PACE Part D Choice Act of 2023

NAPA Reauthorization Act (S. 133 / H.R. 619 - P.L. 118-92) Alzheimers Accountability and Investment Act (S. 134 / H.R. 620 - P.L. 118-93) Comprehensive Care for Alzheimers Act (S. 626 / H.R. 1637) Reauthorization of the BOLD Infrastructure for Alzheimer's Act (P.L. 115-406) BOLD Infrastructure for Alzheimer's Reauthorization Act of 2024 (S. 3775/ H.R. 7218 - P.L. 118-142) Accelerating Access to Dementia & Alzheimers Provider Training (AADAPT) Act (S. 4276/H.R. 7688) Elizabeth Dole Home Care Act, of 2023 (S. 141 / H.R. 542) Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (H.R. 8371) VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of 2023 (S. 10) Access to Innovative Treatments Act of 2023 (H.R. 2408) Mandating Exclusive Review of Individual Treatments (MERIT) Act (H.R. 133) Elder Justice Reauthorization and Modernization Act of 2023 (S. 1198/H.R. 2718) Expanding Veterans Options for Long-Term Care Act (S. 495/H.R.1815) Palliative Care and Hospice Education and Training Act (S. 2243) Facilitating Innovative Nuclear Diagnostics (FIND) Act of 2023 (S. 1544/H.R. 1199) Supporting Our Seniors Act (S. 2584) Alleviating Barriers for Caregiving Act (S. 3109) Credit for Caring Act of 2024 (S. 3702/H.R. 7165) Credit for Caring Act of 2025 (S. 925/H.R. 2036) Lifespan Respite Care Reauthorization Act of 2024 (S. 4325/H.R. 6160) Lifespan Respite Care Reauthorization Act of 2025 (S.830/H.R.2560) DeOndra Dixon INvestigation of Co-occurring Conditions across the Lifespan to Understand Down Syndrome (INCLUDE) Project Act of 2024 (H.R. 7406) Paid Family and Medical Leave Tax Credit Extension Act (S. 3680) Paid Family and Medical Leave Tax Credit Extension and Enhancement Act (S. 400/H.R. 996) CONNECT for Health Act of 2023 (S. 2016/H.R. 4189) PACE Part D Choice Act of 2023 (S. 1703/H.R. 3549) Improving Seniors' Access to Timely Care Act of 2024 (S. 4532/H.R. 8702) Harmonizing Environmental Analyses and Launching Therapeutic Hubs to Yield Bolstered Research And Innovation in Neurological Science (HEALTHY BRAINS) Act of 2024 (H.R. 9233) Better Empowerment Now to Enhance Framework and Improve Treatments Act of 2023 (BENEFIT)(S. 526/H.R. 1092) Essential Caregivers Act of 2024 (S. 4280/H.R. 8331) Ensuring Patient Access to Critical Breakthrough Products Act of 2024 (H.R. 1691) Linking Seniors to Needed Legal Services Act of 2024 (H.R. 8588) Amending the Rules of the House of Representatives to establish a Permanent Select Committee on Aging (H. Res. 1029) Catching Up Family Caregivers Act of 2024 (S. 5149 / H.R. 9764) Improving Retirement Security for Family Caregivers Act of 2024 (S. 5148 / H.R. 9765) Charitable Act (S. 317/H.R. 801) Other matters related to disaster preparedness and older adults, public health emergencies, public health preparedness and response, telehealth, health disparities, and older Americans/people with disabilities in all phases of emergencies Other matters related to Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer's Disease Other matters related to care payment models, including the GUIDE model Other matters related to Medicare care planning code 99483 Other matters related to health care workforce shortages Other matters related to home- and community-based services Other matters related to disaster preparedness and older adults Other matters related to Social Security Other matters related to technology-enabled collaborative learning and capacity-building models (Project ECHO) Other matters related to beta-amyloid PET scans Other matters related to selected diagnoses and services rendered under ICD-10 Other matters related to caregiving Other matters related to medical devices Other matters related to rural health Other matters related to veterans' health Other matters related to Tricare Other matters related to research Other matters related to biomarkers including blood based tests and cerebral spinal fluid (CSF) Other matters related to public health

Client expense: $530,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

Linking Seniors to Needed Legal Services Act (H.R. 8588) Accelerating Access to Dementia & Alzheimers Provider Training (AADAPT) Act (S. 4276/H.R. 7688) Amending the Rules of the House of Representatives to establish a Permanent Select Committee on Aging (H. Res. 1029) Improving Seniors' Access to Timely Care Act (S. 4532/H.R. 8702) to amend Title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans Harmonizing Environmental Analyses and Launching Therapeutic Hubs to Yield Bolstered Research And Innovation in Neurological Science (HEALTHY BRAINS) Act (H.R. 9233) Better Empowerment Now to Enhance Framework and Improve Treatments Act of 2023 (BENEFIT) Act (S. 526/H.R. 1092) Essential Caregivers Act of 2024 (S. 4280/H.R. 8331) Ensuring Patient Access to Critical Breakthrough Products Act (H.R. 1691) PACE Part D Choice Act of 2023 (S. 1703/H.R. 3549) Credit for Caring Act of 2024 (S. 3702/H.R. 7165) Paid Family and Medical Leave Tax Credit Extension and Enhancement Act (S. 3680) CONNECT for Health Act of 2023 (S. 2016 / H.R. 4189) Lifespan Respite Care Reauthorization Act (H.R. 6160) to amend the Public Health Service Act to reauthorize a lifespan respite care program DeOndra Dixon Investigation of Co-occurring Conditions across the Lifespan to Understand Down Syndrome (INCLUDE) Project Act of 2024 (H.R. 7406) NAPA Reauthorization Act (S. 133/H.R. 619/P.L. 118-92) Alzheimers Accountability and Investment Act (S. 134/H.R. 620/P.L. 118-93) Comprehensive Care for Alzheimers Act (S. 626/H.R. 1637) Elizabeth Dole Home Care Act of 2023 (S. 141/H.R. 542) Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (H.R. 8371) VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of 2023 (S. 10) Mandating Exclusive Review of Individual Treatments (MERIT) Act (H.R. 133) Access to Innovative Treatments Act of 2023 (H.R. 2408) Elder Justice Reauthorization and Modernization Act of 2023 (H.R. 2718/S. 1198) Expanding Veterans Options for Long Term Care Act (H.R.1815/S. 495) Palliative Care and Hospice Education and Training Act (S.2243) Facilitating Innovative Nuclear Diagnostics Act of 2023 (H.R. 1199/S. 1544) Supporting Our Seniors Act (S. 2584) Alleviating Barriers for Caregiving Act (S. 3109) Reauthorization of the BOLD Infrastructure for Alzheimer's Act (P.L. 115-406) BOLD Reauthorization Act (P.L.118-142) Catching Up Family Caregivers Act (S. 5149 / H.R. 9764) Improving Retirement Security for Family Caregivers Act (S. 5148 / H.R. 9765) Other matters related to Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimers Disease Other matters related to care payment models, including the GUIDE model Other matters related to Medicare care planning code 99483 Other matters related to health care workforce shortages Other matters related to home- and community-based services Other matters related to disaster preparedness and older adults Other matters related to Social Security Other matters related to technology-enabled collaborative learning and capacity-building models (Project ECHO) Other matters related to beta amyloid PET scans Other matters related to selected diagnoses and services rendered under ICD-10 Other matters related to caregiving Other matters related to medical devices other matters related to rural health other matters related to veterans health other matters related to Tricare Other matters related to research Other matters related to biomarkers including blood based tests and cerebral spinal fluid (csf)

Issues related to electric vehicles and ev charging infrastructure Issues related to freight rail Issues related to drone use beyond line of site S.307/H.R. 3549 - Increasing Competitiveness for American Drones Act of 2023 S. 2071 - Rail Reliability Service Act Issues related to the 2024 Water Resources Development Act (WRDA) Issues related to broadband deployment and rail crossings Issues related to carbon dioxide pipelines, including pipeline safety authorization H.R. 8610 - Counter-UAS Authority Security, Safety, and Reauthorization Act

Client expense: $749,732 · Firm income: Not reported

PACE regulations and PACE demonstration. Medicaid and Medicare reimbursement. Medicare Part D reform. ACO Reach. S. 1703/H.R. 3549 - PACE Part D Choice Act. H.R. 6590 - PACE Expanded Act. S. 3950 - DUALS Act of 2024. H.R. 10545 - American Relief Act.

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

General health care issues; 330 funding; health care workforce issues; Program for All-inclusive Care for the Elderly; S.1703/H.R.3549, PACE Part D Choice Act; Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

MMM [House, Senate, HHS, CMS, FDA, Administration on Aging, EOP, DOC] 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. Medicaid Eligibility and Beneficiary Assets. Medicaid Estate Recovery Act (H.R. 7573): Proposals to provide financial protection to the families of Medicaid beneficiaries, including ending Medicaid estate claims and Medicaid liens, except in cases when benefits had been incorrectly paid, as determined by a court.

Linking Seniors to Needed Legal Services Act (H.R. 8588) Accelerating Access to Dementia & Alzheimers Provider Training (AADAPT) Act (S. 4276/H.R. 7688) Amending the Rules of the House of Representatives to establish a Permanent Select Committee on Aging (H. Res. 1029) Improving Seniors' Access to Timely Care Act (S. 4532/H.R. 8702) to amend Title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans Harmonizing Environmental Analyses and Launching Therapeutic Hubs to Yield Bolstered Research And Innovation in Neurological Science (HEALTHY BRAINS) Act (H.R. 9233) Better Empowerment Now to Enhance Framework and Improve Treatments Act of 2023 (BENEFIT) Act (S. 526/H.R. 1092) Essential Caregivers Act of 2024 (S. 4280/H.R. 8331) Ensuring Patient Access to Critical Breakthrough Products Act (H.R. 1691) PACE Part D Choice Act of 2023 (S. 1703/H.R. 3549) Credit for Caring Act of 2024 (S. 3702/H.R. 7165) Paid Family and Medical Leave Tax Credit Extension and Enhancement Act (S. 3680) CONNECT for Health Act of 2023 (S. 2016 / H.R. 4189) Lifespan Respite Care Reauthorization Act (H.R. 6160) to amend the Public Health Service Act to reauthorize a lifespan respite care program DeOndra Dixon Investigation of Co-occurring Conditions across the Lifespan to Understand Down Syndrome (INCLUDE) Project Act of 2024 (H.R. 7406) NAPA Reauthorization Act (S. 133/H.R. 619/P.L. 118-92) Alzheimers Accountability and Investment Act (S. 134/H.R. 620/P.L. 118-93) Comprehensive Care for Alzheimers Act (S. 626/H.R. 1637) Elizabeth Dole Home Care Act of 2023 (S. 141/H.R. 542) VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of 2023 (S. 10) Mandating Exclusive Review of Individual Treatments (MERIT) Act (H.R. 133) Access to Innovative Treatments Act of 2023 (H.R. 2408) Elder Justice Reauthorization and Modernization Act of 2023 (H.R. 2718/S. 1198) Expanding Veterans Options for Long Term Care Act (H.R.1815/S. 495) Palliative Care and Hospice Education and Training Act (S.2243) Facilitating Innovative Nuclear Diagnostics Act of 2023 (H.R. 1199/S. 1544) Supporting Our Seniors Act (S. 2584) Alleviating Barriers for Caregiving Act (S. 3109) Reauthorization of the BOLD Infrastructure for Alzheimer's Act (P.L. 115-406) BOLD Reauthorization Act (S. 3775/ H.R. 7218) Other matters related to Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimers Disease Other matters related to care payment models, including the GUIDE model Other matters related to Medicare care planning code 99483 Other matters related to health care workforce shortages Other matters related to home- and community-based services Other matters related to disaster preparedness and older adults Other matters related to Social Security Other matters related to technology-enabled collaborative learning and capacity-building models (Project ECHO) Other matters related to beta amyloid PET scans Other matters related to selected diagnoses and services rendered under ICD-10 Other matters related to caregiving Other matters related to medical devices other matters related to rural health other matters related to veterans health other matters related to Tricare Other matters related to research Other matters related to biomarkers including blood based tests and cerebral spinal fluid (csf)

General health care issues; 330 funding; health care workforce issues; Program for All-inclusive Care for the Elderly; S.1703/H.R.3549, PACE Part D Choice Act; Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PACE regulations and PACE demonstration. Medicaid and Medicare reimbursement. Medicare Part D reform. ACO Reach. S. 1703/H.R. 3549 - PACE Part D Choice Act. H.R. 6590 - PACE Expanded Act. S. 3950 - DUALS Act of 2024.

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

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.

Issues related to electric vehicles and ev charging infrastructure Issues related to freight rail Issues related to drone use beyond line of site S.307/H.R. 3549 - Increasing Competitiveness for American Drones Act of 2023 S. 2071 - Rail Reliability Service Act Issues related to the 2024 Water Resources Development Act (WRDA) Issues related to broadband deployment and rail crossings Issues related to carbon dioxide pipelines, including pipeline safety authorization H.R. 8610 - Counter-UAS Authority Security, Safety, and Reauthorization Act

Client expense: $945,424 · Firm income: Not reported

General health care issues; 330 funding; health care workforce issues; Program for All-inclusive Care for the Elderly; S.1703/H.R.3549, PACE Part D Choice Act; Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Accelerating Access to Dementia & Alzheimers Provider Training (AADAPT) Act (S. 4276/H.R. 7688) Amending the Rules of the House of Representatives to establish a Permanent Select Committee on Aging (H. Res. 1029) Improving Seniors' Access to Timely Care Act (S. 4532/H.R. 8702) to amend Title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans PACE Part D Choice Act of 2023 (S. 1703/H.R. 3549) Credit for Caring Act of 2024 (S. 3702/H.R. 7165) Paid Family and Medical Leave Tax Credit Extension and Enhancement Act (S. 3680) CONNECT for Health Act of 2023 (S. 2016 / H.R. 4189) Lifespan Respite Care Reauthorization Act (H.R. 6160) to amend the Public Health Service Act to reauthorize a lifespan respite care program DeOndra Dixon Investigation of Co-occurring Conditions across the Lifespan to Understand Down Syndrome (INCLUDE) Project Act of 2024 (H.R. 7406) NAPA Reauthorization Act (S. 133/H.R. 619) Alzheimers Accountability and Investment Act (S. 134/H.R. 620) Comprehensive Care for Alzheimers Act (S. 626/H.R. 1637) Elizabeth Dole Home Care Act of 2023 (S. 141/H.R. 542) VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of 2023 (S. 10) Mandating Exclusive Review of Individual Treatments (MERIT) Act (H.R. 133) Access to Innovative Treatments Act of 2023 (H.R. 2408) Elder Justice Reauthorization and Modernization Act of 2023 (H.R. 2718/S. 1198) Expanding Veterans Options for Long Term Care Act (H.R.1815/S. 495) Palliative Care and Hospice Education and Training Act (S.2243) Facilitating Innovative Nuclear Diagnostics Act of 2023 (H.R. 1199/S. 1544) Supporting Our Seniors Act (S. 2584) Alleviating Barriers for Caregiving Act (S. 3109) Reauthorization of the BOLD Infrastructure for Alzheimer's Act (P.L. 115-406) BOLD Reauthorization Act (S. 3775/ H.R. 7218) Other matters related to Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimers Disease Other matters related to care payment models, including the GUIDE model Other matters related to Medicare care planning code 99483 Other matters related to health care workforce shortages Other matters related to home- and community-based services Other matters related to disaster preparedness and older adults Other matters related to Social Security Other matters related to technology-enabled collaborative learning and capacity-building models (Project ECHO) Other matters related to beta amyloid PET scans Other matters related to selected diagnoses and services rendered under ICD-10 Other matters related to caregiving Other matters related to medical devices other matters related to rural health other matters related to veterans health other matters related to Tricare

Issues related to electric vehicles and ev charging infrastructure Issues related to freight rail Issues related to drone use beyond line of site S.307/H.R. 3549 - Increasing Competitiveness for American Drones Act of 2023 S. 2071 - Rail Reliability Service Act Issues related to the 2024 Water Resources Development Act (WRDA) Issues related to broadband deployment and rail crossings Issues related to carbon dioxide pipelines, including pipeline safety authorization

Client expense: $1,245,282 · Firm income: Not reported

PACE regulations and PACE demonstration. Medicaid and Medicare reimbursement. Medicare Part D reform. ACO Reach. S. 1703/H.R. 3549 - PACE Part D Choice Act. H.R. 6590 - PACE Expanded Act. S. 3950 - DUALS Act of 2024.

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

No bill number. Discussed medically necessary dental coverage and oral health care in Medicare. No bill number. Discussed Medicare coverage for telehealth services. No bill number. Discussed workforce training, physician reimbursement, and Medicare provider access. No bill number. Discussed Improving Seniors Timely Access to Care Act of 2024. H.R. 2407, the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act. No bill number. Discussed Medicaid estate recovery. No bill number. Discussed Medicare Advantage data. H.R. 3549/ S. 1703, the PACE Part D Choice Act of 2023. No bill number. Discussed family caregivers and Medicare and Medicaid policy. No bill number. Discussed Medicare FY25 Skilled Nursing Facility Payment Proposed Rule. No bill number. Discussed Medicare FY25 Hospital Inpatient Payment Proposed Rule. No bill number. Discussed hospitals and a buffer of essential medicines. No bill number. Discussed Medicaid unwinding. H.R. 8114, To prohibit the Secretary of Health and Human Services from finalizing a rule proposed by the Centers for Medicare & Medicaid Services to place certain limitations on Medicaid payments for home or community-based services. No bill number. Discussed Care Executive Order. H.R. 8018, the Alleviating Barriers for Caregivers Act. S. 3109, Alleviating Barriers for Caregivers Act. S. 3766/H.R. 7274, Connecting Caregivers to Medicare Act. No bill number. Discussed Acute Hospital Care at Home waiver and family caregivers. No bill number. Discussed family caregivers, direct care workers, care at home, and in other settings. S. 4120/H.R. 7994, the Long-Term Care Workforce Support Act. H.R. 8094, to amend Title XIX of the Social Security Act to modify certain asset recovery rules. H.R. 7573, the Stop Unfair Medicaid Recoveries Act. No bill number. Discussed the Coordinating Care for Veterans and Wounded Warriors Act. No bill number. Discussed nursing home staffing standards. No bill number. Discussed Medicare home health and hospice benefits. No bill number. Discussed health care coverage expansion. H.R. 8331/S. 4280, the Essential Caregivers Act. H.R. 7442, Philippine Medicare Portability Study Act. H.R. 3227, the Ensuring Seniors Access to Quality Care Act. H.R. 8244, Ensuring Seniors Access to Quality Care Act. H.R.468, the Building Americas Health Care Workforce Act. HR 7513/S.3410, the Protecting Americas Seniors Access to Care Act. H.J.Res.139, Providing for Congressional disapproval of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting. S.J.Res.91, A joint resolution providing for congressional disapproval of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting" S.4137, the Improving Access to Medicare Coverage Act of 2024.

No bill number. Discussed out-of-pocket caps for prescription drugs. No bill number. Discussed pharmacy benefit manager reforms. H.R. 4818, the Treat and Reduce Obesity Act. No bill number. Discussed medication safety at home. No bill number. Discussed Medicare drug price negotiation program. No bill number. Discussed Medicare Prescription Payment Plan. S.79, the Interagency Patent Coordination and Improvement Act of 2023. S.142, the Preserve Access to Affordable Generics and Biosimilars Act of 2023. S.148, the Stop STALLING Act. S.150, the Affordable Prescriptions for Patients Act of 2023. S.113, the Prescription Pricing for the People Act of 2023. H.R. 5539/ S. 3131, Optimizing Research Progress Hope and New Cures Act. H.R. 5547/ S. 476, Maintaining Investments in New Innovation Act. H.R. 3549/ S. 1703, the PACE Part D Choice Act of 2023. No bill number. Discussed generic prescription drug shortages. S.2220/ H.R. 4370, the PREVAIL Act. No bill number. Discussed US Patent and Trade Office proposed rule. H.R. 8848, Affordable and Safe Prescription Drug Importation Act of 2024.

Client expense: $5,170,000 · Firm income: Not reported

General health care issues; 330 funding; health care workforce issues; Program for All-inclusive Care for the Elderly; S.1703/H.R.3549, PACE Part D Choice Act; Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to electric vehicles and ev charging infrastructure Issues related to freight rail Issues related to drone use beyond line of site S.307/H.R. 3549, Increasing Competitiveness for American Drones Act of 2023 S. 2071, Rail Reliability Service Act Issues related to the 2024 Water Resources Development Act (WRDA) Issues related to broadband deployment and rail crossings

Client expense: $932,375 · Firm income: Not reported

PACE regulations and PACE demonstration. Medicaid and Medicare reimbursement. Medicare Part D reform. ACO Reach. S. 1703/H.R. 3549 - PACE Part D Choice Act. H.R. 6590 - PACE Expanded Act. S. 3950 - DUALS Act of 2024.

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

Issues related to electric vehicles and ev charging infrastructure Issues related to freight rail Issues related to drone use beyond line of site S.307/H.R. 3549, Increasing Competitiveness for American Drones Act of 2023 S. 2071, Rail Reliability Service Act Issues related to the 2024 Water Resources Development Act (WRDA)

Client expense: $865,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to electric vehicles and ev charging infrastructure Issues related to freight rail Issues related to drone use beyond line of site S.307/H.R. 3549, Increasing Competitiveness for American Drones Act of 2023 S. 2071, Rail Reliability Service Act Issues related to the 2024 Water Resources Development Act (WRDA)

Client expense: $986,032 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PACE regulations and PACE demonstration. Medicaid and Medicare reimbursement. Medicare Part D reform. ACO Reach. S. 1703/H.R. 3549 - PACE Part D Choice Act. H.R. 6590 - PACE Expanded Act.

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

Issues related to electric vehicles and ev charging infrastructure Issues related to freight rail Issues related to drone use beyond line of site S.307/H.R. 3549, Increasing Competitiveness for American Drones Act of 2023 S. 2071, Rail Reliability Service Act

Client expense: $986,032 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PACE regulations and PACE demonstration. Medicaid and Medicare reimbursement. Medicare Part D reform. ACO Reach. S. 1703/H.R. 3549 - PACE Part D Choice Act.

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

PACE regulations and PACE demonstration. Medicaid and Medicare reimbursement. Medicare Part D reform. ACO Reach. S. 1703/H.R. 3549 - PACE Part D Choice Act.

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

Issues related to electric vehicles and ev charging infrastructure Issues related to freight rail Issues related to drone use beyond line of site S.307/H.R. 3549, Increasing Competitiveness for American Drones Act of 2023 S. 2071, Rail Reliability Service Act

Client expense: $880,092 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE