340B Transparency Act

S. 2840, Bipartisan Primary Care and Health Workforce Act H.R. 3305 - Black Maternal Health Momnibus Act H.R. 4420, the Preparedness and Response Reauthorization Act H.R. 4531, the Support for Patients and Communities Reauthorization Act H.R. 2534, PROTECT 340B Act of 2023 H.R. 5013, the Value in Health Care Act of 2023 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. 7050 - Substance Use Disorder Workforce Act S.4101/ H.R.7931 - the Preserving Emergency Access in Key Sites Act Keeping Obstetrics Local Act S.4088, Welcome Back to the Health Care Workforce Act Issues related to essential hospital designation Issues related to health equity Issues related to the 340B Drug Pricing program Issues related to contact pharmacies Issues related to the health care workforce Issues related to Community Paramedicine Issues related to Artificial Intelligence and Health Care Issues related to hospital digital infrastructure Issues related to cybersecurity H.R. 9351 Save our Safety-Net Hospitals Act of 2024 Issues related to Opioid overdose reduction

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

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

The 340B Drug Pricing Program; H.R. 2534, The Protect 340B Act; FY24 and FY25 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations bills. HR 3290,to amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. H.R.3561 - PATIENT Act of 2023, The Stop Drug Shortages Act (Draft legislation- House), H.R. 5378: Lower Costs, More Transparency Act, S. 1182: 340B Reporting and Accountability Act; S.1133: 340B Accountability Act of 2023,S.1038: Drug Price Transparency in Medicaid Act of 2023,H.R.1613: Drug Price Transparency in Medicaid Act of 2023,H.R.198: Drug Pricing Transparency and Accountability Act; S. 2973: Modernizing and Ensuring PBM Accountability Act, Draft Senate legislation the SUSTAIN 340B Act, HR 7635 and S. 5021, the 340B PATIENTS Act.H.R. 8574, 340B ACCESS Act: H.R.8144 - Rural 340B Access Act of 2024

Client expense: $260,046 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE

340B Program; H.R.2534 Protect 340B Act; 340B Transparency and Oversight H.R.3290/S.1133; The PATIENT Act H.R.3561; Resident Physician Shortage Reduction Act H.R.2389; Preventive Health Savings Act S.114/H.R.766; Safety from Violence for Healthcare Employees "SAVE" Act H.R.2584; H.R.5378 Lower Costs, More Transparency Act; Stop Drug Shortages Act; H.R.5378 Lower Costs, More Transparency Act; Senate 340B RFI - responded; 340B Access Act; Telehealth extenders; The American Relief Act 2025, HR10545

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Contract Pharmacy-HR 7635, The 340B PATIENTS Act of 2024 340B Transparency-No legislation yet Contract Pharmacy Protect 340B-340B Patients Act 340B Transparency-Opposition to H.R. 3290 (overly burdensome reporting legislation that distorts the 340B program) Letter to HHS Secretary Becerra

Client expense: $15,000 · Firm income: Not reported

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

Health care policy Funding for the National Emerging Special Pathogen Training and Education Center (NETEC) and Regional Emerging Special Pathogen Treatment Centers (RESPTC) Proposals to address rising drug costs Legislative proposals related to the 340B program H.R. 2534, PROTECT 340B Act H.R. 3290, legislation requiring 340B program covered entities report a wide range of data H.R. 7635/S.5021 340B PATIENTS Act H.R. 5378, Lower Costs, More Transparency Act -provisions related to 340B covered entity reporting, reimbursement of 340B covered drugs, price transparency, and funding for health programs Proposals related to telehealth H.R. 4189/S. 2016, CONNECT for Health Act SUPPORT Act reauthorization H.R. 10545, "American Relief Act"

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Proposals related to telehealth H.R. 4189/S. 2016, CONNECT for Health Act Healthcare policy Proposals to reduce drug costs and improve access Proposals to modify the 340B program H.R. 2534, PROTECT 340B Act H.R. 7635/S.5021 340B PATIENTS Act H.R. 3290 and proposals implementing reporting requirements for 340B covered entities H.R. 5378, Lower Costs, More Transparency Act H.R. 7153/S. 3679, Dr. Lorna Breen Health Care Provider Protection Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for H.R.7327 - Protecting Front Line Multimission Hospitals Act of 2024. Sustainability of safety net health systems. Social determinants of health. Support of telehealth policies, including for audio-only telehealth services. 340B Protect Act, H.R.4390. 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.2665, Supporting Safety Net Hospitals Act. H.R.3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023. Support for policies to enhance health care workforce programs. H.R.5378, Lower Costs, More Transparency Act. S.3548, Health Care Prices Revealed and Information to Consumers Explained Transparency Act. S.3450, Mental and Physical Health Care Comorbidities Act of 2023. H.R. 10337, Expanding the Healthcare Workforce Act.

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

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

H.R. 198: Drug Pricing Transparency and Accountability Act - Provisions related to the 340B Program H.R. 456: Fairness in Orphan Drug Exclusivity Act H.R. 766: Dr. Michael C. Burgess Preventive Health Savings Act H.R. 830: HELP Copays Act - To amend title XXVII of the Public Health Service Act to apply additional payments, discounts, and other financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes H.R. 1613: Drug Price Transparency in Medicaid Act of 2023 H.R. 1790: Biologics Competition Act of 2023 - To direct the Secretary of Health and Human Services to evaluate the extent to which the substitution of interchangeable biological products is impacted by differences between the system for determining a biological product to be interchangeable and the system for assigning therapeutic equivalence ratings to drugs, and for other purposes H.R. 2534: PROTECT 340B Act of 2023 - Provisions related to the 340B program H.R. 2679: Pharmacy Benefits Manager Accountability Act H.R. 2707: MADE in America Act H.R. 2816: Pharmacy Benefit Manager Sunshine and Accountability Act H.R. 2880: Protecting Patients Against PBM Abuses Act 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. 3433: Give Kids a Chance Act of 2024 H.R. 3561: Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or PATIENT Act of 2023 H.R. 3839: To amend the Federal Food, Drug, and Cosmetic Act to increase transparency in generic drug applications H.R. 4421: Preparing for All Hazards and Pathogens Reauthorization Act H.R. 4818: Treat and Reduce Obesity Act of 2023 H.R. 4895: Lowering Drug Costs for American Families Act - Provisions related to drug pricing H.R. 4988: Modern Authentication of Pharmaceuticals Act of 2023 H.R. 5376: Share the Savings with Seniors Act  H.R. 5378: Lower Costs, More Transparency Act H.R. 5391: Protecting Patient Access to Cancer and Complex Therapies Act H.R. 5539: ORPHAN Cures Act H.R. 6283: Delinking Revenue from Unfair Gouging or DRUG Act H.R. 6664: Innovation in Pediatric Drugs Act of 2023 H.R. 7024 Tax Relief for American Families and Workers Act of 2024 H.R. 7174: Ensuring Pathways to Innovative Cures (EPIC) Act: To amend title XI of the Social Security Act to equalize the negotiation period between small-molecule and biologic candidates under the Drug Price Negotiation Program H.R. 7248: FDA Modernization Act 3.0 H.R. 7623: Telehealth Modernization Act of 2024 H.R. 7635: The 340B PATIENTS Act of 2024 H.R. 8574: 340B Affording Care for Communities and Ensuring a Strong Safety-net (ACCESS) Act H.R. 9096: Pharmacists Fight Back Act S. 113: Prescription Pricing for the People Act of 2023 - Provisions related to PBMs S. 127: Pharmacy Benefit Manager Transparency Act of 2023 - Provisions related to PBMs S. 148: Stop STALLING Act - Provisions related to citizen petitions S. 1067: Ensuring Timely Access to Generics Act of 2023 S. 1130: Health Care PRICE Transparency Act S. 1264: SMART Prices Act - Provisions related to drug pricing reform S. 1339: Pharmacy Benefit Manager Reform Act - Provisions related to PBMs S. 1375: HELP Copays Act - To amend title XXVII of the Public Health Service Act to apply additional payments, discounts, and other financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes S. 1542: Delinking Revenue from Unfair Gouging Act or DRUG Act - Provisions related to PBMs S. 1589: Safeguarding Patients and Taxpayers Act S. 1967: PBM Act S. 2305: Biosimilar Red Tape Elimination Act S. 2333: Pandemic and All-Hazards Preparedness and Response Act S. 2474: Share the Savings with Seniors Act S. 2477: Equitable Community Access to Pharmacist Services Act S. 2973: Modernizing and Ensuring PBM Accountability Act (MEPA) S. 3393: SUPPORT for Patients and Communities Reauthorization Act S. 3430: Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 S. 5021: 340B PATIENTS Act of 2024 S. 5040: Protecting Patients from Deceptive Drugs Online Act S. 5459: Biosimilars Access and Affordability Act BioCompete Act (draft) Executive Order of February 28, 2024, Preventing Access to Americans' Bulk Sensitive Personal Data and United States Government-Related Data by Countries of Concern Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future (SUSTAIN) 340B Act (draft) User fee policy issues Inflation Reduction Act of 2022 (P.L. 117-169) IRA price negotiation expansion policy issues Pharmacy Benefit Manager reform and policy issues Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA) Cancer Moonshot Initiative 21st Century Cures 2.0 Drug cost and pricing policy issues Principles for drug pricing reform Drug importation policy issues Accelerated approval policy issues FDA regulatory approval authority policy issues Competition policy issues Orphan Drug Act policy issues Antimicrobial resistance (AMR) policy issues Supply chain policy issues Clinical trial diversity policy issues 340B drug discount program policy issues Patient assistance program policy issues Biosimilar approval and reimbursement policy issues Drug shortages policy issues  Pandemic preparedness policy issues Artificial intelligence policy issues Vaccine provisions of the Inflation Reduction Act Policy issues related to vaccines

Client expense: $920,000 · Firm income: Not reported

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

Issues regarding childrens health care coverage and access to care under Medicaid, CHIP, the Exchanges, TRICARE, and private insurance Issues regarding the annual Notice of Benefit and Payment Parameters for the Exchanges and private insurance Issues regarding childrens mental health and the national emergency in childrens mental health, including mental health parity, the mental health workforce and related access issues. Issue regarding Medicaid supplemental payments and directed payments Issues related to Health Information Technology, interoperability, information blocking, and cybersecurity Issues regarding the importance of Medicaid to children, including military and veteran families  Issues regarding Medicaid support for providers caring for children on Medicaid, including DSH payments Issues regarding Children's Hospitals Graduate Medical Education (CHGME) program and funding Issues related to 340B Drug Pricing Program, prescription drug pricing, drug shortages, high-cost drugs/therapies and pharmaceutical supply chain, including H.R. 3290 Issues related to pediatric workforce, Medicare GME, the Pediatric Specialty Loan Repayment Program, and Title VII and VIII Issues regarding Organ Procurement and Transplantation Network Issues regarding site neutrality, facility fees, and price transparency in health care  Issues regarding pediatric pandemic and disaster preparedness and response and emergency preparedness Issues regarding food security and nutrition Issues regarding drugs and medical device shortages and high costs, including IV fluid shortages and infant formula Issues related to the regulation of laboratory-developed tests Issues regarding prescribing of drugs via telehealth Issues related to mental health services in schools Issues related to pediatric cancer and the Moonshot Issues regarding Artificial Intelligence (AI) Issues regarding oversight and implementation of EPSDT H.R. 2412 The Helping Kids Cope Act S.2372/HR. 4758 - Accelerating Kids Access to Care Act  H.R. 1397, Telehealth Improvement for Kids Essential Services (TIKES) Act H.R. 7623/ S. 3967, Telehealth Modernization Act Issues involving Site Neutral payment legislation, including H.R. 3281 and H.R. 3561 S. 3029/H.R. 6085 PREEMIE Reauthorization Act H.R. 2584/S.2768, Safety form Violence for Healthcare employees (Save) Act S. 1409, Kids Online Safety Act H.R. 6663/S. 3364, Kid PROOF Act of 2023 H.R. 6664 Innovation for Pediatric Drugs Act of 2023 H.R. 7808, the Early Action and Responsiveness Lifts Youth (EARLY) Minds Act H.R. 7153/S. 3679 Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. 3757 Congenital Heart Futures Reauthorization Act of 2024 H.R. 6960 Emergency Medical Services for Children Reauthorization Act of 2024 H.R. 3391 Gabriella Miller Kids First Research Act 2.0 H.R. 6963 Pediatric Cancer Drug Supply Act H.R. 3433/ S. 2897, Give Kids A Chance Act H.R. 7384, Creating Hope Reauthorization Act. H.R. 6664/S. 4905, Innovation in Pediatric Drugs Act

Client expense: $1,600,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

Issues related to Direct-to-Consumer Prescription Drug Advertisements; Issues related to Cybersecurity; Health care issues related to P.L. 118-42, the Consolidated Appropriations Act 2024, and P.L. 118-47, the Further Consolidated Appropriations Act 2024; Issues related to P.L. 117-328, the Consolidated Appropriations Act 2023; Issues related to P.L. 117-169, the Inflation Reduction Act of 2022, including enhanced advance premium tax credits (APTCs) and Medicare Part D redesign; Issues related to P.L. 93-406, Employee Retirement Income Security Act of 1974 (ERISA), preemption; S. 727, Insulin for All Act of 2023; S. 1269, Improving Needed Safeguards for Users of Lifesaving Insulin Now (INSULIN) Act of 2023; S. 146, Cap Insulin Prices Act; S. 954, Affordable Insulin Now Act of 2023; H.R. 1488, Affordable Insulin Now Act; H.R. 1587, Making Insulin Affordable for All Children Act; H.R. 1485, Insulin for all Act of 2023; H.R. 3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program; S. 464/H.R. 2630, the Safe Step Act; H.R. 1843/S. 1001, Telehealth Expansion Act; H.R. 824, Telehealth Benefit Expansion for Workers Act of 2023; Issues related to mental health coverage, workforce, and mental health parity; Issues related to surprise billing law and regulation; Issues related to artificial intelligence and health care issues; Issues related to removing barriers to biosimilar medicine access; H.R. 4189/S. 2016, The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; H.R. 3432/S.3651, Telemental Health Care Access Act of 2023; H.R. 1692, The Health Care Affordability Act; H.R. 8152, the American Privacy Rights Act (APRA) of 2024; P.L. No: 118-158 and draft FY2025 Continuing Resolution, issues related to telehealth.

Client expense: $1,420,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, 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/H.R. 6283, 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; S. 2406, PBM Oversight Act of 2023; S. 2973, 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. 3285, Fairness for Patient Medications Act; S. 2973 Modernizing and Ensuring PBM Accountability Act; S. 3548, Health Care Prices Revealed and Information to Consumers Explained Transparency Act (Health Care PRICE Transparency Act 2.0); H.R.3285 - Fairness for Patient Medications 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; H.R. 7535, Prescription Drug Supply Chain Pricing Transparency Act; S. 2305, Biosimilar Red Tape Elimination Act; H.R. 6986/S.3583, to address patent thickets; H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act; Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future of 340B Act (SUSTAIN 340B Act); S.150, the Affordable Prescription Drug for Patients Act; S. 142, the Preserve Access to Affordable Generics and Biosimilars Act; S. 5503, H.R. 10362, the Patients Before Monopolies (PBM) Act; P.L. No: 118-158 and draft FY2025 Continuing Resolution, issues related to PBMs.

Client expense: $1,420,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

340B Drug Discount Program, eligibility waiver H.R. 3290 H.R. 2389, S.1302 - Resident Physician Shortage Reduction Act H.R. 3561 - PATIENT Act H.R. 2665 - Supporting Safety-Net Hospitals Act HR 7635 - 340B PATIENTS Act SUSTAIN 340B Act ACCESS 340B Act Graduate Medical Education Disproportionate Share Hospital (DSH) payments Childrens Health Insurance Program Medicare Dependent Hospital Program (MDH) Medicaid Low Volume Payments (LV) Federal Medical Assistance Percentage Extension Inpatient Prospective Payment System Outpatient Prospective Payment System Bad debt/charity care Hospital Outpatient Department payments Site Neutral Payment Policies Acute Hospital Care at Home Program Telehealth coverage

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Sustainability of safety net health systems; social determinants of health; promoting coordinated care; support of telehealth policies; 340B Protect Act, H.R. 4390; 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. 3281, the Transparent PRICE Act; H.R. 1613, the Drug Price Transparency in Medicaid Act of 2023; H.R. 2665, the Supporting Safety Net Hospitals Act; and H.R. 3561, the Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023; H.R. 5378, the Lower Costs, More Transparency Act; S.3548, the Health Care Prices Revealed and Information to Consumers Explained Transparency Act; H.R.6363, the Further Continuing Appropriations and Other Extensions Act, 2024; H.R. 2872, Further Additional Continuing Appropriations and Other Extensions Act, 2024; H.R. 7463, Extension of Continuing Appropriations and Other Matters Act, 2024; H.R. 8247, the Uterine Fibroid Intervention and Gynecological Health Treatment Act of 2024; H.R. 8574, the 340B Affording Care for Communities and Ensuring a Strong Safety-net Act; and H.R. 10337, Expanding the Health Care Workforce Act.

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

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

Funding for Disproportionate Share Hospitals (Medicaid DSH); Funding for Medicare graduate medical education (GME); Medicare site neutrality policies; support of telehealth policies, including for audio-only telehealth services; H.R. 7053/S. 3792 - acute hospital care at home waiver flexibility; H.R. 1613, the Drug Price Transparency in Medicaid Act of 2023; H.R. 2665, the Supporting Safety Net Hospitals Act; H.R. 3561, the Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023; 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. 5378, the Lower Costs, More Transparency Act; H.R. 5860, the Continuing Appropriations Act, 2024 and Other Extensions Act; S.3548, the Health Care Prices Revealed and Information to Consumers Explained Transparency Act; H.R.6363, the Further Continuing Appropriations and Other Extensions Act, 2024; H.R. 2872, Further Additional Continuing Appropriations and Other Extensions Act, 2024; H.R. 7463, Extension of Continuing Appropriations and Other Matters Act, 2024; H.R. 7327, the Protecting Front Line Multimission Hospitals Act of 2024; S. 3450, the Mental and Physical Health Care Comorbidities Act of 2023; and H.R. 10337, Expanding the Health Care Workforce Act.

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

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

H.R. 198: Drug Pricing Transparency and Accountability Act - Provisions related to the 340B Program H.R. 456: Fairness in Orphan Drug Exclusivity Act H.R. 830: HELP Copays Act - To amend title XXVII of the Public Health Service Act to apply additional payments, discounts, and other financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes H.R. 1613: Drug Price Transparency in Medicaid Act of 2023 H.R. 1790: Biologics Competition Act of 2023 - To direct the Secretary of Health and Human Services to evaluate the extent to which the substitution of interchangeable biological products is impacted by differences between the system for determining a biological product to be interchangeable and the system for assigning therapeutic equivalence ratings to drugs, and for other purposes H.R. 2534: PROTECT 340B Act of 2023 - Provisions related to the 340B program H.R. 2679: Pharmacy Benefits Manager Accountability Act H.R. 2707: MADE in America Act H.R. 2816: Pharmacy Benefit Manager Sunshine and Accountability Act H.R. 2880: Protecting Patients Against PBM Abuses Act 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. 3433: Give Kids a Chance Act of 2024 H.R. 3561: Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or PATIENT Act of 2023 H.R. 3839: To amend the Federal Food, Drug, and Cosmetic Act to increase transparency in generic drug applications H.R. 4421: Preparing for All Hazards and Pathogens Reauthorization Act H.R. 4818: Treat and Reduce Obesity Act of 2023 H.R. 4895: Lowering Drug Costs for American Families Act - Provisions related to drug pricing H.R. 4988: Modern Authentication of Pharmaceuticals Act of 2023 H.R. 5376: Share the Savings with Seniors Act  H.R. 5378: Lower Costs, More Transparency Act H.R. 5391: Protecting Patient Access to Cancer and Complex Therapies Act H.R. 5539: ORPHAN Cures Act H.R. 6283: Delinking Revenue from Unfair Gouging or DRUG Act H.R. 6664: Innovation in Pediatric Drugs Act of 2023 H.R. 7174: Ensuring Pathways to Innovative Cures (EPIC) Act: To amend title XI of the Social Security Act to equalize the negotiation period between small-molecule and biologic candidates under the Drug Price Negotiation Program H.R. 7248: FDA Modernization Act 3.0 H.R. 7623: Telehealth Modernization Act of 2024 H.R. 7635: The 340B PATIENTS Act of 2024 H.R. 8574: 340B Affording Care for Communities and Ensuring a Strong Safety-net (ACCESS) Act H.R. 9096: Pharmacists Fight Back Act S. 113: Prescription Pricing for the People Act of 2023 - Provisions related to PBMs S. 127: Pharmacy Benefit Manager Transparency Act of 2023 - Provisions related to PBMs S. 148: Stop STALLING Act - Provisions related to citizen petitions S. 1067: Ensuring Timely Access to Generics Act of 2023 S. 1130: Health Care PRICE Transparency Act S. 1264: SMART Prices Act - Provisions related to drug pricing reform S. 1339: Pharmacy Benefit Manager Reform Act - Provisions related to PBMs S. 1375: HELP Copays Act - To amend title XXVII of the Public Health Service Act to apply additional payments, discounts, and other financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes S. 1497: Emergency Access to Insulin Act of 2023 S. 1542: Delinking Revenue from Unfair Gouging Act or DRUG Act - Provisions related to PBMs S. 1589: Safeguarding Patients and Taxpayers Act S. 1967: PBM Act S. 2305: Biosimilar Red Tape Elimination Act S. 2333: Pandemic and All-Hazards Preparedness and Response Act S. 2474: Share the Savings with Seniors Act S. 2973: Modernizing and Ensuring PBM Accountability Act S. 3393: SUPPORT for Patients and Communities Reauthorization Act S. 3430: Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 S. 5021: 340B PATIENTS Act of 2024 S. 5040: Protecting Patients from Deceptive Drugs Online Act S. 5459: Biosimilars Access and Affordability Act BioCompete Act (draft) Executive Order of February 28, 2024, Preventing Access to Americans' Bulk Sensitive Personal Data and United States Government-Related Data by Countries of Concern Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future (SUSTAIN) 340B Act (draft) User fee policy issues Inflation Reduction Act of 2022 (P.L. 117-169) IRA price negotiation expansion policy issues Pharmacy Benefit Manager reform and policy issues Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA) Cancer Moonshot Initiative 21st Century Cures 2.0 Drug cost and pricing policy issues Principles for drug pricing reform Drug importation policy issues Accelerated approval policy issues FDA regulatory approval authority policy issues Competition policy issues Orphan Drug Act policy issues Compounding policy issues Antimicrobial resistance (AMR) policy issues Supply chain policy issues Clinical trial diversity policy issues 340B drug discount program policy issues Patient assistance program policy issues Biosimilar approval and reimbursement policy issues Drug shortages policy issues  Pandemic preparedness policy issues Artificial intelligence policy issues

Client expense: $7,560,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2840, Bipartisan Primary Care and Health Workforce Act H.R. 3305 - Black Maternal Health Momnibus Act H.R. 4420, the Preparedness and Response Reauthorization Act H.R. 4531, the Support for Patients and Communities Reauthorization Act H.R. 2534, PROTECT 340B Act of 2023 H.R. 5013, the Value in Health Care Act of 2023 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. 7050 - Substance Use Disorder Workforce Act S.4101/ H.R.7931 - the Preserving Emergency Access in Key Sites Act Keeping Obstetrics Local Act S.4088, Welcome Back to the Health Care Workforce Act Issues related to essential hospital designation Issues related to health equity Issues related to the 340B Drug Pricing program Issues related to contact pharmacies Issues related to the health care workforce Issues related to Community Paramedicine Issues related to Artificial Intelligence and Health Care Issues related to hospital digital infrastructure Issues related to cybersecurity H.R. 9351 Save our Safety-Net Hospitals Act of 2024 Issues related to Opioid overdose reduction

Client expense: $870,000 · Firm income: Not reported

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

S. 1133: 340B Accountability Act 340B Drug Discount Program - Program Implementation & Oversight H.R 2534 - PROTECT 340B Act S. 5021/HR. 7635 - 340B PATIENTS Act of 2024 340B Drug Discount Program - RFI for SUSTAIN 340B Act H.R. 2408: Access to Innovative Treatments Act of 2023 HR. 8574: 340B Affording Care for Communities and Ensuring a Strong Safety-Net Act(340B ACCESS Act) 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. 2408: Access to Innovative Treatments Act of 2023 Accelerated Approval Drug Shortages Supply Chain Integrity and Traceability Drug Patenting PBM Reform S. 2973: Modernizing and Ensuring PBM Accountability (MEPA) Act Alternative Payment Arrangements for Gene Therapies Coverage of Accelerated Approval Products Drug Benefit Design Orphan Drug Issues H.R. 5539/S. 3131: ORPHAN Cures Act H.R. 6664: Innovation in Pediatric Drugs Act of 2023 S. 1214: Retaining Access and Restoring Exclusivity (RARE) Act Implementation of the Inflation Reduction Act (IRA) of 2022 Reimbursement and Coverage of Innovative Products H.R. 830/S. 1375: HELP Copays Act H.R. 2408: Access to Innovative Treatments Act of 2023 H.R. 2630/S. 652: SAFE STEP Act H.R. 5378: Lower Costs, More Transparency Act Lower Costs, More Cures Act Medicare Part B Physician-Administered Products Patient Cost-Sharing and Smoothing Step Therapy Support of Patient Premiums and Cost-Sharing Obligations Value-based Contracting and Communications H.R. 198: Drug Pricing Transparency and Accountability Act - Provisions related to the 340B Program H.R. 456: Fairness in Orphan Drug Exclusivity Act H.R. 2408: Access to Innovative Treatments Act of 2023 H.R. 2679: Pharmacy Benefits Manager Accountability Act H.R. 2880: Protecting Patients Against PBM Abuses Act H.R. 3433: Give Kids a Chance Act of 2023 H.R. 4895: Lowering Drug Costs for American Families Act - Provisions related to drug pricing H.R. 5376: Share the Savings with Seniors Act S. 476/H.R. 5547: Maintaining Investments in New Innovation Act H.R. 6283: Delinking Revenue from Unfair Gouging or DRUG Act H.R. 6664: Innovation in Pediatric Drugs Act of 2023 S. 113: Prescription Pricing for the People Act of 2023 - Provisions related to PBMs S. 127: Pharmacy Benefit Manager Transparency Act of 2023 - Provisions related to PBMs S. 1264: SMART Prices Act - Provisions related to drug pricing reform S. 1339: Pharmacy Benefit Manager Reform Act - Provisions related to PBMs S. 1542: Delinking Revenue from Unfair Gouging Act or DRUG Act - Provisions related to PBMs S. 1906: Promising Pathway Act - Approval pathway policy issues S. 1967: PBM Act S. 2456: Protecting Seniors from High Drug Costs Act S. 2474: Share the Savings with Seniors Act S. 2973: Modernizing and Ensuring PBM Accountability Act (MEPA) S. 4953: Protect Drug Innovation Act User fee policy issues Pharmacy Benefit Manager reform and policy issues Drug cost and pricing policy issues Drug importation policy issues Accelerated approval authority policy issues FDA regulatory approval authority policy issues Competition policy issues Clinical trial diversity policy issues Patient assistance program policy issues Drug shortages policy issues Artificial intelligence policy issues S. 2305: Biosimilar Red Tape Elimination Act IRA price negotiation expansion policy issues Rare Pediatric Disease Priority Review Voucher program policies

Client expense: $720,000 · 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), Office of Management & Budget (OMB), SENATE, White House Office

Issues related to reforming and increasing transparency within the 340B Drug Pricing Program including in H.R. 3290 - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program and H.R.8574 - To amend the Public Health Service Act to reform the 340B drug pricing program, and for other purposes. Issues related to PBM provisions included in H.R.10445 - Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to reforming and increasing transparency within the 340B Drug Pricing Program including in H.R. 3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to reforming and increasing transparency within the 340B Drug Pricing Program including in H.R. 3290 - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. Issues related to PBM provisions included in H.R.10445 - Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to reforming and increasing transparency within the 340B Drug Pricing Program including in H.R. 3290 - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. Issues related to PBM provisions included in H.R.10445 - Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General pharmaceutical coverage and reimbursement issues, issues and activities affecting oncology, neurodegenerative and fertility products. Issues related to reforming and increasing transparency within the 340B Drug Pricing Program including in H.R. 3290 - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. Issues related to PBM provisions included in H.R.10445 - Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act. Issues related to IVF treatments.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to reforming and increasing transparency within the 340B Drug Pricing Program including in H.R. 3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

(H.R.6033) - Supporting Patient Education and Knowledge (SPEAK) Act - Expressed support for the Supporting Patient Education and Knowledge. This legislation authorizes the Department of Health and Human Services to identify best practices and ways to improve telehealth access for patients with limited English proficiency and create new resources for telehealth providers. The bill outlines participation by health information technology providers, physicians, hospitals, insurance companies and language services providers in the process. Urged Congress to provide adequate resources including increased training and development programs to bolster the workforce, as well as to provide more flexibility in meeting staffing requirements and standards, including telehealth options. (H.R. 7623) Telehealth Modernization Act: Expressed support for the Telehealth Modernization Act - This legislation ensures that seniors and rural patients who may not have internet connectivity can receive the care they need through audio-only telehealth services, in addition to allowing health centers and rural health clinics to provide telehealth services. (H.R. 3305/S. 1606) Black Maternal Health Momnibus Act - Expressed support for the Black Maternal Health Momnibus Act. This legislation would make critical investments in the social determinants of health, address behavioral health needs, cultural competency, and gaps in the perinatal workforce, and bolster the collection of data to address every driver of maternal mortality, morbidity, and disparities in the United States. (H.R. 8245) Rural Hospital Stabilization Act: Expressed support for the Rural Hospital Stabilization Act. This legislation would ensure that healthcare providers in rural areas continue to provide services and meet their communities' needs. (H.R. 8244) Ensuring Seniors' Access to Care Act: Expressed support for the Ensuring Seniors' Access to Care Act. This legislation would allow nursing home providers, who have been prohibited from training staff to be certified nurse aids (CNA) because of compliance penalties, to begin training staff once they have demonstrated their return to compliance, rather than having to wait a full two years. Urged Congress to make essential telehealth flexibilities permanent well before the statutory deadline of Dec. 31, 2024. (S. 3410/H.R. 5796) The Protecting Rural Seniors' Access to Care Act - Expressed support for the Protecting Rural Seniors' Access to Care Act. This legislation would prohibit HHS from finalizing a proposed nursing home staffing requirement rule and establish an advisory panel on nursing home staffing. (H.R. 3226/S.1573) The PREMIE Reauthorization Act - Expressed support for the PREMIE Reauthorization Act. This legislation would reauthorize essential maternal and infant health programs and research at a time when maternal and infant death rates, especially in communities of color, have increased dramatically. (2584/S.2768) The Safety from Violence for Healthcare Employees Act - Expressed support for the Safety from Violence for Healthcare Employees Act. This legislation would address rising incidents of violence in healthcare settings by establishing stronger legal penalties for people who knowingly and intentionally assault or intimidate hospital employees. (H.R. 5568) The Care for Moms Act - Expressed support for the Care for Moms Act. This legislation supports the maternal health workforce, promotes access to prenatal and postpartum care, and provides essential resources to providers in rural areas. Urged Congress to support legislation on Proposed Nursing Home Staffing Requirements that prohibits the HHS Secretary from finalizing a proposed nursing home staffing rule. (H.R. 4771) - Children's Health Insurance Program Permanency (CHIPP) Act - Expressed support for the Children's Health Insurance Program Permanency (CHIPP) Act. This legislation would make the Children's Health Insurance Program (CHIP) permanent and place it on par with other federal public health insurance programs rather than needing periodic reauthorization. (S. 2415/H.R. 3838) - Preventing Maternal Deaths Reauthorization Act of 2023 - Expressed support for Preventing Maternal Deaths Reauthorization Act of 2023. This legislation continues crucial federal support for the state-based maternal mortality review committees (MMRCs) that review pregnancy-related deaths to identify causes and make recommendations for the prevention of future mortalities. Provided the Senate with information regarding the 340B program and expressed strong support for continuing to strengthen and protect this vital program. Urged Congress to provide a $1 billion increase for the Title V Maternal and Child Health (MCH) Services Block Grant in the FY2025 Labor, Health and Human Services, Education & Related Agencies Appropriations bill. Urged Congress to provide $100 million for the Surveillance for Emerging Threats to Mothers and Babies (SET-NET) at the Centers for Disease Control and Prevention (CDC). Urged Congress to bolster existing federal programs to build a strong health workforce and improve primary care to assist health providers in hiring and retaining workers. (H.R. 2389) - Resident Physician Shortage Reduction Act - Expressed support for the Resident Physician Shortage Reduction Act. (H.R. 3290) - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program-Expressed opposition. (H.R. 3561) Section 302 - Expressed opposition to Section 302. This legislative provision would reduce payments for the drug administration services furnished in off-campus provider-based departments. Urged Congress to support access to quality palliative care and appropriate effective pain management by prioritizing a Palliative Care, Trans-Institute Strategy by the National Institute of Aging (NIA) in the Labor, Health and Human Services, Education, and Related Agencies appropriations bill. Urged Congress to increase funding for federally qualified health centers (FQHCs) as part of the Community Health Center Fund reauthorization. (S.2243) - Palliative Care and Hospice Education and Training Act (PCHETA). Urged Congress to support the Palliative Care and Hospice Education and Training Act. This legislation would address the palliative care workforce shortage and help respond to pressing issues including appropriate pain management and pandemic preparedness.

