance Now Guaranteed for Kids (CARING for Kids) Act H.R. 482/S. 350, Newborn Screening Saves Lives Reauthorization Act of 2021 H.R. 485, Stronger Child Abuse Prevention and Treatment Act H.R. 550, Immunization Infrastructure Modernization Act of 2021 H.R. 909/S. 484, Moms Matter Act H.R. 959/S. 346, Black Maternal Health Momnibus Act of 2021 H.R. 1065/S. 1486, Pregnant Workers Fairness Act H.R. 1324/S/ 467, Effective Suicide Screening and Assessment in the Emergency Department Act of 2021 H.R. 1390, Childrens Health Insurance Program Pandemic Enhancement and Relief (CHIPPER) Act H.R. 1620, Violence Against Women Act Reauthorization Act of 2021 H.R. 1791, Childrens Health Insurance Program Permanency (CHIPP) Act H.R. 2094/S. 1301, Promoting Physical Activity for Americans Act H.R. 2347/S. 2691, Strengthening the Vaccines for Children Program Act of 2021 H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act of 2021 H.R. 3182, Safe Sleep for Babies Act of 2021 H.R. 3407/S. 411, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act H.R. 4217/S. 2779, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act H.R. 5376, Build Back Better Act - provisions related to nursing education infrastructure, health equity, social determinants of health, mental and behavioral health for patients and health care providers, and child and maternal health H.R. 5487/S. 3972, Stillbirth Health Improvement and Education (SHINE) for Autumn Act of 2021 H.R. 5585, Advanced Research Projects Agency-Health (ARPA-H) Act H.R. 7076, Supporting Childrens Mental Health Care Access Act of 2022 H.R. 7236, Strengthen Kids Mental Health Now Act of 2022 H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022 H.R. 7790, Infant Formula Supplemental Appropriations Act, 2022 S. 104/H.R. 379, Improving Social Determinants of Health Act of 2021 S. 248/H.R. 804, Family and Medical Insurance Leave (FAMILY) Act S. 499/H.R. 369, Improving Health Insurance Affordability Act of 2021 S. 674, Public Health Infrastructure Saves Lives Act S. 844/H.R. 3109, PHIT Act of 2021 S. 1259, Safe Cribs Act S. 1275/H.R. 2119, Family Violence Prevention and Services Improvement Act of 2021 S. 1658/H.R. 3110, Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act S. 1738, Hallways to Health Care Act S. 2069/H.R. 4323, Excellence in Mental Health and Addiction Treatment Act S. 3479, Building a Sustainable Workforce for Healthy Communities Act S. 3623, Violence Against Women Act Reauthorization Act of 2022 S. 3799, Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act) S. 4170, Mental Health Reform Reauthorization Act of 2022

Client expense: Not reported · Firm income: $24,000

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

Legislation and policies relating to: Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Implementation of the Dr. Lorna Breen Health Care Provider Protection Act (P.L. 117-105) H.R. 909/S. 484, Moms Matter Act H.R. 959/S. 346, Black Maternal Health Momnibus Act of 2021 H.R. 1620, Violence Against Women Act Reauthorization Act of 2021 H.R. 2347/S. 2691, Strengthening the Vaccines for Children Program Act of 2021 H.R. 3407/S. 411, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act H.R. 4217/S. 2779, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act H.R. 5376, Build Back Better Act - provisions related to nursing education infrastructure, health equity, social determinants of health, mental and behavioral health for patients and health care providers, and child and maternal health H.R. 5585, Advanced Research Projects Agency-Health (ARPA-H) Act H.R. 7236, Strengthen Kids Mental Health Now Act of 2022 H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022 S. 104/H.R. 379, Improving Social Determinants of Health Act of 2021 S. 674, Public Health Infrastructure Saves Lives Act S. 3623, Violence Against Women Act Reauthorization Act of 2022 S. 4170, Mental Health Reform Reauthorization Act of 2022

Client expense: Not reported · Firm income: $26,600

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation Medicaid Postpartum Coverage Extension MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act H.R. 3352, Midwives for Maximizing Optimal Maternity Services

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 and S 4170 - Mental Health Reform Reauthorization Act of 2022: Advocated to add doctoral occupational therapy programs to the list of programs eligible for Mental and Behavioral Health Education and Training Grants. HR 2461/S 1089 - Access to Assistive Technology and Devices for Americans Study Act (Triple A Study): Support passage HR 3320/S 1679 - The Allied Health Workforce Diversity Act: Support passage. HR 3150/S 1578 - Mental Health Professionals Workforce Shortage Loan Repayment Act of 2021: Support passage. No bill number: Advocated for the role of occupational therapy in acute and long-term recovery from the COVID pandemic. HR 909/S 484 - Moms Matter Act: Support passage. HR 7116 - 9-8-8 Implantation Act of 2022: Support passage. S. 3799 - PREVENT Pandemics Act: Support passage. S 4306 - Improving Access to Behavioral Health Integration Act: Support passage. S 2938 - Bipartisan Safer Communities Act: Support passage. HR 6770-PACE Plus Act and S 3626-PACE Expanded Act: Support passage. No Bill: Advocated for occupational therapy's role in long COVID treatment and recovery. HR 7667 - Food and Drug Amendments of 2022: Support for Section 811. Bans of Devices for One or More Intended Uses. S. 4748-FDASLA Act of 2022: Support for Sen. Chris Murphy's amendment banning the use of electric skin shock devices.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 379 - Improving Social Determinants of Health Act of 2021 - Rep. Barragan, Nanette Diaz - Social Determinants of Health H.R. 778 - Secure Data and Privacy for Contact Tracing Act of 2021 - Rep. Speier, Jackie - digital contact tracing for COVID-19 H.R. 908 - MORE Health Education Act - Rep. Blunt Rochester, Lisa - federally facilitated exchanges H.R. 909 - Moms Matter Act - Rep. Blunt Rochester, Lisa - maternal mental health conditions and SUD H.R. 943 - Social Determinants for Moms Act - Rep. McBath, Lucy -SDOH and maternal health H.R. 1212 - Kira Johnson Act - Rep. Adams, Alma - maternal health outcomes H.R. 1218 - Data Mapping to Save Moms Lives Act - Rep. Butterfield, G. K. -maternal health data H.R. 1268 - Building COVID-19 Vaccine Confidence Act of 2021 - Rep. Velazquez, Nydia - COVID-19 H.R. 1319 - American Rescue Plan Act of 2021 - Rep. Yarmuth, John - COVID-19 relief H.R. 1350 - Supporting Best Practices for Healthy Moms Act - Rep. Kelly, Robin - maternal health outcomes H.R. 1364 - Parity Enforcement Act of 2021 - Rep. Norcross, Donald - mental health and SUD H.R. 1400 - COVID-19 Health Disparities Action Act of 2021 - Rep. Cardenas, Tony -COVID-19 and health disparities H.R. 1406 - COVID-19 Emergency Telehealth Impact Reporting Act of 2021 - Rep. Curtis, John - telehealth and COVID-19 H.R. 1544 - Virtual Community Support Act of 2021 - Rep. Cardenas, Tony - mental health and SUD grants for community peer support H.R. 1647 - TREATS Act - Rep. McKinley, David - increase use of telehealth for SUD treatment H.R. 1721 - To amend the Consolidated Appropriations Act, 2021 to authorize additional funds for the Emergency Broadband Connectivity Fund, to provide grants to States and Tribal Entities to strengthen the National Lifeline Eligibility Verifier, to provide for Federal coordination between the National Lifeline Eligibility Verifier and the National Accuracy Clearinghouse - Rep. Veasey, Marc - Broadband H.R. 1835 - COVID Community Care Act - Rep. Lee, Barbara - COVID-19 response H.R. 1848 - LIFT America Act - Rep. Pallone, Frank, Jr. - broadband and public health infrastructure H.R. 1872 - MORE Health Education Act - Rep. Blunt Rochester, Lisa - Federal Exchange outreach and educational activities H.R. 1976 - Medicare for All Act of 2021 - Rep. Jayapal, Pramila - public option H.R. 1985 - Nursing Home Reform Modernization Act of 2021 - Rep. Pascrell, Bill, Jr. - quality and transparency H.R. 2010 - Public Option Deficit Reduction Act- Rep. DeFazio, Peter - public option H.R. 7427 - To amend title XI of the Social Security Act to require CMI testing of incentive payments for behavioral health providers and certain other providers for adoption and use of certified electronic health record technology, and for other purposes. - Rep. Matsui, Doris - behavioral health and electronic health records H.R. 7512 - Protecting Patients from Deceptive Health Plans Act - Rep. Hayes, Jahana - excepted benefits coverage H.R. 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 - Rep. Pallone, Frank - reauthorization of behavioral health programs H.R. 7667 - Food and Drug Amendments of 2022 - Rep. Eshoo, Anna - reauthorization of user fee programs H.R. 7780 - Mental Health Matters Act - Rep. DeSaulnier, Mark - behavioral health programs for early schooling S. 24 - Protecting Personal Health Data Act - Sen. Klobuchar, Amy - privacy S. 104 - Improving Social Determinants of Health Act of 2021- Sen. Smith, Tina - health disparities S. 199 - Secure Data and Privacy for Contact Tracing Act of 2021 - Sen. Schatz, Brian - digital contact tracing for COVID-19 S. 201 - Improving Access to Health Care in Rural and Underserved Areas Act - Sen. Rosen, Jacky - rural health S. 334 - IMPACT to Save Moms Act - Sen. Casey, Robert - maternal health S. 340 - TREATS Act - Sen. Portman, Rob - telehealth, SUD and mental health S. 345 - Maternal Vaccinations Act - Sen. Kaine, Tim - maternal health S. 346 - Black Maternal Health Momnibus Act of 2021 - Sen. Booker, Cory - maternal health and health disparities S. 347 - Data to Save Moms Act - Sen. Smith, Tina - maternal health data S. 352 - Health Care Improvement Act of 2021 - Sen. Warner, Mark - health care costs and coverage S. 408 - Supporting Best Practices for Healthy Moms Act - Sen. Toomey, Pat - maternal health S. 411 - MOMMAs Act - Sen. Durbin, Richard - maternal health S. 512 - Equitable Data Collection and Disclosure on COVID-19 Act of 2021- Sen. Warren, Elizabeth - COVID-19 Data Collection S. 586 - NOPAIN Act - Sen. Capito, Shelley Moore - non-opioid treatment S. 674 - Public Health Infrastructure Saves Lives Act- Sen. Murray, Patty - public health infrastructure S. 708 - Preventing Mental Health and Substance Use Crises During Emergencies Act - Sen. Kelly, Mark - mental health and SUD national strategy S. 745 - Accessible, Affordable Internet for All Act - Sen. Klobuchar, Amy - broadband S. 779 - Protecting Americans with Pre-Existing Conditions Act of 2021- Sen. Warner, Mark R. - state innovation waivers S. 782 - Nursing Home Reform Modernization Act of 2021- Sen. Casey, Robert P., Jr. - nursing home quality and transparency S. 783 - COVID Community Care Act - Sen. Warren, Elizabeth - COVID-19 response S. 851 - Social Determinants for Moms Act- Sen. Blumenthal, Richard - SDOH and maternal health S. 893 - Tech to Save Moms Act- Sen. Menendez, Robert - maternal health S. 983 - CHOICE Act - Sen. Whitehouse, Sheldon - public option S. 987 - TREATS Act - Sen. Portman, Rob - SUD prevention and treatment S. 1010 - Turn the Tide Act - Sen. Shaheen, Jeanne - Substance Use Disorder S. 1042 - Kira Johnson Act - Sen. Warnock, Raphael - maternal health S. 3799 - Prevent Pandemics Act - Sen. Murray, Patty - pandemic preparedness S. 4264 - Advancing Integration in Medicare and Medicaid (AIM) Act - Sen. Scott, Tim - coordinating full-benefits for dual eligible individuals S. 4293 - Pharmacy Benefit Manager Transparency Act of 2022 - Sen. Cantwell, Maria and Sen. Grassley, Chuck - scope of PBM practices S. 4306 - Improving Access to Behavioral Health Integration Act - Sen. Smith, Tina - behavioral health Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers, enforcement; cybersecurity; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues related to Medicare Secondary Payer requirements; issues related to health care price transparency; issues related to all payor claims databases; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital and provider consolidation; issues related to trauma-informed care; issues related to medical management; issues relating to quality improvement; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; issues related to health equity; issues related to vaccination; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; prescription drug pricing; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; rural health; issues related to behavioral health benefits; issues related to Managed Long Term Services and Supports (MLTSS); issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; issues related to repeal of the antitrust-related portions of the McCarran-Ferguson Act; issues relating to surprise medical bills; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage and reproductive health; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues related to health insurance tax; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; reinsurance, risk corridors, and risk adjustment; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters; essential health benefits, actuarial value, and accreditation; NQF reauthorization; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations; issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to short term limited duration products; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); issues related to association health plans; issues related to cost-sharing reductions (CSRs); issues related to the refundable credit for coverage under a qualified health plan and enhancements included in the American Rescue Plan Act (ARPA); issues related to Medicaid coverage gap; issues related to small employer group size; issues related to Certificate of Public Advantage; issues relating to veterans health care; issues relating to caregivers; and other issues relating to health care reform implementation.

Client expense: $2,890,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

H.Res. 1141 - Educator Mental Health Awareness Week Resolution H.Res. 1191 - Providing for consideration of the bill (H.R. 4176) to improve Federal population surveys by requiring the collection of voluntary, self-disclosed information on sexual orientation and gender identity in certain surveys, and for other purposes; providing for consideration of the bill (H.R. 5585) to establish the Advanced Research Projects Agency-Health, and for other purposes; providing for consideration of the bill (H.R. 7666) to amend the Public Health Service Act to reauthorize certain programs relating to mental health and substance use disorders, and for other purposes; and for other purposes. H.R. 623 - Gabriella Miller Kids First Research Act 2.0 H.R. 909 / S. 484 - Moms Matter Act H.R. 1384 / S. 445 - Mainstreaming Addiction Treatment (MAT) Act H.R. 1475/ S. 1795 - Pursuing Equity in Mental Health Act H.R. 2067 - MATE Act H.R. 2256/ S. 834 - Resident Physician Shortage Reduction Act of 2021 H.R. 2377 - Federal Extreme Risk Protection Order Act of 2021 H.R. 2376 - Excellence in Recovery Housing Act H.R. 2929 - Virtual Peer Support Act H.R. 3173/ S. 3018 - Improving Seniors Timely Access to Care Act of 2021 H.R. 3407/ S. 411 - MOMMAS Act H.R. 3447 - Permanency for Audio-Only Telehealth Act H.R. 3450/ S. 1727 - Medicaid Bump Act H.R. 3753/ S. 1962 - Parity Implementation Assistance Act H.R. 3771 - South Asian Heart Health Awareness Act of 2021 H.R. 4058/ S. 2061 - Telemental Health Care Access Act. H.R. 4122 / S. 3658 - Resident Education Deferred Interest (REDI) Act H.R. 4217 / S. 2779 - TRIUMPH for New Moms Act H.R. 4770 - Evaluating Disparities and Outcomes of Telehealth (EDOT) Act of 2021 H.R. 4944 - Helping Kids Cope Act of 2021 H.R. 5218 - Collaborate in an Orderly and Cohesive Manner Act H.R. 5585 - Advanced Research Project Agency-Health Act H.R. 6943 / S. 3635 - Public Safety Officer Support Act H.R. 7073 - Into the Light for Maternal Mental Health Act H.R. 7076 - Supporting Childrens Mental Health Care Access Act of 2022 H.R. 7116 - 988 Implementation Act of 2022 H.R. 7232 - 988 and Parity Assistance Act of 2022 H.R. 7233 - Keeping Incarceration Discharges Streamlined for Children and Accommodating Resources in Education Act or the KIDS CARES Act H.R. 7234 - Summer Barrow Prevention, Treatment, and Recovery Act H.R. 7235 / S.4301 - Substance Use Prevention, Treatment, and Recovery Services Block Grant Act of 2022 H.R. 7236 - Strengthen Kids Mental Health Now Act of 2022 H.R. 7237 - Reauthorizing Evidence-based and Crisis Help Initiatives Needed to Generate Improved Mental Health Outcomes for Patients Act of 2022 or the REACHING Improved Mental Health Outcomes for Patients Act of 2022 H.R. 7238 - Timely Treatment for Opioid Use Disorder Act of 2022 H.R. 7241 - Community Mental Health Services Block Grant Reauthorization Act H.R. 7248 - Continuing Systems of Care for Children Act H.R. 7249 / S. 3686 - Anna Westin Legacy Act of 2022 H.R. 7254 - Mental Health Justice and Parity Act of 2022 H.R. 7255 / S. 4271 - Garrett Lee Smith Memorial Reauthorization Act H.R. 7427 - To amend title XI of the Social Security Act to require CMI testing of incentive payments for behavioral health providers and certain other providers for adoption and use of certified electronic health record technology, and for other purposes. H.R. 7565 - NIH Improve Act H.R. 7649 - To direct the Secretary of Health and Human Services to open a public docket for the submission of public comments regarding factors that should be taken into consideration when reviewing a proposed modification to an approved risk evaluation and mitigation strategy, and for other purposes. H.R. 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 H.R. 7667 - Food and Drug Amendments of 2022 H.R. 7740 - Employee and Retiree Access to Justice Act of 2022 H.R. 7767 - Strengthening Behavioral Health Benefits Act H.R. 7845 - NIH Clinical Trial Diversity Act H.R. 7857 - Minority Fellowship Program Reauthorization Act of 2022 H.R. 7910 - Protecting Our Kids Act H.R. 8180 - Undertaking Needed Investments in Therapy, Education, and De-Escalation Act of 2022 H.R. 8229 - Telemental Health Parity Act S. 2938 - Bipartisan Safer Communities Act S. 4132 - Womens Health Protection Act S. 4170 - Mental Health Reform Reauthorization Act of 2022 S. 4306 - Improving Access to Behavioral Health Integration Act S. 4348 - Food and Drug Administration Safety and Landmark Advancements S. 4461 - Expanding Access to Mental Health Training Act S. 4448 - Suicide Prevention Act No legislation - Implementation of new REMS regulations

Client expense: $181,613 · Firm income: Not reported

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

S. 484/HR. 909, "Moms Matter Act", all provisions. H.R.8295, "Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2023", all provisions

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies relating to: Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Provisions of the Infrastructure Investment and Jobs Act (P.L. 117-58) related to public health infrastructure improvements H.R. 909/S. 484, Moms Matter Act H.R. 959/S. 346, Black Maternal Health Momnibus Act of 2021 H.R. 2347/S. 2691, Strengthening the Vaccines for Children Program Act of 2021 H.R. 3407/S. 411, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act H.R. 4217/S. 2779, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act H.R. 5376, Build Back Better Act - provisions related to nursing education infrastructure, health equity, social determinants of health, mental and behavioral health for patients and health care providers, and child and maternal health S. 104/H.R. 379, Improving Social Determinants of Health Act of 2021 S. 610/H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act S. 674, Public Health Infrastructure Saves Lives Act

Client expense: Not reported · Firm income: $26,600

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies relating to: Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Provisions of the Infrastructure Investment and Jobs Act (P.L. 117-58) related to public health infrastructure improvements H.R. 66, Comprehensive Access to Robust Insurance Now Guaranteed for Kids (CARING for Kids) Act H.R. 482/S. 350, Newborn Screening Saves Lives Reauthorization Act of 2021 H.R. 485, Stronger Child Abuse Prevention and Treatment Act H.R. 550, Immunization Infrastructure Modernization Act of 2021 H.R. 909/S. 484, Moms Matter Act H.R. 959/S. 346, Black Maternal Health Momnibus Act of 2021 H.R. 1065/S. 1486, Pregnant Workers Fairness Act H.R. 1324/S/ 467, Effective Suicide Screening and Assessment in the Emergency Department Act of 2021 H.R. 1390, Childrens Health Insurance Program Pandemic Enhancement and Relief (CHIPPER) Act H.R. 1791, Childrens Health Insurance Program Permanency (CHIPP) Act H.R. 2094/S. 1301, Promoting Physical Activity for Americans Act H.R. 2347/S. 2691, Strengthening the Vaccines for Children Program Act of 2021 H.R. 3173/S. 3018, Improving Seniors Timely Access to Care Act of 2021 H.R. 3182, Safe Sleep for Babies Act of 2021 H.R. 3407/S. 411, Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act H.R. 4217/S. 2779, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act H.R. 5376, Build Back Better Act - provisions related to nursing education infrastructure, health equity, social determinants of health, mental and behavioral health for patients and health care providers, and child and maternal health H.R. 5487/S. 3972, Stillbirth Health Improvement and Education (SHINE) for Autumn Act of 2021 H.R. 7076, Supporting Childrens Mental Health Care Access Act of 2022 S. 104/H.R. 379, Improving Social Determinants of Health Act of 2021 S. 248/H.R. 804, Family and Medical Insurance Leave (FAMILY) Act S. 499/H.R. 369, Improving Health Insurance Affordability Act of 2021 S. 610/H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act S. 674, Public Health Infrastructure Saves Lives Act S. 844/H.R. 3109, PHIT Act of 2021 S. 1259, Safe Cribs Act S. 1275/H.R. 2119, Family Violence Prevention and Services Improvement Act of 2021 S. 1658/H.R. 3110, Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act S. 2069/H.R. 4323, Excellence in Mental Health and Addiction Treatment Act S. 3479, Building a Sustainable Workforce for Healthy Communities Act S. 3799, Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act)

Client expense: Not reported · Firm income: $24,000

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

H.R. 379 - Improving Social Determinants of Health Act of 2021 - Rep. Barragan, Nanette Diaz - Social Determinants of Health H.R. 778 - Secure Data and Privacy for Contact Tracing Act of 2021 - Rep. Speier, Jackie - digital contact tracing for COVID-19 H.R. 908 - MORE Health Education Act - Rep. Blunt Rochester, Lisa - federally facilitated exchanges H.R. 909 - Moms Matter Act - Rep. Blunt Rochester, Lisa - maternal mental health conditions and SUD H.R. 943 - Social Determinants for Moms Act - Rep. McBath, Lucy -SDOH and maternal health H.R. 1212 - Kira Johnson Act - Rep. Adams, Alma - maternal health outcomes H.R. 1218 - Data Mapping to Save Moms Lives Act - Rep. Butterfield, G. K. -maternal health data H.R. 1268 - Building COVID-19 Vaccine Confidence Act of 2021 - Rep. Velazquez, Nydia - COVID-19 H.R. 1319 - American Rescue Plan Act of 2021 - Rep. Yarmuth, John - COVID-19 relief H.R. 1350 - Supporting Best Practices for Healthy Moms Act - Rep. Kelly, Robin - maternal health outcomes H.R. 1364 - Parity Enforcement Act of 2021 - Rep. Norcross, Donald - mental health and SUD H.R. 1400 - COVID-19 Health Disparities Action Act of 2021 - Rep. Cardenas, Tony -COVID-19 and health disparities H.R. 1406 - COVID-19 Emergency Telehealth Impact Reporting Act of 2021 - Rep. Curtis, John - telehealth and COVID-19 H.R. 1544 - Virtual Community Support Act of 2021 - Rep. Cardenas, Tony - mental health and SUD grants for community peer support H.R. 1647 - TREATS Act - Rep. McKinley, David - increase use of telehealth for SUD treatment H.R. 1721 - To amend the Consolidated Appropriations Act, 2021 to authorize additional funds for the Emergency Broadband Connectivity Fund, to provide grants to States and Tribal Entities to strengthen the National Lifeline Eligibility Verifier, to provide for Federal coordination between the National Lifeline Eligibility Verifier and the National Accuracy Clearinghouse - Rep. Veasey, Marc - Broadband H.R. 1835 - COVID Community Care Act - Rep. Lee, Barbara - COVID-19 response H.R. 1848 - LIFT America Act - Rep. Pallone, Frank, Jr. - broadband and public health infrastructure H.R. 1872 - MORE Health Education Act - Rep. Blunt Rochester, Lisa - Federal Exchange outreach and educational activities H.R. 1976 - Medicare for All Act of 2021 - Rep. Jayapal, Pramila - public option H.R. 1985 - Nursing Home Reform Modernization Act of 2021 - Rep. Pascrell, Bill, Jr. - quality and transparency H.R. 2010 - Public Option Deficit Reduction Act- Rep. DeFazio, Peter - public option S. 24 - Protecting Personal Health Data Act - Sen. Klobuchar, Amy - privacy S. 104 - Improving Social Determinants of Health Act of 2021- Sen. Smith, Tina - health disparities S. 199 - Secure Data and Privacy for Contact Tracing Act of 2021 - Sen. Schatz, Brian - digital contact tracing for COVID-19 S. 201 - Improving Access to Health Care in Rural and Underserved Areas Act - Sen. Rosen, Jacky - rural health S. 334 - IMPACT to Save Moms Act - Sen. Casey, Robert - maternal health S. 340 - TREATS Act - Sen. Portman, Rob - telehealth, SUD and mental health S. 345 - Maternal Vaccinations Act - Sen. Kaine, Tim - maternal health S. 346 - Black Maternal Health Momnibus Act of 2021 - Sen. Booker, Cory - maternal health and health disparities S. 347 - Data to Save Moms Act - Sen. Smith, Tina - maternal health data S. 352 - Health Care Improvement Act of 2021 - Sen. Warner, Mark - health care costs and coverage S. 408 - Supporting Best Practices for Healthy Moms Act - Sen. Toomey, Pat - maternal health S. 411 - MOMMAs Act - Sen. Durbin, Richard - maternal health S. 512 - Equitable Data Collection and Disclosure on COVID-19 Act of 2021- Sen. Warren, Elizabeth - COVID-19 Data Collection S. 586 - NOPAIN Act - Sen. Capito, Shelley Moore - non-opioid treatment S. 674 - Public Health Infrastructure Saves Lives Act- Sen. Murray, Patty - public health infrastructure S. 708 - Preventing Mental Health and Substance Use Crises During Emergencies Act - Sen. Kelly, Mark - mental health and SUD national strategy S. 745 - Accessible, Affordable Internet for All Act - Sen. Klobuchar, Amy - broadband S. 779 - Protecting Americans with Pre-Existing Conditions Act of 2021- Sen. Warner, Mark R. - state innovation waivers S. 782 - Nursing Home Reform Modernization Act of 2021- Sen. Casey, Robert P., Jr. - nursing home quality and transparency S. 783 - COVID Community Care Act - Sen. Warren, Elizabeth - COVID-19 response S. 851 - Social Determinants for Moms Act- Sen. Blumenthal, Richard - SDOH and maternal health S. 893 - Tech to Save Moms Act- Sen. Menendez, Robert - maternal health S. 983 - CHOICE Act - Sen. Whitehouse, Sheldon - public option S. 987 - TREATS Act - Sen. Portman, Rob - SUD prevention and treatment S. 1010 - Turn the Tide Act - Sen. Shaheen, Jeanne - Substance Use Disorder S. 1042 - Kira Johnson Act - Sen. Warnock, Raphael - maternal health S. 3799 - Prevent Pandemics Act - Sen. Murray, Patty - pandemic preparedness Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers, enforcement; cybersecurity; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues related to Medicare Secondary Payer requirements; issues related to health care price transparency; issues related to all payor claims databases; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital and provider consolidation; issues related to trauma-informed care; issues related to medical management; issues relating to quality improvement; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to the end of the public health emergency; issues related to health equity; issues related to vaccination; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; prescription drug pricing; telehealth; issues related to the cost of insulin, including price, copays, rebates, and medical management tools; rural health; issues related to behavioral health benefits; issues related to Managed Long Term Services and Supports (MLTSS); issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; issues related to repeal of the antitrust-related portions of the McCarran-Ferguson Act; issues relating to surprise medical bills; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues related to health insurance tax; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; reinsurance, risk corridors, and risk adjustment; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters; essential health benefits, actuarial value, and accreditation; NQF reauthorization; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations; issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to short term limited duration products; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); issues related to association health plans; issues related to cost-sharing reductions (CSRs); issues related to the refundable credit for coverage under a qualified health plan and enhancements included in the American Rescue Plan Act (ARPA); issues related to Medicaid coverage gap; issues related to small employer group size; issues related to Certificate of Public Advantage; issues relating to veterans health care; issues relating to caregivers; and other issues relating to health care reform implementation.

Client expense: $4,680,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of

S. 610 - Dr. Lorna Breen Health Care Provider Protection Act: Support introduction and passage. S. 2210/HR 4131-Better Care Better Jobs Act: Advocate for increased use of occupational therapy within Home and Community Based Services (HCBS) and protection of the habilitation benefit. No bill - Behavioral Health Workforce Education Training (BHWET) program: discussed possible bill to get occupational therapy doctorate programs recognized by the Health Resources and Services Administration (HRSA) as mental health provider and eligible for this program. HR 2461/S 1089 - Access to Assistive Technology and Devices for Americans Study Act (Triple A Study): Support passage HR 3320/S 1679 - The Allied Health Workforce Diversity Act: Support passage. HR 3150/S 1578 - Mental Health Professionals Workforce Shortage Loan Repayment Act of 2021: Support passage. No bill number: Advocated for the role of occupational therapy in acute and long-term recovery from the COVID pandemic. HR 909/S 484 - Moms Matter Act: Support passage. HR 7116l - 9-8-8 Implantation Act of 2022: Support passage. S. 3799 - PREVENT Pandemics Act: Support passage.

Client expense: $180,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation Medicaid Postpartum Coverage Extension MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation MCH Block Grant and Maternal Health Program Funding Support FY 2023 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 484, "Moms Matter Act", all provisions. H.R. 909, "Moms Matter Act", all provisions. H.R. 5376, "Build Back Better Act", all provisions. Issues pertaining to the FY 2023 Labor, Health and Human Services, and Related Agencies Appropriations.

Client expense: Not reported · Firm income: Not reported

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for regulatory/sub-regulatory/application guidance that would require the use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant, including requiring each grantee delivering SUD treatment services to provide access to all FDA-approved medications for SUDs treated by that grantee. Advocated for a requirement that SAPT, State Opioid Response Grant (SOR), and Rural Communities Opioid Response Program grantees that receive grant funds for the delivery of addiction treatment services should be limited to Medicaid providers in order to better integrate federal grant dollars and Medicaid funds and Administration support for increased oversight and improved mechanisms for ensuring that such funding does not supplant the consistent and scalable funding that Medicaid (or Medicare) provides. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to increase promotion to State Medicaid programs of adoption of two, new sets of bundled G codes to increase or establish payment for outpatient opioid use disorder (OUD) treatment and treatment services provided by opioid treatment programs (OTPs) at Medicare payment rates or higher. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would create a special registration exemption for jails, prisons, and their authorized personnel to prescribe and otherwise dispense controlled medications for initiation, maintenance or withdrawal management of OUD that is significantly less burdensome than currently applicable registration requirements in the Controlled Substances Act and related regulations. Such special registration should not limit the number of persons who are detained or incarcerated who can be treated with such medications by a qualified practitioner; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; In the absence of Congressional action to eliminate the x-waiver, efforts to increase the DATA 2000 waiver patient limit -- aka, the applicable number; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Sent Congressional letter recommending closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education ASAM and ten other health professional associations have called for the FDA to immediately and fully retract its buprenorphine Drug Safety Communication of January 12, 2022. In their letter, the signatories maintain that the communication is based on flawed analysis. As part of the National Alliance for Underage Drinking, ASAM sent a letter to Representative Roybal-Allard, Representative Joyce, and Representative DeLauro in support of reauthorization of the Sober Truth on Preventing (STOP Act). First passed by Congress in 2006 and later reauthorized in the 21st Century Cures Act, the STOP Act aims to reduce underage age drinking through a comprehensive approach comprised of cost-effective, evidence-based strategies. On January 26th, ASAM submitted a comment letter to CMSs proposed rule Patient Protection and Affordable Care Act (ACA); HHS Notice of Benefit and Payment Parameters (the NBPP 2023 Rule). In its letter, ASAM supports, among other things: reinterpretation of the ACAs guaranteed availability requirement; the new interpretation would require issuers to enroll individuals with past-due premiums; reversion to pre-2020 non-discrimination protections that would prohibit certain exchanges, insurers, and agents and brokers from discriminating based on sexual orientation and gender identity; ensuring nondiscriminatory benefit design through refining the EHB nondiscrimination policy, providing a clear regulatory framework to evaluate plan benefit design and implementation based upon clinical guidelines and evidence; and requirements that issuers offer at least one standardized plan at every product network type, metal level, and in every service area where the issuer also offers non-standardized plans and that standardized plans use fixed copays instead of coinsurance. The letter also documents ASAMs general support for proposals related to network adequacy regulations, with recommendations for further refinement. On March 22, 2022, ASAM and other stakeholders sent a letter, spearheaded by former Representative Patrick J. Kennedy, to the Secretary of State Antony J. Blinken, and the U.S. Agency for International Development Administrator, Samantha Power. The letter urges mental health and substance use disorders (SUDs) be integrated in the U.S. - Ukraine relief efforts, and that the U.S. coordinate with multilateral health organizations and the World Health Organization to address mental health and SUDs caused and exacerbated by the invasion of Ukraine. ASAM joined a coalition letter to urge Congress to respond to a new and growing threat to our nations youth: e-cigarette manufacturers use of synthetic nicotine to evade Food and Drug Administration (FDA) oversight. Specifically, the letter urges Congress to quickly address this serious public health situation by enacting legislation at the earliest possible opportunity that enables FDAs Center for Tobacco Products to regulate synthetic nicotine products. ASAM joined a coalition letter to express support for the Food and Drug Administrations commitment to issuing proposed rules to prohibit menthol as a characterizing flavor in cigarettes and prohibit all characterizing flavors in cigars. Once issued, the letter urges FDA to move quickly to finalize and implement these life-saving rules. ASAM joined a coalition letter supporting the Into the Light for Maternal Mental Health and Substance Use Disorders Act of 2022, which would address critical issues of maternal mental health and well-being. ASAM joined a coalition letter urging Congress to support increased funding of important addiction prevention, treatment, harm reduction, and recovery support programs aimed at strengthening the addiction service workforce in Fiscal Year 2023. Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Supported HR 7246/S 3940 - the Student Athlete Opioid Misuse Prevention Act which would establish a grant program through SAMHSA to provide educational and training at the youth, high school, and collegiate level for students and student athletes themselves, as well as athletic directors, youth sports coaches and organizers, school administrators, and others on the signs and dangers of opioid and substance misuse, and strategies for prevention. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Supported H.R.7116- the 9-8-8 Implementation Act which would provide resources needed to improve the nations mental health/substance use crisis system.

Client expense: $90,000 · Firm income: Not reported

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for regulatory/sub-regulatory/application guidance that would require the use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant, including requiring each grantee delivering SUD treatment services to provide access to all FDA-approved medications for SUDs treated by that grantee. Advocated for a requirement that SAPT, State Opioid Response Grant (SOR), and Rural Communities Opioid Response Program grantees that receive grant funds for the delivery of addiction treatment services should be limited to Medicaid providers in order to better integrate federal grant dollars and Medicaid funds and Administration support for increased oversight and improved mechanisms for ensuring that such funding does not supplant the consistent and scalable funding that Medicaid (or Medicare) provides. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to increase promotion to State Medicaid programs of adoption of two, new sets of bundled G codes to increase or establish payment for outpatient opioid use disorder (OUD) treatment and treatment services provided by opioid treatment programs (OTPs) at Medicare payment rates or higher. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would create a special registration exemption for jails, prisons, and their authorized personnel to prescribe and otherwise dispense controlled medications for initiation, maintenance or withdrawal management of OUD that is significantly less burdensome than currently applicable registration requirements in the Controlled Substances Act and related regulations. Such special registration should not limit the number of persons who are detained or incarcerated who can be treated with such medications by a qualified practitioner; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; In the absence of Congressional action to eliminate the x-waiver, efforts to increase the DATA 2000 waiver patient limit -- aka, the applicable number; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Sent Congressional letter recommending closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education ASAM and ten other health professional associations have called for the FDA to immediately and fully retract its buprenorphine Drug Safety Communication of January 12, 2022. In their letter, the signatories maintain that the communication is based on flawed analysis. As part of the National Alliance for Underage Drinking, ASAM sent a letter to Representative Roybal-Allard, Representative Joyce, and Representative DeLauro in support of reauthorization of the Sober Truth on Preventing (STOP Act). First passed by Congress in 2006 and later reauthorized in the 21st Century Cures Act, the STOP Act aims to reduce underage age drinking through a comprehensive approach comprised of cost-effective, evidence-based strategies. On January 26th, ASAM submitted a comment letter to CMSs proposed rule Patient Protection and Affordable Care Act (ACA); HHS Notice of Benefit and Payment Parameters (the NBPP 2023 Rule). In its letter, ASAM supports, among other things: reinterpretation of the ACAs guaranteed availability requirement; the new interpretation would require issuers to enroll individuals with past-due premiums; reversion to pre-2020 non-discrimination protections that would prohibit certain exchanges, insurers, and agents and brokers from discriminating based on sexual orientation and gender identity; ensuring nondiscriminatory benefit design through refining the EHB nondiscrimination policy, providing a clear regulatory framework to evaluate plan benefit design and implementation based upon clinical guidelines and evidence; and requirements that issuers offer at least one standardized plan at every product network type, metal level, and in every service area where the issuer also offers non-standardized plans and that standardized plans use fixed copays instead of coinsurance. The letter also documents ASAMs general support for proposals related to network adequacy regulations, with recommendations for further refinement. On March 22, 2022, ASAM and other stakeholders sent a letter, spearheaded by former Representative Patrick J. Kennedy, to the Secretary of State Antony J. Blinken, and the U.S. Agency for International Development Administrator, Samantha Power. The letter urges mental health and substance use disorders (SUDs) be integrated in the U.S. - Ukraine relief efforts, and that the U.S. coordinate with multilateral health organizations and the World Health Organization to address mental health and SUDs caused and exacerbated by the invasion of Ukraine. ASAM joined a coalition letter to urge Congress to respond to a new and growing threat to our nations youth: e-cigarette manufacturers use of synthetic nicotine to evade Food and Drug Administration (FDA) oversight. Specifically, the letter urges Congress to quickly address this serious public health situation by enacting legislation at the earliest possible opportunity that enables FDAs Center for Tobacco Products to regulate synthetic nicotine products. ASAM joined a coalition letter to express support for the Food and Drug Administrations commitment to issuing proposed rules to prohibit menthol as a characterizing flavor in cigarettes and prohibit all characterizing flavors in cigars. Once issued, the letter urges FDA to move quickly to finalize and implement these life-saving rules. ASAM joined a coalition letter supporting the Into the Light for Maternal Mental Health and Substance Use Disorders Act of 2022, which would address critical issues of maternal mental health and well-being. ASAM joined a coalition letter urging Congress to support increased funding of important addiction prevention, treatment, harm reduction, and recovery support programs aimed at strengthening the addiction service workforce in Fiscal Year 2023. Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Supported HR 7246/S 3940 - the Student Athlete Opioid Misuse Prevention Act which would establish a grant program through SAMHSA to provide educational and training at the youth, high school, and collegiate level for students and student athletes themselves, as well as athletic directors, youth sports coaches and organizers, school administrators, and others on the signs and dangers of opioid and substance misuse, and strategies for prevention. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Supported H.R.7116- the 9-8-8 Implementation Act which would provide resources needed to improve the nations mental health/substance use crisis system.

Client expense: $90,000 · Firm income: Not reported

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for regulatory/sub-regulatory/application guidance that would require the use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant, including requiring each grantee delivering SUD treatment services to provide access to all FDA-approved medications for SUDs treated by that grantee. Advocated for a requirement that SAPT, State Opioid Response Grant (SOR), and Rural Communities Opioid Response Program grantees that receive grant funds for the delivery of addiction treatment services should be limited to Medicaid providers in order to better integrate federal grant dollars and Medicaid funds and Administration support for increased oversight and improved mechanisms for ensuring that such funding does not supplant the consistent and scalable funding that Medicaid (or Medicare) provides. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to increase promotion to State Medicaid programs of adoption of two, new sets of bundled G codes to increase or establish payment for outpatient opioid use disorder (OUD) treatment and treatment services provided by opioid treatment programs (OTPs) at Medicare payment rates or higher. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would create a special registration exemption for jails, prisons, and their authorized personnel to prescribe and otherwise dispense controlled medications for initiation, maintenance or withdrawal management of OUD that is significantly less burdensome than currently applicable registration requirements in the Controlled Substances Act and related regulations. Such special registration should not limit the number of persons who are detained or incarcerated who can be treated with such medications by a qualified practitioner; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; In the absence of Congressional action to eliminate the x-waiver, efforts to increase the DATA 2000 waiver patient limit -- aka, the applicable number; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Sent Congressional letter recommending closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education ASAM and ten other health professional associations have called for the FDA to immediately and fully retract its buprenorphine Drug Safety Communication of January 12, 2022. In their letter, the signatories maintain that the communication is based on flawed analysis. As part of the National Alliance for Underage Drinking, ASAM sent a letter to Representative Roybal-Allard, Representative Joyce, and Representative DeLauro in support of reauthorization of the Sober Truth on Preventing (STOP Act). First passed by Congress in 2006 and later reauthorized in the 21st Century Cures Act, the STOP Act aims to reduce underage age drinking through a comprehensive approach comprised of cost-effective, evidence-based strategies. On January 26th, ASAM submitted a comment letter to CMSs proposed rule Patient Protection and Affordable Care Act (ACA); HHS Notice of Benefit and Payment Parameters (the NBPP 2023 Rule). In its letter, ASAM supports, among other things: reinterpretation of the ACAs guaranteed availability requirement; the new interpretation would require issuers to enroll individuals with past-due premiums; reversion to pre-2020 non-discrimination protections that would prohibit certain exchanges, insurers, and agents and brokers from discriminating based on sexual orientation and gender identity; ensuring nondiscriminatory benefit design through refining the EHB nondiscrimination policy, providing a clear regulatory framework to evaluate plan benefit design and implementation based upon clinical guidelines and evidence; and requirements that issuers offer at least one standardized plan at every product network type, metal level, and in every service area where the issuer also offers non-standardized plans and that standardized plans use fixed copays instead of coinsurance. The letter also documents ASAMs general support for proposals related to network adequacy regulations, with recommendations for further refinement. On March 22, 2022, ASAM and other stakeholders sent a letter, spearheaded by former Representative Patrick J. Kennedy, to the Secretary of State Antony J. Blinken, and the U.S. Agency for International Development Administrator, Samantha Power. The letter urges mental health and substance use disorders (SUDs) be integrated in the U.S. - Ukraine relief efforts, and that the U.S. coordinate with multilateral health organizations and the World Health Organization to address mental health and SUDs caused and exacerbated by the invasion of Ukraine. ASAM joined a coalition letter to urge Congress to respond to a new and growing threat to our nations youth: e-cigarette manufacturers use of synthetic nicotine to evade Food and Drug Administration (FDA) oversight. Specifically, the letter urges Congress to quickly address this serious public health situation by enacting legislation at the earliest possible opportunity that enables FDAs Center for Tobacco Products to regulate synthetic nicotine products. ASAM joined a coalition letter to express support for the Food and Drug Administrations commitment to issuing proposed rules to prohibit menthol as a characterizing flavor in cigarettes and prohibit all characterizing flavors in cigars. Once issued, the letter urges FDA to move quickly to finalize and implement these life-saving rules. ASAM joined a coalition letter supporting the Into the Light for Maternal Mental Health and Substance Use Disorders Act of 2022, which would address critical issues of maternal mental health and well-being. ASAM joined a coalition letter urging Congress to support increased funding of important addiction prevention, treatment, harm reduction, and recovery support programs aimed at strengthening the addiction service workforce in Fiscal Year 2023. Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Supported HR 7246/S 3940 - the Student Athlete Opioid Misuse Prevention Act which would establish a grant program through SAMHSA to provide educational and training at the youth, high school, and collegiate level for students and student athletes themselves, as well as athletic directors, youth sports coaches and organizers, school administrators, and others on the signs and dangers of opioid and substance misuse, and strategies for prevention. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Supported H.R.7116- the 9-8-8 Implementation Act which would provide resources needed to improve the nations mental health/substance use crisis system.

Client expense: $90,000 · Firm income: Not reported

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for regulatory/sub-regulatory/application guidance that would require the use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant, including requiring each grantee delivering SUD treatment services to provide access to all FDA-approved medications for SUDs treated by that grantee. Advocated for a requirement that SAPT, State Opioid Response Grant (SOR), and Rural Communities Opioid Response Program grantees that receive grant funds for the delivery of addiction treatment services should be limited to Medicaid providers in order to better integrate federal grant dollars and Medicaid funds and Administration support for increased oversight and improved mechanisms for ensuring that such funding does not supplant the consistent and scalable funding that Medicaid (or Medicare) provides. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to increase promotion to State Medicaid programs of adoption of two, new sets of bundled G codes to increase or establish payment for outpatient opioid use disorder (OUD) treatment and treatment services provided by opioid treatment programs (OTPs) at Medicare payment rates or higher. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would create a special registration exemption for jails, prisons, and their authorized personnel to prescribe and otherwise dispense controlled medications for initiation, maintenance or withdrawal management of OUD that is significantly less burdensome than currently applicable registration requirements in the Controlled Substances Act and related regulations. Such special registration should not limit the number of persons who are detained or incarcerated who can be treated with such medications by a qualified practitioner; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; In the absence of Congressional action to eliminate the x-waiver, efforts to increase the DATA 2000 waiver patient limit -- aka, the applicable number; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Sent Congressional letter recommending closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education ASAM and ten other health professional associations have called for the FDA to immediately and fully retract its buprenorphine Drug Safety Communication of January 12, 2022. In their letter, the signatories maintain that the communication is based on flawed analysis. As part of the National Alliance for Underage Drinking, ASAM sent a letter to Representative Roybal-Allard, Representative Joyce, and Representative DeLauro in support of reauthorization of the Sober Truth on Preventing (STOP Act). First passed by Congress in 2006 and later reauthorized in the 21st Century Cures Act, the STOP Act aims to reduce underage age drinking through a comprehensive approach comprised of cost-effective, evidence-based strategies. On January 26th, ASAM submitted a comment letter to CMSs proposed rule Patient Protection and Affordable Care Act (ACA); HHS Notice of Benefit and Payment Parameters (the NBPP 2023 Rule). In its letter, ASAM supports, among other things: reinterpretation of the ACAs guaranteed availability requirement; the new interpretation would require issuers to enroll individuals with past-due premiums; reversion to pre-2020 non-discrimination protections that would prohibit certain exchanges, insurers, and agents and brokers from discriminating based on sexual orientation and gender identity; ensuring nondiscriminatory benefit design through refining the EHB nondiscrimination policy, providing a clear regulatory framework to evaluate plan benefit design and implementation based upon clinical guidelines and evidence; and requirements that issuers offer at least one standardized plan at every product network type, metal level, and in every service area where the issuer also offers non-standardized plans and that standardized plans use fixed copays instead of coinsurance. The letter also documents ASAMs general support for proposals related to network adequacy regulations, with recommendations for further refinement. On March 22, 2022, ASAM and other stakeholders sent a letter, spearheaded by former Representative Patrick J. Kennedy, to the Secretary of State Antony J. Blinken, and the U.S. Agency for International Development Administrator, Samantha Power. The letter urges mental health and substance use disorders (SUDs) be integrated in the U.S. - Ukraine relief efforts, and that the U.S. coordinate with multilateral health organizations and the World Health Organization to address mental health and SUDs caused and exacerbated by the invasion of Ukraine. ASAM joined a coalition letter to urge Congress to respond to a new and growing threat to our nations youth: e-cigarette manufacturers use of synthetic nicotine to evade Food and Drug Administration (FDA) oversight. Specifically, the letter urges Congress to quickly address this serious public health situation by enacting legislation at the earliest possible opportunity that enables FDAs Center for Tobacco Products to regulate synthetic nicotine products. ASAM joined a coalition letter to express support for the Food and Drug Administrations commitment to issuing proposed rules to prohibit menthol as a characterizing flavor in cigarettes and prohibit all characterizing flavors in cigars. Once issued, the letter urges FDA to move quickly to finalize and implement these life-saving rules. ASAM joined a coalition letter supporting the Into the Light for Maternal Mental Health and Substance Use Disorders Act of 2022, which would address critical issues of maternal mental health and well-being. ASAM joined a coalition letter urging Congress to support increased funding of important addiction prevention, treatment, harm reduction, and recovery support programs aimed at strengthening the addiction service workforce in Fiscal Year 2023. Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Supported HR 7246/S 3940 - the Student Athlete Opioid Misuse Prevention Act which would establish a grant program through SAMHSA to provide educational and training at the youth, high school, and collegiate level for students and student athletes themselves, as well as athletic directors, youth sports coaches and organizers, school administrators, and others on the signs and dangers of opioid and substance misuse, and strategies for prevention. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Supported H.R.7116- the 9-8-8 Implementation Act which would provide resources needed to improve the nations mental health/substance use crisis system.

Client expense: $90,000 · Firm income: Not reported

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for regulatory/sub-regulatory/application guidance that would require the use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant, including requiring each grantee delivering SUD treatment services to provide access to all FDA-approved medications for SUDs treated by that grantee. Advocated for a requirement that SAPT, State Opioid Response Grant (SOR), and Rural Communities Opioid Response Program grantees that receive grant funds for the delivery of addiction treatment services should be limited to Medicaid providers in order to better integrate federal grant dollars and Medicaid funds and Administration support for increased oversight and improved mechanisms for ensuring that such funding does not supplant the consistent and scalable funding that Medicaid (or Medicare) provides. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to increase promotion to State Medicaid programs of adoption of two, new sets of bundled G codes to increase or establish payment for outpatient opioid use disorder (OUD) treatment and treatment services provided by opioid treatment programs (OTPs) at Medicare payment rates or higher. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would create a special registration exemption for jails, prisons, and their authorized personnel to prescribe and otherwise dispense controlled medications for initiation, maintenance or withdrawal management of OUD that is significantly less burdensome than currently applicable registration requirements in the Controlled Substances Act and related regulations. Such special registration should not limit the number of persons who are detained or incarcerated who can be treated with such medications by a qualified practitioner; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; In the absence of Congressional action to eliminate the x-waiver, efforts to increase the DATA 2000 waiver patient limit -- aka, the applicable number; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Sent Congressional letter recommending closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education ASAM and ten other health professional associations have called for the FDA to immediately and fully retract its buprenorphine Drug Safety Communication of January 12, 2022. In their letter, the signatories maintain that the communication is based on flawed analysis. As part of the National Alliance for Underage Drinking, ASAM sent a letter to Representative Roybal-Allard, Representative Joyce, and Representative DeLauro in support of reauthorization of the Sober Truth on Preventing (STOP Act). First passed by Congress in 2006 and later reauthorized in the 21st Century Cures Act, the STOP Act aims to reduce underage age drinking through a comprehensive approach comprised of cost-effective, evidence-based strategies. On January 26th, ASAM submitted a comment letter to CMSs proposed rule Patient Protection and Affordable Care Act (ACA); HHS Notice of Benefit and Payment Parameters (the NBPP 2023 Rule). In its letter, ASAM supports, among other things: reinterpretation of the ACAs guaranteed availability requirement; the new interpretation would require issuers to enroll individuals with past-due premiums; reversion to pre-2020 non-discrimination protections that would prohibit certain exchanges, insurers, and agents and brokers from discriminating based on sexual orientation and gender identity; ensuring nondiscriminatory benefit design through refining the EHB nondiscrimination policy, providing a clear regulatory framework to evaluate plan benefit design and implementation based upon clinical guidelines and evidence; and requirements that issuers offer at least one standardized plan at every product network type, metal level, and in every service area where the issuer also offers non-standardized plans and that standardized plans use fixed copays instead of coinsurance. The letter also documents ASAMs general support for proposals related to network adequacy regulations, with recommendations for further refinement. On March 22, 2022, ASAM and other stakeholders sent a letter, spearheaded by former Representative Patrick J. Kennedy, to the Secretary of State Antony J. Blinken, and the U.S. Agency for International Development Administrator, Samantha Power. The letter urges mental health and substance use disorders (SUDs) be integrated in the U.S. - Ukraine relief efforts, and that the U.S. coordinate with multilateral health organizations and the World Health Organization to address mental health and SUDs caused and exacerbated by the invasion of Ukraine. ASAM joined a coalition letter to urge Congress to respond to a new and growing threat to our nations youth: e-cigarette manufacturers use of synthetic nicotine to evade Food and Drug Administration (FDA) oversight. Specifically, the letter urges Congress to quickly address this serious public health situation by enacting legislation at the earliest possible opportunity that enables FDAs Center for Tobacco Products to regulate synthetic nicotine products. ASAM joined a coalition letter to express support for the Food and Drug Administrations commitment to issuing proposed rules to prohibit menthol as a characterizing flavor in cigarettes and prohibit all characterizing flavors in cigars. Once issued, the letter urges FDA to move quickly to finalize and implement these life-saving rules. ASAM joined a coalition letter supporting the Into the Light for Maternal Mental Health and Substance Use Disorders Act of 2022, which would address critical issues of maternal mental health and well-being. ASAM joined a coalition letter urging Congress to support increased funding of important addiction prevention, treatment, harm reduction, and recovery support programs aimed at strengthening the addiction service workforce in Fiscal Year 2023. Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Supported HR 7246/S 3940 - the Student Athlete Opioid Misuse Prevention Act which would establish a grant program through SAMHSA to provide educational and training at the youth, high school, and collegiate level for students and student athletes themselves, as well as athletic directors, youth sports coaches and organizers, school administrators, and others on the signs and dangers of opioid and substance misuse, and strategies for prevention. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Supported H.R.7116- the 9-8-8 Implementation Act which would provide resources needed to improve the nations mental health/substance use crisis system.

Client expense: $90,000 · Firm income: Not reported

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for regulatory/sub-regulatory/application guidance that would require the use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant, including requiring each grantee delivering SUD treatment services to provide access to all FDA-approved medications for SUDs treated by that grantee. Advocated for a requirement that SAPT, State Opioid Response Grant (SOR), and Rural Communities Opioid Response Program grantees that receive grant funds for the delivery of addiction treatment services should be limited to Medicaid providers in order to better integrate federal grant dollars and Medicaid funds and Administration support for increased oversight and improved mechanisms for ensuring that such funding does not supplant the consistent and scalable funding that Medicaid (or Medicare) provides. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to increase promotion to State Medicaid programs of adoption of two, new sets of bundled G codes to increase or establish payment for outpatient opioid use disorder (OUD) treatment and treatment services provided by opioid treatment programs (OTPs) at Medicare payment rates or higher. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would create a special registration exemption for jails, prisons, and their authorized personnel to prescribe and otherwise dispense controlled medications for initiation, maintenance or withdrawal management of OUD that is significantly less burdensome than currently applicable registration requirements in the Controlled Substances Act and related regulations. Such special registration should not limit the number of persons who are detained or incarcerated who can be treated with such medications by a qualified practitioner; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; In the absence of Congressional action to eliminate the x-waiver, efforts to increase the DATA 2000 waiver patient limit -- aka, the applicable number; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Sent Congressional letter recommending closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education ASAM and ten other health professional associations have called for the FDA to immediately and fully retract its buprenorphine Drug Safety Communication of January 12, 2022. In their letter, the signatories maintain that the communication is based on flawed analysis. As part of the National Alliance for Underage Drinking, ASAM sent a letter to Representative Roybal-Allard, Representative Joyce, and Representative DeLauro in support of reauthorization of the Sober Truth on Preventing (STOP Act). First passed by Congress in 2006 and later reauthorized in the 21st Century Cures Act, the STOP Act aims to reduce underage age drinking through a comprehensive approach comprised of cost-effective, evidence-based strategies. On January 26th, ASAM submitted a comment letter to CMSs proposed rule Patient Protection and Affordable Care Act (ACA); HHS Notice of Benefit and Payment Parameters (the NBPP 2023 Rule). In its letter, ASAM supports, among other things: reinterpretation of the ACAs guaranteed availability requirement; the new interpretation would require issuers to enroll individuals with past-due premiums; reversion to pre-2020 non-discrimination protections that would prohibit certain exchanges, insurers, and agents and brokers from discriminating based on sexual orientation and gender identity; ensuring nondiscriminatory benefit design through refining the EHB nondiscrimination policy, providing a clear regulatory framework to evaluate plan benefit design and implementation based upon clinical guidelines and evidence; and requirements that issuers offer at least one standardized plan at every product network type, metal level, and in every service area where the issuer also offers non-standardized plans and that standardized plans use fixed copays instead of coinsurance. The letter also documents ASAMs general support for proposals related to network adequacy regulations, with recommendations for further refinement. On March 22, 2022, ASAM and other stakeholders sent a letter, spearheaded by former Representative Patrick J. Kennedy, to the Secretary of State Antony J. Blinken, and the U.S. Agency for International Development Administrator, Samantha Power. The letter urges mental health and substance use disorders (SUDs) be integrated in the U.S. - Ukraine relief efforts, and that the U.S. coordinate with multilateral health organizations and the World Health Organization to address mental health and SUDs caused and exacerbated by the invasion of Ukraine. ASAM joined a coalition letter to urge Congress to respond to a new and growing threat to our nations youth: e-cigarette manufacturers use of synthetic nicotine to evade Food and Drug Administration (FDA) oversight. Specifically, the letter urges Congress to quickly address this serious public health situation by enacting legislation at the earliest possible opportunity that enables FDAs Center for Tobacco Products to regulate synthetic nicotine products. ASAM joined a coalition letter to express support for the Food and Drug Administrations commitment to issuing proposed rules to prohibit menthol as a characterizing flavor in cigarettes and prohibit all characterizing flavors in cigars. Once issued, the letter urges FDA to move quickly to finalize and implement these life-saving rules. ASAM joined a coalition letter supporting the Into the Light for Maternal Mental Health and Substance Use Disorders Act of 2022, which would address critical issues of maternal mental health and well-being. ASAM joined a coalition letter urging Congress to support increased funding of important addiction prevention, treatment, harm reduction, and recovery support programs aimed at strengthening the addiction service workforce in Fiscal Year 2023. Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Supported HR 7246/S 3940 - the Student Athlete Opioid Misuse Prevention Act which would establish a grant program through SAMHSA to provide educational and training at the youth, high school, and collegiate level for students and student athletes themselves, as well as athletic directors, youth sports coaches and organizers, school administrators, and others on the signs and dangers of opioid and substance misuse, and strategies for prevention. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Supported H.R.7116- the 9-8-8 Implementation Act which would provide resources needed to improve the nations mental health/substance use crisis system.

Client expense: $90,000 · Firm income: Not reported

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

H.R. 4217, "TRIUMPH for New Moms Act of 2021", all provisions. H.R. 909/S. 484, "MOMS Matter Act", all provisions. Issues pertaining to maternal mental health. P.L. 116-93, "Consolidated Appropriations Act of 2020", all provisions.

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

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

Legislation and policies relating to: Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Provisions of the Infrastructure Investment and Jobs Act (H.R. 3684) related to public health infrastructure improvements H.R. 909/S. 484, Moms Matter Act H.R. 959/S. 346, Black Maternal Health Momnibus Act of 2021 H.R. 2347/S. 2691, Strengthening the Vaccines for Children Program Act of 2021 H.R. 4217, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act H.R. 5376, Build Back Better Act - provisions related to nursing education infrastructure, health equity, social determinants of health, mental and behavioral health for patients and health care providers, and child and maternal health S.J. Res. 29 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Labor relating to COVID-19 Vaccination and Testing, Emergency Temporary Standard S. 104/H.R. 379, Improving Social Determinants of Health Act of 2021 S. 610/H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act S. 674, Public Health Infrastructure Saves Lives Act S. 1902, Behavioral Health Crisis Services Expansion Act

Client expense: Not reported · Firm income: $26,600

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

Legislation and policies relating to: Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Provisions of the Infrastructure Investment and Jobs Act (H.R. 3684) related to public health infrastructure improvements Provisions of the draft Build Back Better Act related to health equity, social determinants of health, mental and behavioral health for patients and health care providers, and child and maternal health H.R. 66, Comprehensive Access to Robust Insurance Now Guaranteed for Kids (CARING for Kids) Act H.R. 482, Newborn Screening Saves Lives Reauthorization Act of 2021 H.R. 485, Stronger Child Abuse Prevention and Treatment Act H.R. 550, Immunization Infrastructure Modernization Act of 2021 H.R. 909/S. 484, Moms Matter Act H.R. 959/S. 346, Black Maternal Health Momnibus Act of 2021 H.R. 1065/S. 1486, Pregnant Workers Fairness Act H.R. 1324/S/ 467, Effective Suicide Screening and Assessment in the Emergency Department Act of 2021 H.R. 1390, Childrens Health Insurance Program Pandemic Enhancement and Relief (CHIPPER) Act H.R. 1791, Childrens Health Insurance Program Permanency (CHIPP) Act H.R. 2094/S. 1301, Promoting Physical Activity for Americans Act H.R. 2347/S. 2691, Strengthening the Vaccines for Children Program Act of 2021 H.R. 3110, Providing Urgent Maternal Protections to Nursing Mothers (PUMP) Act H.R. 3182, Safe Sleep for Babies Act of 2021 H.R. 4217, Taskforce Recommending Improvements for Unaddressed Mental Perinatal & Postpartum Health (TRIUMPH) for New Moms Act H.R. 5235, Student Mental Health Helpline Act of 2021 H.R. 5487, Stillbirth Health Improvement and Education (SHINE) for Autumn Act of 2021 S.J. Res. 29 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Labor relating to COVID-19 Vaccination and Testing, Emergency Temporary Standard S. 104/H.R. 379, Improving Social Determinants of Health Act of 2021 S. 248/H.R. 804, Family and Medical Insurance Leave (FAMILY) Act S. 499/H.R. 369, Improving Health Insurance Affordability Act of 2021 S. 610/H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act S. 674, Public Health Infrastructure Saves Lives Act S. 844/H.R. 3109, PHIT Act of 2021 S. 1259, Safe Cribs Act S. 1275/H.R. 2119, Family Violence Prevention and Services Improvement Act of 2021 S. 1301/H.R. 2094, Promoting Physical Activity for Americans Act S. 1658/H.R. 3110, Providing Urgent Maternal Protections for Nursing Mothers Act S. 1675, Maternal Health Quality Improvement Act S. 1902, Behavioral Health Crisis Services Expansion Act

Client expense: Not reported · Firm income: $24,000

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA)

H.R. 205 - Accelerating Broadband Connectivity Act of 2021 - Rep. Kelly, Trent [R-MS-1] - broadband H.R. 341 - Ensuring Telehealth Expansion Act of 2021 - Rep. Williams, Roger [R-TX-25] - telehealth H.R. 366 - Protecting Access to Post-COVID-19 Telehealth Act of 2021 - Rep. Thompson, Mike [D-CA-5] - telehealth H.R. 379 - Improving Social Determinants of Health Act of 2021 - Rep. Barragan, Nanette Diaz [D-CA-44] - SDOH H.R. 434 - Preventing Mental Health and Substance Use Crises During Emergencies Act - Rep. Trone, David J. [D-MD-6] - mental health and SUD H.R. 596 - ACCESS Act - Rep. Schakowsky, Janice D. [D-IL-9] - telehealth H.R. 675 - COVID-19 Price Gouging Prevention Act - Rep. Schakowsky, Janice D. [D-IL-9] - price gouging H.R. 747 - Access to TESTs Act - Rep. DeGette, Diana [D-CO-1] - COVID-19 H.R. 909 - Moms Matter Act - Rep. Blunt Rochester, Lisa [D-DE-At Large] - maternal health H.R. 925 - Data to Save Moms Act - Rep. Davids, Sharice [D-KS-3] - maternal health H.R. 937 - Tech To Save Moms Act - Rep. Johnson, Eddie Bernice [D-TX-30] - maternal health H.R. 943 - Social Determinants for Moms Act - Rep. McBath, Lucy [D-GA-6] - maternal health H.R. 951 - Maternal Vaccination Act - Rep. Sewell, Terri A. [D-AL-7] - maternal health H.R. 959 - To end preventable maternal mortality and severe maternal morbidity in the United States and close disparities in maternal health outcomes, and for other purposes - Rep. Underwood, Lauren [D-IL-14] - maternal health H.R. 1046 - Federal Broadband Deployment in Unserved Areas Act - Rep. Curtis, John R. [R-UT-3] - broadband H.R. 1218 - Data Mapping to Save Moms Lives Act - Rep. Butterfield, G. K. [D-NC-1] - maternal health H.R. 1319 - American Rescue Plan Act of 2021 - Rep. Yarmuth, John A. [D-KY-3] - COVID-19 relief H.R. 1332 - Telehealth Modernization Act - Rep. Carter, Earl L. "Buddy" [R-GA-1] - telehealth H.R. 1721 - To amend the Consolidated Appropriations Act, 2021 to authorize additional funds for the Emergency Broadband Connectivity Fund, to provide grants to States and Tribal Entities to strengthen the National Lifeline Eligibility Verifier, to provide for Federal coordination between the National Lifeline Eligibility Verifier and the National Accuracy Clearinghouse, and for other purposes - Rep. Veasey, Marc A. [D-TX-33] - broadband and telehealth H.R. 1872 - MORE Health Education Act - Rep. Blunt Rochester, Lisa [D-DE-At Large] - health education H.R. 1888 - Improving Access to Indian Health Services Act- Rep. Ruiz, Raul [D-CA-36] - FMAP for Indian health services H.R. 2010 - To amend the Patient Protection and Affordable Care Act to establish a public health insurance option - Rep. DeFazio, Peter A. [D-OR-4] - public option H.R. 3063 - MOMMIES Act - Rep. Pressley, Ayanna [D-MA-7] - maternal health H.R. 3126 - Healthy MOM Act - Rep. Watson Coleman, Bonnie [D-NJ-12] - maternal health H.R. 3407 - MOMMAs Act - Rep. Kelly, Robin L. [D-IL-2] - maternal health H.R. 3688 - To address maternal mortality and morbidity - Rep. Adams, Alma S. [D-NC-12] - maternal health H.R. 3753 - Parity Implementation Assistance Act - Rep. Cardenas, Tony [D-CA-29] - mental health and SUD H.R. 4026 - Social Determinants of Health Data Analysis Act of 2021 - Rep. Burgess, Michael C. [R-TX-26] - SDOH H.R. 4387 - Maternal Health Quality Improvement Act of 2021 - Rep. Kelly, Robin L. [D-IL-2] - maternal health H.R. 4502 - Labor, Health and Human Services, Education, Agriculture, Rural Development, Energy and Water Development, Financial Services and General Government, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2022 - Rep. DeLauro, Rosa L. [D-CT-3] - health care funding H.R. 4918 - Rural Telehealth Expansion Act - Rep. Rosendale Sr., Matthew M. [R-MT-At Large] - telehealth and rural health H.R. 5376 - Build Back Better Act - Rep. Yarmuth, John A. [D-KY-3] - health care funding H.R. 5506 - Rural Telehealth Access Task Force Act - Rep. Pence, Greg [R-IN-6] - telehealth and rural health H.R. 5837 - To amend title XVIII of the Social Security Act to expand access to telehealth services relating to substance use disorder treatment - Rep. Curtis, John R. [R-UT-3] - telehealth SUD services S. 104 - Improving Social Determinants of Health Act of 2021- Sen. Smith, Tina [D-MN] - SDOH S. 168 - TREAT Act - Sen. Murphy, Christopher [D-CT] - telehealth S. 287 - A bill to direct the Secretary of Health and Human Services to issue guidance to States to educate providers, managed care entities, and other insurers about the value and process of delivering respectful maternal health care through diverse and multidisciplinary care provider models, and for other purposes - Sen. Baldwin, Tammy [D-WI] - maternal health S. 334 - IMPACT to Save Moms Act - Sen. Casey, Robert P., Jr. [D-PA] - maternal health S. 345 - Maternal Vaccinations Act - Sen. Kaine, Tim [D-VA] - maternal health S. 346 - Black Maternal Health Momnibus Act of 2021 - Sen. Booker, Cory A. [D-NJ] - maternal health S. 347 - Data to Save Moms Act - Sen. Smith, Tina [D-MN] - maternal health S. 368 - Telehealth Modernization Act - Sen. Scott, Tim [R-SC] - telehealth S. 408 - Supporting Best Practices for Healthy Moms Act - Sen. Toomey, Pat [R-PA] - maternal health S. 411 - MOMMAs Act - Sen. Durbin, Richard J. [D-IL] - maternal health S. 851 - A bill to address social determinants of maternal health - Sen. Blumenthal, Richard [D-CT] - SDOH S. 983 - A bill to amend the Patient Protection and Affordable Care Act to establish a public health insurance option, and for other purposes - Sen. Whitehouse, Sheldon [D-RI] - public option S. 1333 - A bill to address maternal mortality and morbidity - Sen. Gillibrand, Kirsten E. [D-NY] - maternal health S. 1542 - MOMMIES Act - Sen. Booker, Cory A. [D-NJ] - maternal health S. 1622 - HEALTH for MOM Act of 2021 - Sen. Portman, Rob [R-OH] - maternal health S. 1704 - Telehealth Expansion Act of 2021 - Sen. Daines, Steve [R-MT] - telehealth S. 1804 - Mothers and Newborns Success Act - Sen. Kaine, Tim [D-VA] - maternal health S. 1833 - Ensuring Access to Primary Care for Women & Children Act - Sen. Brown, Sherrod [D-OH] - maternal health S. 1962 - Parity Implementation Assistance Act - Sen. Murphy, Christopher [D-CT] - mental health and SUD S. 1988 - Protecting Rural Telehealth Access Act - Sen. Manchin, Joe, III [D-WV] - telehealth S. 2061 - Telemental Health Care Access Act of 2021 - Sen. Cassidy, Bill [R-LA] - telehealth S. 2779 - TRIUMPH for New Moms Act of 2021 - Sen. Hassan, Maggie [D-NH] - maternal health and mental health S. 3039 - Social Determinants Accelerator Act of 2021 - Sen. Young, Todd [R-IN] - SDOH S. 3062 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2022 - Sen. Murray, Patty [D-WA] - HHS 2022 appropriations Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10), identifiers, enforcement; cybersecurity; FEHBP enrollment data clearinghouse initiative, the enrollment reconciliation process, and a related OPM reimbursement factor for records that cannot be reconciled; issues relating to health insurance plan participation in FEHBP, including contract requirements; issues related to Medicare Secondary Payer requirements; issues related to health care price transparency; issues related to all payor claims databases; issues related to implementation of the National Health Information Infrastructure; electronic health records, personal health records, and similar technologies; issues relating to market consolidation; issues related to hospital and provider consolidation; issues related to trauma-informed care; issues related to medical management; issues relating to quality improvement; issues relating to the national health data stewardship; issues relating to hospital outpatient measurement and reporting; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to health equity; issues related to vaccination; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; prescription drug pricing; telemedicine; rural health; issues related to behavioral health benefits; issues related to Managed Long Term Services and Supports (MLTSS); issues related to the collection of race and ethnicity data; issues related to medical loss ratios; reference pricing; review of rates for reasonableness; preexisting condition insurance plans; issues relating to antitrust; issues related to repeal of the antitrust-related portions of the McCarran-Ferguson Act; issues relating to surprise medical bills; accountable care organizations; provider non-discrimination; coverage of preventive services; contraceptive coverage; pre-existing condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; issues related to health insurance tax; health plan automatic enrollment requirements; issues related to qualified health plans including certification and rate filing templates; health insurance market rules; reinsurance, risk corridors, and risk adjustment; dependent coverage; summary of benefits and coverage disclosures; benefit and payment parameters; essential health benefits, actuarial value, and accreditation; NQF reauthorization; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations; issues related to supplemental products; issues related to HIPAA excepted benefits; issues related to short term limited duration products; issues related to the federally-facilitated marketplaces (i.e., Exchanges/formerly referred to as the web portal); issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); issues related to association health plans; issues related to cost-sharing reductions (CSRs); issues related to the refundable credit for coverage under a qualified health plan and enhancements included in the American Rescue Plan Act (ARPA); issues related to Medicaid coverage gap; issues related to small employer group size; issues related to Certificate of Public Advantage; issues relating to veterans health care; issues relating to caregivers; and other issues relating to health care reform implementation.

Client expense: $2,630,000 · Firm income: Not reported

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

Momnibus Legislation Medicaid Postpartum Coverage Extension MCH Block Grant and Maternal Health Program Funding Support FY 2022 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Momnibus Legislation MCH Block Grant and Maternal Health Program Funding Support FY 2022 H.R. 3337/S. 1716, Birth Access Benefiting Improved Essential Facility Services (BABIES) Act H.R. 909/S.484, The Moms Matter Act S. 1675/H.R. 4387, Maternal Health Quality Improvement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE