Assuring Medicare’s Promise Act of 2023

1. H.R. 34, Assuring Medicares Promise Act of 2023, entire bill 2. S. 1174, Medicare and Social Security Fair Share Act, entire bill 3. Proposals to disallow deductions for expenditures regarding collective bargaining organizing 4. H.R. 3936, Tax Cuts for Working Families Act, entire bill 5. H.R. 3937, Small Business Jobs Act, entire bill 6. H.R. 3938, Build It in America Act, entire bill 7. H.R. 6498, Billionaire Minimum Income Tax Act, entire bill 8. S. 3367, Billionaire Income Tax Act, entire bill 9. S. 2741,Surviving Widow(er) Income Fair Treatment Act of 2023 or SWIFT Act, entire bill 10. H.R. 6858, Social Security Overpayment Relief Act, entire bill 11. Proposals to extend the Tax Cuts and Jobs Act of 2017

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting (CMS 3442-P) ARPA American Rescue Act Plan Funding OSHA Covid-19 Health Care Emergency Temporary Standard (ETS) Bill That Extends Moratorium on 2% Medicare Sequester Cuts Through End of 2021 Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Client expense: Not reported · Firm income: Not reported

1. H.R. 34, Assuring Medicares Promise Act of 2023, entire bill 2. S. 1174, Medicare and Social Security Fair Share Act, entire bill 3. Proposals to disallow deductions for expenditures regarding collective bargaining organizing 4. H.R. 3936, Tax Cuts for Working Families Act, entire bill 5. H.R. 3937, Small Business Jobs Act, entire bill 6. H.R. 3938, Build It in America Act, entire bill 7. H.R. 6498, Billionaire Minimum Income Tax Act, entire bill 8. S. 3367, Billionaire Income Tax Act, entire bill 9. S. 2741,Surviving Widow(er) Income Fair Treatment Act of 2023 or SWIFT Act, entire bill 10. H.R. 6858, Social Security Overpayment Relief Act, entire bill 11. Proposals to extend the Tax Cuts and Jobs Act of 2017

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Observation Stays. The Improving Access to Medicare Coverage Act of 2023 (H.R. 5138 and S. 4137): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Prices (No bill): Proposal to have the Biden Administration lower the price of the prostate cancer drug Xtandi through executive action by using so-called march-in rights under the Bayh-Dole Act; to amend the Federal Food, Drug, and Cosmetic Act to grant eligible researchers access to drugs or biologic products for research purposes at a price no higher than the cost to the manufacturer; to block so-called Dispense-As-Written campaigns where drug manufacturers incentivize health care providers to specify a brand drug on a prescription to block generic substitution at the pharmacy. Medicare Drug Costs. The Pharmaceutical Research Transparency Act of 2023 (S. 1476 and H.R. 3160): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Drug Savings. The Seniors Securing Access to Vital and Essential Prescription Drugs Act (H.R. 2893): Proposals to discount the treatment of eligible retirement plans in determining the eligibility of individuals for premium and cost sharing subsidies under Part D of the Medicare program. (No bills): Proposals to eliminate the Medicare Part D low-income subsidy programs asset test and raise the income eligibility levels to 200 percent of the federal poverty level. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. The Affordable Pricing for Taxpayer-Funded Prescription Drugs Act of 2023 (H.R. 3093): Proposals to require companies that receive federal funding for research (or a license of the rights to a patent or regulatory test data) for a biomedical product or service to agree to set reasonable prices for the resulting biomedical product or service and authorize to determine a reasonable price based on a formula that ensures the U.S. price for the product or service is not more than the median price for the product or service in Canada and six other reference countries. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act (Public Law No: 117-169). Medicare and Medicaid Prescription Drugs. (No bill): Joined comments with 19 other organizations urging HHS to use its existing authority to license competition in order to lower consumer and taxpayer costs for semaglutide drugs treating diabetes and weight management (e.g., Ozempic and Wegovy). Medicare Prescription Drugs. The PACE Part D Choice Act (H.R. 3549 and S. 1703): Proposal to increase the affordability of the Program of All-Inclusive Care for the Elderly (PACE) for Medicare beneficiaries by lowering the cost of Part D premiums substantially for Medicare-only enrollees, thus opening up the PACE program to this population. Medicare Low-Income Subsidy (LIS) Program. (No bill): Proposal to increase funding for LIS outreach and enrollment, so that low-income beneficiaries can more readily access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 34) and The Medicare and Social Security Fair Share Act (S. 1174 and H.R. 4535): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Trustees Report (No bill). Review of the findings on economic, legislative and other developments affecting the actuarial soundness of the Medicare Part A (Hospital Insurance) Trust Fund and the Trust Funds for Parts B and D coverage. Medicare Dental Coverage. The Medicare Dental Benefit Act (S. 2012 and H.R. 4146): Proposal to add a dental benefit to Medicare. Medicare Hearing Coverage. The Help Extend Auditory Relief Act of 2024 (H.R. 8064): Proposal to expand Medicare coverage to include hearing examinations and diagnoses, fittings and hearing aids. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Public Health Emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Privatization (No bill): Proposals to create reimbursement policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home and Community-Based Services. The HCBS Access Act (H.R. 1493 and S. 762): Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Caregiving. The Alleviating Barriers to Caregiving Act (H.R. 8018 and S. 3109): Proposal to require the Secretaries of HHS and SSA to review and streamline enrollment in coverage and benefits for family caregivers in Medicare, Medicaid, CHIP and Social Security. Medicare and Medicaid Nursing Homes. The Nursing Home Disclosure Act (H.R. 177): Proposal to direct HHS to establish a national registry of medical directors. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 7513 and S. 3410): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. (H.J. Res. 139 and S.J. Res. 91): Proposal to use the Congressional Review Act to disapprove the HHS Secretarys final rule promulgating national staffing standards in nursing homes Medicare, Medicaid Nursing Homes. The Building Americas Health Care Workforce Act (H.R. 9067): Proposal to allow time spent working in a nursing home (prior to any formal training, and permitted during the COVID-19 pandemic) to count toward a 75-hour minimum federal training standard that is required for certified nursing assistants. Medicare, Medicaid Nursing Homes. The Ensuring Seniors Access to Quality Care Act (H.R. 3227): Proposal to repeal regulations that prohibit certified nursing assistant training and competency evaluation programs in skilled nursing facilities that have a record of health and safety deficiencies and have incurred penalties (e.g., civil monetary penalties for substandard quality of care). Medicare, Medicaid Nursing Homes, Assisted Living and Other Long Term Care Services and Supports (LTSS) Settings. The Long-Term Care Workforce Support Act (H.R. 7994 and S. 4120): Proposals to increase the number of direct care professionals, including in rural communities; pathways to enter and be supported in the workforce for women, people of color, and people with disabilities; and to improve compensation for direct care professionals to reduce vacancies and turnover. Medicare and Medicaid Nursing Home Ownership. (No bill): A final HHS regulation for comprehensive ownership disclosure in the nursing home sector issued on November 17th, 2023. Rule calls for strengthened cost reporting requirements, together with ongoing national analyses and monitoring of the performance of the nursing home sector that uses ownership, staffing, cost report data and inspection data. Medicare and Medicaid Nursing Home Staffing. (No bill): Final regulations establishing national staffing standards in nursing homes that would safeguard the health and safety of all elderly and disabled residents. Medicaid Long-Term Services and Supports (LTSS). (No bill): Proposals to request that CMS collect standardized LTSS expenditure data annually from every state and across all LTSS programs and for disaggregation of expenditure data by the delivery system and demographic characteristics in order to identify disparities in access and use of LTSS and help states and CMS deploy targeted strategies to meet the needs of older adults and people with disabilities. Oversight of Health Care Industry Owned by Private Equity Firms. (No bill): Joined with other organizations in submitting comments (April 2024) to HHS, the Federal Trade Commission and the Department of Justice urging sustained, stepped up and rigorous oversight be extended to health care industry transactions that are financed by private equity company companies and other types of private investors.

S.842 Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2023; H.R.814 Protect Social Security and Medicare Act; H.Res.118 Maintaining Medicare; H.R.1618 Commission on Sustaining Medicare and Social Security Act of 2023; H.Res.178 Affirming the House of Representatives' commitment to protect and strengthen Social Security and Medicare; . H.R.1746 Preventing Medicare Telefraud Act; H.R.33 Medicare Dental, Vision, and Hearing Benefit Act of 2023; H.R.1129 -To direct the Secretary of Health and Human Services to revise regulations to remove the requirement under the Medicare program that an off-campus facility or organization shall be located within a 35-mile radius of a hospital or critical access hospital.H.R.34 Assuring Medicares Promise Act of 2023; H.R.2474 Strengthening Medicare for Patients and Providers Act; H.R.2863 Preventing Hospital Overbilling of Medicare; H.R.2665 Supporting Safety Net Hospitals Act; H.R.3417 FAIR Act;S3403 Medicare Patient Empowerment Act of 2023; HR 5854 Medicare Advantage Consumer Protection and Transparency Act; HR4411 Medicare Advantage Integrity Act of 2023; HR4146 Medicare Dental Benefit Act of 2023.

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

Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting (CMS 3442-P) ARPA American Rescue Act Plan Funding OSHA Covid-19 Health Care Emergency Temporary Standard (ETS) Bill That Extends Moratorium on 2% Medicare Sequester Cuts Through End of 2021 Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Medicare Observation Stays. The Improving Access to Medicare Coverage Act of 2023 (H.R. 5138 and S. 4137): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Prices (No bill): Proposal to have the Biden Administration lower the price of the prostate cancer drug Xtandi through executive action by using so-called march-in rights under the Bayh-Dole Act; to amend the Federal Food, Drug, and Cosmetic Act to grant eligible researchers access to drugs or biologic products for research purposes at a price no higher than the cost to the manufacturer; to block so-called Dispense-As-Written campaigns where drug manufacturers incentivize health care providers to specify a brand drug on a prescription to block generic substitution at the pharmacy. Medicare Drug Costs. The Pharmaceutical Research Transparency Act of 2023 (S. 1476 and H.R. 3160): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Drug Savings. The Seniors Securing Access to Vital and Essential Prescription Drugs Act (H.R. 2893): Proposals to discount the treatment of eligible retirement plans in determining the eligibility of individuals for premium and cost sharing subsidies under Part D of the Medicare program. (No bills): Proposals to eliminate the Medicare Part D low-income subsidy programs asset test and raise the income eligibility levels to 200 percent of the federal poverty level. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. The Affordable Pricing for Taxpayer-Funded Prescription Drugs Act of 2023 (H.R. 3093): Proposals to require companies that receive federal funding for research (or a license of the rights to a patent or regulatory test data) for a biomedical product or service to agree to set reasonable prices for the resulting biomedical product or service and authorize to determine a reasonable price based on a formula that ensures the U.S. price for the product or service is not more than the median price for the product or service in Canada and six other reference countries. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act. Medicare Low-Income Subsidy (LIS) Program. (No bill): Proposal to increase funding for LIS outreach and enrollment, so that low-income beneficiaries can more readily access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 34) and The Medicare and Social Security Fair Share Act (S. 1174 and H.R. 4535): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental Coverage. The Medicare Dental Benefit Act (S. 2012 and H.R. 4146): Proposal to add a dental benefit to Medicare. Medicare Hearing Coverage. The Medicare Hearing Aid Coverage Act of 2021 (H.R. 244): Proposal to expand Medicare coverage to include hearing aids and services for seniors under Medicare Part B. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Public Health Emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Privatization (No bill): Proposals to create reimbursement policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home And Community-Based Services. The HCBS Access Act (H.R. 1493 and S. 762): Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Caregiving. The Alleviating Barriers to Caregiving Act (H.R. 8018 and S. 3109): Proposal to require the Secretaries of HHS and SSA to review and streamline enrollment in coverage and benefits for family caregivers in Medicare, Medicaid, CHIP and Social Security. Medicare and Medicaid Nursing Homes. The Nursing Home Disclosure Act (H.R. 177): Proposal to direct HHS to establish a national registry of medical directors. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 7513 and S. 3410): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. (H.J. Res. 139 and S.J. Res. 91): Proposal to use the Congressional Review Act to disapprove the HHS Secretarys final rule promulgating national staffing standards in nursing homes Medicare, Medicaid Nursing Homes, Assisted Living and Other Long Term Care Services and Supports (LTSS) Settings. The Long-Term Care Workforce Support Act (H.R. 7994 and S. 4120): Proposal to increase the number of direct care professionals, including in rural communities; pathways to enter and be supported in the workforce for women, people of color, and people with disabilities; and to improve compensation for direct care professionals to reduce vacancies and turnover. Medicare and Medicaid Nursing Home Ownership. (No bill): A proposed final HHS regulation for comprehensive ownership disclosure in the nursing home sector issued on November 17th, 2023. Rule calls for strengthened cost reporting requirements, together with ongoing national analyses and monitoring of the performance of the nursing home sector that uses ownership, staffing, cost report data and inspection data. Medicare and Medicaid Nursing Home Staffing. (No bill): Final regulations establishing national staffing standards in nursing homes that would safeguard the health and safety of all elderly and disabled residents. Medicaid Long-Term Services and Supports (LTSS). (No bill): Proposal to request that CMS collect standardized LTSS expenditure data annually from every state and across all LTSS programs and for disaggregation of expenditure data by the delivery system and demographic characteristics in order to identify disparities in access and use of LTSS and help states and CMS deploy targeted strategies to meet the needs of older adults and people with disabilities.

1. H.R. 34, Assuring Medicares Promise Act of 2023, entire bill 2. S. 1174, Medicare and Social Security Fair Share Act, entire bill 3. Proposals to disallow deductions for expenditures regarding collective bargaining organizing 4. H.R. 3936, Tax Cuts for Working Families Act, entire bill 5. H.R. 3937, Small Business Jobs Act, entire bill 6. H.R. 3938, Build It in America Act, entire bill 7. H.R. 6498, Billionaire Minimum Income Tax Act, entire bill 8. S. 3367, Billionaire Income Tax Act, entire bill 9. S. 2741,Surviving Widow(er) Income Fair Treatment Act of 2023 or SWIFT Act, entire bill 10. H.R. 6858, Social Security Overpayment Relief Act, entire bill 11. Proposals to extend the Tax Cuts and Jobs Act of 2017

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.842 Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2023; H.R.814 Protect Social Security and Medicare Act; H.Res.118 Maintaining Medicare; H.R.1618 Commission on Sustaining Medicare and Social Security Act of 2023; H.Res.178 Affirming the House of Representatives' commitment to protect and strengthen Social Security and Medicare; . H.R.1746 Preventing Medicare Telefraud Act; H.R.33 Medicare Dental, Vision, and Hearing Benefit Act of 2023; H.R.1129 -To direct the Secretary of Health and Human Services to revise regulations to remove the requirement under the Medicare program that an off-campus facility or organization shall be located within a 35-mile radius of a hospital or critical access hospital.H.R.34 Assuring Medicares Promise Act of 2023; H.R.2474 Strengthening Medicare for Patients and Providers Act; H.R.2863 Preventing Hospital Overbilling of Medicare; H.R.2665 Supporting Safety Net Hospitals Act; H.R.3417 FAIR Act;S3403 Medicare Patient Empowerment Act of 2023; HR 5854 Medicare Advantage Consumer Protection and Transparency Act; HR4411 Medicare Advantage Integrity Act of 2023; HR4146 Medicare Dental Benefit Act of 2023.

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

Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting (CMS 3442-P) ARPA American Rescue Act Plan Funding OSHA Covid-19 Health Care Emergency Temporary Standard (ETS) Bill That Extends Moratorium on 2% Medicare Sequester Cuts Through End of 2021 Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

1. H.R. 34, Assuring Medicares Promise Act of 2023, entire bill 2. S. 1174, Medicare and Social Security Fair Share Act, entire bill 3. Proposals to disallow deductions for expenditures regarding collective bargaining organizing 4. H.R. 3936, Tax Cuts for Working Families Act, entire bill 5. H.R. 3937, Small Business Jobs Act, entire bill 6. H.R. 3938, Build It in America Act, entire bill 7. H.R. 6498, Billionaire Minimum Income Tax Act, entire bill 8. S. 3367, Billionaire Income Tax Act, entire bill 9. S. 2741,Surviving Widow(er) Income Fair Treatment Act of 2023 or SWIFT Act, entire bill 10. H.R. 6858, Social Security Overpayment Relief Act, entire bill

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Observation Stays. Improving Access to Medicare Coverage Act of 2023 (H.R. 5138): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Prices (No bill): Proposal to have the Biden Administration lower the price of the prostate cancer drug Xtandi through executive action by using so-called march-in rights under the Bayh-Dole Act; to amend the Federal Food, Drug, and Cosmetic Act to grant eligible researchers access to drugs or biologic products for research purposes at a price no higher than the cost to the manufacturer; to block so-called Dispense-As-Written campaigns where drug manufacturers incentivize health care providers to specify a brand drug on a prescription to block generic substitution at the pharmacy. Medicare Drug Costs. Pharmaceutical Research Transparency Act of 2023 (S. 1476 and H.R. 3160): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Drug Savings. Seniors Securing Access to Vital and Essential Prescription Drugs Act (H.R. 2893): Proposals to discount the treatment of eligible retirement plans in determining the eligibility of individuals for premium and cost sharing subsidies under Part D of the Medicare program. (No bills): Proposals to eliminate the Medicare Part D low-income subsidy programs asset test and raise the income eligibility levels to 200 percent of the federal poverty level. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. Affordable Pricing for Taxpayer-Funded Prescription Drugs Act of 2023 (H.R. 3093): Proposals to require companies that receive federal funding for research (or a license of the rights to a patent or regulatory test data) for a biomedical product or service to agree to set reasonable prices for the resulting biomedical product or service and authorize to determine a reasonable price based on a formula that ensures the U.S. price for the product or service is not more than the median price for the product or service in Canada and six other reference countries. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act. Medicare Low-Income Subsidy (LIS) Program. (No bill): Proposal to increase funding for LIS outreach and enrollment, so that low-income beneficiaries can more readily access needed medications at prices they can afford. Medicare Reform. Assuring Medicares Promise Act (H.R. 34) and Medicare and Social Security Fair Share Act (S. 1174 and H.R. 4535): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental Coverage. Medicare Dental Benefit Act (S. 2012 and H.R. 4146): Proposal to add a dental benefit to Medicare. Medicare Hearing Coverage. The Medicare Hearing Aid Coverage Act of 2021 (H.R. 244): Proposal to expand Medicare coverage to include hearing aids and services for seniors under Medicare Part B. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Public Health Emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Privatization (No bill): Proposals to create reimbursement policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home And Community-Based Services. HCBS Access Act (H.R. 1493 and S. 762): Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Medicare and Medicaid Nursing Homes. Nursing Home Disclosure Act (H.R. 177): Proposal to direct HHS to establish a national registry of medical directors. Medicare, Medicaid Nursing Homes. Protecting Americas Seniors Access to Care Act (H.R. 7513): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes, Assisted Living and Other LTSS Settings. Long-Term Care Workforce Support Act (No bill number): Proposal to increase the number of direct care professionals, including in rural communities; pathways to enter and be supported in the workforce for women, people of color, and people with disabilities; and to improve compensation for direct care professionals to reduce vacancies and turnover. Medicare and Medicaid Nursing Home Ownership. (No bill): A proposed final HHS regulation for comprehensive ownership disclosure in the nursing home sector issued on November 17th, 2023. Rule calls for strengthened cost reporting requirements, together with ongoing national analyses and monitoring of the performance of the nursing home sector that uses ownership, staffing, cost report data and inspection data. Medicare and Medicaid Nursing Home Staffing. (No bill): A proposed CMS final regulations for establishing national staffing standards in nursing homes that would safeguard the health and safety of all elderly and disabled residents. Medicaid Long-Term Services and Supports (LTSS). (No bill): Proposal to request that CMS collect standardized LTSS expenditure data annually from every state and across all LTSS programs and for disaggregation of expenditure data by the delivery system and demographic characteristics in order to identify disparities in access and use of LTSS and help states and CMS deploy targeted strategies to meet the needs of older adults and people with disabilities.

S.842 Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2023; H.R.814 Protect Social Security and Medicare Act; H.Res.118 Maintaining Medicare; H.R.1618 Commission on Sustaining Medicare and Social Security Act of 2023; H.Res.178 Affirming the House of Representatives' commitment to protect and strengthen Social Security and Medicare; . H.R.1746 Preventing Medicare Telefraud Act; H.R.33 Medicare Dental, Vision, and Hearing Benefit Act of 2023; H.R.1129 -To direct the Secretary of Health and Human Services to revise regulations to remove the requirement under the Medicare program that an off-campus facility or organization shall be located within a 35-mile radius of a hospital or critical access hospital.H.R.34 Assuring Medicares Promise Act of 2023; H.R.2474 Strengthening Medicare for Patients and Providers Act; H.R.2863 Preventing Hospital Overbilling of Medicare; H.R.2665 Supporting Safety Net Hospitals Act; H.R.3417 FAIR Act;S3403 Medicare Patient Empowerment Act of 2023; HR 5854 Medicare Advantage Consumer Protection and Transparency Act; HR4411 Medicare Advantage Integrity Act of 2023; HR4146 Medicare Dental Benefit Act of 2023.

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

Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting (CMS 3442-P) ARPA American Rescue Act Plan Funding OSHA Covid-19 Health Care Emergency Temporary Standard (ETS) Bill That Extends Moratorium on 2% Medicare Sequester Cuts Through End of 2021 Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Medicare Observation Stays. Improving Access to Medicare Coverage Act of 2023 (H.R. 5138): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Prices (No bill): Proposal to have the Biden Administration lower the price of the prostate cancer drug Xtandi through executive action by using so-called march-in rights under the Bayh-Dole Act; to amend the Federal Food, Drug, and Cosmetic Act to grant eligible researchers access to drugs or biologic products for research purposes at a price no higher than the cost to the manufacturer; to block so-called Dispense-As-Written campaigns where drug manufacturers incentivize health care providers to specify a brand drug on a prescription to block generic substitution at the pharmacy. Medicare Drug Costs. Pharmaceutical Research Transparency Act of 2023 (S. 1476 and H.R. 3160): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Drug Savings. Seniors Securing Access to Vital and Essential Prescription Drugs Act (H.R. 2893): Proposals to discount the treatment of eligible retirement plans in determining the eligibility of individuals for premium and cost sharing subsidies under Part D of the Medicare program. (No bills): Proposals to eliminate the Medicare Part D low-income subsidy programs asset test and raise the income eligibility levels to 200 percent of the federal poverty level. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and raise the income threshold for the low-income subsidy. Medicare Prescription Drugs. Affordable Pricing for Taxpayer-Funded Prescription Drugs Act of 2023 (H.R. 3093): Proposes to require companies that receive federal funding for research (or a license of the rights to a patent or regulatory test data) for a biomedical product or service to agree to set reasonable prices for the resulting biomedical product or service and authorize to determine a reasonable price based on a formula that ensures the U.S. price for the product or service is not more than the median price for the product or service in Canada and six other reference countries with, based on specified criteria, large economies and high incomes. Medicare Prescription Drugs. (No bill) Supported an administrative proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill) Supported HHS promulgating robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act. Medicare Low-Income Subsidy (LIS) Program. (No bill) Supported increased funding for LIS outreach and enrollment, so that low-income beneficiaries can more readily access needed medications at prices they can afford. Medicare Reform. Assuring Medicares Promise Act (H.R. 34) and Medicare and Social Security Fair Share Act (S. 1174 and H.R 4535): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental Coverage. Medicare Dental Benefit Act (S. 2012 and H.R. 4146): Proposal to add a dental benefit to Medicare. Medicare Hearing Coverage. The Medicare Hearing Aid Coverage Act of 2021 (H.R. 244): Proposal to expand Medicare coverage to include hearing aids and services for seniors under Part B of the Medicare program. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Public Health Emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage. (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Privatization (No bill): Proposals to create reimbursement policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home And Community-Based Services. Inflation Reduction Act (Public Law No: 117-169): Proposals to expand Medicaid home and community-based services and the Medicare savings programs. Medicaid Home And Community-Based Services. HCBS Access Act (H.R. 1493 and S. 762). Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Medicare and Medicaid Nursing Homes. Nursing Home Disclosure Act (H.R. 177). Proposal to direct HHS to establish a national registry of medical directors. Medicare and Medicaid Nursing Home Ownership. (No bill) Supporting the final HHS regulations for comprehensive ownership disclosure in the nursing home sector issued on November 17th, 2023. Calling for strengthened cost reporting requirements, together with ongoing national analyses and monitoring of the performance of the nursing home sector that uses ownership, staffing, cost report data and inspection data. Medicare and Medicaid Nursing Home Staffing. (No bill) Support for CMS to promulgate improved final regulations for establishing national staffing standards in nursing homes that would safeguard the health and safety of all elderly and disabled residents. Medicaid Long-Term Services and Supports (LTSS). (No bill): To request that CMS collect standardized LTSS expenditure data annually from every state and across all LTSS programs and for disaggregation of expenditure data by the delivery system and demographic characteristics in order to identify disparities in access and use of LTSS and help states and CMS deploy targeted strategies to meet the needs of older adults and people with disabilities.

1. H.R. 34, Assuring Medicares Promise Act of 2023, entire bill 2. S. 1174, Medicare and Social Security Fair Share Act, entire bill 3. Proposals to disallow deductions for expenditures regarding collective bargaining organizing 4. H.R. 3936, Tax Cuts for Working Families Act, entire bill 5. H.R. 3937, Small Business Jobs Act, entire bill 6. H.R. 3938, Build It in America Act, entire bill 7. H.R. 6498, Billionaire Minimum Income Tax Act, entire bill 8. S. 3367, Billionaire Income Tax Act, entire bill 9. S. 2741,Surviving Widow(er) Income Fair Treatment Act of 2023 or SWIFT Act, entire bill 10. H.R. 6858,

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.842 Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2023; H.R.814 Protect Social Security and Medicare Act; H.Res.118 Maintaining Medicare; H.R.1618 Commission on Sustaining Medicare and Social Security Act of 2023; H.Res.178 Affirming the House of Representatives' commitment to protect and strengthen Social Security and Medicare; . H.R.1746 Preventing Medicare Telefraud Act; H.R.33 Medicare Dental, Vision, and Hearing Benefit Act of 2023; H.R.1129 -To direct the Secretary of Health and Human Services to revise regulations to remove the requirement under the Medicare program that an off-campus facility or organization shall be located within a 35-mile radius of a hospital or critical access hospital.H.R.34 Assuring Medicares Promise Act of 2023; H.R.2474 Strengthening Medicare for Patients and Providers Act; H.R.2863 Preventing Hospital Overbilling of Medicare; H.R.2665 Supporting Safety Net Hospitals Act; H.R.3417 FAIR Act;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting (CMS 3442-P) ARPA American Rescue Act Plan Funding OSHA Covid-19 Health Care Emergency Temporary Standard (ETS) Bill That Extends Moratorium on 2% Medicare Sequester Cuts Through End of 2021 Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

1. H.R. 34, Assuring Medicares Promise Act of 2023, entire bill 2. S. 1174, Medicare and Social Security Fair Share Act, entire bill 3. Proposals to disallow deductions for expenditures regarding collective bargaining organizing 4. H.R. 3936, Tax Cuts for Working Families Act, entire bill 5. H.R. 3937, Small Business Jobs Act, entire bill 6. H.R. 3938, Build It in America Act, entire bill