Client expense: $166,785 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to reforming and increasing transparency within the 340B Drug Pricing Program including in H.R. 3290 - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. Issues related to PBM provisions included in H.R.10445 - Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to prescription drug value, including implementation of the Inflation Reduction Act (PL 117-169). Issues related to vaccine development, distribution and injury compensation. Issues related to insulin pricing. Issues related to FDA regulation of pharmaceuticals. Issues related to prescription drug pricing and pharmacy benefit manager business practices, including S. 127, Pharmacy Benefit Manager Transparency Act, S.1339 - Pharmacy Benefit Manager Reform Act, H.R. 2679, the PBM Accountability Act, H.R.4822 - Health Care Price Transparency Act, H.R. 5378 - Lower Costs, More Transparency Act. Issues related to the 340B program, including H.R. 3290, to ensure transparency and oversight of the 340B drug discount program. Pandemic All-Hazards Preparedness Act (PAHPA) reauthorization, including S.2333 - Pandemic and All-Hazards Preparedness and Response Act. Issues related to Type 1 diabetes screening. H.R.10545, FY25 Continuing Appropriations.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to prescription drug value, including implementation of the Inflation Reduction Act (PL 117-169). Issues related to vaccine development and distribution. Issues related to insulin pricing. Issues related to FDA regulation of pharmaceuticals. Issues related to prescription drug pricing and pharmacy benefit manager business practices, including S. 127, Pharmacy Benefit Manager Transparency Act, S.1339 - Pharmacy Benefit Manager Reform Act, H.R. 2679, the PBM Accountability Act, H.R.4822 - Health Care Price Transparency Act, H.R. 5378 - Lower Costs, More Transparency Act. Issues related to the 340B program, including H.R. 3290, to ensure transparency and oversight of the 340B drug discount program. Pandemic All-Hazards Preparedness Act (PAHPA) reauthorization, including S.2333 - Pandemic and All-Hazards Preparedness and Response Act. S.3558 - Biosecure. H.R.10545, FY25 Continuing Appropriations.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to prescription drug value, including implementation of the Inflation Reduction Act (PL 117-169). Issues related to vaccine development, distribution and injury compensation. Issues related to FDA regulation of pharmaceuticals. Issues related to prescription drug pricing and pharmacy benefit manager business practices, including S. 127, Pharmacy Benefit Manager Transparency Act, S.1339 - Pharmacy Benefit Manager Reform Act, H.R. 2679, the PBM Accountability Act, H.R.4822 - Health Care Price Transparency Act, H.R. 5378 - Lower Costs, More Transparency Act. Issues related to the 340B program, including H.R. 3290, to ensure transparency and oversight of the 340B drug discount program. Pandemic All-Hazards Preparedness Act (PAHPA) reauthorization, including S.2333 - Pandemic and All-Hazards Preparedness and Response Act. H.R.10545, FY25 Continuing Appropriations.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to prescription drug value, including implementation of the Inflation Reduction Act (PL 117-169). Issues related to FDA regulation of pharmaceuticals. Issues related to prescription drug pricing and pharmacy benefit manager business practices, including S. 127, Pharmacy Benefit Manager Transparency Act, S.1339 - Pharmacy Benefit Manager Reform Act, H.R. 2679, the PBM Accountability Act, H.R.4822 - Health Care Price Transparency Act, H.R. 5378 - Lower Costs, More Transparency Act. Issues related to the 340B program, including H.R. 3290, to ensure transparency and oversight of the 340B drug discount program. Pandemic All-Hazards Preparedness Act (PAHPA) reauthorization, including S.2333 - Pandemic and All-Hazards Preparedness and Response Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to prescription drug value, including implementation of the Inflation Reduction Act (PL 117-169). Issues related to FDA regulation of pharmaceuticals. Issues related to prescription drug pricing and pharmacy benefit manager business practices, including S. 127, Pharmacy Benefit Manager Transparency Act, S.1339 - Pharmacy Benefit Manager Reform Act, H.R. 2679, the PBM Accountability Act, H.R.4822 - Health Care Price Transparency Act, H.R. 5378 - Lower Costs, More Transparency Act. Issues related to the 340B program, including H.R. 3290, to ensure transparency and oversight of the 340B drug discount program. Pandemic All-Hazards Preparedness Act (PAHPA) reauthorization, including S.2333 - Pandemic and All-Hazards Preparedness and Response Act. H.R. 10545, FY25 Continuing Appropriations.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program (H.R. 3290) Rural health care innovation (PA Rural Health Model) Public Health Emergency designation SAVE Act (H.R. 2584) Fairness for Rural Teaching Hospitals Act (H.R.2433) Public Service Loan Forgiveness program/physician federal loan forgiveness Healthcare Workforce Behavioral health PATIENT Act of 2023 (H.R.3561) Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act (S.1113, H.R.2530) CHGME Youth behavioral health Electronic health records Pandemic and All-Hazards Preparedness Reauthorization Act Nursing and allied health education (NAHE) program Bipartisan Primary Care and Health Workforce Act (S.2840) Transparent PRICE Act (H.R.3281) Save Americas Rural Hospitals Act (H.R.833) Supporting Safety Net Hospitals Act (H.R.2665) Patient Access to Higher Quality Care Act (H.R.977/S.470) FEMA Covid-19 reimbursement Health Care Price Transparency Act (H.R.4822) Providers and Payers Compete Act (H.R.3284) Lower Costs, More Transparency Act (H.R.5378) Health Care Prices Revealed and Information to Consumers Explained Transparency Act (S.3548) Medical and Nurse Licensure Compact Health care consolidation, mergers and acquisitions Accelerating Kids Access to Care Act (H.R. 4758, S.2372)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

maintaining telehealth regulations and flexibilities beyond public health emergency HR 2584 - SAVE Act HR 3561 - PATIENT Act HR 1613 - Drug Price Transparency in Medicaid Act HR 3290 - amending 340B program HR 3089 - Accelerating Kids Access to Care Act Disproportionate Share Hospital (DSH) payments

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

maintaining telehealth regulations beyond emergency HR 2584 - SAVE Act HR 3561 - PATIENT Act HR 1613 - Drug Price Transparency in Medicaid Act HR 3290 - amending 340B program HR 3089 - Accelerating Kids Access to Care Act Disproportionate Share Hospital (DSH) payments

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor the following: H.R.3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program, Indigent Care issues (340B Drug Discount program) Disproportionate Share Hospital programs Opioids related issues 340B Bipartisan Working Group/Draft Bill H.R.8574, 340B Affording Care for Communities and Ensuring a Strong Safety-net Act, Entirety Hospital Directed Payment Program related issues

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

Monitor the following: H.R.3290,To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program, Indigent Care issues (340B Drug Discount program) Veterans Medical Care/VA Mission Act, Implementation Disproportionate Share Hospital programs Prescription Drug Prices Nursing Education The Veterans Specific Education for Tomorrow's Health Professionals Act, Entirety 340B Bipartisan Working Group/Draft Bill H.R.8574, 340B Affording Care for Communities and Ensuring a Strong Safety-net Act, Entirety

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

Issues related to participation in the 340B Drug Discount Program HR 3290, 340B Transparency bill SUSTAIN 340B ACT - Draft Senate 340B reform legislation HR 8574 - 340B ACCESS Act Polices related to PBMs and drug cost transparency

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

340B Program issues and patient access to pharmaceuticals, including related provisions in H.R. 3290, to amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program." Legislative issues associated with patient access to treatment, including: the CMMI Most Favored Nation and related demonstration initiatives; and step therapy, including related provisions in H.R. 2630/S. 652, the Safe Step Act. Medical Supply Chain, including issues related to a new rating system; targeted action to support the diversification of certain supplies; additional funding to the Strategic National Stockpile (SNS) and more diverse stockpile; increasing flexibility for supply chains. Enhanced FDA reporting and risk mitigation plans for certain medicines. Incentives for antimicrobial and antiviral research, medical countermeasures, and novel product development.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 2665, The Supporting Safety Net Hospitals Act HR 2584, Safety from Violence for Healthcare Employees (Save) Act S 923, Better Mental Health Care for Americans Act HR 3046, Medical Student Education Authorization Act S 1133, the 340B Accountability Act of 2023 HR 3746, Fiscal Responsibility Act of 2023 HR 6833, Continuing Appropriations Act of 2023 HR 9747, Continuing Appropriations and Extensions Act, 2025 HR 3290, Transparency and Oversight of the 340B Drug Discount Program Act HR 3841, To reauthorize the program of payments to children's hospitals that operate graduate medical education programs HR 3887, The Children's Hospital GME Support Reauthorization Act of 2023 HR 4509 The Transparency in Billing Act HR 4507 The Transparency in Coverage Act of 2023 HR 4527 The Health DATA Act HR 4508 Hidden Fees Disclosure Act HR 4822 The Health Care Price Transparency Act of 2023 HR 1613 The Drug Transparency Act S 1038 The Drug Transparency Act HR 3561 The Patient Act HR 2534 Protect 340B Act of 2023 HR 3226 The PREEMIE Act of 2023 S 1573 The PREEMIE Act of 2023 HR 5378 The Lower Costs, More Transparency Act HR 6664 Innovation in Pediatric Drugs Act of 2023 HR 7635 The 340B Pharmaceutical Access to Invest in Essential, Needed Treatments & Support Act of 2024 HR 8574 340B Affording Care for Communities and Ensuring a Strong Safety-net Act HR 8260, Hospital Inpatient Services Modernization Act S 2768, Hospital Inpatient Services Modernization Act HR 10545 American Relief Act of 2025 S 2372 Accelerating Kids Access to Care Act HR 4758 Accelerating Kids Access to Care Act CDC Injury Control Research Centers Funding NIH Pediatric Medical Research Prioritization FDA Proposed Rule Titles "Medical Device Laboratory Developed Tests"

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

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

HR 2665, The Supporting Safety Net Hospitals Act HR 2584, Safety from Violence for Healthcare Employees (Save) Act S 923, Better Mental Health Care for Americans Act HR 3046, Medical Student Education Authorization Act S 1133, the 340B Accountability Act of 2023 HR 3746, Fiscal Responsibility Act of 2023 HR 6833, Continuing Appropriations Act of 2023 HR 9747, Continuing Appropriations and Extensions Act, 2025 HR 3290, Transparency and Oversight of the 340B Drug Discount Program Act HR 3841, To reauthorize the program of payments to children's hospitals that operate graduate medical education programs HR 3887, The Children's Hospital GME Support Reauthorization Act of 2023 HR 4509 The Transparency in Billing Act HR 4507 The Transparency in Coverage Act of 2023 HR 4527 The Health DATA Act HR 4508 Hidden Fees Disclosure Act HR 4822 The Health Care Price Transparency Act of 2023 HR 1613 The Drug Transparency Act S 1038 The Drug Transparency Act HR 3561 The Patient Act HR 2534 Protect 340B Act of 2023 HR 3226 The PREEMIE Act of 2023 S 1573 The PREEMIE Act of 2023 HR 5378 The Lower Costs, More Transparency Act HR 6664 Innovation in Pediatric Drugs Act of 2023 HR 7635 The 340B Pharmaceutical Access to Invest in Essential, Needed Treatments & Support Act of 2024 HR 8574 340B Affording Care for Communities and Ensuring a Strong Safety-net Act HR 8260, Hospital Inpatient Services Modernization Act S 2768, Hospital Inpatient Services Modernization Act HR 10545 American Relief Act of 2025 S 2372 Accelerating Kids Access to Care Act HR 4758 Accelerating Kids Access to Care Act CDC Injury Control Research Centers Funding NIH Pediatric Medical Research Prioritization FDA Proposed Rule Titles "Medical Device Laboratory Developed Tests"

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

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

340B Drug Pricing Program (H.R. 3290) Rural health care innovation (PA Rural Health Model) SAVE Act (H.R. 2584) Healthcare Workforce Behavioral health CHGME Nursing and allied health education (NAHE) program Save Americas Rural Hospitals Act (H.R.833) FEMA Covid-19 reimbursement Health care consolidation, mergers and acquisitions Accelerating Kids Access to Care Act (H.R. 4758, S.2372)

Client expense: $250,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The 340B Drug Pricing Program; H.R. 2534, The Protect 340B Act; FY24 and FY25 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations bills. HR 3290,to amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. H.R.3561 - PATIENT Act of 2023, The Stop Drug Shortages Act (Draft legislation- House), H.R. 5378: Lower Costs, More Transparency Act, S. 1182: 340B Reporting and Accountability Act; S.1133: 340B Accountability Act of 2023,S.1038: Drug Price Transparency in Medicaid Act of 2023,H.R.1613: Drug Price Transparency in Medicaid Act of 2023,H.R.198: Drug Pricing Transparency and Accountability Act; S. 2973: Modernizing and Ensuring PBM Accountability Act, Draft Senate legislation the SUSTAIN 340B Act, HR 7635 and S. 5021, the 340B PATIENTS Act.H.R. 8574, 340B ACCESS Act: H.R.8144 - Rural 340B Access Act of 2024

Client expense: $260,046 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), 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 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 Medicare Advantage BUD FY 2025 Appropriations bills Nursing and allied health workforce funding FY 2025 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-10913, Medicare Part C Utilization Management Annual Data Submission and Audit Protocol Data Request; Notice, Agency Information Collection Activities: Proposed Collection; Comment Request; Federal Register (Vol 89, No 145), September 10, 2024

Client expense: $300,000 · 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)

PBM reforms. 340B. IRA implementation. Drug pricing. H.R.5378 - Lower Costs, More Transparency Act. H.R.5376 - Share the Savings with Seniors Act. H.R.6283/S.1542 - DRUG Act. H.R.2880 - Protecting Patients Against PBM Abuses Act. S.2973 - Modernizing and Ensuring PBM Accountability Act. H.R.830 - HELP Copays Act. H.R.7085 - BIOSECURE Act. S.127 - Pharmacy Benefit Manager Transparency Act of 2023. S.1339 - Pharmacy Benefit Manager Reform Act 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.10445 - Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.3046/S.1403 - Medical Student Education Authorization Act of 2023 Issue: Support grants for primary care training in medically under-resourced communities. Draft Social Determinants Accelerator Act Issue: Support grants to address social determinants of health. H.R.9161/S.4773 - Health Equity and Accountability Act of 2024 Issue: Support programs to improve health equity and address social determinants of health. S.2333 - Pandemic and All-Hazards Preparedness and Response Act H.R.4420 - Preparedness and Response Reauthorization Act H.R.4421 - Preparing for All Hazards and Pathogens Reauthorization Act H.R.4697 - Protecting PAHPA Act of 2023 Issues: Support the reauthorization of the Pandemic and All-Hazards Preparedness Act with increased funding authorization levels. Issue: Support authorities to strengthen CDCs and ASPRs ability to prevent and respond to existing and emerging threats. S.1995 - Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Educate Congress on how the 340B Drug Pricing Program helps safety-net providers to fulfill their missions and care for patients and communities. Support measures to preserve and strengthen the 340B Drug Pricing Program. Oppose efforts to reduce the scope of the program and transition 340B into a rebate model. H.R.2534 - Preserving Rules Ordered for the Entities Covered Through 340B Act of 2023 (PROTECT 340B Act) Issue: Support measures to prevent pharmacy benefit managers and commercial insurers from imposing discriminatory reimbursement policies on 340B covered entities. H.R.7635 - 340B Pharmaceutical Access to Invest in Essential, Needed Treatments and Support (340B PATIENTS) Act Issue: Support amending the 340B statute to codify covered entities ability to use contract pharmacies. H.R.3290 - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. Issue: Oppose efforts to impose additional reporting requirements on 340B hospitals. Draft Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future of 340B (SUSTAIN 340B) Act Issue: Support efforts to prohibit pharmaceutical and pharmacy benefit manager (PBM) discrimination against covered entities. Oppose efforts to define patient in the context of the program. Oppose efforts to impose additional administrative and reporting requirements on 340B hospitals. H.R.8574 - 340B ACCESS Act Issue: Oppose efforts to restrict hospital eligibility for the 340B program. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Support policies to improve maternal health outcomes through expanded Medicaid coverage, enhanced data collection, and improved access to behavioral health care during the perinatal period. P.L. 118-159 - Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 S.4638 National Defense Authorization Act for Fiscal Year 2025 Issue: Oppose prohibition on coverage for gender affirming care. H.R.2369 - Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2023 Issue: Educate Congress on development of laboratory developed tests (LDTs) at academic medical centers and oppose policies that would increase burdensome regulations and negatively impact patients access to care by allowing FDA regulation of the development of LDTs at academic medical centers. Issue: Educate Congress on the medical education and training continuum, the annual residency Match, and the role of the National Resident Matching Program (NRMP) in medical education and residency. Issue: Provide guidance on the implementation of the No Surprises Act (P.L.116-260). Issue: Educate Congress and the administration on the role of academic medicine in the provision of mental and behavioral health care, including initiatives to respond to the opioid epidemic. Support policies to strengthen the behavioral health workforce, promote the uptake of integrated behavioral health models, advance mental health research, and ensure access to coverage and care. Issue: Educate Congress about the financial challenges facing academic medical centers, including reimbursement challenges, workforce challenges, inflation, and others. Issue: Educate Congress and the administration about the impact of the unwinding of the COVID-19 public health emergency on the academic medicine community and the patients they serve. H.R.3887 - Childrens Hospital GME Support Reauthorization Act of 2023 H.R.3841 - To amend title III of the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs. Issue: Support clean reauthorization of the Childrens Hospital GME program. Issue: Support reauthorization of the National Health Service Corps and Teaching Health Center Graduate Medical Education. Issue: Express concern regarding actions to inappropriately undermine FDA regulatory authority. Issue: Educate Congress and the administration about medical education on nutrition, hunger, and health; reproductive health; substance use disorders; medication assisted treatment for opioid use disorders; trans health; preventing fraud and abuse; diversity, equity, and inclusion; menopause management; health care for people with disabilities; and maternal health. Issue: Educate Congress and the administration about resident physician practice decision making post US SCOTUS decision in Dobbs. Issue: Educate Congress on resident expectations related to clinical practice and oppose so-called physician service mandates. H.R.7855 - Rural Residency Planning and Development Act of 2024 Issue: Support codification of HRSAs rural residency planning and development program. Issue: Support providing discretionary funds for rural teaching hospitals to expand their residency programs. Issue: Educate Congress on vaccine safety. Issue: Encourage changes to HRSA financial aid programs as a result of FAFSA updates. Issue: Educate Congress on the use of artificial intelligence (AI) in academic medicine. S.4031 - Providing Resources and Opportunities for Health Education and Learning (PRO-HEAL) Act Issue: Support HRSA grants to expand provider pipeline programs to create pathways to health care careers. H.R.7258/S.3968 - Community Training, Education, and Access for Medical Education, and Access for Medical Students (TEAMS) Act Issue: Support enhanced community-based training opportunities for medical students, particularly in rural and medically underserved areas, and fostering long-term sustainable physician practices in high-need communities. H.R.7153/S.3673 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act Issue: Support ability of HRSA to implement evidenced-based practices for preventing suicide and improving mental health and resiliency among health care professionals, and for training health care professionals in appropriate strategies to address substance use disorders. Issue: Provide input on Next Generation Cures initiative. Issue: Promote overdose prevention. H.R. 10047 The Closing the Substance Use Care Gap Act Issue: Support extension of SAMHSA harm reduction programs.

Client expense: $632,324 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Council on Disability, Natl Institutes of Health (NIH), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Vice President of the U.S., White House Office

Monitoring legislation that could impact access to hospital or physician care, particularly related to the Medicare and Medicaid programs and the 340B drug discount program. In addition, monitoring legislation that could impact health care workforce training or behavioral health services or medical research or related to the use of telehealth. Specific legislation includes: legislation related to outpatient departments and unique identification numbers (H.R. 3237)", The "Resident Physician Shortage Reduction Act (H.R. 2389/S.1302)", the "Patient Act (H.R. 3561)", legislation related to the 340B drug discount program (H.R. 3290), the "Transparent Price Act (H.R. 3281)", the "Lower Costs, More Transparency Act (H.R. 5378)", "Educate Act (H.R. 7725)" and H.R. 10545, a bill making further continuing appropriations for the fiscal year ending September 30, 2025, and for other purposes.

Client expense: Not reported · Firm income: $33,750

Government targets: HOUSE OF REPRESENTATIVES, SENATE