Transparent PRICE Act

H.R. 485 - Protecting Health Care For All Patients Act of 2023 - Rep. McMorris Rodgers, Cathy - federal programs using prices based on quality-adjusted life years H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023 - Rep. Walberg, Tim - telehealth and ERISA amendments H.R. 830 - HELP Copays Act - Rep. Carter, Earl - health insurers responsibility for payments made by or on behalf of a plan enrollee toward a plans cost-sharing requirements H.R. 1488 - Affordable Insulin Now Act of 2023 - Rep. Craig, Angie - cost-sharing for insulin products H.R. 2666 - MVP Act - Rep. Guthrie, Brett - value-based purchasing arrangements under Medicaid program and reforms to price reporting H.R. 2691 - Transparent Price Act - Rep. McMorris Rodgers, Cathy - health insurer price transparency H.R. 2813 - Self-Insurance Protection Act - Rep. Good, Bob - ERISA amendments H.R. 2868 - Association Health Plans Act - Rep. Walberg, Tim - ERISA amendments H.R. 2872 - Further Additional Continuing Appropriations and Other Extensions Act, 2024 - Rep. Graves, Garret - extends FY24 funding and program authorities through March 8, 2024 H.R. 2882 - Further Consolidated Appropriations Act, 2024 - Rep. Ciscomani, Juan - provides annual funding through September 30, 2024, for the Departments of Labor, Health and Human Services, and Education, and Related Agencies H.R. 3305 - Black Maternal Health Momnibus Act - Rep. Underwood, Lauren - maternal health including in Medicaid and CHIP H.R. 3561 - PATIENT Act - Rep. McMorris Rodgers, Cathy - PBM transparency, PBM contract design, health insurance transparency, hospital transparency H.R. 3799 - Custom Health Option and Individual Care Expense Arrangement Act- Rep. Hern, Kevin - health reimbursement arrangements H.R. 3801 - Employer Reporting Improvement Act - Rep. Smith, Adrian - ACA reporting requirements H.R. 6956 - Opioid Settlement Accountability Act - Rep. Kaptur, Marcy - funding for opioid prevention and treatment services, training, equipment, and social support services H.R. 6960 - Emergency Medical Services for Children Reauthorization Act of 2024 - Rep. Carter, Earl L. Buddy - funding for emergency medical services for children program H.R. 7513 - Protecting Americas Seniors Access to Care Act - Rep. Fischbach, Michelle - regarding minimum staffing for nursing facilities H.R. 7858 - Telehealth Enhancement for Mental Health Act of 2024 - Rep. James, John - Medicare, behavioral health, telehealth H.R. 7899 - To direct the Attorney General, in consultation with the Secretary of Health and Human Services, to promulgate the final regulations relating to special registration for telemedicine. - Rep. Ezell, Mike - telehealth H.R. 7907 - Welcome Back to the Health Care Workforce Act - Rep. Krishnamoorthi, Raja- grants/funding, health care workforce H.R. 7929 - Nursing Home Workforce Support and Expansion Act of 2024 - Rep. Horsford, Steven - grants/funding, health care workforce H.R. 7994 - Long-Term Care Workforce Support Act - Rep. Dingell, Debbie - health care workforce H.R. 8444 - Mental Health in Schools Act - Rep. Napolitano, Grace - grant to promote mental health S. 1606 - A bill to end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. - Sen. Booker, Cory - maternal mortality S. 3393 - SUPPORT for Patients and Communities Reauthorization Act. - Sen. Sanders, Bernie - SUD treatment S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 - Sen. Wyden, Ron - mental health, telehealth, health workforce S. 3612 - Access to Family Building Act- Sen. Duckworth, Tammy- right to access reproductive technology (ex. IVF) S. 3756 - At HOME Services Act of 2024- Sen. Rubio, Marco- pilot program for outpatient observation, acute care at home S. 3775 - BOLD Infrastructure for Alzheimers Reauthorization Act of 2024- Sen. Collins, Susan - healthcare infrastructure, Alzheimers S. 3805 - A bill to amend title XI of the Social Security Act to prohibit health plans from imposing fees on health care providers for electronic funds transfers and health care payment and remittance advice transactions, and for other purposes. - Sen. Cassidy, Bill - SSA, healthcare, electronic funds, payments, remittance S. 3847 - Improving Social Determinants of Health Act of 2024- Sen. Smith, Tina- CDC authorization S. 4088 - Welcome Back to the Health Care Workforce Act - Sen. Kaine, Tim - grants/funding, health care workforce S. 4120 - Long-Term Care Workforce Support Act - Sen. Casey, Robert P., Jr. - health care workforce S. 4195 - Childhood Diabetes Reduction Act of 2024 - Sen. Sanders, Bernie - nutrition labeling S. 4357 - Comprehensive Dental Reform Act of 2024- Sen. Sanders, Bernie - promotes access to oral health care S. 4358 - Preventing and Treating Substance Use Disorders Among Older Adults Act- Sen. Casey, Robert - SAMHSA grant program for SUDs S. 4554 - Reproductive Freedom for Women Act- Sen. Murray, Patty - protecting abortion and reproductive rights Issues related to broadband and public health infrastructure; mental health and telehealth; behavioral health; rural health; substance use disorder treatments; Health Savings Accounts; provider directories; artificial intelligence and privacy; insurance industry response to and support for providers regarding the Change Healthcare cyberattack; ACA Marketplace; and Mental Health Parity Proposed Rule.

Client expense: $2,390,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, SENATE, White House Office

Q2 Lobbying Report (April 1-June 30) HCR Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program Resident Physician Shortage Act of 2023 (H.R. 2389) No Surprises Act regulations Food and Drug Amendments No Surprise Bills for New Moms Act (H.R. 3387) Securing the U.S. Organ Procurement and Transplantation Network Act (H.R. 2544) Promoting Access to Treatments and Increasing Extremely Needed Transparency Act (H.R. 3561) Medicaid VBPs for Patients (MVP) Act (H.R. 2666) Providers and Payers COMPETE Act (H.R. 3284) To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290) Transparent PRICE Act (H.R. 3281/H.R. 2691)) Resident Physician Shortage Reduction (S. 1302) Medical Student Education Authorization Act (H.R. 3046) Save Americas Rural Hospitals Act (H.R. 833) Chronic Care Management Improvement Act (H.R. 2829) Safety From Violence for Healthcare Employees Act (H.R. 2584) Supporting Safety Net Hospitals Act (H.R. 2665) Patient Access to Higher Quality Health Care Act (H.R. 977/S.470) FEMA re: COVID-19 related reimbursement Public Health Guidance Transparency and Accountability Act of 2023 (H.R. 4529) Public Health Emergency Congressional Review Act (H.R. 4381) CDC Leadership Accountability Act of 2023 (H.R. 3813) Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) Preparedness and Response Reauthorization Act (H.R. 4420) Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887) Health Care Price Transparency Act of 2023 (H.R. 4822) Providers and Payers COMPETE Act (H.R. 3284) Lower Costs, More Transparency Act (H.R. 5378 Transparency in Coverage Act (H.R. 4507) GOLD Card Act of 2023 (H.R. 4968) No Fees for EFTs Act (H.R.6487) Rural Health Care Facilities Revitalization Act (H.R. 5989) Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (H.R. 7153) To amend title XVIII of the Social Security Act to establish a definition of essential health system in statute (H.R. 7397) Substance Use Disorder Workforce Act (H.R. 7050) 340B PATIENTS Act (H.R. 7635) The 340B Affording Care for Communities and Ensuring a Strong Safety-net (ACCESS) Act (H.R. 8574) Improving Seniors Access to Timely Care Act (H.R. 8702/S.4532) The Preserving Emergency Access in Key Sites (PEAKS) Act (H.R. 7931) Rural Health Care Facilities Revitalization Act (H.R. 5989) MMM Accelerated and Advance Payment Program repayment flexibility Graduate Medical Education (GME) funding Telehealth flexibilities and payment Annual Prospective Payment System Rules Organ acquisition payment policies Californias Medicaid Hospital Quality Assurance Fee Program BUD FY 2024 Appropriations bills Nursing and allied health workforce funding FY 2024 budget request Further Continuing Appropriations and Other Extensions Act (H.R. 6363) Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R. 5894) Tax Relief for American Families and Workers Act of 2024 (H.R. 7024) Extension of Continuing Appropriations and Other Matters Act, 2024 (H.R. 7463) Submitted Comments Regulatory Comment Letters SUBJECT: CMS-1808-P, Medicare and Medicaid Programs and the Childrens Health Insurance Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2025 Rates; Quality Programs Requirements; and Other Policy Changes; Proposed Rule, Federal Register (Vol. 89, No. 86), May 2, 2024 SUBJECT: CMS-4207-NC, Medicare Program; Request for Information on Medicare Advantage Data, Federal Register (Vol. 89, No. 20), January 30, 2024 SUBJECT: CMS-1806-P, Medicare Program; FFY 2025 Inpatient Psychiatric Facilities Prospective Payment System - Rate Update, Proposed Rule, Federal Register (Vol. 89, No. 65), April 3, 2024 SUBJECT: CMS-1804-P, Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for FFY 2025 and Updates to the IRF Quality Reporting Program; Proposed Rule, Federal Register (Vol. 89, No. 62), March 29, 2024 SUBJECT: Docket No. ATR 102 - Request for Information on Consolidation in Health Care Markets SUBJECT: CMS-3367-P, Medicare Program; Strengthening Oversight of Accrediting Organizations (AOs) and Preventing AO Conflict of Interest, and Related Provisions, Proposed Rule, Federal Register (Vol 89, No 32), February 15, 2024 Legislative Comment Letters Rep. Ami Bera Request for Information Regarding the Current State of Artificial Intelligence (AI) in the Health Care Industry, April 30, 2024 Senate Request for Information Regarding Draft SUSTAIN 340B Act, April 1, 2024

Client expense: $420,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Issues related to prescription drug coverage and pharmacy benefits Issues related to the prescription drug marketplace, patents, and competition Regulatory and proposed legislative changes to Medicare Part D and Medicaid prescription drug benefits S.113 - Prescription Pricing for the People Act S.127 - Pharmacy Benefit Manager Transparency Act S.142 - Preserve Access to Affordable Generics and Biosimilars Act S.148 - Stop STALLING Act S.150 - Affordable Prescriptions for Patients Act S.652 - Safe Step Act S.655 - Chronic Disease Management Act S.727 - Insulin for All Act S.775 - Increasing Transparency in Generic Drug Applications Act S.954 - Affordable Insulin Now Act S.1038 - Drug Price Transparency in Medicaid Act S.1067 - Ensuring Timely Access to Generics Act S.1114 - Expanding Access to Low-Cost Generics Act S.1120 - Improved Access to Affordable Medications Act S.1128 - Ensuring Access to Generic Medications Act S.1130 - Health Care PRICE Transparency Act S.1131 - Drug Price Transparency Act S.1217 - Ending the Prescription Drug Kickback Act S.1218 - Fair Prescription Drug Prices for Americans Act S.1269 - INSULIN Act S.1339 - Pharmacy Benefit Manager Reform Act S.1375 - HELP Copays Act S.1497 - Emergency Access to Insulin Act S.1491 - Pharmacy and Medically Underserved Areas Enhancement Act S.1542 - Delinking Revenue from Unfair Gouging (DRUG) Act S.1543 - A bill to require regulations concerning the disclosure of direct and indirect compensation from entities providing pharmacy benefit management services or third party administration services S.1967 - Patients Before Middlemen (PBM) Act S.2052 - Protect Patient Access to Pharmacies Act S.2129 - Ensuring Access to Lower-Cost Medicines for Seniors Act S.2254 - Medicare PBM Accountability Act S.2405 - Strengthening Pharmacy Access for Seniors Act S.2406 - PBM Oversight Act S.2408 - IMPROVE Part D Regulations Act S.2436 - Neighborhood Options for Patients Buying Medicines (NO PBM) Act S.2456 - Protecting Seniors from High Drug Costs Act S.2474 - Share the Savings with Seniors Act S.2477 - Equitable Community Access to Pharmacist Services Act S.2493 - PBM Reporting Transparency Act S.2666 - EPCS 2.0 Act S.2840 - Bipartisan Primary Care and Health Workforce Act (Bruan Amendment #3 - Price Transparency Requirements) S.2939 - Pharmacy Access Oversight and Reporting Act S.2973 - Modernizing and Ensuring PBM Accountability Act S.3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act H.R.830 - HELP Copays Act H.R.1352 - Increasing Access to Biosimilars Act H.R.1488 - Affordable Insulin Now Act H.R.1587 - Making Insulin Affordable for All Children Act H.R.1613 - Drug Price Transparency in Medicaid Act H.R.1770 - Equitable Community Access to Pharmacists Act H.R.1790 - Biologics Competition Act H.R.2630 - Safe Step Act H.R.2666 - Medicaid VBPs for Patients (MVP) Act H.R.2670 - PBM Accountability Act H.R.2691 - Transparent PRICE Act H.R.2880 - Protecting Patients Against PBM Abuses Act H.R.3030 - Stop the Overuse of Petitions and Get Affordable Medicines to Enter Soon (STOP GAMES) Act H.R.3134 - Emergency Access to Insulin Act H.R.3262 - to amend title XI of the Social Security Act to increase transparency of certain health-related ownership information H.R.3281 - Transparent PRICE Act H.R.3282 - Promoting Transparency and Health Competition in Medicare Act H.R.3285 - Fairness for Patient Medications H.R.3561- Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act H.R.3800 - Chronic Disease Flexible Coverage Act H.R.4011 - Timely Access to Clinical Treatment Act H.R.4507 - Transparency in Coverage Act H.R.4508 - Hidden Fee Disclosure Act H.R.4509 - Transparency in Billing Act H.R.4527 - Health Data Act H.R.4712 - Patient Right to Shop Act H.R.4822 - Health Care Price Transparency Act H.R.4846 - To amend the Internal Revenue Code of 1986, title XXVII of the Public Health Service Act, and the Employee Retirement Income Security Act of 1974 to provide for oversight of pharmacy benefit manager services H.R.4881 - To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program H.R.4883 - Medicare Common Ownership Transparency Act H.R.5372 - Expanding Seniors Access to Lower Cost Medicines Act H.R.5376 - Share the Savings with Seniors Act H.R.5378 - Lower Costs More Transparency Act H.R.5384 - Advancing Enrollment and Reducing Drug Costs Act H.R.5385 - Medicare PBM Accountability Act H.R.5386 - Cutting Copays Act H.R.5393 -Transparency and Fairness for Pharmacies Act H.R.5400 - Neighborhood Options for Patients Buying Medicines (NO PBM) Act H.R.5461 - Ensuring Access to Lower-Cost Medicines for Seniors Act Implementation of the Inflation Reduction Act of 2022, P.L. 169- Provisions on Medicare Part D modernization and drug price negotiation

Client expense: $4,803,802 · 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), SENATE

H.R. 485 - Protecting Health Care For All Patients Act of 2023 - Rep. McMorris Rodgers, Cathy - federal programs using prices based on quality-adjusted life years H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023 - Rep. Walberg, Tim - treating benefits for telehealth services offered under a group health plan or group health insurance coverage as excepted benefits H.R. 830 - HELP Copays Act - Rep. Carter, Earl - health insurers responsibility for payments made by or on behalf of a plan enrollee toward a plans cost-sharing requirements H.R. 1488 - Affordable Insulin Now Act of 2023 - Rep. Craig, Angie - cost-sharing for insulin products H.R. 2666 - MVP Act - Rep. Guthrie, Brett - value-based purchasing arrangements under Medicaid program and reforms to price reporting H.R. 2691 - Transparent Price Act - Rep. McMorris Rodgers, Cathy - health insurer price transparency H.R. 2813 - Self-Insurance Protection Act - Rep. Good, Bob - ERISA amendments H.R. 2868 - Association Health Plans Act - Rep. Walberg, Tim - ERISA amendments H.R. 2872 - Further Additional Continuing Appropriations and Other Extensions Act, 2024 - Rep. Graves, Garret - extends FY24 funding and program authorities through March 8, 2024 H.R. 2882- Further Consolidated Appropriations Act, 2024 - Rep. Ciscomani, Juan - provides annual funding through September 30, 2024, for the Departments of Labor, Health and Human Services, and Education, and Related Agencies H.R. 3305 - Black Maternal Health Momnibus Act - Rep. Underwood, Lauren - maternal health including in Medicaid and CHIP H.R. 3561 - PATIENT Act - Rep. McMorris Rodgers, Cathy - PBM transparency, PBM contract design, health insurance transparency, hospital transparency H.R. 3799 - Custom Health Option and Individual Care Expense Arrangement Act- Rep. Hern, Kevin - health reimbursement arrangements H.R. 3801 - Employer Reporting Improvement Act - Rep. Smith, Adrian - ACA reporting requirements H.R. 6956 - Opioid Settlement Accountability Act - Rep. Kaptur, Marcy - funding for opioid prevention and treatment services, training, equipment, and social support services H.R. 6960 - Emergency Medical Services for Children Reauthorization Act of 2024 - Rep. Carter, Earl L. - funding for emergency medical services for children program H.R. 7513 - Protecting Americas Seniors Access to Care Act - Rep. Fischbach, Michelle - regarding minimum staffing for nursing facilities S. 1606 - A bill to end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. - Sen. Booker, Cory - maternal mortality S. 3393 - SUPPORT for Patients and Communities Reauthorization Act - Sen. Sanders, Bernie - SUD treatment S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 - Sen. Wyden, Ron - mental health, telehealth, health workforce S. 3612- Access to Family Building Act- Sen. Duckworth, Tammy- right to access reproductive technology (ex. IVF) S. 3756- At HOME Services Act of 2024- Sen. Rubio, Marco- pilot program for outpatient observation, acute care at home S. 3775- BOLD Infrastructure for Alzheimer's Reauthorization Act of 2024- Sen. Collins, Susan - healthcare infrastructure, Alzheimers S. 3805- A bill to amend title XI of the Social Security Act to prohibit health plans from imposing fees on health care providers for electronic funds transfers and health care payment and remittance advice transactions, and for other purposes. - Sen. Cassidy, Bill - SSA, healthcare, electronic funds, payments, remittance S. 3847- Improving Social Determinants of Health Act of 2024- Sen. Smith, Tina- CDC authorization Issues related to broadband and public health infrastructure; mental health and telehealth; COVID-19 testing; public option programs; behavioral health; rural health; substance use disorder treatments; Health Savings Accounts; provider directories; and artificial intelligence and privacy. Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10 and ICD-11), 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; ACA 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: $4,210,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, White House Office

Discussion with OMB/OIRA regarding OSHA Occupational Exposure to COVID-19 in Healthcare Settings Final Rule; Discussion with FDA Drug Shortage expert regarding Inflation Reduction Act Provisions that could impact duration of shortages; Discussion with ASPR Hospital Preparedness Program Staff about speaking at a meeting regarding HPP issues; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Inpatient Prospective Payment System/Long Term Care Hospital Proposed Rule; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Medicare Advantage Final Rule; Hill outreach about reducing hospital workplace violence; Hill outreach about the benefits of hospital mergers and acquisitions; Statement to the U.S. Senate Committee on Health, Education, Labor, and Pensions, Examining Health Care Workforce Shortages: Where Do We Go from Here?; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an RFI on the drivers of health care workforce shortages; Support S.1110, Rural Hospitals Support Act, a bill to amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; Support H.R. 1110, Telehealth Option Act, a bill to direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Childrens Health Insurance programs during the COVID-19 emergency; Feedback on the Connect for Health Act; AHA provided feedback on the creating opportunities new for necessary and effective care technologies (CONNECT) Act; False Claims Act Case AHA Provides Statement for House Hearing on Price Transparency, Competition; Oppose H.R.977/S.470 Patient Access Higher Quality Health Care Act, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support S.940, The Rural America Health Corps Act A bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Support the Conrad State 30 and Physician Access Reauthorization Act that would allow international doctors trained in the United States to remain in the country if they practice in areas experiencing medical shortages; Letter to CMS regarding intent to issue staffing mandates for nursing homes and urged CMS and policy makers to focus on efforts that will bolster our workforce; Support HR 2389/ S 1302, Resident Physician Shortage Reduction Act of 2023, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Support HR 2411/ S 1150, National Nursing Workforce Center Act of 2023, a bill to amend the Public Health Service Act to support and stabilize the existing nursing workforce, establish programs to increase the number of nurses; Support HR 2534, Preserving Rules Ordered for The Entities Covered Through 340B Act of 2023 or the PROTECT 340B Act of 2023, a bill to amend title XXVII of the Public Health Service Act to ensure the equitable treatment of covered entities and pharmacies participating in the 340B drug discount program; Support HR 2559, Strengthening Community Care Act of 2023, a bill to extend funding for community health centers and the National Health Service Corp; Statement to the House Education and the Workforce Subcommittee on Health, Employment, Labor, and Pensions hearing titled, Competition and Transparency: The Pathway Forward for a Stronger Health Care Market highlighting that mergers and acquisitions can be a helpful tool for many hospitals and pushing back against site-neutral payment policies; Letter urging Congress to continue to protect this critical program and oppose efforts to cut its benefits, which would result in reduced access to quality care for the patients and communities served by 340B hospitals; Statement to Subcommittee on Health of the Committee on Energy and Commerce on its hearing Examining Existing Federal Programs to Build a Stronger Health Workforce and Improve Primary Care; Support S 1447, Bipartisan Solution to Cyclical Violence Act of 2023, a bill to amend the Public Health Service Act to establish a grant program supporting trauma center violence intervention and violence prevention programs, and for other purposes; Support HR 3046/ S 1403, Medical Student Education Authorization Act of 2023, a bill to amend the Public Health Service Act to establish a grant program to award grants to accredited public institutions of higher education, and for other purposes; Concerns with HR 2691, Transparent Prices Required to Inform Consumer and Employers Act or the Transparent PRICE Act, a bill to promote hospital and insurer price transparency; Letter strongly opposing the draft bills, which would create additional site-neutral payment cuts and threaten access to care, especially in rural and other vulnerable communities; Comment letter to the Office of Civil Rights on its HIPAA Privacy Rule to Support Reproductive Health Care Privacy and concerns the guidance is too broad and will result in significant adverse consequences for hospitals, patients and the public at large; Statement to SFC for the hearing on Consolidation and Corporate Ownership in Health Care: Trends and Impacts on Access, Quality, and Costs; Comment letters to CMS on their Inpatient and Long-term Care Facility Prospective Payment System FY 2024 proposed rule; Letter to reauthorize key programs within the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act of 2018, supporting policies that will reduce barriers to receiving and administering behavioral health care by improving payment policies, reducing unnecessary regulatory and administrative burden, and strengthening the behavioral health workforce; Comment letter on the Environmental Protection Agencys (EPA) proposed standards for the use of ethylene oxide (EtO) to sterilize medical devices urge caution and thoughtfulness in EPAs approach to avoid disrupting health care delivery through the unintentional fracturing of the already fragile medical device supply chain; Comment on Energy and Commerce Committee Chair Rodgers drug shortages discussion draft; Support S. 2364 Mapping Americas Pharmaceutical Supply Act A bill to map the United States pharmaceutical supply chain and use data analytics to identify supply chain vulnerabilities and other national security threats; Support S. 2510 RAPID Reserve Act A bill to improve supply chain resiliency for critical drug products with vulnerable supply chains and ensure that reserves of critical drugs and active pharmaceutical ingredients are maintained to prevent supply disruptions in the event of drug shortages or public health emergencies; Support S. 1961, Pharmaceutical Supply Chain Risk Assessment Act of 2023, A bill to require an interagency risk assessment of the pharmaceutical supply chain to identify and mitigate health and national security risks, and for other purposes; support the Drug Shortage Prevention Act that will help pave the way for additional improvements to the U.S. drug supply chain, which will, in turn, improve patient access and care; Support S.1636/H.R. 3440 Protecting Rural Telehealth Access Act A bill to amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program. Drug Shortages RFI Letter to the U.S. Senate Committee on Finance in response to a Request For Information on drug shortages; Support H.R. 4713 Rural Hospital Technical Assistance Program Act A letter to support HR 4713, the Rural Hospital Technical Assistant Program Act. A bill to make permanent a program that provides technical assistance for rural hospitals to help prevent closures; Verbal Support Train More Nurse Act, It instructs HHS and DOL to conduct a joint review of all grant programs supporting the nursing workforce and coming up with recommendations to Congress within a year on how to change the programs to increase nurse faculty, provide pathways for those who want to become nurse faculty, and increase the nursing pipeline for both RNs and LPNs; Support H.R.2412 Helping Kids Cope Act To amend the Public Health Service Act to authorize grants to increase national capacity to provide pediatric behavioral health services at childrens hospitals and through community-based providers to improve childrens access to care; and to authorize grants to begin to address large numbers of children boarding in emergency departments, to support the pediatric behavioral health workforce, and for other purposes; Meeting with OMB to discuss Proposed Minimum Staffing Requirements for Long-term Care Facilities; Meeting with OMB to discuss FY 2024 IPPS and LTCH Final Rule; Meeting with Senate Finance Committee regarding the FY 2024 LTCH Final Rule; A letter to comment on ways to improve access to care in rural and underserved areas ensuring that Americans in these rural and underserved areas have high-quality, affordable health care; Support S. 2016/ H.R. 4189, CONNECT for Health Act of 2023, a bill to support to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; A letter to the Department of Veterans Affairs (VA) expressing significant concerns about Cotivitis audit and appeals process, including its inadequate appeals procedures, the scope of audits being performed and the untenable timelines that are being executed; Support S. 3211/ H.R. 6205, Healthcare Workforce Resilience Act, a bill to support Healthcare Workforce Resilience Act to enhance our Nations nurse and physician workforce by recapturing unused immigrant visas; Support for Reauthorization of PAPHA, The Pandemic and All-Hazards Preparedness Act (PAHPA), To amend the Public Health Service Act to reauthorize certain programs with respect to public health security and all-hazards preparedness and response related to the Administration for Strategic Preparedness and Response and certain programs with respect to public health security and all-hazards preparedness and response related to the Centers for Disease Control and Prevention, and for other purposes; Support H.R. 6430, Rural Community Hospitals (ARCH) Act, a bill to support the Assistance for Rural Community Hospitals (ARCH) Act; To support small rural hospitals for which Medicare patients make up a significant percentage of inpatient days or discharges, Congress established the Medicare- dependent Hospital (MDH) program in 1987, allowing eligible hospitals to receive the sum of their prospective payment system (PPS) payment rate, plus three- quarters of the amount by which their cost per discharge exceeds the PPS rate; Support H.R. 4531/ S.3393, Patients and Communities Reauthorization Act, a bill to reauthorize certain programs that provide for opioid use disorder prevention, recovery, and treatment, and for other purposes; A letter to the FDA on its laboratory developed tests (LDTs) proposed rule urging the agency to not apply its device regulations to hospital and health system LDTs because they are not devices; rather, they are diagnostic tools developed and used in the context of patient care. Instead, we urged the FDA to continue to apply its enforcement discretion to hospital and health system LDTs; Submit Statement to the Committee on Energy and Commerce Subcommittee on Health hearing, Supporting Access to Long-Term Services and Supports: An Examination of the Impacts of Proposed Regulations on Workforce and Access to Care to share the hospital fields comments on proposed regulations for minimum staffing standards for LTC facilities and their potential impact on access to care; Concern H.R. 5378 Lower Costs, More Transparency Act, A bill to promotes price transparency in the health care sector, and for other purposes; Hill Briefing on SAVE Act, Support S. 2768 / H.R. 2584, The Safety from Violence for Healthcare Employees (SAVE) Act, A bill to protect hospital personnel from violence, and for other purposes; Health Care Spending in the United States: Unsustainable for Patients, Employers, and Taxpayers; Statement to the House Committee on Energy and Commerce Subcommittee on Health regarding the topic of national health expenditures, The Independent Dispute Resolution Process (IDR), To comment on the proposed rule related to the operations of the Independent Dispute Resolution Process (IDR) established by the No Surprises Act (NSA); Examining Chronic Drug Shortages in the United States, Statement to the House Committee on Ways and Means regarding the important topic of drug shortages in the United States; Support H.R. 6205 / S. 3211, Healthcare Workforce Resilience Act, A bill to reauthorize title II of the Higher Education Act of 1965, and for other purposes; H.R. 7513; Protecting Americas Seniors Access to Care, Statement to the House Committee on Ways and Means regarding Protecting Americas Seniors Access to Care to prohibit the Secretary of Health and Human Services from finalizing a proposed rule regarding minimum staffing for nursing facilities, and to establish an advisory panel on the skilled nursing facility workforce; Enhancing Access to Care at Home in Rural and Underserved Communities, Statement to the House Committee on Ways and Means on how telehealth flexibilities, the hospital-at-home (H@H) program and home health agencies have expanded access to care for patients in their homes and the need for these programs to continue; The recent cyberattack on Change Healthcare, Letter to House and Senate leadership requesting assistance for hospitals impacted by the cyberattack; The recent cyberattack on Change Healthcare, Letter to Senate Finance Committee leadership to share concerns regarding the Administrations proposal to penalize hospitals that do not meet certain cybersecurity requirements; Support S. 3779 / H.R. 7265, Child Suicide Prevention and Lethal Means Safety Act, A bill authorizing the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes; Evaluating Approaches to Diagnostic Test Regulation and the Impact of FDAs Proposed Rule.", Statement to the House Committee on Energy and Commerce Subcommittee on Health on the impact of the Food and Drug Administrations (FDA) proposed regulation of diagnostic tests; Senate RFI on the SUSTAIN 340B Act Draft, A letter to provide feedback on the Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future of (SUSTAIN) 340B Act bipartisan discussion draft and accompanying request for information on the 340B Drug Pricing Program; Access to Health Care in America: Ensuring Resilient Emergency Medical Care, Statement to the House Committee on Ways and Means on access to emergency medical services in rural areas; Support H.R. 7623, Telehealth Modernization Act, A bill to amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program; House RFI on strengthening ERISA, A letter to provide feedback on an RFI from the House Education and Workforce Committee on ways to strengthen and improve ERISA, Addressing drug shortagesAHAs statement for record to Ways and Means committee hearing on Examining Chronic Drug Shortages in the United States, Statement commenting on the impact of the FDAs proposed regulation of laboratory developed tests (LDTs), AHAs statement for the record to Energy and Commerce Subcommittee on Health on "Evaluating Approaches to Diagnostic Test Regulation and the Impact of FDAs Proposed Rule.", Response to RFI on oversight and regulation of LDTs, Response to Sen. Cassidy, Ranking Member of HELP Committee on his RFI seeking feedback on the FDAs proposed regulation of hospital LDTs, OMB meeting, including FDA officials, on the FDAs rulemaking on the regulation of hospital LDTs as medical devicesOMB/FDA; Support S 3679 / H.R. 7153, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, A bill to reauthorize the Dr. Lorna Breen Health Care Provider Protection Act, and for other purposes, Support S. 1110, the Rural Hospital Support Act, A bill to amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; Support HR 1565, Critical Access Hospital Relief Act of 2023, A bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services.