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.842 Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2023; H.R.814 Protect Social Security and Medicare Act; H.Res.118 Maintaining Medicare; H.R.1618 Commission on Sustaining Medicare and Social Security Act of 2023; H.Res.178 Affirming the House of Representatives' commitment to protect and strengthen Social Security and Medicare; . H.R.1746 Preventing Medicare Telefraud Act; H.R.33 Medicare Dental, Vision, and Hearing Benefit Act of 2023; H.R.1129 -To direct the Secretary of Health and Human Services to revise regulations to remove the requirement under the Medicare program that an off-campus facility or organization shall be located within a 35-mile radius of a hospital or critical access hospital.H.R.34 Assuring Medicares Promise Act of 2023; H.R.814 Protect Social Security and Medicare Act; H.R.2474 Strengthening Medicare for Patients and Providers Act; H.R.2863 Preventing Hospital Overbilling of Medicare; H.R.2665 Supporting Safety Net Hospitals Act; H.R.3417 FAIR Act;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Observation Stays. Improving Access to Medicare Coverage Act of 2023 (H.R. 5138): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Prices (No bill): Proposal to have the Biden Administration lower the price of the prostate cancer drug Xtandi through executive action by using so-called march-in rights under the Bayh-Dole Act; to amend the Federal Food, Drug, and Cosmetic Act to grant eligible researchers access to drugs or biologic products for research purposes at a price no higher than the cost to the manufacturer; to block so-called Dispense-As-Written campaigns where drug manufacturers incentivize health care providers to specify a brand drug on a prescription to block generic substitution at the pharmacy. Medicare Drug Costs. Pharmaceutical Research Transparency Act of 2023 (S. 1476 and H.R. 3160): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Drug Savings. Seniors Securing Access to Vital and Essential Prescription Drugs Act (H.R. 2893): Proposals to discount the treatment of eligible retirement plans in determining the eligibility of individuals for premium and cost sharing subsidies under Part D of the Medicare program. (No bills): Proposals to eliminate the Medicare Part D low-income subsidy programs asset test and raise the income eligibility levels to 200 percent of the federal poverty level. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and raise the income threshold for the low-income subsidy. Medicare Prescription Drugs. Affordable Pricing for Taxpayer-Funded Prescription Drugs Act of 2023 (H.R. 3093): Proposes to require companies that receive federal funding for research (or a license of the rights to a patent or regulatory test data) for a biomedical product or service to agree to set reasonable prices for the resulting biomedical product or service and authorize to determine a reasonable price based on a formula that ensures the U.S. price for the product or service is not more than the median price for the product or service in Canada and six other reference countries with, based on specified criteria, large economies and high incomes. Medicare Prescription Drugs. Supported an administrative proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. Supported HHS promulgating robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act. Medicare Low-Income Subsidy (LIS) Program. Supported increased funding for LIS outreach and enrollment, so that low-income beneficiaries can more readily access needed medications at prices they can afford. Medicare Reform. Assuring Medicares Promise Act (H.R. 34) and Medicare and Social Security Fair Share Act (S. 1174 and H.R 4535): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental Coverage. Medicare Dental Benefit Act (S. 2012 and H.R. 4146): Proposal to add a dental benefit to Medicare. Medicare Hearing Coverage. The Medicare Hearing Aid Coverage Act of 2021 (H.R. 244): Proposal to expand Medicare coverage to include hearing aids and services for seniors under Part B of the Medicare program. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Public Health emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage. (No bill): Proposals to create transparency around Medicare Advantage plans use of prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Privatization (No bill): Proposals to create reimbursement policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home And Community-Based Services. Inflation Reduction Act (Public Law No: 117-169): Proposals to expand Medicaid home and community-based services and the Medicare savings programs. Medicaid Home And Community-Based Services. HCBS Access Act (H.R. 1493 and S. 762). Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Medicare and Medicaid Nursing Homes. Nursing Home Disclosure Act (H.R. 177). Proposal to direct HHS to establish a national registry of medical directors. Medicare and Medicaid Nursing Home Ownership. (No bill) Supporting the strengthening of proposed HHS regulations for comprehensive ownership disclosure in the nursing home sector, and for national safe staffing standards. Medicare and Medicaid Nursing Home Staffing. Support for CMS to promulgate improved final regulations for establishing national staffing standards in nursing homes that would safeguard the health and safety of all elderly and disabled residents. Medicaid Long-Term Services and Supports (LTSS). (No bill): To request that CMS collect standardized LTSS expenditure data annually from every state and across all LTSS programs and for disaggregation of expenditure data by the delivery system and demographic characteristics in order to identify disparities in access and use of LTSS and help states and CMS deploy targeted strategies to meet the needs of older adults and people with disabilities.

Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting (CMS 3442-P) ARPA American Rescue Act Plan Funding OSHA Covid-19 Health Care Emergency Temporary Standard (ETS) Bill That Extends Moratorium on 2% Medicare Sequester Cuts Through End of 2021 Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Medicare Observation Stays. (No bill): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Prices (No bill): Proposal to have the Biden Administration lower the price of the prostate cancer drug Xtandi through executive action by using so-called march-in rights under the Bayh-Dole Act; to amend the Federal Food, Drug, and Cosmetic Act to grant eligible researchers access to drugs or biologic products for research purposes at a price no higher than the cost to the manufacturer; to block so-called Dispense-As-Written campaigns where drug manufacturers incentivize health care providers to specify a brand drug on a prescription to block generic substitution at the pharmacy. These campaigns increase drug spending by encouraging overuse of brand drugs when cheaper, equally effective generic alternative is available; and to reduce the period after Food and Drug Administration approval where a brand manufacturer could exclusively market their drug in the United States from 12 years to five years. This reduced exclusivity period would hasten the introduction of lower cost biosimilars to the market, helping bring down cost for consumers. Medicare Drug Costs. Pharmaceutical Research Transparency Act of 2023 (S. 1476 and H.R. 3160): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Drug Savings. Seniors Securing Access to Vital and Essential Prescription Drugs Act (H.R. 2893): Proposals to discount the treatment of eligible retirement plans in determining the eligibility of individuals for premium and cost sharing subsidies under Part D of the Medicare program. (No bills): Proposals to eliminate the Medicare Part D low-income subsidy programs asset test and raise the income eligibility levels to 200 percent of the federal poverty level. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and raise the income threshold for the low-income subsidy. Medicare Prescription Drugs. Affordable Pricing for Taxpayer-Funded Prescription Drugs Act of 2023 (H.R. 3039): Proposes to require companies that receive federal funding for research (or a license of the rights to a patent or regulatory test data) for a biomedical product or service to agree to set reasonable prices for the resulting biomedical product or service and authorize to determine a reasonable price based on a formula that ensures the U.S. price for the product or service is not more than the median price for the product or service in Canada and six other reference countries with, based on specified criteria, large economies and high incomes. Medicare Reform. Assuring Medicares Promise Act (H.R. 34): Proposal to close the loophole for wealthy individuals to bypass paying net investment income tax (NIIT) and would direct the revenue to the Hospital Insurance Fund, which pays for Medicare Part A that covers inpatient care in hospitals. Medicare Dental Coverage. Medicare Dental Benefit Act (S. 2012): Proposal to add a dental benefit to Medicare. Medicare Hearing Coverage. The Medicare Hearing Aid Coverage Act of 2021 (H.R. 244): Proposal to expand Medicare coverage to include hearing aids and services for seniors under Part B of the Medicare program. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Public Health emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage. (No bill): Proposals to create transparency around Medicare Advantage plans use of prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Privatization (No bill): Proposals to create reimbursement policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home And Community-Based Services. Inflation Reduction Act (Public Law No: 117-169): Proposals to expand Medicaid home and community-based services and the Medicare savings programs. Medicaid Home And Community-Based Services. HCBS Access Act (H.R. 1493 and S. 762). Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Medicare and Medicaid Nursing Homes. Nursing Home Disclosure Act (H.R. 177). Proposal to direct HHS to establish a national registry of medical directors. Medicare and Medicaid Nursing Home Ownership. (No bill) Supporting the strengthening of proposed HHS regulations for comprehensive ownership disclosure in the nursing home sector, and for national safe staffing standards. Medicaid Long-Term Services and Supports (LTSS). (No bill): To request that CMS collect standardized LTSS expenditure data annually from every state and across all LTSS programs and for disaggregation of expenditure data by the delivery system and demographic characteristics in order to identify disparities in access and use of LTSS and help states and CMS deploy targeted strategies to meet the needs of older adults and people with disabilities.

S.842 Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2023; H.R.814 Protect Social Security and Medicare Act; H.Res.118 Maintaining Medicare; H.R.1618 Commission on Sustaining Medicare and Social Security Act of 2023; H.Res.178 Affirming the House of Representatives' commitment to protect and strengthen Social Security and Medicare; . H.R.1746 Preventing Medicare Telefraud Act; H.R.33 Medicare Dental, Vision, and Hearing Benefit Act of 2023; H.R.1129 -To direct the Secretary of Health and Human Services to revise regulations to remove the requirement under the Medicare program that an off-campus facility or organization shall be located within a 35-mile radius of a hospital or critical access hospital.H.R.34 Assuring Medicares Promise Act of 2023; H.R.814 Protect Social Security and Medicare Act; H.R.2474 Strengthening Medicare for Patients and Providers Act; H.R.2863 Preventing Hospital Overbilling of Medicare; H.R.2665 Supporting Safety Net Hospitals Act; H.R.3417 FAIR Act;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. Nomination of Danny Werfel as Commissioner of the Internal Revenue Service 2. H.R. 34, Assuring Medicares Promise Act of 2023, entire bill 3. S. 1174, Medicare and Social Security Fair Share Act, entire bill 4. Proposals to disallow deductions for expenditures regarding collective bargaining organizing

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

Government targets: SENATE

ARPA American Rescue Act Plan Funding OSHA Covid-19 Health Care Emergency Temporary Standard (ETS) Bill That Extends Moratorium on 2% Medicare Sequester Cuts Through End of 2021 Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Medicare Observation Stays. The Improving Access to Medicare Coverage Act (No bill): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Drug Costs (No bill): Proposal to have the Biden Administration lower the price of the prostate cancer drug Xtandi through executive action by using so-called march-in rights under the Bayh-Dole Act. Drug Costs. Pharmaceutical Research and Transparency Act (No bill): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Drug Costs. Discounted Drugs for Clinical Trials Act (No bill): Proposal to amend the Federal Food, Drug, and Cosmetic Act to grant eligible researchers access to drugs or biologic products for research purposes at a price no higher than the cost to the manufacturer. Drug Costs. Generic Substitution Non-Interference Act (No bill): Proposal would block so-called Dispense-As-Written campaigns where drug manufacturers incentivize health care providers to specify a brand drug on a prescription to block generic substitution at the pharmacy. These campaigns increase drug spending by encouraging overuse of brand drugs when cheaper, equally effective generic alternative is available. Drug Costs. The Price Relief, Innovation and Competition for Essential Drugs (PRICED) Act, (No bill): Proposal to reduce the period after Food and Drug Administration approval where a brand manufacturer could exclusively market their drug in the United States from 12 years to five years. This reduced exclusivity period would hasten the introduction of lower cost biosimilars to the market, helping bring down costs for consumers. Drug Savings. Seniors Securing Access to Vital and Essential Prescription Drugs Act (No bill): Proposals to discount the treatment of eligible retirement plans in determining the eligibility of individuals for premium and cost sharing subsidies under Part D of the Medicare program. The Lowering Medicare Premiums and Prescription Drug Costs Act (No bill): Proposals to eliminate the Medicare Part D low-income subsidy programs asset test and raise the income eligibility levels to 200 percent of the federal poverty level. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and raise the income threshold for the low-income subsidy. Medicare Prescription Drug Prices. Affordable Pricing for Taxpayer-Funded Prescription Drugs Act (No bill): Proposals to require companies that receive federal funding for research (or a license of the rights to a patent or regulatory test data) for a biomedical product or service to agree to set reasonable prices for the resulting biomedical product or service and authorize to determine a reasonable price based on a formula that ensures the U.S. price for the product or service is not more than the median price for the product or service in Canada and six other reference countries with, based on specified criteria, large economies and high incomes; and requires companies entering these agreements to report to HHS certain financial information related to the biomedical product or service involved. Medicare Reform. Assuring Medicares Promise Act (H.R. 34): Proposal to close the loophole for wealthy individuals to bypass paying net investment income tax (NIIT) and would direct the revenue to the Hospital Insurance Fund, which pays for Medicare Part A that covers inpatient care in hospitals. Medicare Dental Coverage. Medicare Dental Benefit Act (No bill): Proposal to add a dental benefit to Medicare. Medicare Hearing Coverage. The Medicare Hearing Aid Coverage Act of 2023 (H.R. 244): Proposal to expand Medicare coverage to include hearing aids and services for seniors under Part B of the Medicare program. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with Department of Health and Human Services (HHS)/Center for Medicare and Medicaid Services (CMS). Public Health emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage. Seniors Timely Access to Care Act (No bill): Proposal to create transparency around Medicare Advantage plans use of prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. Medicare Advantage Consumer Protection and Transparency Act (No bill): Proposal to create transparency around Medicare Advantage plans use of prior authorization. Medicare Privatization (No bill): Proposals to create reimbursement policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid/Medicaid. Inflation Reduction Act (Public Law No: 117-169): Proposals to expand Medicaid home and community-based services and the Medicare savings programs. Medicaid Home and Community-Based Services. HCBS Access Act (H.R. 1493 and S. 762): Proposes to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Nursing Homes. Nursing Home Disclosure Act (H.R. 177): Proposals to establish a national registry of medical directors. Nursing Homes. (No bill): Proposals for HHS to issue regulations for comprehensive ownership disclosure in the nursing home sector, and for national safe staffing standards. Medicaid Long-Term Services and Supports (LTSS). (No bill): Proposals for CMS to collect standardized LTSS expenditure data annually from every state and across all LTSS programs, disaggregation of expenditure data by the delivery system and demographic characteristics in order to identify disparities in access and use of LTSS and help states and for CMS to deploy targeted strategies to meet the needs of older adults and people with disabilities.

(Unnamed HR) - Implementing a minimum income tax on all sources of income on households with more than $100 million General Tax - Expanded child tax credit; Net interest deduction tax break; Bonus depreciation Family and Small Business Taxpayer Protection Act (HR 23) - Repealing mandatory funding granted to the IRS through the IRA No Tax Breaks for Outsourcing Act (HR 884, S 357) - Enact President Biden's proposed international tax reforms Assuring Medicare's Promise act (HR 34) - Close loopholes for high earners in NIIT & SECA and directs funds raised to shore up Medicares finances

Client expense: $260,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.842 Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2023; H.R.814 Protect Social Security and Medicare Act; H.Res.118 Maintaining Medicare; H.R.1618 Commission on Sustaining Medicare and Social Security Act of 2023; H.Res.178 Affirming the House of Representatives' commitment to protect and strengthen Social Security and Medicare; . H.R.1746 Preventing Medicare Telefraud Act; H.R.33 Medicare Dental, Vision, and Hearing Benefit Act of 2023; H.R.1129 -To direct the Secretary of Health and Human Services to revise regulations to remove the requirement under the Medicare program that an off-campus facility or organization shall be located within a 35-mile radius of a hospital or critical access hospital.H.R.34 Assuring Medicares Promise Act of 2023; H.R.814 Protect Social Security and Medicare Act; H.R.2474 Strengthening Medicare for Patients and Providers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

ARPA American Rescue Act Plan Funding OSHA Covid-19 Health Care Emergency Temporary Standard (ETS) Bill That Extends Moratorium on 2% Medicare Sequester Cuts Through End of 2021 Healthcare Price Transparency Rules for Hospitals 340B Medicare DSH Medicare Physician Payment (MACRA) H.R. 365 The Primary Care Enhancement Act S. 898/H.R. 2141 Conrad State 30 and Physician Access Reauthorization Act S. 1130 Rural Emergency Acute Care Hospital (REACH) Act S. 257 / H.R. 1611: Protecting Access to Rural Therapy Services Act S. 258 / H.R. 169: Critical Access Hospital Relief Act of 2015 H.R. 672 / S. 607: Rural Community Hospital Demonstration Extension Act of 2015 S. 1135: Hospital Payment Fairness Act H.R. 1479: Repeal of the Obamacare Bay State Boondoggle Act S. 1648: Rural Emergency Acute Care Hospital Act H.R. 3225: Save Rural Hospitals Act H.R. 1343 / S. 688: Establishing Beneficiary Equity in the Hospital Readmission Program Act S. 1148 / H.R. 2124: Resident Physician Shortage Reduction Act S. 2484 / H.R. 4442: CONNECT for Health Act H.R. 2156: Medicare Audit Improvement Act H.R. 5164: Rural Hospital Regulatory Relief Act S. 3435: Craig Thomas Rural Hospital and Provider Equity Act of 2016 H.R. 5406: Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act H.R. 34: 21st Century Cures Act H.R. 3298: Medicare Post-Acute Care Value-Based Purchasing Act H.R 1628: American Health Care Act S. 872 / H.R. 1955: Rural Hospital Access Act S. 377: Medicare Ambulance Access, Fraud Prevention and Reform Act H.R. 1156: Patient Access to Higher Quality Health Care Act of 2017 H.R. 2: Medicare Access and CHIP Reauthorization Act of 2016 H.R. 1628 Better Care Reconciliation Act (BCRA) H.R. 4392 To provide that the provision of the Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs final regulation relating to changes in the payment amount for certain drugs and biologicals purchased under the 340B drug discount program shall have no force or effect, and for other purposes. The Senate Committee on Health, Education, Labor and Pensions (HELP) June 26 passed the Lower Health Care Costs Act of 2019 (S.1895) Congress should act now to delay the Medicaid DSH cuts that are scheduled to go into effect Nov. 22. The Coronavirus Aid, Relief, and Economic Security (CARES) Act.