Client expense: $6,010,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE

Q1 Lobbying Report (Jan. 1-March 31) HCR Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program Resident Physician Shortage Act of 2023 (H.R. 2389) No Surprises Act regulations Public Health Emergency designation Food and Drug Amendments No Surprise Bills for New Moms Act (H.R. 3387) Securing the U.S. Organ Procurement and Transplantation Network Act (H.R. 2544) Promoting Access to Treatments and Increasing Extremely Needed Transparency Act (H.R. 3561) Medicaid VBPs for Patients (MVP) Act (H.R. 2666) Providers and Payers COMPETE Act (H.R. 3284) To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290) Transparent PRICE Act (H.R. 3281/H.R. 2691)) Resident Physician Shortage Reduction (S. 1302) Medical Student Education Authorization Act (H.R. 3046) Save Americas Rural Hospitals Act (H.R. 833) Chronic Care Management Improvement Act (H.R. 2829) Safety From Violence for Healthcare Employees Act (H.R. 2584) Supporting Safety Net Hospitals Act (H.R. 2665) Patient Access to Higher Quality Health Care Act (H.R. 977/S.470) FEMA re: COVID-19 related reimbursement Public Health Guidance Transparency and Accountability Act of 2023 (H.R. 4529) Public Health Emergency Congressional Review Act (H.R. 4381) CDC Leadership Accountability Act of 2023 (H.R. 3813) Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) Preparedness and Response Reauthorization Act (H.R. 4420) Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887) Health Care Price Transparency Act of 2023 (H.R. 4822) Providers and Payers COMPETE Act (H.R. 3284) Lower Costs, More Transparency Act (H.R. 5378 Transparency in Coverage Act (H.R. 4507) GOLD Card Act of 2023 (H.R. 4968) No Fees for EFTs Act (H.R.6487) Rural Health Care Facilities Revitalization Act (H.R. 5989) Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (H.R. 7153) To amend title XVIII of the Social Security Act to establish a definition of essential health system in statute (H.R. 7397) Substance Use Disorder Workforce Act (H.R. 7050) 340B PATIENTS Act (HR7635) MMM Accelerated and Advance Payment Program repayment flexibility Graduate Medical Education (GME) funding Telehealth flexibilities and payment Annual Prospective Payment System Rules Organ acquisition payment policies Californias Medicaid Hospital Quality Assurance Fee Program BUD FY 2024 Appropriations bills Nursing and allied health workforce funding FY 2024 budget request Further Continuing Appropriations and Other Extensions Act (H.R. 6363) Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R. 5894) Tax Relief for American Families and Workers Act of 2024 (H.R. 7024) Extension of Continuing Appropriations and Other Matters Act, 2024 (H.R. 7463) Submitted Comments SUBJECT: CMS-4205-P, Medicare Program; Contract Year 2025 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Health Information Technology Standards and Implementation Specifications (Vol 88, No. 219), Wednesday, November 15th SUBJECT: RIN 0955-AA05, 21st Century Cures Act: Establishment of Disincentives for Health Care Providers That Have Committed Information Blocking, Proposed Rule, Federal Register (Vol 88, No 210), November 1, 2023 Subject: CMS-9897-P Federal Independent Dispute Resolution Operations, Proposed Rule, Federal Register (Vol. 88, No. 212), November 3, 2023

Client expense: $430,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

H.R. 485 - Protecting Health Care For All Patients Act of 2023 - Rep. McMorris Rodgers, Cathy - federal programs using prices based on quality-adjusted life years H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023 - Rep. Walberg, Tim - telehealth and ERISA amendments H.R. 830 - HELP Copays Act - Rep. Carter, Earl - health insurers responsibility for payments made by or on behalf of a plan enrollee toward a plans cost-sharing requirements H.R. 1488 - Affordable Insulin Now Act of 2023 - Rep. Craig, Angie - cost-sharing for insulin products H.R. 1613 - Drug Price Transparency in Medicaid Act of 2023 - Rep. Carter, Earl -spread-pricing by PBMs for Medicaid H.R. 2666 - MVP Act - Rep. Guthrie, Brett - value-based purchasing arrangements under Medicaid program and reforms to price reporting H.R. 2691 - Transparent Price Act - Rep. McMorris Rodgers, Cathy - health insurer price transparency H.R. 2813 - Self-Insurance Protection Act - Rep. Good, Bob - ERISA amendments H.R. 2868 - Association Health Plans Act - Rep. Walberg, Tim - ERISA amendments H.R. 3305 - Black Maternal Health Momnibus Act - Rep. Underwood, Lauren - maternal health including in Medicaid and CHIP H.R. 3561 - PATIENT Act - Rep. McMorris Rodgers, Cathy - PBM transparency, PBM contract design, health insurance transparency, hospital transparency H.R. 3799 - Custom Health Option and Individual Care Expense Arrangement Act- Rep. Hern, Kevin - health reimbursement arrangements H.R. 3801 - Employer Reporting Improvement Act - Rep. Smith, Adrian - ACA reporting requirements S. 113 - Prescription Pricing for the People Act of 2023 - Sen. Grassley, Chuck - preventing anti-competitive tactics for prescription drugs S. 127 - Pharmacy Benefit Manager Transparency Act of 2023 - Sen. Cantwell, Maria - pharmacy benefit manager transparency S. 652 - Safe Step Act - Sen. Murkowski, Lisa - medication step therapy protocol S. 954 - Affordable Insulin Now Act of 2023 - Sen. Warnock, Raphael - cost-sharing for insulin products S. 1038 - Drug Price Transparency in Medicaid Act of 2023 - Sen. Welch, Peter - prohibits spread-pricing by PBMs in Medicaid S. 1606 - A bill to end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. - Sen. Booker, Cory - maternal mortality S. 3393 - SUPPORT for Patients and Communities Reauthorization Act. - Sen. Sanders, Bernie - SUD treatment S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 - Sen. Wyden, Ron - mental health, telehealth, health workforce Issues related to broadband and public health infrastructure; mental health and telehealth; COVID-19 testing; public option programs; behavioral health; rural health; substance use disorder treatments; Health Savings Accounts; provider directories; and artificial intelligence and privacy. Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10 and ICD-11), 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; ACA 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: $2,400,000 · 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), SENATE, Treasury, Dept of, White House Office

Discussion with OMB/OIRA regarding OSHA Occupational Exposure to COVID-19 in Healthcare Settings Final Rule; Discussion with FDA Drug Shortage expert regarding Inflation Reduction Act Provisions that could impact duration of shortages; Discussion with ASPR Hospital Preparedness Program Staff about speaking at a meeting regarding HPP issues; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Inpatient Prospective Payment System/Long Term Care Hospital Proposed Rule; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Medicare Advantage Final Rule; Hill outreach about reducing hospital workplace violence; Hill outreach about the benefits of hospital mergers and acquisitions; Hill outreach about the anticompetitive behaviors of travel nurse staffing agencies; Statement to the U.S. Senate Committee on Health, Education, Labor, and Pensions, Examining Health Care Workforce Shortages: Where Do We Go from Here?; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an Request For Information on the reauthorization of the Pandemic and All-Hazards Preparedness Act; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an RFI on the drivers of health care workforce shortages; Support S.1110, Rural Hospitals Support Act, a bill to amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; Support H.R. 1110Telehealth Option Act, a bill to direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Childrens Health Insurance programs during the COVID-19 emergency; Feedback on the Connect for Health Act; AHA provided feedback on the creating opportunities new for necessary and effective care technologies (CONNECT) Act; False Claims Act Case AHA Provides Statement for House Hearing on Price Transparency, Competition; Oppose H.R.977/S.470 Patient Access Higher Quality Health Care Act, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support S.940, The Rural America Health Corps Act A bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Support the Conrad State 30 and Physician Access Reauthorization Act that would allow international doctors trained in the United States to remain in the country if they practice in areas experiencing medical shortages; Letter to CMS regarding intent to issue staffing mandates for nursing homes and urged CMS and policy makers to focus on efforts that will bolster our workforce; Support HR 2389/ S 1302, Resident Physician Shortage Reduction Act of 2023, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Support HR 2411/ S 1150, National Nursing Workforce Center Act of 2023, a bill to amend the Public Health Service Act to support and stabilize the existing nursing workforce, establish programs to increase the number of nurses; Support HR 2534, Preserving Rules Ordered for The Entities Covered Through 340B Act of 2023 or the PROTECT 340B Act of 2023, a bill to amend title XXVII of the Public Health Service Act to ensure the equitable treatment of covered entities and pharmacies participating in the 340B drug discount program; Support HR 2559, Strengthening Community Care Act of 2023, a bill to extend funding for community health centers and the National Health Service Corp; Support HR 2584/S.2768, Safety From Violence for Healthcare Employees Act or the SAVE Act, a bill to protect hospital personnel from violence, and for other purpose; Statement to the House Education and the Workforce Subcommittee on Health, Employment, Labor, and Pensions hearing titled, Competition and Transparency: The Pathway Forward for a Stronger Health Care Market highlighting that mergers and acquisitions can be a helpful tool for many hospitals and pushing back against site-neutral payment policies; Letter urging Congress to continue to protect this critical program and oppose efforts to cut its benefits, which would result in reduced access to quality care for the patients and communities served by 340B hospitals; Statement to Subcommittee on Health of the Committee on Energy and Commerce on its hearing Examining Existing Federal Programs to Build a Stronger Health Workforce and Improve Primary Care; Support S 1447, Bipartisan Solution to Cyclical Violence Act of 2023, a bill to amend the Public Health Service Act to establish a grant program supporting trauma center violence intervention and violence prevention programs, and for other purposes; Support HR 3046/ S 1403, Medical Student Education Authorization Act of 2023, a bill to amend the Public Health Service Act to establish a grant program to award grants to accredited public institutions of higher education, and for other purposes; Concerns with HR 2691, Transparent Prices Required to Inform Consumer and Employers Act or the Transparent PRICE Act, a bill to promote hospital and insurer price transparency; Letter strongly opposing the draft bills, which would create additional site-neutral payment cuts and threaten access to care, especially in rural and other vulnerable communities; Comment letter to the Office of Civil Rights on its HIPAA Privacy Rule to Support Reproductive Health Care Privacy and concerns the guidance is too broad and will result in significant adverse consequences for hospitals, patients and the public at large; Statement to SFC for the hearing on Consolidation and Corporate Ownership in Health Care: Trends and Impacts on Access, Quality, and Costs; Comment letters to CMS on their Inpatient and Long-term Care Facility Prospective Payment System FY 2024 proposed rule; Letter to reauthorize key programs within the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act of 2018, we encourage you to consider policies that will reduce barriers to receiving and administering behavioral health care by improving payment policies, reducing unnecessary regulatory and administrative burden, and strengthening the behavioral health workforce; Comment letter on the Environmental Protection Agencys (EPA) proposed standards for the use of ethylene oxide (EtO) to sterilize medical devices urge caution and thoughtfulness in EPAs approach to avoid disrupting health care delivery through the unintentional fracturing of the already fragile medical device supply chain; Hill briefing, Site-neutral Payment Proposals Would Jeopardize Access to Care for Patients and Communities; Comment on Energy and Commerce Committee Chair Rodgers drug shortages discussion draft; Support S. 2364 Mapping Americas Pharmaceutical Supply Act A bill to map the United States pharmaceutical supply chain and use data analytics to identify supply chain vulnerabilities and other national security threats; Support S. 2510 RAPID Reserve Act A bill to improve supply chain resiliency for critical drug products with vulnerable supply chains and ensure that reserves of critical drugs and active pharmaceutical ingredients are maintained to prevent supply disruptions in the event of drug shortages or public health emergencies; Support S. 1961Pharmaceutical Supply Chain Risk Assessment Act of 2023A bill to require an interagency risk assessment of the pharmaceutical supply chain to identify and mitigate health and national security risks, and for other purposes; Drug Shortage Prevention Act Letter to express support for the Drug Shortage Prevention Act that will help pave the way for additional improvements to the U.S. drug supply chain, which will, in turn, improve patient access and care; Bipartisan request for information on the critically important 340B Drug Pricing Program Letter on the savings 340B hospitals achieve through purchasing certain outpatient drugs at a discount allow them to provide a range of programs and services that directly benefit their patients; Support S.1636/H.R. 3440 Protecting Rural Telehealth Access Act A bill to amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program. Drug Shortages RFI Letter to the U.S. Senate Committee on Energy and Commerce and Finance in response to a Request For Information on drug shortages; Support H.R. 4713 Rural Hospital Technical Assistance Program Act A letter to support HR 4713, the Rural Hospital Technical Assistant Program Act. A bill to make permanent a program that provides technical assistance for rural hospitals to help prevent closures; Verbal Support Train More Nurse Act It instructs HHS and DOL to conduct a joint review of all grant programs supporting the nursing workforce and coming up with recommendations to Congress within a year on how to change the programs to increase nurse faculty, provide pathways for those who want to become nurse faculty, and increase the nursing pipeline for both RNs and LPNs; Support H.R.2412 Helping Kids Cope Act To amend the Public Health Service Act to authorize grants to increase national capacity to provide pediatric behavioral health services at childrens hospitals and through community-based providers to improve childrens access to care; and to authorize grants to begin to address large numbers of children boarding in emergency departments, to support the pediatric behavioral health workforce, and for other purposes; Meeting with OMB to discuss Proposed Minimum Staffing Requirements for Long-term Care Facilities; Meeting with OMB to discuss FY 2024 IPPS and LTCH Final Rule; Meeting with Senate Finance Committee regarding the FY 2024 LTCH Final Rule; A letter to comment on ways to improve access to care in rural and underserved areas ensuring that Americans in these rural and underserved areas have high-quality, affordable health care; Support S. 2016/ H.R. 4189, CONNECT for Health Act of 2023, a bill to support to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; A letter to the Department of Veterans Affairs (VA) expressing significant concerns about Cotivitis audit and appeals process, including its inadequate appeals procedures, the scope of audits being performed and the untenable timelines that are being executed; Support S. 3211/ H.R. 6205, Healthcare Workforce Resilience Act, a bill to support Healthcare Workforce Resilience Act to enhance our Nations nurse and physician workforce by recapturing unused immigrant visas; Support for Reauthorization of PAPHA, The Pandemic and All-Hazards Preparedness Act (PAHPA), To amend the Public Health Service Act to reauthorize certain programs with respect to public health security and all-hazards preparedness and response related to the Administration for Strategic Preparedness and Response and certain programs with respect to public health security and all-hazards preparedness and response related to the Centers for Disease Control and Prevention, and for other purposes; Support H.R. 6430, Rural Community Hospitals (ARCH) Act, a bill to support the Assistance for Rural Community Hospitals (ARCH) Act; To support small rural hospitals for which Medicare patients make up a significant percentage of inpatient days or discharges, Congress established the Medicare- dependent Hospital (MDH) program in 1987, allowing eligible hospitals to receive the sum of their prospective payment system (PPS) payment rate, plus three- quarters of the amount by which their cost per discharge exceeds the PPS rate; Support H.R. 4531/ S.3393, Patients and Communities Reauthorization Act, a bill to reauthorize certain programs that provide for opioid use disorder prevention, recovery, and treatment, and for other purposes; A letter to the FDA on its laboratory developed tests (LDTs) proposed rule urging the agency to not apply its device regulations to hospital and health system LDTs because they are not devices; rather, they are diagnostic tools developed and used in the context of patient care. Instead, we urged the FDA to continue to apply its enforcement discretion to hospital and health system LDTs; Submit Statement to the Committee on Energy and Commerce Subcommittee on Health hearing, Supporting Access to Long-Term Services and Supports: An Examination of the Impacts of Proposed Regulations on Workforce and Access to Care to share the hospital fields comments on proposed regulations for minimum staffing standards for LTC facilities and their potential impact on access to care.

Client expense: $8,090,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE

Issues related to prescription drug coverage and pharmacy benefits Issues related to the prescription drug marketplace, patents, and competition Regulatory and proposed legislative changes to Medicare Part D and Medicaid prescription drug benefits S.113 - Prescription Pricing for the People Act S.127 - Pharmacy Benefit Manager Transparency Act S.142 - Preserve Access to Affordable Generics and Biosimilars Act S.148 - Stop STALLING Act S.150 - Affordable Prescriptions for Patients Act S.652 - Safe Step Act S.655 - Chronic Disease Management Act S.727 - Insulin for All Act S.775 - Increasing Transparency in Generic Drug Applications Act S.954 - Affordable Insulin Now Act S.1038 - Drug Price Transparency in Medicaid Act S.1067 - Ensuring Timely Access to Generics Act S.1114 - Expanding Access to Low-Cost Generics Act S.1120 - Improved Access to Affordable Medications Act S.1128 - Ensuring Access to Generic Medications Act S.1130 - Health Care PRICE Transparency Act S.1131 - Drug Price Transparency Act S.1217 - Ending the Prescription Drug Kickback Act S.1218 - Fair Prescription Drug Prices for Americans Act S.1269 - INSULIN Act S.1339 - Pharmacy Benefit Manager Reform Act S.1375 - HELP Copays Act S.1497 - Emergency Access to Insulin Act S.1491 - Pharmacy and Medically Underserved Areas Enhancement Act S.1542 - Delinking Revenue from Unfair Gouging (DRUG) Act S.1543 - A bill to require regulations concerning the disclosure of direct and indirect compensation from entities providing pharmacy benefit management services or third party administration services S.1967 - Patients Before Middlemen (PBM) Act S.2052 - Protect Patient Access to Pharmacies Act S.2129 - Ensuring Access to Lower-Cost Medicines for Seniors Act S.2254 - Medicare PBM Accountability Act S.2405 - Strengthening Pharmacy Access for Seniors Act S.2406 - PBM Oversight Act S.2408 - IMPROVE Part D Regulations Act S.2436 - Neighborhood Options for Patients Buying Medicines (NO PBM) Act S.2456 - Protecting Seniors from High Drug Costs Act S.2474 - Share the Savings with Seniors Act S.2477 - Equitable Community Access to Pharmacist Services Act S.2493 - PBM Reporting Transparency Act S.2666 - EPCS 2.0 Act S.2840 - Bipartisan Primary Care and Health Workforce Act (Bruan Amendment #3 - Price Transparency Requirements) S.2939 - Pharmacy Access Oversight and Reporting Act S.2973 - Modernizing and Ensuring PBM Accountability Act S.3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act H.R.830 - HELP Copays Act H.R.1352 - Increasing Access to Biosimilars Act H.R.1488 - Affordable Insulin Now Act H.R.1587 - Making Insulin Affordable for All Children Act H.R.1613 - Drug Price Transparency in Medicaid Act H.R.1770 - Equitable Community Access to Pharmacists Act H.R.1790 - Biologics Competition Act H.R.2630 - Safe Step Act H.R.2666 - Medicaid VBPs for Patients (MVP) Act H.R.2670 - PBM Accountability Act H.R.2691 - Transparent PRICE Act H.R.2880 - Protecting Patients Against PBM Abuses Act H.R.3030 - Stop the Overuse of Petitions and Get Affordable Medicines to Enter Soon (STOP GAMES) Act H.R.3134 - Emergency Access to Insulin Act H.R.3262 - to amend title XI of the Social Security Act to increase transparency of certain health-related ownership information H.R.3281 - Transparent PRICE Act H.R.3282 - Promoting Transparency and Health Competition in Medicare Act H.R.3285 - Fairness for Patient Medications H.R.3561- Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act H.R.3800 - Chronic Disease Flexible Coverage Act H.R.4011 - Timely Access to Clinical Treatment Act H.R.4507 - Transparency in Coverage Act H.R.4508 - Hidden Fee Disclosure Act H.R.4509 - Transparency in Billing Act H.R.4527 - Health Data Act H.R.4712 - Patient Right to Shop Act H.R.4822 - Health Care Price Transparency Act H.R.4846 - To amend the Internal Revenue Code of 1986, title XXVII of the Public Health Service Act, and the Employee Retirement Income Security Act of 1974 to provide for oversight of pharmacy benefit manager services H.R.4881 - To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program H.R.4883 - Medicare Common Ownership Transparency Act H.R.5372 - Expanding Seniors Access to Lower Cost Medicines Act H.R.5376 - Share the Savings with Seniors Act H.R.5378 - Lower Costs More Transparency Act H.R.5384 - Advancing Enrollment and Reducing Drug Costs Act H.R.5385 - Medicare PBM Accountability Act H.R.5386 - Cutting Copays Act H.R.5393 -Transparency and Fairness for Pharmacies Act H.R.5400 - Neighborhood Options for Patients Buying Medicines (NO PBM) Act H.R.5461 - Ensuring Access to Lower-Cost Medicines for Seniors Act Implementation of the Inflation Reduction Act of 2022, P.L. 169- Provisions on Medicare Part D modernization and drug price negotiation

Client expense: $5,294,628 · 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), SENATE

Q4 Lobbying Report (Oct.1-Dec. 31) HCR Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program Resident Physician Shortage Act of 2023 (H.R. 2389) No Surprises Act regulations Public Health Emergency designation Food and Drug Amendments No Surprise Bills for New Moms Act (H.R. 3387) Securing the U.S. Organ Procurement and Transplantation Network Act (H.R. 2544) Promoting Access to Treatments and Increasing Extremely Needed Transparency Act (H.R. 3561) Medicaid VBPs for Patients (MVP) Act (H.R. 2666) Providers and Payers COMPETE Act (H.R. 3284) To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290) Transparent PRICE Act (H.R. 3281/H.R. 2691)) Resident Physician Shortage Reduction (S. 1302) Medical Student Education Authorization Act (H.R. 3046) Save Americas Rural Hospitals Act (H.R. 833) Chronic Care Management Improvement Act (H.R. 2829) Safety From Violence for Healthcare Employees Act (H.R. 2584) Supporting Safety Net Hospitals Act (H.R. 2665) Patient Access to Higher Quality Health Care Act (H.R. 977/S.470) FEMA re: COVID-19 related reimbursement Public Health Guidance Transparency and Accountability Act of 2023 (H.R. 4529) Public Health Emergency Congressional Review Act (H.R. 4381) CDC Leadership Accountability Act of 2023 (H.R. 3813) Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) Preparedness and Response Reauthorization Act (H.R. 4420) Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887) Health Care Price Transparency Act of 2023 (H.R. 4822) Providers and Payers COMPETE Act (H.R. 3284) Lower Costs, More Transparency Act (H.R. 5378 Transparency in Coverage Act (H.R. 4507) GOLD Card Act of 2023 (H.R. 4968) No Fees for EFTs Act (H.R.6487) MMM Accelerated and Advance Payment Program repayment flexibility Graduate Medical Education (GME) funding Telehealth flexibilities and payment Annual Prospective Payment System Rules Organ acquisition payment policies Californias Medicaid Hospital Quality Assurance Fee Program BUD FY 2024 Appropriations bills Nursing and allied health workforce funding FY 2024 budget request Further Continuing Appropriations and Other Extensions Act (H.R. 6363) Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R. 5894) Submitted Comments SUBJECT: [Docket No. FDA-2023-N-2177], Medical Devices; Laboratory-Developed Tests, Proposed Rule, Federal Register (Vol 88, No 190), October 3, 2023 SUBJECT: CMS-9890 Federal Independent Dispute Resolution Process Fees, Proposed Rule, Federal Register (Vol. 88, No. 185), September 26, 2023 SUBJECT: Medicare Program and Medicaid Programs: Minimum Staffing for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting (CMS-3442-P): Vol 88, No 171, September 6, 2023 SUBJECT: (File Code 1210-AC11), Requirements Related to the Mental Health Parity and Addiction Equity Act; Proposed Rule, Federal Register (Vol. 88, No. 148), August 3, 2023

Client expense: $420,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

H.R. 2691, the Transparent PRICE Act; S 652/HR 2630, Safe Step Act; S 1375/HR 830, HELP Copays Act; H.R. 2679, the PBM Accountability Act; S. 1339, Pharmacy Benefit Manager Reform Act; H.R. 3284, the Providers and Payers COMPETE Act; H.R. 3237, requiring each off-campus outpatient department of a provider to include a unique identifier; H.R. 3285, the Fairness for Patient Medications Act; H.R. 3262, to increase transparency of certain health-related ownership information; S. 1214, the RARE Act; The Lower Costs, More Transparency Act; The Stop Drug Shortages Act; H.R. 4822; Health Care Price Transparency Act of 2023; The Patient Act; Improving Seniors Timely Access to Care Act; The Cutting Copays Act; The Modernizing and Ensuring PBM Accountability Act; The Transparency in Billing Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 485 - Protecting Health Care For All Patients Act of 2023 - Rep. Rodgers, Cathy McMorris - federal programs using prices based on quality-adjusted life years H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023 - Rep. Walberg, Tim - telehealth and ERISA amendments H.R. 830 - HELP Copays Act - Rep. Carter, Earl - health insurers responsibility for payments made by or on behalf of a plan enrollee toward a plans cost-sharing requirements H.R. 1488 - Affordable Insulin Now Act of 2023 - Rep. Craig, Angie - cost-sharing for insulin products H.R. 1613 - Drug Price Transparency in Medicaid Act of 2023 - Rep. Carter, Buddy - prohibits spread-pricing by PBMs in Medicaid H.R. 2666 - MVP Act - Rep. Guthrie, Brett - value-based purchasing arrangements under Medicaid program and reforms to price reporting H.R. 2691 - Transparent Price Act - Rep. Rodgers, Cathy McMorris - health insurer price transparency H.R. 2813 - Self-Insurance Protection Act - Rep. Good, Bob - ERISA amendments H.R. 2868 - Association Health Plans Act - Rep. Walberg, Tim - ERISA amendments H.R. 3305 - Black Maternal Health Momnibus Act - Rep. Underwood, Lauren - maternal health including in Medicaid and CHIP H.R. 3561 - PATIENT Act - Rep. Rodgers, Cathy McMorris - PBM transparency, PBM contract design, health insurance transparency, hospital transparency H.R. 3797 - Paperwork Burden Reduction Act - Rep. Smith, Jason - employers mailing 1095 physical tax forms H.R. 3798 - Small Business Flexibility Act - Rep. Tenney, Claudia - small business coverage notifications H.R. 3799 - Custom Health Option and Individual Care Expense Arrangement Act- Rep. Hern, Kevin - health reimbursement arrangements H.R. 3801 - Employer Reporting Improvement Act - Rep. Smith, Adrian - ACA reporting requirements S. 113 - Prescription Pricing for the People Act of 2023 - Sen. Grassley, Chuck - preventing anti-competitive tactics for prescription drugs S. 127 - Pharmacy Benefit Manager Transparency Act of 2023 - Sen. Cantwell, Maria - pharmacy benefit manager transparency S. 652 - Safe Step Act - Sen. Murkowski, Lisa - medication step therapy protocol S. 954 - Affordable Insulin Now Act of 2023 - Sen. Warnock, Raphael - cost-sharing for insulin products S. 1038 - Drug Price Transparency in Medicaid Act of 2023 - Sen. Welch, Peter - prohibits spread-pricing by PBMs in Medicaid S. 1606 - A bill to end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. - Sen. Booker, Cory - maternal mortality Accessible, Affordable Internet for All Act (no bill number) - broadband Advancing Integration in Medicare and Medicaid (AIM) Act (no bill number) - coordinating full-benefits for dual eligible individuals Advancing Telehealth Beyond COVID-19 Act (no bill number) - telehealth American Data Privacy and Protection Act (no bill number) - data privacy American Rescue Plan Act (no bill number) - COVID-19 relief Behavioral Health Integration Awareness Act (no bill number) - mental health and Medicare Better Health Care Directories Act (no bill number) - commercial plans Building COVID-19 Vaccine Confidence Act (no bill number) - COVID-19 CHOICE Act (no bill number) - public option CONNECT for Health Act (no bill number) - expansion of telehealth for Medicare Consolidated Appropriations Act (no bill number) - continued Medicaid and Medicare provisions and funding for FY2023 Consumer Online Privacy Rights Act (no bill number) - data privacy Continuing Appropriations and Ukraine Supplemental Appropriations Act (no bill number) - continued funding for Medicare and Medicaid Improving Seniors Timely Access to Care Act (no bill number) - prior authorization in Medicare Advantage Medicaid Saves Lives Act (no bill number) - Medicaid expansion Medicare for All Act (no bill number) - public option Medicare Multi-Cancer Early Detection Screening Coverage Act (no bill number) - Cancer screening in Medicare Mental Health Matters Act (no bill number) - changes to the procedure around MHPEA litigation MOMMAs Act (no bill number) - maternal health Moms Matter Act (no bill number) - maternal mental health conditions and SUD MORE Health Education Act (no bill number) - Federal Exchange outreach and educational activities NO PAIN Act (no bill number) - non-opioid treatment No Surprises for Survivors Act (no bill number) - 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 Nursing Home Reform Modernization Act (no bill number) - nursing home quality and transparency Parity Enforcement Act (no bill number) - mental health and SUD Parity Implementation Assistance Act (no bill number) - mental health parity PATCH Act (no bill number) - privacy and cybersecurity Patients Before Middlemen Act (no bill number) - pharmacy benefit managers Physician Wellness Program Act (no bill number) - mental health and Medicare Prevent Pandemics Act (no bill number) - pandemic preparedness Preventing Mental Health and Substance Use Crises During Emergencies Act (no bill number) - mental health and SUD national strategy Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act (no bill number) - commercial plans Protecting Americans with Pre-Existing Conditions Act (no bill number) - state innovation waivers Protecting Patients from Deceptive Health Plans Act (no bill number) - excepted benefits coverage Protecting Personal Health Data Act (no bill number) - privacy Public Health Infrastructure Saves Lives Act (no bill number) - public health infrastructure Public Option Deficit Reduction Act (no bill number) - public option Restore Protections for Dialysis Patients Act (no bill number) - reform of MSP Secondary Payer Act Restoring Hope for Mental Health and Well-Being Act (no bill number) - reauthorization of several behavioral health programs RICE Act (no bill number) - commercial plans SAFE DATA Act (no bill number) - consumer data privacy and data transparency and security Safe Step Act (no bill number) -commercial plans and medication step-therapy requirements Secure Data and Privacy for Contact Tracing Act (no bill number) - digital contact tracing for COVID-19 Social Determinants for Moms Act (no bill number) - SDOH and maternal health Strengthen Kids Mental Health Now Act (no bill number) - mental health and Medicaid Supporting Best Practices for Healthy Moms Act (no bill number) - maternal health Tech to Save Moms Act (no bill number) - maternal health The Jackie Walorski Maternal and Child Home Visiting Reauthorization Act (no bill number) - funding for maternal and early childhood health programs 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 (no bill number) - Broadband 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. (no bill number) - commercial plans 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. (no bill number) - behavioral health and electronic health records To amend title XVIII of the Social Security Act to ensure adequate coverage of outpatient mental health services under the Medicare program. (no bill number) - mental health and Medicare 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. (no bill number) - commercial plans 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. (no bill number) - mental health and Medicare TREATS Act (no bill number) - increase use of telehealth for SUD treatment Turn the Tide Act (no bill number) - Substance Use Disorder Virtual Community Support Act (no bill number) - mental health and SUD grants for community peer support Issues related to benefits, design, or structure of HIPAA-excepted benefits and supplemental benefits; mental health parity; surprise billing; broadband and public health infrastructure; mental health and telehealth; COVID-19 testing; public option programs; behavioral health; rural health; substance use disorder treatments; Health Savings Accounts; and provider directories. Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10 and ICD-11), 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; ACA 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: $3,080,000 · 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, White House Office

Discussion with OMB/OIRA regarding OSHA Occupational Exposure to COVID-19 in Healthcare Settings Final Rule; Discussion with FDA Drug Shortage expert regarding Inflation Reduction Act Provisions that could impact duration of shortages; Discussion with ASPR Hospital Preparedness Program Staff about speaking at a meeting regarding HPP issues; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Inpatient Prospective Payment System/Long Term Care Hospital Proposed Rule; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Medicare Advantage Final Rule; Hill outreach about reducing hospital workplace violence; Hill outreach about the benefits of hospital mergers and acquisitions; Hill outreach about the anticompetitive behaviors of travel nurse staffing agencies; Statement to the U.S. Senate Committee on Health, Education, Labor, and Pensions, Examining Health Care Workforce Shortages: Where Do We Go from Here?; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an Request For Information on the reauthorization of the Pandemic and All-Hazards Preparedness Act; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an RFI on the drivers of health care workforce shortages; Support S.1110, Rural Hospitals Support Act, a bill to amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; Support H.R. 1110Telehealth Option Act, a bill to direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Childrens Health Insurance programs during the COVID-19 emergency; Feedback on the Connect for Health Act; AHA provided feedback on the creating opportunities new for necessary and effective care technologies (CONNECT) Act; False Claims Act Case AHA Provides Statement for House Hearing on Price Transparency, Competition; Oppose H.R.977/S.470 Patient Access Higher Quality Health Care Act, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support S.940, The Rural America Health Corps Act A bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Support the Conrad State 30 and Physician Access Reauthorization Act that would allow international doctors trained in the United States to remain in the country if they practice in areas experiencing medical shortages; Letter to CMS regarding intent to issue staffing mandates for nursing homes and urged CMS and policy makers to focus on efforts that will bolster our workforce; Support HR 2389/ S 1302, Resident Physician Shortage Reduction Act of 2023, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Support HR 2411/ S 1150, National Nursing Workforce Center Act of 2023, a bill to amend the Public Health Service Act to support and stabilize the existing nursing workforce, establish programs to increase the number of nurses; Support HR 2534, Preserving Rules Ordered for The Entities Covered Through 340B Act of 2023 or the PROTECT 340B Act of 2023, a bill to amend title XXVII of the Public Health Service Act to ensure the equitable treatment of covered entities and pharmacies participating in the 340B drug discount program; Support HR 2559, Strengthening Community Care Act of 2023, a bill to extend funding for community health centers and the National Health Service Corp; Support HR 2584/S.2768, Safety From Violence for Healthcare Employees Act or the SAVE Act, a bill to protect hospital personnel from violence, and for other purpose; Statement to the House Education and the Workforce Subcommittee on Health, Employment, Labor, and Pensions hearing titled, Competition and Transparency: The Pathway Forward for a Stronger Health Care Market highlighting that mergers and acquisitions can be a helpful tool for many hospitals and pushing back against site-neutral payment policies; Letter urging Congress to continue to protect this critical program and oppose efforts to cut its benefits, which would result in reduced access to quality care for the patients and communities served by 340B hospitals; Statement to Subcommittee on Health of the Committee on Energy and Commerce on its hearing Examining Existing Federal Programs to Build a Stronger Health Workforce and Improve Primary Care; Support S 1447, Bipartisan Solution to Cyclical Violence Act of 2023, a bill to amend the Public Health Service Act to establish a grant program supporting trauma center violence intervention and violence prevention programs, and for other purposes; Support HR 3046/ S 1403, Medical Student Education Authorization Act of 2023, a bill to amend the Public Health Service Act to establish a grant program to award grants to accredited public institutions of higher education, and for other purposes; Concerns with HR 2691, Transparent Prices Required to Inform Consumer and Employers Act or the Transparent PRICE Act, a bill to promote hospital and insurer price transparency; Letter strongly opposing the draft bills, which would create additional site-neutral payment cuts and threaten access to care, especially in rural and other vulnerable communities; Comment letter to the Office of Civil Rights on its HIPAA Privacy Rule to Support Reproductive Health Care Privacy and concerns the guidance is too broad and will result in significant adverse consequences for hospitals, patients and the public at large; Statement to SFC for the hearing on Consolidation and Corporate Ownership in Health Care: Trends and Impacts on Access, Quality, and Costs; Comment letters to CMS on their Inpatient and Long-term Care Facility Prospective Payment System FY 2024 proposed rule; Letter to reauthorize key programs within the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act of 2018, we encourage you to consider policies that will reduce barriers to receiving and administering behavioral health care by improving payment policies, reducing unnecessary regulatory and administrative burden, and strengthening the behavioral health workforce; Comment letter on the Environmental Protection Agencys (EPA) proposed standards for the use of ethylene oxide (EtO) to sterilize medical devices urge caution and thoughtfulness in EPAs approach to avoid disrupting health care delivery through the unintentional fracturing of the already fragile medical device supply chain; Hill briefing, Site-neutral Payment Proposals Would Jeopardize Access to Care for Patients and Communities; Comment on Energy and Commerce Committee Chair Rodgers drug shortages discussion draft; Support S. 2364 Mapping Americas Pharmaceutical Supply Act A bill to map the United States pharmaceutical supply chain and use data analytics to identify supply chain vulnerabilities and other national security threats; Support S. 2510 RAPID Reserve Act A bill to improve supply chain resiliency for critical drug products with vulnerable supply chains and ensure that reserves of critical drugs and active pharmaceutical ingredients are maintained to prevent supply disruptions in the event of drug shortages or public health emergencies; Support S. 1961Pharmaceutical Supply Chain Risk Assessment Act of 2023A bill to require an interagency risk assessment of the pharmaceutical supply chain to identify and mitigate health and national security risks, and for other purposes; Drug Shortage Prevention Act Letter to express support for the Drug Shortage Prevention Act that will help pave the way for additional improvements to the U.S. drug supply chain, which will, in turn, improve patient access and care; Bipartisan request for information on the critically important 340B Drug Pricing Program Letter on the savings 340B hospitals achieve through purchasing certain outpatient drugs at a discount allow them to provide a range of programs and services that directly benefit their patients; Support S.1636/H.R. 3440 Protecting Rural Telehealth Access Act A bill to amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program. Drug Shortages RFI Letter to the U.S. Senate Committee on Energy and Commerce and Finance in response to a Request For Information on drug shortages; Support H.R. 4713 Rural Hospital Technical Assistance Program Act A letter to support HR 4713, the Rural Hospital Technical Assistant Program Act. A bill to make permanent a program that provides technical assistance for rural hospitals to help prevent closures; Verbal Support Train More Nurse Act It instructs HHS and DOL to conduct a joint review of all grant programs supporting the nursing workforce and coming up with recommendations to Congress within a year on how to change the programs to increase nurse faculty, provide pathways for those who want to become nurse faculty, and increase the nursing pipeline for both RNs and LPNs; Support H.R.2412 Helping Kids Cope Act To amend the Public Health Service Act to authorize grants to increase national capacity to provide pediatric behavioral health services at childrens hospitals and through community-based providers to improve childrens access to care; and to authorize grants to begin to address large numbers of children boarding in emergency departments, to support the pediatric behavioral health workforce, and for other purposes; Meeting with OMB to discuss Proposed Minimum Staffing Requirements for Long-term Care Facilities; Meeting with OMB to discuss FY 2024 IPPS and LTCH Final Rule; Meeting with Senate Finance Committee regarding the FY 2024 LTCH Final Rule.

Client expense: $5,150,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE

Issues related to S. 113, the Prescription Pricing for the People Act; S. 127, the Pharmacy Benefit Manager Transparency Act; S. 1339, Pharmacy Benefit Manager Reform Act; S.1542, the Delinking Revenue from Unfair Gouging (DRUG) Act; H.R. 1613, the Drug Price Transparency in Medicaid Act of 2023; H.R. 2666, the Medicaid VBPs for Patients (MVP) Act; H.R. 3561, the Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (previously H.R. 2691 Transparent PRICE Act); H.R. 3281, To promote hospital and insurer price transparency; H.R.2880, Protecting Patients Against PBM Abuses Act; H.R. 2679, The PBM Accountability Act; H.R.3285, the Fairness for Patient Medications Act, to establish patient protections with respect to highly rebated drugs; H.R. 3262, To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information; H.R. 3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program; H.R. 2666, the Medicaid VBPs for Patients (MVP) Act; H.R. 3284, the Providers and Payers COMPETE Act. S. 1967 the Patients Before Middlemen (PBM) Act; Protect Patients Access to Pharmacies Act; PBM Oversight Act of 2023; Modernizing and Ensuring PBM Accountability Act; S. 2436, the Neighborhood Options for Patients Buying Medicines (NO PBMs) Act; S. 2405, the Strengthening Pharmacy Access for Seniors Act; S.2254, the Medicare PBM Accountability Act; S. 2052, the Protect Patient Access to Pharmacies Act; H.R. 4822, the Health Care Price Transparency Act of 2023; H.R. 3284, the Providers and Payers COMPETE Act; H.R. 4508, the Hidden Fee Disclosure Act H.R. 4507, the Transparency in Coverage Act of 2023; H.R. 4895, the Lowering Drug Costs for American Families Act; H.R. 5378 Lower Costs, More Transparency Act; H.R. 4527, Health Data Access, Transparency, and Affordability Act (DATA) Act; H.R. 4508, Hidden Fee Disclosure Act; H.R.3285 - Fairness for Patient Medications Act; S.2973, Modernizing and Ensuring PBM Accountability Act. H.R.3285 - Fairness for Patient Medications Act; H.R. ___, the Stop Drug Shortages Act; H.R. 3008, the Drug Shortage Prevention Act of 2023; H.R. 3810, the Drug Origin Transparency Act of 2023; H.R. 3793, the Ensuring Access to Lifesaving Drugs Act of 2023; H.R. 167, the Patient Access to Urgent-Use Pharmacy Compounding Act of 2023.

Client expense: $1,630,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to prescription drug coverage and pharmacy benefits Issues related to the prescription drug marketplace, patents, and competition Regulatory and proposed legislative changes to Medicare Part D and Medicaid prescription drug benefits S.113 - Prescription Pricing for the People Act S.127 - Pharmacy Benefit Manager Transparency Act S.142 - Preserve Access to Affordable Generics and Biosimilars Act S.148 - Stop STALLING Act S.150 - Affordable Prescriptions for Patients Act S.652 - Safe Step Act S.655 - Chronic Disease Management Act S.727 - Insulin for All Act S.775 - Increasing Transparency in Generic Drug Applications Act S.954 - Affordable Insulin Now Act S.1038 - Drug Price Transparency in Medicaid Act S.1067 - Ensuring Timely Access to Generics Act S.1114 - Expanding Access to Low-Cost Generics Act S.1120 - Improved Access to Affordable Medications Act S.1128 - Ensuring Access to Generic Medications Act S.1130 - Health Care PRICE Transparency Act S.1131 - Drug Price Transparency Act S.1217 - Ending the Prescription Drug Kickback Act S.1218 - Fair Prescription Drug Prices for Americans Act S.1269 - INSULIN Act S.1339 - Pharmacy Benefit Manager Reform Act S.1375 - HELP Copays Act S.1497 - Emergency Access to Insulin Act S.1491 - Pharmacy and Medically Underserved Areas Enhancement Act S.1542 - Delinking Revenue from Unfair Gouging (DRUG) Act S.1543 - A bill to require regulations concerning the disclosure of direct and indirect compensation from entities providing pharmacy benefit management services or third party administration services S.1967 - Patients Before Middlemen (PBM) Act S.2052 - Protect Patient Access to Pharmacies Act S.2129 - Ensuring Access to Lower-Cost Medicines for Seniors Act S.2254 - Medicare PBM Accountability Act S.2405 - Strengthening Pharmacy Access for Seniors Act S.2406 - PBM Oversight Act S.2408 - IMPROVE Part D Regulations Act S.2436 - Neighborhood Options for Patients Buying Medicines (NO PBM) Act S.2456 - Protecting Seniors from High Drug Costs Act S.2474 - Share the Savings with Seniors Act S.2477 - Equitable Community Access to Pharmacist Services Act S.2493 - PBM Reporting Transparency Act S.2666 - EPCS 2.0 Act S.2840 - Bipartisan Primary Care and Health Workforce Act (Bruan Amendment #3 - Price Transparency Requirements) S.2939 - Pharmacy Access Oversight and Reporting Act S.2973 - Modernizing and Ensuring PBM Accountability Act H.R.830 - HELP Copays Act H.R.1352 - Increasing Access to Biosimilars Act H.R.1488 - Affordable Insulin Now Act H.R.1587 - Making Insulin Affordable for All Children Act H.R.1613 - Drug Price Transparency in Medicaid Act H.R.1770 - Equitable Community Access to Pharmacists Act H.R.1790 - Biologics Competition Act H.R.2630 - Safe Step Act H.R.2666 - Medicaid VBPs for Patients (MVP) Act H.R.2670 - PBM Accountability Act H.R.2691 - Transparent PRICE Act H.R.2880 - Protecting Patients Against PBM Abuses Act H.R.3030 - Stop the Overuse of Petitions and Get Affordable Medicines to Enter Soon (STOP GAMES) Act H.R.3134 - Emergency Access to Insulin Act H.R.3262 - to amend title XI of the Social Security Act to increase transparency of certain health-related ownership information H.R.3281 - Transparent PRICE Act H.R.3282 - Promoting Transparency and Health Competition in Medicare Act H.R.3285 - Fairness for Patient Medications H.R.3561- Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act H.R.3800 - Chronic Disease Flexible Coverage Act H.R.4011 - Timely Access to Clinical Treatment Act H.R.4507 - Transparency in Coverage Act H.R.4508 - Hidden Fee Disclosure Act H.R.4509 - Transparency in Billing Act H.R.4527 - Health Data Act H.R.4712 - Patient Right to Shop Act H.R.4822 - Health Care Price Transparency Act H.R.4846 - To amend the Internal Revenue Code of 1986, title XXVII of the Public Health Service Act, and the Employee Retirement Income Security Act of 1974 to provide for oversight of pharmacy benefit manager services H.R.4881 - To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program H.R.4883 - Medicare Common Ownership Transparency Act H.R.5372 - Expanding Seniors Access to Lower Cost Medicines Act H.R.5376 - Share the Savings with Seniors Act H.R.5378 - Lower Costs More Transparency Act H.R.5384 - Advancing Enrollment and Reducing Drug Costs Act H.R.5385 - Medicare PBM Accountability Act H.R.5386 - Cutting Copays Act H.R.5393 -Transparency and Fairness for Pharmacies Act H.R.5400 - Neighborhood Options for Patients Buying Medicines (NO PBM) Act H.R.5461 - Ensuring Access to Lower-Cost Medicines for Seniors Act Implementation of the Inflation Reduction Act of 2022, P.L. 169- Provisions on Medicare Part D modernization and drug price negotiation

Client expense: $3,973,758 · 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), SENATE

Q3 Lobbying Report (July 1-Sept 30) HCR Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program Resident Physician Shortage Act of 2023 (H.R. 2389) No Surprises Act regulations Public Health Emergency designation Food and Drug Amendments No Surprise Bills for New Moms Act (H.R. 3387) Securing the U.S. Organ Procurement and Transplantation Network Act (H.R. 2544) Promoting Access to Treatments and Increasing Extremely Needed Transparency Act (H.R. 3561) Medicaid VBPs for Patients (MVP) Act (H.R. 2666) Providers and Payers COMPETE Act (H.R. 3284) To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290) Transparent PRICE Act (H.R. 3281/H.R. 2691)) Resident Physician Shortage Reduction (S. 1302) Medical Student Education Authorization Act (H.R. 3046) Save Americas Rural Hospitals Act (H.R. 833) Chronic Care Management Improvement Act (H.R. 2829) Safety From Violence for Healthcare Employees Act (H.R. 2584) Supporting Safety Net Hospitals Act (H.R. 2665) Patient Access to Higher Quality Health Care Act (H.R. 977/S.470) FEMA re: COVID-19 related reimbursement Public Health Guidance Transparency and Accountability Act of 2023 (H.R. 4529) Public Health Emergency Congressional Review Act (H.R. 4381) CDC Leadership Accountability Act of 2023 (H.R. 3813) Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) Preparedness and Response Reauthorization Act (H.R. 4420) Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887) Health Care Price Transparency Act of 2023 (H.R. 4822) Providers and Payers COMPETE Act (H.R. 3284) Lower Costs, More Transparency Act (H.R. 5378 Transparency in Coverage Act (H.R. 4507) MMM Accelerated and Advance Payment Program repayment flexibility Graduate Medical Education (GME) funding Telehealth flexibilities and payment Annual Prospective Payment System Rules Organ acquisition payment policies BUD FY 2024 Appropriations bills Nursing and allied health workforce funding FY 2024 budget request Submitted Comments SUBJECT: CMS-1784-P, Medicare and Medicaid Program: CY 2024 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Advantage; Medicare and Medicaid Provider and Supplier Enrollment Policies; and Basic Health Program, Federal Register (Vol. 88, No. 50), August 7, 2023 SUBJECT: CMS-1786-P, Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Payment for Intensive Outpatient Services in Rural Health Clinics, Federally Qualified Health Centers, and Opioid Treatment Programs; Hospital Price Transparency; Changes to Community Mental Health Centers Conditions of Participation, Proposed Changes to the Inpatient Prospective Payment System Medicare Code Editor; Rural Emergency Hospital Conditions of Participation Technical Correction, Federal Register (Vol. 88, No. 145), July 31, 2023 Subject: 340B Program - Senate Request for Information SUBJECT: CMS-5540-NC, Request for Information; Episode-Based Payment Model, Federal Register (Vol. 88, No. 136), July 18, 2023 SUBJECT: (CMS-1793-P) Medicare Program; Hospital Outpatient Prospective Payment System: Remedy for the 340B-Acquired Drug Payment Policy for Calendar Years 2018-2022; Federal Register (Vol. 88, No. 131), July 11, 2023 SUBJECT: CMS-1780-P, Medicare Program; Calendar Year (CY) 2024 Home Health (HH) Prospective Payment System Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin Items and Services; Hospice Informal Dispute Resolution and Special Focus Program Requirements, Certain Requirements for Durable Medical Equipment Prosthetics and Orthotics Supplies; and Provider and Supplier Enrollment Requirements; Federal Register (Vol. 88, No. 130), July 10, 2023 Comments re: Application and Employment Certification for Public Service Loan Forgiveness (Agency/Docket no. ED-2023-SCC-0079; Docket ID no. 2023-10191) SUBJECT: CMS-2434-P, Medicaid Program; Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program; Proposed Rule, Federal Register (Vol. 88, No. 102), May 26, 2023 SUBJECT: CMS-2439-P, Medicaid Program; Medicaid and Children's Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality; Proposed Rule, Federal Register (Vol. 88, No. 85), May 3, 2023 SUBJECT: CMS-2442-P, Medicaid Program; Ensuring Access to Medicaid Services; Proposed Rule, Federal Register (Vol. 88, No. 85), May 3, 2023

Client expense: $380,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Educate policymakers on issues related to S. 113, the Prescription Pricing for the People Act; S. 127,the Pharmacy Benefit Manager Transparency Act; S. 1339, Pharmacy Benefit Manager Reform Act; S.1542, the DRUG Act; H.R. 1613, the Drug Price Transparency in Medicaid Act of 2023; H.R. 2666, the Medicaid VBPs for Patients(MVP) Act; H.R. 3561, the Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (previously H.R. 2691 Transparent PRICE Act); H.R. 3281, To promote hospital and insurer price transparency; H.R.2880, Protecting Patients Against PBM Abuses Act; H.R. 2679, The PBM Accountability Act; H.R.3285, the Fairness for Patient Medications Act, to establish patient protections with respect to highly rebated drugs; H.R. 3262,To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information; H.R. 3290, To amend title Ill of the Public Health Service Act to ensure transparency and oversight of th e 340B drug discount program; H.R. 2666, the Medicaid VBPs for Patients (MVP) Act; H.R. 3284, the Providers and Payers COMPETE Act; and issues related to Neighborhood Options for Patients Buying Medicines (NO PBMs) Act; S. 2405, the Strengthening Pharmacy Access for SeniorsAct; S.2254,the Medicare PBM Accountability Act; S. 2052, the Protect Patient Access to Pharmacies Act; H.R. 4822,the Health Care Price Transparency Act of 2023; H.R. 3284, the Providers and Payers COMPETE Act; H.R. 4508, the Hidden Fee Disdosure Act H.R. 4507, the Transparency in Coverage Act of 2023; H.R. 4895, the Lowering Drug Costs for American Families Act; H.R. 5378 Lower Costs, More Transparency Act; H.R. 4527, Health DATA Act;H.R. 4508, Hidden Fee Disdosure Act; H.R.3285 - Fairness for Patient Medications Act; S. Modernizing and Ensuring PBM Accountability Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2691, the Transparent PRICE Act; S 652/HR 2630, Safe Step Act; S 1375/HR 830, HELP Copays Act; H.R. 2679, the PBM Accountability Act; S. 1339, Pharmacy Benefit Manager Reform Act; H.R. 3284, the Providers and Payers COMPETE Act; H.R. 3237, requiring each off-campus outpatient department of a provider to include a unique identifier; H.R. 3285, the Fairness for Patient Medications Act; H.R. 3262, to increase transparency of certain health-related ownership information; S. 1214, the RARE Act; The Lower Costs, More Transparency Act; The Stop Drug Shortages Act; H.R. 4822; Health Care Price Transparency Act of 2023; The Patient Act; Improving Seniors Timely Access to Care Act; The Cutting Copays Act; The Modernizing and Ensuring PBM Accountability Act; The Transparency in Billing Act.

Client expense: $27,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Medicare Payment Advisory Commission (MedPAC), SENATE

H.R. 485 - Protecting Health Care For All Patients Act of 2023 - Rep. McMorris Rodgers, Cathy - federal programs using prices based on quality-adjusted life years H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023 - Rep. Walberg, Tim - telehealth and ERISA amendments H.R. 830 - HELP Copays Act - Rep. Carter, Earl - health insurers responsibility for payments made by or on behalf of a plan enrollee toward a plans cost-sharing requirements H.R. 1488 - Affordable Insulin Now Act of 2023 - Rep. Craig Angie - cost-sharing for insulin products H.R. 1613 - Drug Price Transparency in Medicaid Act of 2023 - Rep. Carter, Earl -spread-pricing by PBMs for Medicaid H.R. 2666 - MVP Act - Rep. Guthrie, Brett - value-based purchasing arrangements under Medicaid program and reforms to price reporting H.R. 2691 - Transparent Price Act - Rep. McMorris Rodgers, Cathy - health insurer price transparency H.R. 2813 - Self-Insurance Protection Act - Rep. Good, Bob - ERISA amendments H.R. 2868 - Association Health Plans Act - Rep. Walberg, Tim - ERISA amendments H.R. 3305 - Black Maternal Health Momnibus Act - Rep. Underwood, Lauren - maternal health including in Medicaid and CHIP H.R. 3561 - PATIENT Act - Rep. McMorris Rodgers, Cathy - PBM transparency, PBM contract design, health insurance transparency, hospital transparency H.R. 3797 - Paperwork Burden Reduction Act - Rep. Smith, Jason - employers mailing 1095 physical tax forms H.R. 3798 - Small Business Flexibility Act - Rep. Tenney, Claudia - small business coverage notifications H.R. 3799 - Custom Health Option and Individual Care Expense Arrangement Act- Rep. Hern, Kevin - health reimbursement arrangements H.R. 3801 - Employer Reporting Improvement Act - Rep. Smith, Adrian - ACA reporting requirements S. 113 - Prescription Pricing for the People Act of 2023 - Sen. Grassley, Chuck - preventing anti-competitive tactics for prescription drugs S. 127 - Pharmacy Benefit Manager Transparency Act of 2023 - Sen. Cantwell, Maria - pharmacy benefit manager transparency S. 652 - Safe Step Act - Sen. Murkowski, Lisa - medication step therapy protocol S. 954 - Affordable Insulin Now Act of 2023 - Sen. Warnock, Raphael - cost-sharing for insulin products S. 1038 - Drug Price Transparency in Medicaid Act of 2023 - Sen. Welch, Peter - prohibits spread-pricing by PBMs in Medicaid S. 1339 - Pharmacy Benefit Manager Reform Act - Sen. Sanders, Bernard - pharmacy benefit managers S. 1606 - A bill to end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. - Sen. Booker, Cory - maternal mortality Accessible, Affordable Internet for All Act (no bill number) - broadband Advancing Integration in Medicare and Medicaid (AIM) Act (no bill number) - coordinating full-benefits for dual eligible individuals Advancing Telehealth Beyond COVID-19 Act (no bill number) - telehealth American Data Privacy and Protection Act (no bill number) - data privacy American Rescue Plan Act (no bill number) - COVID-19 relief Behavioral Health Integration Awareness Act (no bill number) - mental health and Medicare Better Health Care Directories Act (no bill number) - commercial plans Building COVID-19 Vaccine Confidence Act (no bill number) - COVID-19 CHOICE Act (no bill number) - public option CONNECT for Health Act (no bill number) - expansion of telehealth for Medicare Consolidated Appropriations Act (no bill number) - continued Medicaid and Medicare provisions and funding for FY2023 Consumer Online Privacy Rights Act (no bill number) - data privacy Continuing Appropriations and Ukraine Supplemental Appropriations Act (no bill number) - continued funding for Medicare and Medicaid COVID Community Care Act (no bill number) - COVID-19 response COVID-19 Emergency Telehealth Impact Reporting Act (no bill number) - telehealth and COVID-19 COVID-19 Health Disparities Action Act (no bill number) -COVID-19 and health disparities Data Mapping to Save Moms Lives Act (no bill number) - maternal health data Equitable Data Collection and Disclosure on COVID-19 Act (no bill number) - COVID-19 Data Collection Fighting Stimulant and other Substance Use Disorders Act (no bill number) - mental health and Medicare Food and Drug Amendments (no bill number) - reauthorization of user fee programs Health Care Improvement Act (no bill number) - care costs and coverage Hospital Competition Act (no bill number) - procedural changes around The Mental Health Parity and Addiction Equity Act (MHPEA) litigation IMPACT to Save Moms Act (no bill number) - maternal health Improving Access to Behavioral Health Integration Act (no bill number) - behavioral health Improving Access to Health Care in Rural and Underserved Areas Act (no bill number)- rural health Improving Seniors Timely Access to Care Act (no bill number) - prior authorization in Medicare Advantage Improving Social Determinants of Health Act (no bill number) - health disparities Inpatient Psychiatric Facility Improvement Act (no bill number) - mental health and Medicare Kira Johnson Act (no bill number) - maternal health LIFT America Act (no bill number) - broadband and public health infrastructure Lower Costs, More Cures Act (no bill number) - prescription drug prices for Medicare and Medicaid Maternal Vaccinations Act (no bill number) - maternal health Medicaid Saves Lives Act (no bill number) - Medicaid expansion Medicare for All Act (no bill number) - public option Medicare Multi-Cancer Early Detection Screening Coverage Act (no bill number) - Cancer screening in Medicare Mental Health Matters Act (no bill number) - changes to the procedure around MHPEA litigation MOMMAs Act (no bill number) - maternal health Moms Matter Act (no bill number) - maternal mental health conditions and SUD MORE Health Education Act (no bill number) - Federal Exchange outreach and educational activities NO PAIN Act (no bill number) - non-opioid treatment No Surprises for Survivors Act (no bill number) - 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 Nursing Home Reform Modernization Act (no bill number) - nursing home quality and transparency Parity Enforcement Act (no bill number) - mental health and SUD Parity Implementation Assistance Act (no bill number) - mental health parity PATCH Act (no bill number) - privacy and cybersecurity Patients Before Middlemen Act (no bill number) - pharmacy benefit managers Physician Wellness Program Act (no bill number) - mental health and Medicare Prevent Pandemics Act (no bill number) - pandemic preparedness Preventing Mental Health and Substance Use Crises During Emergencies Act (no bill number) - mental health and SUD national strategy Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act (no bill number) - commercial plans Protecting Americans with Pre-Existing Conditions Act (no bill number) - state innovation waivers Protecting Patients from Deceptive Health Plans Act (no bill number) - excepted benefits coverage Protecting Personal Health Data Act (no bill number) - privacy Public Health Infrastructure Saves Lives Act (no bill number) - public health infrastructure Public Option Deficit Reduction Act (no bill number) - public option Restore Protections for Dialysis Patients Act (no bill number) - reform of MSP Secondary Payer Act Restoring Hope for Mental Health and Well-Being Act (no bill number) - reauthorization of several behavioral health programs RICE Act (no bill number) - commercial plans SAFE DATA Act (no bill number) - consumer data privacy and data transparency and security Safe Step Act (no bill number) -commercial plans and medication step-therapy requirements Secure Data and Privacy for Contact Tracing Act (no bill number) - digital contact tracing for COVID-19 Social Determinants for Moms Act (no bill number) - SDOH and maternal health Strengthen Kids Mental Health Now Act (no bill number) - mental health and Medicaid Supporting Best Practices for Healthy Moms Act (no bill number) - maternal health Tech to Save Moms Act (no bill number) - maternal health The Jackie Walorski Maternal and Child Home Visiting Reauthorization Act (no bill number) - funding for maternal and early childhood health programs 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 (no bill number) - Broadband 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. (no bill number) - commercial plans 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. (no bill number) - behavioral health and electronic health records To amend title XVIII of the Social Security Act to ensure adequate coverage of outpatient mental health services under the Medicare program. (no bill number) - mental health and Medicare 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. (no bill number) - commercial plans 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. (no bill number) - mental health and Medicare TREATS Act (no bill number) - increase use of telehealth for SUD treatment Turn the Tide Act (no bill number) - Substance Use Disorder Virtual Community Support Act (no bill number) - mental health and SUD grants for community peer support Issues related to broadband and public health infrastructure; mental health and telehealth; COVID-19 testing; public option programs; behavioral health; rural health; substance use disorder treatments; Health Savings Accounts; and provider directories. Regulatory Issues: HIPAA administrative simplification issues, including standards for privacy, security, and electronic transactions and code sets (including ICD-10 and ICD-11), 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; ACA 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: $2,840,000 · 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, White House Office

H.R. 1488 - Affordable Insulin Now Act of 2023 - Rep. Craig Angie - cost-sharing for insulin products H.R. 1613 - Drug Price Transparency in Medicaid Act of 2023 - Rep. Carter, Earl -spread-pricing by PBMs for Medicaid H.R. 2691 - Transparent Price Act - Rep. McMorris Rodgers, Cathy - health insurer price transparency H.R. 3561 - PATIENT Act - Rep. McMorris Rodgers, Cathy - PBM transparency, PBM contract design, health insurance transparency, hospital transparency S. 79 - Interagency Patent Coordination and Improvement Act of 2023 - Sen. Durbin, Richard - prescription drug patenting S. 113 - Prescription Pricing for the People Act of 2023 - Sen. Grassley, Chuck - preventing anti-competitive tactics for prescription drugs S. 127 - Pharmacy Benefit Manager Transparency Act of 2023 - Sen. Cantwell, Maria - pharmacy benefit manager transparency S. 142 - Preserve Access to Affordable Generics and Biosimilars Act - Sen. Klobuchar, Amy - pharmacy and biosimilar prescription drugs S. 148 - Stop STALLING Act - Sen. Klobuchar, Amy - pharmacy market approval processes S. 150 - Affordable Prescriptions for Patients Act of 2023 - Sen. Cornyn, John - pharmacy and prescription drug prices S. 574 - Increasing Prescription Drug Competition Act - Sen. Hassan, Maggie - closure of pharmaceutical patent loophole S. 954 - Affordable Insulin Now Act of 2023 - Sen. Warnock, Raphael - insulin pricing and cost sharing S. 1038 - Drug Price Transparency in Medicaid Act of 2023 - Sen. Welch, Peter - prohibits spread-pricing by PBMs in Medicaid S. 1339 - Pharmacy Benefit Manager Reform Act - Sen. Sanders, Bernard - pharmacy benefit managers Biosimilar Red Tape Elimination Act (no bill number) - pharmacy and biosimilar prescription drugs Empowering Medicare Seniors to Negotiate Drug Prices Act (no bill number) -Medicare drug prices Fairness in Orphan Drug Exclusivity Act (no bill number) - orphan drugs Increasing Transparency in Generic Drug Applications Act (no bill number) - cuts red tape for generics to come to market Medicare Drug Price Negotiation Act (no bill number) - Drug Prices Patent Eligibility Restoration Act (no bill number) - patent changes Protecting Consumer Access to Generic Drugs Act (no bill number) - patent infringement settlements Regulatory Issues: Issues relating to long term safety and effectiveness of medical devices and drugs, including registries; issues relating to post-market surveillance of drugs and medical devices; issues relating to price of drugs and biologics and proposals to limit high prices; issues related to prescription drug coupons and discount programs; contraceptive coverage; issues relating to vaccines; issues related to health equity; issues related to vaccination; potential Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; issues related to coverage of EUA drugs under Medicare Part D; issues related to drug patents and market exclusivity; issues related to pharmacy benefit managers; issues related to biosimilars; issues related to approval of drugs and biologics; issues relating to opioids; issues relating to COVID-19, including testing, vaccines and therapeutics; issues related to health care price transparency; issues relating to prescription drug rebates; direct-to-consumer advertising for prescription drugs; issues relating to access for investigational drugs; issues related to comparative effectiveness research and quality-adjusted life years; issues related to health plan step-therapy; and other issues relating to health care reform implementation.

Client expense: $2,840,000 · 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), SENATE, White House Office

Discussion with OMB/OIRA regarding OSHA Occupational Exposure to COVID-19 in Healthcare Settings Final Rule; Discussion with FDA Drug Shortage expert regarding Inflation Reduction Act Provisions that could impact duration of shortages; Discussion with ASPR Hospital Preparedness Program Staff about speaking at a meeting regarding HPP issues; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Inpatient Prospective Payment System/Long Term Care Hospital Proposed Rule; Discussion with White House Office of Management & Budget, Centers for Medicare & Medicaid Services (CMS) - HHS FY 2024 Medicare Advantage Final Rule; Hill outreach about reducing hospital workplace violence; Hill outreach about the benefits of hospital mergers and acquisitions; Hill outreach about the anticompetitive behaviors of travel nurse staffing agencies; Statement to the U.S. Senate Committee on Health, Education, Labor, and Pensions, Examining Health Care Workforce Shortages: Where Do We Go from Here?; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an Request For Information on the reauthorization of the Pandemic and All-Hazards Preparedness Act; Letter to the U.S. Senate Committee on Health, Education, Labor, and Pensions in response to an RFI on the drivers of health care workforce shortages; Support S.1110, Rural Hospitals Support Act, a bill to amend title XVIII of the Social Security Act to rebase the calculation of payments for sole community hospitals and Medicare-dependent hospitals, and for other purposes; Support H.R. 1110Telehealth Option Act, a bill to direct the Secretary of Health and Human Services, the Medicare Payment Advisory Commission, and the Medicaid and CHIP Payment and Access Commission to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Childrens Health Insurance programs during the COVID-19 emergency; Feedback on the Connect for Health Act; AHA provided feedback on the creating opportunities new for necessary and effective care technologies (CONNECT) Act; False Claims Act Case AHA Provides Statement for House Hearing on Price Transparency, Competition; Oppose H.R.977/S.470 Patient Access Higher Quality Health Care Act, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support S.940, The Rural America Health Corps Act A bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Support the Conrad State 30 and Physician Access Reauthorization Act that would allow international doctors trained in the United States to remain in the country if they practice in areas experiencing medical shortages; Letter to CMS regarding intent to issue staffing mandates for nursing homes and urged CMS and policy makers to focus on efforts that will bolster our workforce; Support HR 2389/ S 1302, Resident Physician Shortage Reduction Act of 2023, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Support HR 2411/ S 1150, National Nursing Workforce Center Act of 2023, a bill to amend the Public Health Service Act to support and stabilize the existing nursing workforce, establish programs to increase the number of nurses; Support HR 2534, Preserving Rules Ordered for The Entities Covered Through 340B Act of 2023 or the PROTECT 340B Act of 2023, a bill to amend title XXVII of the Public Health Service Act to ensure the equitable treatment of covered entities and pharmacies participating in the 340B drug discount program; Support HR 2559, Strengthening Community Care Act of 2023, a bill to extend funding for community health centers and the National Health Service Corp; Support HR 2584, Safety From Violence for Healthcare Employees Act or the SAVE Act, a bill to protect hospital personnel from violence, and for other purpose; Statement to the House Education and the Workforce Subcommittee on Health, Employment, Labor, and Pensions hearing titled, Competition and Transparency: The Pathway Forward for a Stronger Health Care Market highlighting that mergers and acquisitions can be a helpful tool for many hospitals and pushing back against site-neutral payment policies; Letter urging Congress to continue to protect this critical program and oppose efforts to cut its benefits, which would result in reduced access to quality care for the patients and communities served by 340B hospitals; Statement to Subcommittee on Health of the Committee on Energy and Commerce on its hearing Examining Existing Federal Programs to Build a Stronger Health Workforce and Improve Primary Care; Support S 1447, Bipartisan Solution to Cyclical Violence Act of 2023, a bill to amend the Public Health Service Act to establish a grant program supporting trauma center violence intervention and violence prevention programs, and for other purposes; Support HR 3046/ S 1403, Medical Student Education Authorization Act of 2023, a bill to amend the Public Health Service Act to establish a grant program to award grants to accredited public institutions of higher education, and for other purposes; Concerns with HR 2691, Transparent Prices Required to Inform Consumer and Employers Act or the Transparent PRICE Act, a bill to promote hospital and insurer price transparency; Letter strongly opposing the draft bills, which would create additional site-neutral payment cuts and threaten access to care, especially in rural and other vulnerable communities; Comment letter to the Office of Civil Rights on its HIPAA Privacy Rule to Support Reproductive Health Care Privacy and concerns the guidance is too broad and will result in significant adverse consequences for hospitals, patients and the public at large; Statement to SFC for the hearing on Consolidation and Corporate Ownership in Health Care: Trends and Impacts on Access, Quality, and Costs; Comment letters to CMS on their Inpatient and Long-term Care Facility Prospective Payment System FY 2024 proposed rule; Letter to reauthorize key programs within the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act of 2018, we encourage you to consider policies that will reduce barriers to receiving and administering behavioral health care by improving payment policies, reducing unnecessary regulatory and administrative burden, and strengthening the behavioral health workforce; Comment letter on the Environmental Protection Agencys (EPA) proposed standards for the use of ethylene oxide (EtO) to sterilize medical devices urge caution and thoughtfulness in EPAs approach to avoid disrupting health care delivery through the unintentional fracturing of the already fragile medical device supply chain; Hill briefing, Site-neutral Payment Proposals Would Jeopardize Access to Care for Patients and Communities.

Client expense: $6,380,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE

H.R. 2584 - Safety from Violence for Healthcare Employees (SAVE) Act - Support creating legal penalties for individuals who knowingly and intentionally assault or intimidate hospital employees. H.R. 2691 - Transparent PRICE Act - Codifying Hospital Price Transparency requirements H.R. 2819 - Good Samaritan Health Professionals Act of 2023 - Support expanded liability protections for doctors who choose to volunteer during national or public health emergencies H.R. 3305 / S. 1606 - Black Maternal Health Momnibus Act - Support policies to improve maternal health H.R. 3421 / S. 1655 - Medicare for All Act of 2023 - Oppose a single-payer system H.R. 3577 - Medical and Stockpile Accountability Act - Support supply chain improvements H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023 - Support treating telehealth services as excepted benefits S. 665 - Conrad State 30 and Physician Access Reauthorization Act - Support extending and enhancing program CONNECT for Health Act of 2023 - Support expansion of telehealth services Identify and support solutions to address health care workforce shortage Support addressing growing crisis of antimicrobial resistance (AMR) Support reauthorization of Pandemic and All-Hazards Preparedness Act Support continued Congressional work on behavioral health Loan repayment for nurses in rural areas

Client expense: $710,000 · Firm income: Not reported

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

H.R.2923 - Living Donor Protection Act of 2023 H.R. 2691 - Hospital Price Transparency

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS)

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Site-Neutral Payment (Sec. 603 of the Balanced Budget Act of 2015); To amend title XI of the Social Security Act to increase transparency of certain health-related ownership information (H.R. ____); To amend title XVIII of the Social Security Act to promote transparency of common ownership interests under Parts C and D of the Medicare Program (H.R. ____); To amend title XVIII of the Social Security Act to provide for parity in Medicare payments for hospital outpatient department services furnished off-campus (H.R. ____); To amend title XVIII of the Social Security Act to require payment for all hospital-owned physician offices located off-campus be paid in accordance with the applicable payment system for the items and services furnished (H.R. ____); To amend XVIII of the Social Security Act to provide for site neutral payments under the Medicare program for certain services furnished in ambulatory settings (H.R. ____); To amend titles XI and XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department (H.R. ____); To phase out certain services designated as inpatient-only services under the Medicare program (H.R. ____); Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 (H.R. 3561); To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290); Safety From Violence for Healthcare Employees (SAVE) Act (H.R. 2584); Doctors of Community (DOC) Act (H.R. 2569); Modernizing Opioid Treatment Access Act (H.R. 1359); Transparent PRICE Act (H.R. 2691); Transparent PRICE Act (H.R. 3281); Expanded Telehealth Access Act (H.R. 3875); Telehealth Benefit Expansion for Workers Act of 2023 (H.R. 824); National Nursing Workforce Center Act of 2023 (H.R. 2411); Supporting Safety Net Hospitals Act (H.R. 2665); Resident Physician Shortage Reduction Act of 2023 (S. 1302).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Q2 Lobbying Report (April 1-June 30) HCR Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program Resident Physician Shortage Act of 2023 (H.R. 2389) No Surprises Act regulations Public Health Emergency designation Food and Drug Amendments No Surprise Bills for New Moms Act (H.R. 3387) Securing the U.S. Organ Procurement and Transplantation Network Act (H.R. 2544) Promoting Access to Treatments and Increasing Extremely Needed Transparency Act (H.R. 3561) Medicaid VBPs for Patients (MVP) Act (H.R. 2666) Providers and Payers COMPETE Act (H.R. 3284) To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290) Transparent PRICE Act (H.R. 3281/H.R. 2691)) Resident Physician Shortage Reduction (S. 1302) Medical Student Education Authorization Act (H.R. 3046) Save Americas Rural Hospitals Act (H.R. 833) Chronic Care Management Improvement Act (H.R. 2829) Safety From Violence for Healthcare Employees Act (H.R. 2584) Supporting Safety Net Hospitals Act (H.R. 2665) Patient Access to Higher Quality Health Care Act (H.R. 977/S.470) FEMA re: COVID-19 related reimbursement MMM Accelerated and Advance Payment Program repayment flexibility Graduate Medical Education (GME) funding Telehealth flexibilities and payment Annual Prospective Payment System Rules Organ acquisition payment policies BUD FY 2024 Appropriations bills Nursing and allied health workforce funding FY 2024 budget request Submitted Comments SUBJECT: CMS-1785-P Medicare Program; Proposed Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2024 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Rural Emergency Hospital and Physician-Owned Hospital Requirements; and Provider and Supplier Disclosure of Ownership, Federal Register (Vol. 88, No. 83), May 1, 2023 SUBJECT: CMS-1779-P, Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2024, Federal Register (Vol 88, No 68), April 10, 2023 SUBJECT: CMS-1783-P, Medicare Program; FFY 2024 Inpatient Psychiatric Facilities Prospective Payment System - Rate Update, Proposed Rule, Federal Register (Vol. 88, No. 68), April 10, 2023 SUBJECT: CMS-1781-P, Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2024 and Updates to the IRF Quality Reporting Program; Proposed Rule, Federal Register (Vol. 88, No. 67), April 7, 2023 SUBJECT: CMS-2445-P, Medicaid Program; Disproportionate Share Hospital Third-Party Payer Rule (Vol 88, No 37) February 24, 2023 SUBJECT: CMS-2445-P, Medicaid Program; Disproportionate Share Hospital Third-Party Payer Rule (Vol 88, No 37) February 24, 2023

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

H.R. 2691, the Transparent PRICE Act; S 652/HR 2630, Safe Step Act; S 1375/HR 830, HELP Copays Act; H.R. 2679, the PBM Accountability Act; S. 1339, Pharmacy Benefit Manager Reform Act; H.R. 3284, the Providers and Payers COMPETE Act; H.R. 3237, requiring each off-campus outpatient department of a provider to include a unique identifier; H.R. 3285, the Fairness for Patient Medications Act; H.R. 3262, to increase transparency of certain health-related ownership information; S. 1214, the RARE Act.

Client expense: $27,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Medicare Payment Advisory Commission (MedPAC), SENATE

H.R. 2691, the Transparent PRICE Act; S 652/HR 2630, Safe Step Act; S 1375/HR 830, HELP Copays Act; H.R. 2679, the PBM Accountability Act; S. 1339, Pharmacy Benefit Manager Reform Act

Client expense: $27,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE