Expanded Telehealth Access Act

H.R. 4189/S.2016, CONNECT for Health Act of 2023 H.R. 4093, Remote Opioid Monitoring Act of 2023 H.R. 824, Telehealth Benefit Expansion for Workers Act of 2023 H.R.1843/S.1001, Telehealth Expansion Act of 2023 H.R. 3875, Expanded Telehealth Access Act H.R. 1458/S. 723, Access to Prescription Digital Therapeutics Act of 2023 H.R. 7623, Telehealth Modernization Act of 2024 H.R. 7856, PREVENT DIABETES Act S. 4094, PREVENT DIABETES Act General issues related to federal regulation of health technology - artificial intelligence, digital therapeutics

Client expense: $1,050,000 · Firm income: Not reported

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

Preserving Seniors Access to Physicians Act of 2023 (H.R. 6683); Medicare Payment Reform; Prevent Interruptions in Physical Therapy Act (H.R.1617/S. 793); Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act (H.R. 7279); Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation (EMPOWER) Act (H.R. 4878/S. 2459); Expanded Telehealth Act (H.R. 3875/S. 2880); Telehealth Modernization Act (H.R. 7623 / S. 3967); Stopping Addiction and Falls for the Elderly (SAFE) Act (H.R. 7618); Medicare Opt-Out; Improving Seniors Timely Access to Care Act (H.R. 8702 / S. 4532); Strengthening Medicare for Patients and Providers Act (H.R. 2474); The Provider Reimbursement Stability Act (H.R. 6371); Physician Fee Stabilization Act (S. 4935); Medicare Patient Access and Practice Stabilization Act of 2024 (H.R. 10073).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare coverage of audiology services and the Medicare Audiology Access Improvement Act (H.R. 6445/S. 2377) Issues related to the provision of audiology and speech-language pathology services through telepractice, including the Expanded Telehealth Access Act (H.R. 3875/S. 2880), the CONNECT for Health Act (H.R. 4189/S. 2016) and the Telehealth Modernization Act (H.R. 7623). Issues related to Medicare Part B reimbursement of audiology and speech-language pathology services, including H.R. 2474, the Strengthening Medicare for Patients and Providers Act, H.R. 2474, H.R. 6545, the Physician Fee Schedule Update and Improvements Act, and S. 4935, the Physician Fee Schedule Stabilization Act Various issues related to CMS Actions surrounding: Audits of medical records and claims for Part A and B services Procedure code development and valuation of audiology and speech-language pathology services Quality reporting under MIPS Implementation of the IMPACT Act Medicare physician fee schedule Prospective payments systems, including home health and skilled nursing facility policy and payment issues Accountable Care Organizations Federally-facilitated marketplace Medicare Advantage Various issues related to interoperable health information, including the post-acute care interoperability project (PACIO) Medicare telehealth coverage under Part A and B Implementation of CARES Act (P.L. 116-136) Provision and payment for Part A therapy Various issues related to implementation of ACA Issues related to Medicare beneficiaries accessing services provided by audiologists without a physician order Issues related to the Center for Medicare and Medicaid Innovation (CMMI) actions related to value-based care The Long-Term Care Workforce Support Act (H.R. 7994/S. 4120) Issues related to the Medicaid program, including Medicaid and Medicaid managed care access, the Early and Periodic Screening, Diagnosis, and Treatment benefit, school-based billing, and block grants, per capita caps, and work requirements. Improving Seniors Timely Access to Care Act (H.R. 8702/S. 4532) The American Relief Act, 2025 (H.R. 10545)

Client expense: $422,000 · Firm income: Not reported

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

H.R. 5378 - Lower Costs, More Transparency Act S. 3967/H.R. 7263 - Telehealth Modernization Act of 2024 S. 1001/H.R. 1843 - Telehealth Expansion Act of 2023 S. 2880/H.R. 3875 - Expanded Telehealth Access Act

Client expense: $330,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE

Issues surrounding Medicare reimbursement and coverage denials (H.R.4315/S.3977) Medicare Orthotics and Prosthetics Patient-Centered Care Act (H.R.2474) Strengthening Medicare for Patients and Providers Act (H.R.3875) Expanded Telehealth Access Act Implementation of Healthcare Common Procedure Coding Systems add-on code G2211 (H.R. 7279) Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act Issues surrounding local coverage determination and Contractor Advisory Committee processes (H.R. 7623) Telehealth Modernization Act of 2024 Issues surrounding 2025 conversion factor and Medicare reimbursement reform (H.R.10445) Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025 (H.R.10545) American Relief Act, 2025 (H.R.10515) American Relief Act, 2025

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and regulation related to the Medicare Advantage program and Medicare/Medicaid coverage, care delivery and financing. HR 8260 Hospital Inpatient Services Modernization Act H.R. 8235 the Rural Physician Workforce Preservation Act H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act HR 3171/S. 3018 The Improving Seniors Timely Access to Care Act H.R. 1110, KEEP Telehealth Options Act of 2023 H.R. 3875, Expanded Telehealth Access Act H.R. 5541, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act H.R. 5611, Helping Ensure Access to Local TeleHealth (HEALTH) Act of 2023 H.R. 6033, Supporting Patient Education And Knowledge (SPEAK) Act of 2023 H.R. 7149, Equal Access to Specialty Care Everywhere (EASE) Act of 2024 H.R. 7623, The Telehealth Modernization Act of 2024 H.R. 7711, To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program H.R. 7858, Telehealth Enhancement for Mental Health Act of 2024 H.R. 7863, To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program H.R. 5386, Cutting Copays Act H.R. 5380, To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage H.R. 5372, Expanding Seniors Access to Lower Cost Medicines Act of 2023 S. 3059 the REAL Health Provider Act (Bennet, Tillis) S. 2973 Modernizing and Ensuring PBM Accountability Act H.R. 2880, the Protecting Patients Against PBM Abuses Act S.1002 - No UPCODE Act H.R. 3282, the Promoting Transparency and Healthy Competition in Medicare Act H.R. 3284, the Providers and Payers COMPETE Act H.R. 3237, To amend title XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department

Client expense: $220,000 · Firm income: Not reported

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

HR 4315/S3977 - Medicare Orthotics & Prosthetics Patient Centered Care Act: Advocate for passage to stop fraud in the provision of orthotics and prosthetics and to ensure access to needed orthotic devices. HR 4878/S 2459 - EMPOWER Act: Advocate for passage of EMPOWER Act, which would change the Medicare supervision requirement for occupational therapy assistants (OTAs) and physical therapist assistants (PTAs) in private practice from "direct" supervision to match state standards and require GAO student of impact of 15% reimbursement cut for OTAs and PTAs in rural and medically underserved areas. H.R. 2474 - Strengthen Medicare for Patients and Providers Act: Support passage. No bill number - Advocate for introduction of legislation allowing occupational therapy practitioners to opt-out of Medicare. No bill number - Support legislation that will reverse the current Medicare multiple procedure payment reduction for therapy services. No bill number Support legislation that will improve the ability of therapy providers to participate in Medicare quality payment programs. HR 3875/S 2880 - Expanded Telehealth Access Act: Advocate for passage in the House and Senate to establish occupational therapists as telehealth providers in Medicare. H.R.7623/S.3967 - Telehealth Modernization Act: Advocate for passage of bill that would among other things establish occupational therapists as telehealth providers in Medicare. S. 2016 and HR 4189 - CONNECT for Health Act: Advocate to revise provisions of legislation to specifically establish occupational therapists as telehealth providers in Medicare. H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act: Advocate for passage of bill that would extend waivers allowing OTs to provide services via telehealth in Medicare. H.R.8151 - Telehealth Therapy Act: Advocate for passage of bill that would allow OTs to provide services via telehealth in Medicare on a permanent basis. H.R.7148 - Medicare Home Health Accessibility Act: Advocate for passage of legislation that would establish occupational therapy as a qualifying Medicare home health service and for introduction of similar bill in the Senate. S. 1592/H.R.8220 - Occupational Therapy in Mental Health Parity Act: Support passage. S. 2942 WELL Seniors Act - support passage H.R. 6371 Provider Reimbursement Stability Act - support passage H.R. 6545 Physician Fee Schedule Update and Improvements Act - support passage H.R. 6683 Preserving Seniors Access to Physicians Act - support passage S. 3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act - support passage S. 2433/S. 3106/H.R. 4079 Substance-Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act - support passage H.R.7279 REDUCE Act: Supported introduction and passage. H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act: Supported introduction and passage. S. 5023 support Stand Strong Falls Prevention Act Support Congressional efforts to stop cuts to the Medicare Physician Fee Schedule Support inclusion of a repeal of the Multiple Procedure payment reduction in Medicare Fee Schedule Reform

Client expense: $189,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Medicare Orthotics and Prosthetics Patient-Centered Care Act Medicare Private Contracting Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act Improving Seniors Timely Access to Care Act Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule Support Medicare Providers Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 4878/S. 2459 - EMPOWER Act (PTA/OTA Supervision) H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act H.R. 3875/S. 2880 Expanded Telehealth Access Act H.R. 4829 Physical Therapist Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R. 2217/S. 4519 - IDEA Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 7279 Reduce Duplicative Unnecessary Clerical Exchanges (REDUCE) Act H.R. 7623 Telehealth Modernization Act (TMA) H.R. 8151 to Expand eligible practitioners to furnish telehealth services H.R. 10073 Medicare Patient Access and Practice Stabilization Act

Client expense: $289,585 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act Implementation/Expansion of CDC Falls Program Physician self-referral/Stark Law 21st Century Cures Act Health Information Technology Medicaid Expansion MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Opioid Epidemic/Pain Management DOL/OSHA Nominations to NQF committees Primary Care Administrative Burden/Prior Authorizations 1332 Empowerment Waivers Affordable Care Act Primary Health Services Enhancement Act Protecting Student Athletes from Concussions Act 1115 Waivers Student and Student Athlete Opioid Misuse Prevention Act Personal Health Investment Today Act Promoting Physical Activity for Americans Act Establishment of an Office of Falls Prevention in the Administration on Aging H.R. 1310 States Handling Access to Reciprocity for Employment (SHARE) Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 3875/S. 2880 - Expanded Telehealth Access Act H.R. 4829 Physical Therapy Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R. 2217/S. 4519 - IDEA Act H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 7279 Reduce Duplicative Unnecessary Clerical Exchanges (REDUCE) Act H.R. 7623 Telehealth Modernization Act (TMA) H.R. 7307 Health Care Workforce Innovation Act H.R. 8151 to Expand eligible practitioners to furnish telehealth services H.R. 9179/S. 4556 to establish the Office of Falls Prevention of the Department of Veterans Affairs H.R. 10073 Medicare Patient Access and Practice Stabilization Act

Client expense: $289,585 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), White House Office

Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS Medicare compare website H.R. 35 - Close the Medigap Act of 2023 - Rep. Doggett, Lloyd - Medigap policies H.R. 3746 - Fiscal Responsibility Act of 2023 - Rep. McHenry, Patrick - work requirements for federal programs H.R. 3875 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 4411 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 4818 - Treat and Reduce Obesity Act of 2023 - Rep. Wenstrup, Brad -Medicare Coverage of weight loss treatment H.R. 5526 - Seniors' Access to Critical Medications Act of 2023 - Rep. Harshbarger, Diana - exception for physician self-referral H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - amends Medicaid Third Party liability requirements H.R. 5746 - Addressing Whole Health in Medicare Advantage Act - Rep. Bilirakis, Gus - Medicare Advantage supplemental benefits H.R. 5854 - Medicare Advantage Consumer Protection and Transparency Act - Rep. Porter, Katie - Medicare Advantage organization reporting H.R. 6364 - Medicare Telehealth Privacy Act of 2023 - Rep. Balderson, Troy - Provider privacy provisions for telehealth under Medicare H.R. 6400 - To amend title XVIII of the Social Security Act to extend eligibility for certain payment increases for biosimilar biological products under the Medicare program - Rep. Cardenas, Tony - Medicare payment increase for biosimilars H.R. 6445 - Medicare Audiology Access Improvement Act of 2023 - Rep. Bilirakis, Gus - Medicare Audiology Coverage H.R. 7147 - Medicare Transaction Fraud Prevention Act - Rep. Schweikert, David - oversight of payments for medical equipment & clinical DLTs under Medicare H.R. 7148 - Medicare Home Health Accessibility Act - Rep. Smucker, Lloyd - occupational therapy eligibility for home health coverage under Medicare H.R. 7254 - Hearing Device Coverage Clarification Act - Rep. Fischbach, Michelle - excludes fully implanted active middle ear hearing devices from the hearing aid coverage exclusion under Medicare H.R. 7274 - Connecting Caregivers to Medicare Act of 2024 - Rep. Carey, Mike - outreach, education, and simplify information for family caregivers on Medicare benefits H.R. 7432 - Sickle Cell Disease Comprehensive Care Act - Rep. Burgess, Michael - enables State Medicaid programs to provide coordinated care through health home to individuals with sickle cell disease H.R. 7512 - Real-Time Benefit Tool Implementation Act - Rep. Arrington, Jodey - implementation of real-time benefit tools under part D of under Medicare H.R. 7573 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - Medicaid Estate Recovery Program H.R. 7619 - Expand the Behavioral Health Workforce Now Act - Rep. Neguse, Joe - education, training, recruitment, and retention of mental health and substance use disorder providers under Medicaid and CHIP H.R. 7623 - Telehealth Modernization Act of 2024 - Rep. Carter, Earl L. Buddy - makes certain telehealth flexibilities permanent under Medicare and adds requirements for Part D plan contracts with PBMs including reporting and delinking provisions H.R. 7856 - Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies Act (PREVENT DIABETES Act)- Rep. DeGette, Diana - Medicare, coverage, preventive care, chronic care H.R. 7863 - To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program. - Rep. Steel, Michelle - Medicare, behavioral health, telehealth, accessibility H.R. 7939 - Patient Access to Innovative New Technologies Act of 2024 - Rep. Carey, Mike - Medicare, quality, medical devices, coverage H.R. 7996 - Improving CARE for Youth Act - Rep. Dunn, Neal - allows for same-day billing for mental health services for youth Medicaid beneficiaries who are being seen for a primary care service H.R. 8018 - Alleviating Barriers for Caregivers Act- Rep. Cammack, Kat - review and simplify caregiver paperwork, CHIP, Medicare, Medicaid H.R. 8064 - Help Extend Auditory Relief Act of 2024- Rep. Cartwright, Matt - Medicare coverage of hearing aids H.R. 8075 - Improving Access to Home Dialysis Act of 2024- Rep. Miller, Carol - Medicare coverage of home dialysis H.R. 8115 - To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid- Rep. Sarbanes, John - Medicaid managed care payment deferral H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act- Rep. Schweikert, David - extend flexibilities and payment for Medicare H.R. 8702 - Improving Seniors Timely Access to Care Act - Rep. Mike Kelly - prior authorization, transparency, MA S. 838 - Improving Access to Mental Health Act - Sen. Stabenow, Debbie - mental health services in Medicare S. 948 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - establishes programs and requirements to support maternal health services under Medicaid and CHIP S. 1002 - No UPCODE Act - Sen. Cassidy, Bill - modifies certain factors that are used to determine Medicare Advantage (MA) payments, particularly relating to health status and related data S. 2880 - Expanded Telehealth Access Act - Sen. Daines, Steve - Medicare payment for telehealth services S. 3573 - Medicare Advantage Supplemental Benefits Transparency Act- Sen. Warner, Mike - MA, data transparency, supplemental benefits S. 3578 - Protect Medicaid Act - Sen. Cassidy, Bill - prohibits federal payments under Medicaid for noncitizens, requires reporting to HHS of states that provide such health benefits S. 3630 - Medicare Transaction Fraud Prevention Act- Sen. Braun, Mike- pilot program for predictive risk-scoring algorithm, oversight, Medicare S. 3651 - Telemental Health Care Access Act of 2024- Sen. Cassidy, Bill - Medicare, mental health services, telehealth S. 3766 - Connecting Caregivers to Medicare Act of 2024- Sen. Tillis, Thomas - Medicare, outreach and education, caregivers S. 3882 - Helping States Integrate Medicare and Medicaid Act- Sen. Casey, Robert - dual eligibles, quality measures, access, enrollment S. 3934 - Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access S. 3950 - Delivering Unified Access to Lifesaving Services Act of 2024 - Sen. Cassidy, Bill - reforming Integrated Medicare/Medicaid Care Programs for Dually Eligible Individuals S. 4094 - PREVENT DIABETES Act - Sen. Scott, Tim - Medicare, coverage, preventive care, chronic care S. 4532 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - prior authorization, transparency, MA S. 4767 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - reduces fraudulent enrollments in qualified health plans Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicare Transparency in Coverage; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; Medicare Advantage Health Risk Assessment and chart reviews; Medicare Advantage supplemental benefits and Social Determinants of health; coverage of weight loss drugs; and Inflation Reduction Act implementation.

Client expense: $2,560,000 · Firm income: Not reported

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

HR 8260 Hospital Inpatient Services Modernization Act H.R. 8235 the Rural Physician Workforce Preservation Act H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act HR 3171/S. 3018 The Improving Seniors Timely Access to Care Act H.R. 1110, KEEP Telehealth Options Act of 2023 H.R. 3875, Expanded Telehealth Access Act H.R. 5541, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act H.R. 5611, Helping Ensure Access to Local TeleHealth (HEALTH) Act of 2023 H.R. 6033, Supporting Patient Education And Knowledge (SPEAK) Act of 2023 H.R. 7149, Equal Access to Specialty Care Everywhere (EASE) Act of 2024 H.R. 7623, The Telehealth Modernization Act of 2024 H.R. 7711, To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program H.R. 7858, Telehealth Enhancement for Mental Health Act of 2024 H.R. 7863, To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program H.R. 5386, Cutting Copays Act H.R. 5380, To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage H.R. 5372, Expanding Seniors Access to Lower Cost Medicines Act of 2023 S. 3059 the REAL Health Provider Act (Bennet, Tillis) S. 2973 Modernizing and Ensuring PBM Accountability Act H.R. 2880, the Protecting Patients Against PBM Abuses Act S.1002 - No UPCODE Act H.R. 3282, the Promoting Transparency and Healthy Competition in Medicare Act H.R. 3284, the Providers and Payers COMPETE Act H.R. 3237, To amend title XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department Legislation and regulation related to the Medicare Advantage program and Medicare/Medicaid coverage, care delivery and financing.

Client expense: $210,000 · Firm income: Not reported

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

H.R.5378, Lower Costs, More Transparency Act, Issues related to site neutral payment cuts, hospital price transparency, unique health identifier, 340B Program; H.R. 3173 / S. 4532, Improving Seniors' Timely Access to Care, all provisions; S.4350 / H.R. 8260, Hospital Inpatient Services Modernization Act of 2024, all provisions; Draft Bill, Issues pertaining to proposed changes to the Medicare Graduate Medical Education program and solutions to address workforce shortages in rural areas; S.4338, the Pay PCPs Act , Feedback to improve physician reimbursement and value-based primary care; S. 1110, the Rural Hospital Support Act, all provisions; H.R. 6430, Assistance for Rural Community Hospitals (ARCH)Act, all provisions; H.R. 7711, Advancing Access to Telehealth Act,all provisions; H.R. 3432, Telemental Health Care Access Act, all provisions; H.R. 3875, the Expanded Telehealth Access Act, all provisions; H.R. 5611, Helping Ensure Access to Local Telehealth (HEALTH) Act of 2023, all provisions; H.R. 6033, Supporting Patient Education and Knowledge (SPEAK) Act of 2023, all provisions; Draft Bill, To amend title XVIII of the Social Security Act to adjust long-term care hospital payment rates under the Medicare program, Issues related to LTCH payment policy reforms; S. 5236, A bill to amend titles XIX and XXI of the Social Security Act to enhance financial support for rural and safety net hospitals providing maternity, labor, and delivery services to vulnerable populations, and for other purposes, Reimbursements to rural and safety net hospitals providing maternity, labor, and delivery services; H.R. 7623, Telehealth Modernization Act, Issues pertaining to Telehealth, Hospital at Home, Unique Health Identifier; H. Jes Res 139 / S.J. Res 91, A joint resolution for congressional disapproval of a rule relating to "Medicare and Medicaid Programs, Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting", All provisions; S. 2016/ H.R. 4189, The CONNECT for Health Act of 2023, Specifically telehealth waivers, geographic restrictions, originating site requirements, in person requirement behavioral health, RHCs and FQHCs access; H.R. 1110, KEEP Telehealth Option Act, All provisions; H.R. 5541, the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, All provisions; HR 2389/ S. 1302, Resident Physician Shortage Reduction Act of 2023, All provisions; H.R. 977/S. 470, Patient Access to Higher Quality Care Act, all provisions; Draft Bill, Obstetric care in Critical Access Hospitals (CAH); Centers for Medicare & Medicaid Services (CMS), Medicare Drug Price Negotiation Program Draft Guidance, Issues pertaining to the implementation of the Medicare drug price negotiation program; Centers for Medicare & Medicaid Services (CMS), Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model, Issues pertaining to Value Based Care and feedback on proposed IOTA model; Centers for Medicare & Medicaid Services (CMS), FY 2025 Inpatient Prospective Payment Systems for Acute Care Hospitals; Disproportionate Share Hospital Payments, Issues pertaining to the FY2025 Inpatient Prospective Payment Systems Rule and Disproportionate Share Hospital Payments Changes in FY25 IPPS Rule; Medicare Payment Advisory Commission (MedPAC), 2025 Priorities, Issues pertaining to 340B Drug Pricing Program, inpatient rehabilitation facility (IRF) payments, the physician fee schedule (PFS) and telehealth in the new cycle; Centers for Medicare & Medicaid Services (CMS), Calendar Year (CY) 2025 Home Health Prospective; Payment System (HH PPS) Rate Update, Issues pertaining to the CY25 Home Health Proposed Rule; Centers for Medicare & Medicaid Services (CMS), Physician fee schedule (PFS) proposed rule for calendar year (CY) 2025, Issues pertaining to physician fee schedule; Centers for Medicare & Medicaid Services (CMS), Outpatient Prospective Payment System (OPPS) Proposed rule for Calendar Year (CY2025), Issues pertaining to outpatient and ambulatory surgery center prospective payment system, conditions of participation for maternal health; Health & Human Services (HHS), Letter to HHS, Medicare Advantage Organizations' Use of Prior Authorization for Post-Acute Care; Centers for Medicare & Medicaid Services (CMS), Significant, Anomalous and Highly Suspect (SAHS) billing in Medicare Shared Savings Program (MSSP) in Calendar Year 2023, Issues pertaining to proposed rule to mitigate the impact of significant, anomalous and highly suspect (SAHS) billing activity within the Medicare Shared Savings Program (MSSP) in calendar year (CY) 2023; Site Neutral Payments, Issues related to site neutral payment cuts for drug administration; Provider Reimbursements, Issues related to provider reimbursement, site neutral payment cuts, Medicare/Medicaid program funding, facility fees, DSH cuts; Medicaid Disproportionate Share Hospital (DSH) program, Medicaid DSH program; LTCH High Cost Outlier Threshold, SFC / W&M Meeting / CMS Meeting , Issues concerning High Cost Outlier in LTCH payment policy; National Provider Identifier (NPI), Included in E&C markup statement in September , Unique identifiers for off-campus Hospital Outpatient Departments (HOPDs); Access to inpatient rehabilitation care, Letter to CMS / Supported Hill Led Effort, Access to inpatient rehabilitation care for MA enrollees; Rural Hospitals, Issues pertaining to the sustainability of MDHS, CAHs, SCHs, and REHs; Physician Payments, Issues pertaining to proposed solutions to improve MACRA, alternative payment models, mental health of workforce; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay and cost-based reimbursement for critical access hospitals under Medicare Advantage.

Client expense: $5,450,000 · Firm income: Not reported

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

H.R. 5391/S. 2764, Protecting Patient Access to Cancer and Complex Therapies Act; Access and reimbursement of Part B Drugs in Medicare; Continued expansion of Telehealth services including in H.R. 3875/S. 3967, Expanded Telehealth Access Act and Telehealth Modernization Act; H.R. 3561, the Promoting Access to Treatments and Increasing Extremely Needed Transparency Act (PATIENT Act) of 2023; H.R. 4822, Health Care Price Transparency Act of 2023; Support for site neutrality policies in H.R. 5378, Lower Costs, More Transparency Act; Implementation of provisions included in Subtitle B of PL. 117-169 - Inflation Reduction Act of 2022; Issues related to MACRA Reform including H.R. 2474, Strengthening Medicare for Patients and Providers Act; Support the passage of H.R. 5526/S. 3458, the Seniors' Access to Critical Medications Act; H.R. 6683, Preserving Seniors Access to Physicians Act of 2023; Issues related to prior authorization in H.R. 8702/S. 4518, Improving Seniors Timely Access to Care Act of 2024

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.5391, S. 2764 - Protecting Patient Access to Cancer and Complex Therapies Act Access and reimbursement of Part B Drugs in Medicare. Continued expansion of Telehealth services including in H.R. 3875/S.3967 - Expanded Telehealth Access Act and H.R. 7623 - Telehealth Modernization Act of 2024. H.R. 3561, the Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023. H.R.4822 - Health Care Price Transparency Act of 2023 Support for site neutrality policies in H.R.5378 - Lower Costs, More Transparency Act Implementation of provisions included in Subtitle B of PL. 117-169 - Inflation Reduction Act of 2022. Issues related to MACRA Reform including HR 2474 - Strengthening Medicare for Patients and Providers Act. Support the passage of the Seniors' Access to Critical Medications Act (H.R. 5526, S. 3458) H.R.6683 - Preserving Seniors Access to Physicians Act of 2023 Issues related to prior authorization in H.R. 8702/S. 4518 - Improving Seniors' Timely Access to Care Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Access and reimbursement of Part B Drugs in Medicare. Continued expansion of Telehealth services including in the H.R. 3875 - Expanded Telehealth Access Act and H.R. 7623 - Telehealth Modernization Act of 2024. Support for site neutrality policies in H.R.5378 - Lower Costs, More Transparency Act Issues related to MACRA Reform including HR 2474 - Strengthening Medicare for Patients and Providers Act. H.R.5391, S. 2764 - Protecting Patient Access to Cancer and Complex Therapies Act Support the passage of the Seniors' Access to Critical Medications Act (H.R. 5526, S. 3458) H.R.6683 - Preserving Seniors Access to Physicians Act of 2023 Issues related to prior authorization in H.R. 8702/S. 4518 - Improving Seniors' Timely Access to Care Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Continued access to occupational therapy services including in the Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act. Continued expansion of telehealth services in H.R. 3875, S.2880 - Expanded Telehealth Access Act H.R. 7623 - the Telehealth Modernization Act, H.R.8261 - Preserving Telehealth, Hospital, and Ambulance Access Act and S. 2016 - CONNECT for Health Act of 2023. Support of H.R.2474 - Strengthening Medicare for Patients and Providers Act. Issues related to MACRA reform. H.R. 4878, the EMPOWER Act, S.2459 - Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation Act H.R.7148 - Medicare Home Health Accessibility Act H.R.8261 - Preserving Telehealth, Hospital, and Ambulance Access Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.2016/H.R. 4189 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; S.3967/H.R. 7263 Telehealth Modernization Act of 2024; S.3651/H.R. 3432 Telehealth Health Care Access Act; S.2880/H.R. 3875 Expanded Telehealth Access Act; H.R. 5541 Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act; S.1001/H.R.1843 - Telehealth Expansion Act of 2023; H.R.1310 - SHARE Act; S.3651/H.R.3432 - Telemental Health Care Access Act of 2023

Client expense: Not reported · Firm income: $200,000

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

S.2016/H.R. 4189 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; S.3967/H.R. 7263 Telehealth Modernization Act of 2024; S.3651/H.R. 3432 Telehealth Health Care Access Act; S.2880/H.R. 3875 Expanded Telehealth Access Act; H.R. 5541 Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act; S.1001/H.R.1843 - Telehealth Expansion Act of 2023; H.R.1310 - SHARE Act; S.3651/H.R.3432 - Telemental Health Care Access Act of 2023

Client expense: Not reported · Firm income: $200,000

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

Minimum Staffing Standards for Long-Term Care Facilities Protecting Rural Seniors Access to Care Act (H.R. 5796/ S. 3490) Physician Fee Schedule Long-term Reform Strengthening Medicare for Patients and Providers Act (H.R. 2474) Ensuring Seniors' Access to Quality Care Act (H.R. 3227/S. 1749) Fee schedule conversion factor tied to inflation Eliminate the budget neutrality requirement Obtain an impact study of the 15% therapy assistant cut on rural and medically underserved areas; mitigate the 15% differential implemented in 2022 Follow and support efforts with respect to the CMS-identified potentially misvalued therapy CPT codes Elimination of Multiple Procedure Payment Reduction (MPPR) Reduced administrative burden through streamlined plan-of-care certifications Changes to the MIPS Quality Payment Program to allow all therapy providers to be eligible for the Quality Payments Program Skilled Nursing Facility Prospective Payment System Clinical Laboratory Fee Schedule Saving Access to Laboratory Services (SALSA) Act ( H.R. 2377 / S. 1000) Home Health Prospective Payment System Medicare Home Health Accessibility Act (H.R. 7148) Expanding Care in the Home Act (H.R. 2853) Medicare Advantage and Merit-based Incentive Payment System (MIPS) Reform Observation Stay Requirements Improving Access to Medicare Coverage Act of 2024 (H.R. 5138) Rehabilitation Therapy Outpatient Supervision Requirements Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation (EMPOWER) Act (H.R. 4878/S. 2459) Teletherapy/Telerehab Patient Access Expanded Telehealth Access Act (H.R. 3875/ S. 2880) Telehealth Modernization Act of 2024 (H.R. 7623/ S. 3967) Rehabilitation Therapy CPT Codes on Permanent Telehealth List Portable X-ray Transportation Payment Issues

Client expense: $81,111 · Firm income: Not reported

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

Minimum Staffing Standards for Long-Term Care Facilities Protecting Rural Seniors Access to Care Act (H.R. 5796/ S. 3490) Physician Fee Schedule Long-term Reform Strengthening Medicare for Patients and Providers Act (H.R. 2474) Ensuring Seniors' Access to Quality Care Act (H.R. 3227/S. 1749) Fee schedule conversion factor tied to inflation Eliminate the budget neutrality requirement Obtain an impact study of the 15% therapy assistant cut on rural and medically underserved areas; mitigate the 15% differential implemented in 2022 Follow and support efforts with respect to the CMS-identified potentially misvalued therapy CPT codes Elimination of Multiple Procedure Payment Reduction (MPPR) Reduced administrative burden through streamlined plan-of-care certifications Changes to the MIPS Quality Payment Program to allow all therapy providers to be eligible for the Quality Payments Program Skilled Nursing Facility Prospective Payment System Clinical Laboratory Fee Schedule Saving Access to Laboratory Services (SALSA) Act ( H.R. 2377 / S. 1000) Home Health Prospective Payment System Medicare Home Health Accessibility Act (H.R. 7148) Expanding Care in the Home Act (H.R. 2853) Medicare Advantage and Merit-based Incentive Payment System (MIPS) Reform Observation Stay Requirements Improving Access to Medicare Coverage Act of 2024 (H.R. 5138) Rehabilitation Therapy Outpatient Supervision Requirements Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation (EMPOWER) Act (H.R. 4878/S. 2459) Teletherapy/Telerehab Patient Access Expanded Telehealth Access Act (H.R. 3875/ S. 2880) Telehealth Modernization Act of 2024 (H.R. 7623/ S. 3967) Rehabilitation Therapy CPT Codes on Permanent Telehealth List Portable X-ray Transportation Payment Issues

Client expense: $81,111 · Firm income: Not reported

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

H.R. 4189/S.2016, CONNECT for Health Act of 2023 H.R. 4093, Remote Opioid Monitoring Act of 2023 H.R. 824, Telehealth Benefit Expansion for Workers Act of 2023 H.R.1843/S.1001, Telehealth Expansion Act of 2023 H.R. 3875, Expanded Telehealth Access Act H.R. 1458/S. 723, Access to Prescription Digital Therapeutics Act of 2023 H.R. 7623, Telehealth Modernization Act of 2024 H.R. 7856, PREVENT DIABETES Act S. 4094, PREVENT DIABETES Act General issues related to federal regulation of health technology - artificial intelligence, digital therapeutics

Client expense: $1,110,000 · Firm income: Not reported

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

Issues related to Medicare coverage of audiology services and the Medicare Audiology Access Improvement Act (H.R. 6445/S. 2377) Issues related to the provision of audiology and speech-language pathology services through telepractice, including the Expanded Telehealth Access Act (H.R. 3875/S. 2880), the CONNECT for Health Act (H.R. 4189/S. 2016) and the Telehealth Modernization Act (H.R. 7623). Issues related to Medicare Part B reimbursement of audiology and speech-language pathology services, including H.R. 2474, the Strengthening Medicare for Patients and Providers Act, H.R. 2474, H.R. 6545, the Physician Fee Schedule Update and Improvements Act, and S. 4935, the Physician Fee Schedule Stabilization Act Various issues related to CMS Actions surrounding: oAudits of medical records and claims for Part A and B services oProcedure code development and valuation of audiology and speech-language pathology services oQuality reporting under MIPS oImplementation of the IMPACT Act oMedicare physician fee schedule oProspective payments systems, including home health and skilled nursing facility policy and payment issues oAccountable Care Organizations oFederally-facilitated marketplace oMedicare Advantage oVarious issues related to interoperable health information, including the post-acute care interoperability project (PACIO) oMedicare telehealth coverage under Part A and B oImplementation of CARES Act (P.L. 116-136) oProvision and payment for Part A therapy oVarious issues related to implementation of ACA oIssues related to Medicare beneficiaries accessing services provided by audiologists without a physician order Issues related to the Center for Medicare and Medicaid Innovation (CMMI) actions related to value-based care The Long-Term Care Workforce Support Act (H.R. 7994/S. 4120) Issues related to the Medicaid program, including Medicaid and Medicaid managed care access, the Early and Periodic Screening, Diagnosis, and Treatment benefit, and school-based billing. Improving Seniors Timely Access to Care Act (H.R. 8702/S. 4532)

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

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

Preserving Seniors Access to Physicians Act of 2023 (H.R. 6683); Medicare Payment Reform; Prevent Interruptions in Physical Therapy Act (H.R.1617/S. 793); Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act (H.R. 7279); Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation (EMPOWER) Act (H.R. 4878/S. 2459); Expanded Telehealth Act (H.R. 3875/S. 2880); Telehealth Modernization Act (H.R. 7623 / S. 3967); Stopping Addiction and Falls for the Elderly (SAFE) Act (H.R. 7618); Medicare Opt-Out; Improving Seniors Timely Access to Care Act (H.R. 8702 / S. 4532); Strengthening Medicare for Patients and Providers Act (H.R. 2474); The Provider Reimbursement Stability Act (H.R. 6371); Physician Fee Stabilization Act (S. 4935).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act Implementation/Expansion of CDC Falls Program Physician self-referral/Stark Law 21st Century Cures Act Health Information Technology Medicaid Expansion MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Opioid Epidemic/Pain Management DOL/OSHA Nominations to NQF committees Primary Care Administrative Burden/Prior Authorizations 1332 Empowerment Waivers Affordable Care Act Primary Health Services Enhancement Act Protecting Student Athletes from Concussions Act 1115 Waivers Student and Student Athlete Opioid Misuse Prevention Act Personal Health Investment Today Act Promoting Physical Activity for Americans Act Establishment of an Office of Falls Prevention in the Administration on Aging H.R. 1310 States Handling Access to Reciprocity for Employment (SHARE) Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 3875/S. 2880 - Expanded Telehealth Access Act H.R. 4829 Physical Therapy Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R. 2217/S. 4519 - IDEA Act H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 7279 Reduce Duplicative Unnecessary Clerical Exchanges (REDUCE) Act H.R. 7623 Telehealth Modernization Act (TMA) H.R. 7307 Health Care Workforce Innovation Act H.R. 8151 to Expand eligible practitioners to furnish telehealth services H.R. 9179/S. 4556 to establish the Office of Falls Prevention of the Department of Veterans Affairs

Client expense: $240,412 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), White House Office

Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Medicare Orthotics and Prosthetics Patient-Centered Care Act Medicare Private Contracting Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act Improving Seniors Timely Access to Care Act Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule Support Medicare Providers Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 4878/S. 2459 - EMPOWER Act (PTA/OTA Supervision) H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act H.R. 3875/S. 2880 Expanded Telehealth Access Act H.R. 4829 Physical Therapist Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R. 2217/S. 4519 - IDEA Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 7279 Reduce Duplicative Unnecessary Clerical Exchanges (REDUCE) Act H.R. 7623 Telehealth Modernization Act (TMA) H.R. 8151 to Expand eligible practitioners to furnish telehealth services

Client expense: $240,412 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

Issues surrounding Medicare reimbursement and coverage denials (H.R.4315/S.3977) Medicare Orthotics and Prosthetics Patient-Centered Care Act (H.R.2474) Strengthening Medicare for Patients and Providers Act (H.R.3875) Expanded Telehealth Access Act Implementation of Healthcare Common Procedure Coding Systems add-on code G2211 (H.R. 7279) Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act Issues surrounding local coverage determination and Contractor Advisory Committee processes (H.R. 7623) Telehealth Modernization Act of 2024 Issues surrounding 2025 conversion factor and Medicare reimbursement reform

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

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

H.R. 5378 - Lower Costs, More Transparency Act S. 3967/H.R. 7263 - Telehealth Modernization Act of 2024 S. 1001/H.R. 1843 - Telehealth Expansion Act of 2023 S. 2880/H.R. 3875 - Expanded Telehealth Access Act

Client expense: $310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE

HR 4315/S3977 - Medicare Orthotics & Prosthetics Patient Centered Care Act: Advocate for passage to stop fraud in the provision of orthotics and prosthetics and to ensure access to needed orthotic devices. HR 4878/S 2459 - EMPOWER Act: Advocate for passage of EMPOWER Act, which would change the Medicare supervision requirement for occupational therapy assistants (OTAs) and physical therapist assistants (PTAs) in private practice from "direct" supervision to match state standards and require GAO student of impact of 15% reimbursement cut for OTAs and PTAs in rural and medically underserved areas. H.R. 2474 - Strengthen Medicare for Patients and Providers Act: Support passage. No bill number - Advocate for introduction of legislation allowing occupational therapy practitioners to opt-out of Medicare. No bill number - Support legislation that will reverse the current Medicare multiple procedure payment reduction for therapy services. No bill number Support legislation that will improve the ability of therapy providers to participate in Medicare quality payment programs. HR 3875/S 2880 - Expanded Telehealth Access Act: Advocate for passage in the House and Senate to establish occupational therapists as telehealth providers in Medicare. H.R.7623/S.3967 - Telehealth Modernization Act: Advocated for passage of bill that would among other things establish occupational therapists as telehealth providers in Medicare. S. 2016 and HR 4189 - CONNECT for Health Act: Advocate to revise provisions of legislation to specifically establish occupational therapists as telehealth providers in Medicare. H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act: Advocate for passage of bill that would extend waivers allowing OTs to provide services via telehealth in Medicare. H.R.8151 - Telehealth Therapy Act: Advocate for passage of bill that would allow OTs to provide services via telehealth in Medicare on a permanent basis. H.R.7148 - Medicare Home Health Accessibility Act: Advocate for passage of legislation that would establish occupational therapy as a qualifying Medicare home health service and for introduction of similar bill in the Senate. S. 1592/H.R.8220 - Occupational Therapy in Mental Health Parity Act: Support passage. S. 2942 WELL Seniors Act - support passage H.R. 6371 Provider Reimbursement Stability Act - support passage H.R. 6545 Physician Fee Schedule Update and Improvements Act - support passage H.R. 6683 Preserving Seniors Access to Physicians Act - support passage S. 3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act - support passage S. 2433/S. 3106/H.R. 4079 Substance-Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act - support passage H.R.7279 REDUCE Act: Supported introduction and passage. H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act: Supported introduction and passage. S. 5023 support Stand Strong Falls Prevention Act Support Congressional efforts to stop cuts to the Medicare Physician Fee Schedule Support inclusion of a repeal of the Multiple Procedure payment reduction in Medicare Fee Schedule Reform

Client expense: $189,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Minimum Staffing Standards for Long-Term Care Facilities Protecting Rural Seniors Access to Care Act (H.R. 5796/ S. 3490) Physician Fee Schedule Long-term Reform Strengthening Medicare for Patients and Providers Act (H.R. 2474) Ensuring Seniors' Access to Quality Care Act (H.R. 3227/S. 1749) Fee schedule conversion factor tied to inflation Eliminate the budget neutrality requirement Obtain an impact study of the 15% therapy assistant cut on rural and medically underserved areas; mitigate the 15% differential implemented in 2022 Follow and support efforts with respect to the CMS-identified potentially misvalued therapy CPT codes Elimination of Multiple Procedure Payment Reduction (MPPR) Reduced administrative burden through streamlined plan-of-care certifications Changes to the MIPS Quality Payment Program to allow all therapy providers to be eligible for the Quality Payments Program Skilled Nursing Facility Prospective Payment System Clinical Laboratory Fee Schedule Saving Access to Laboratory Services (SALSA) Act ( H.R. 2377 / S. 1000) Home Health Prospective Payment System Medicare Home Health Accessibility Act (H.R. 7148) Expanding Care in the Home Act (H.R. 2853) Medicare Advantage and Merit-based Incentive Payment System (MIPS) Reform Observation Stay Requirements Improving Access to Medicare Coverage Act of 2024 (H.R. 5138) Rehabilitation Therapy Outpatient Supervision Requirements Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation (EMPOWER) Act (H.R. 4878/S. 2459) Teletherapy/Telerehab Patient Access Expanded Telehealth Access Act (H.R. 3875/ S. 2880) Telehealth Modernization Act of 2024 (H.R. 7623/ S. 3967) Rehabilitation Therapy CPT Codes on Permanent Telehealth List Portable X-ray Transportation Payment Issues

Client expense: $81,111 · Firm income: Not reported

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

H.R. 7513, Protecting America's Seniors Access to Care Act, all provisions; H.R. 468, Building Americas Health Care Workforce Act, all provisions; H.R. 8113, Transparency into State Directed Payments Act of 2024, all provisions; H.R. 8115, To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid, all provisions; H.R. 1110, KEEP Telehealth Option Act, all provisions; H.R. 7711, Advancing Access to Telehealth Act, all provisions; H.R. 3432, Telemental Health Care Access Act, all provisions; H.R. 3875, the Expanded Telehealth Access Act, all provisions; H.R. 5611, Helping Ensure Access to Local Telehealth (HEALTH) Act of 2023, all provisions; H.R. 6033, Patient Education and Knowledge (SPEAK) Act of 2023, all provisions; H.R. 5541, the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions; H.R. 7863, To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program, all provisions; H.R. 134, To amend title XVIII of the Social Security Act to remove geographic requirements and expand originating sites for telehealth services, all provisions; H.R. 8261, The Preserving Telehealth, Hospital, and Ambulance Access Act, Issues pertaining to Telehealth, Hospital at Home, and MDH-LVA; S.4350 / H.R. 8260, Hospital Inpatient Services, Modernization Act of 2024, all provisions; H.R. 8235, Rural Physician Workforce Preservation Act, all provisions; S. 2016/ H.R. 4189, The CONNECT for Health Act of 2023, Specifically telehealth waivers, geographic restrictions, originating site requirements, in person requirement behavioral health, RHCs and FQHCs access; S. 1110, the Rural Hospital Support Act, all provisions; S. 1673 / H.R. 1666, Protecting Access to Ground Ambulance Medical Services Act of 2023, all provisions; H.R. 6430, Assistance for Rural Community Hospitals (ARCH)Act, all provisions; S. 803, Save Rural Hospitals Act, all provisions; H.R. 4968, GOLD Card Act of 2023, all provisions; H.R. 3173 / S. 4532, Improving Seniors' Timely Access to Care, all provisions; H.R. 5013/S. 3503, Value in Health Care Act, all provisions; HR 2389/ S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions; Draft Bill, Graduate Medical Education Bill, Issues pertaining to proposed changes to the Medicare Graduate Medical Education program and solutions to address workforce shortages in rural areas; H.J.Res. 139 / S.J. Res 91, A joint resolution for congressional disapproval of a rule relating to "Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting", all provisions; HR 1565, Critical Access Hospital Relief Act of 2023, all provisions; H.R. 7623, Telehealth Modernization Act, Issues pertaining to Telehealth, Hospital at Home, Unique Health Identifier; H.R.1128, Rural Health Care Access Act of 2023, all provisions; S.1571, Rural Hospital Closure Relief Act of 2023, all provisions; S. 470 / H.R. 977, The Patient Access to Higher Quality Health Care Act, all provisions; Draft Bill, Keeping Obstetrics Local Act, all provisions;H.R.5378, Lower Costs, More Transparency Act, Issues related to site neutral payment cuts, hospital price transparency, unique health identifier, 340B Program; Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule for the inpatient psychiatric facility (IPF) prospective payment system (PPS), Issues pertaining to payment policy proposals for inpatient psychiatric facilities (IPFs); Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule for skilled nursing facility prospective payment system , Issues pertaining to payment policy proposals for skilled nursing facilities (SNFs); Centers for Medicare & Medicaid Services (CMS)FY25 proposed rule for inpatient rehabilitation facility prospective payment system, Issues pertaining to payment policy proposals for inpatient rehabilitation facilities (IRFs); Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule Hospital Inpatient Prospective Payment Systems , Issues pertaining to payment policy proposals for acute-care hospitals; Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule Long-Term Care Hospital Prospective Payment System, Issues pertaining to payment policy proposals for long term acute-care hospitals; Centers for Medicare & Medicaid Services (CMS), Transforming Episode Accountability Model (TEAM), Deadline expansion and proposed mandatory alternative payment model; Centers for Medicare & Medicaid Services (CMS), Medicare Advantage Data RFI, Issues pertaining to enforcement and accountability of MA plans, prompt payment, gold carding, Standarization, penalties, and plan oversight; Centers for Medicare & Medicaid Services (CMS); Anomalous DME Spending in MSSP, accountable care models; Centers for Medicare & Medicaid Services (CMS), Accrediting Organizations (AO's), Feedback to strengthen accrediting organizations oversight; Provider Reimbursements, Issues related to provider reimbursement, site neutral payment cuts, Medicare/Medicaid program funding, facility fees; Site Neutral Payments, for Q2 2024, Issues related to site neutral payment cuts for drug administration; Valued Based Care, for Q2 2024, Specifically on alternative payment models, MACRA reform, feedback on proposed TEAM model; Rural Hospitals, Issues pertaining to the sustainability of MDHS, CAHs, SCHs, and REHs; Physician Payments, Issues pertaining to proposed solutions to improve MACRA, alternative payment models, mental health of workforce; LTCH High Cost Outlier Threshold, Issues concerning High Cost Outlier in LTCH payment policy; Organ Transplant Model, Issues pertaining to Value Based Care; Rural Health Clinic Payments, Issues related to increasing payments for rural health clinics; Chronic Care Management, Issues pertaining to chronic care management for Medicare beneficiaries.

Client expense: $6,080,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Natl Drug Control Policy (NDCP), SENATE, White House Office

Draft, Broker Accountability Act (no bill number) - ACA Agent/Broker accountability H.R. 35 - Close the Medigap Act of 2023 - Rep. Doggett, Lloyd - Medigap policies H.R. 3746 - Fiscal Responsibility Act of 2023 - Rep. McHenry, Patrick - work requirements for federal programs H.R. 3875 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 4411 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 4818 - Treat and Reduce Obesity Act of 2023 - Rep. Wenstrup, Brad -Medicare Coverage of weight loss treatment H.R. 5526 - Seniors' Access to Critical Medications Act of 2023 - Rep. Harshbarger, Diana - exception for physician self-referral H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - amends Medicaid Third Party liability requirements H.R. 5746 - Addressing Whole Health in Medicare Advantage Act - Rep. Bilirakis, Gus - Medicare Advantage supplemental benefits H.R. 5854 - Medicare Advantage Consumer Protection and Transparency Act - Rep. Porter, Katie - Medicare Advantage organization reporting H.R. 6364 - Medicare Telehealth Privacy Act of 2023 - Rep. Balderson, Troy - Provider privacy provisions for telehealth under Medicare H.R. 6400 - To amend title XVIII of the Social Security Act to extend eligibility for certain payment increases for biosimilar biological products under the Medicare program - Rep. Cardenas, Tony - Medicare payment increase for biosimilars H.R. 6445 - Medicare Audiology Access Improvement Act of 2023 - Rep. Bilirakis, Gus - Medicare Audiology Coverage H.R. 7147 - Medicare Transaction Fraud Prevention Act - Rep. Schweikert, David - oversight of payments for medical equipment & clinical DLTs under Medicare H.R. 7148 - Medicare Home Health Accessibility Act - Rep. Smucker, Lloyd - occupational therapy eligibility for home health coverage under Medicare H.R. 7254 - Hearing Device Coverage Clarification Act - Rep. Fischbach, Michelle - excludes fully implanted active middle ear hearing devices from the hearing aid coverage exclusion under Medicare H.R. 7274 - Connecting Caregivers to Medicare Act of 2024 - Rep. Carey, Mike - outreach, education, and simplify information for family caregivers on Medicare benefits H.R. 7432 - Sickle Cell Disease Comprehensive Care Act - Rep. Burgess, Michael - enables State Medicaid programs to provide coordinated care through health home to individuals with sickle cell disease H.R. 7512 - Real-Time Benefit Tool Implementation Act - Rep. Arrington, Jodey - implementation of real-time benefit tools under part D of under Medicare H.R. 7573 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - Medicaid Estate Recovery Program H.R. 7619 - Expand the Behavioral Health Workforce Now Act - Rep. Neguse, Joe - education, training, recruitment, and retention of mental health and substance use disorder providers under Medicaid and CHIP H.R. 7623 - Telehealth Modernization Act of 2024 - Rep. Carter, Earl L. Buddy - makes certain telehealth flexibilities permanent under Medicare H.R. 7856 - Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies Act (PREVENT DIABETES Act)- Rep. DeGette, Diana - Medicare, coverage, preventive care, chronic care H.R. 7863 - To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program. - Rep. Steel, Michelle - Medicare, behavioral health, telehealth, accessibility H.R. 7939 - Patient Access to Innovative New Technologies Act of 2024 - Rep. Carey, Mike - Medicare, quality, medical devices, coverage H.R. 8018 - Alleviating Barriers for Caregivers Act- Rep. Cammack, Kat - review and simplify caregiver paperwork, CHIP, Medicare, Medicaid H.R. 8064 - Help Extend Auditory Relief Act of 2024- Rep. Cartwright, Matt - Medicare coverage of hearing aids H.R. 8075 - Improving Access to Home Dialysis Act of 2024- Rep. Miller, Carol - Medicare coverage of home dialysis H.R. 8115 - To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid- Rep. Sarbanes, John - Medicaid managed care payment deferral H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act- Rep. Schweikert, David - extend flexibilities and payment for Medicare H.R. 8702 - Improving Seniors Timely Access to Care Act - Rep. Mike Kelly - prior authorization, transparency, MA S. 838 - Improving Access to Mental Health Act - Sen. Stabenow, Debbie - mental health services in Medicare S. 2880 - Expanded Telehealth Access Act - Sen. Daines, Steve - Medicare payment for telehealth services S. 3573 - Medicare Advantage Supplemental Benefits Transparency Act- Sen. Warner, Mike - MA, data transparency, supplemental benefits S. 3578 - Protect Medicaid Act - Sen. Cassidy, Bill - prohibits federal payments under Medicaid for noncitizens, requires reporting to HHS of states that provide such health benefits S. 3630 - Medicare Transaction Fraud Prevention Act- Sen. Braun, Mike- pilot program for predictive risk-scoring algorithm, oversight, Medicare S. 3651 - Telemental Health Care Access Act of 2024- Sen. Cassidy, Bill - Medicare, mental health services, telehealth S. 3766 - Connecting Caregivers to Medicare Act of 2024- Sen. Tillis, Thomas - Medicare, outreach and education, caregivers S. 3882 - Helping States Integrate Medicare and Medicaid Act- Sen. Casey, Robert - dual eligibles, quality measures, access, enrollment S. 3934 - Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access S. 3950 - Delivering Unified Access to Lifesaving Services Act of 2024 - Sen. Cassidy, Bill - reforming Integrated Medicare/Medicaid Care Programs for Dually Eligible Individuals S. 4094 - PREVENT DIABETES Act - Sen. Scott, Tim - Medicare, coverage, preventive care, chronic care S. 4532 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - prior authorization, transparency, MA Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicaid Access Final Rule; Medicaid Redeterminations; value of Medicaid Managed Care; Medicare Advantage Health Risk Assessment; coverage of weight loss drugs; and Inflation Reduction Act implementation.

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

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

S.2016/H.R. 4189 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; S.3967/H.R. 7263 Telehealth Modernization Act of 2024; S.3651/H.R. 3432 Telehealth Health Care Access Act; S.2880/H.R. 3875 Expanded Telehealth Access Act; H.R. 5541 Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act; S.1001/H.R.1843 - Telehealth Expansion Act of 2023; H.R.1310 - SHARE Act; S.3651/H.R.3432 - Telemental Health Care Access Act of 2023

Client expense: Not reported · Firm income: $200,000

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

S.2016/H.R. 4189 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023; S.3967/H.R. 7263 Telehealth Modernization Act of 2024; S.3651/H.R. 3432 Telehealth Health Care Access Act; S.2880/H.R. 3875 Expanded Telehealth Access Act; H.R. 5541 Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act; S.1001/H.R.1843 - Telehealth Expansion Act of 2023; H.R.1310 - SHARE Act; S.3651/H.R.3432 - Telemental Health Care Access Act of 2023

Client expense: Not reported · Firm income: $200,000

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

H.R. 7513, Protecting America's Seniors Access to Care Act, all provisions; H.R. 468, Building Americas Health Care Workforce Act, all provisions; H.R. 8113, Transparency into State Directed Payments Act of 2024, all provisions; H.R. 8115, To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid, all provisions; H.R. 1110, KEEP Telehealth Option Act, all provisions; H.R. 7711, Advancing Access to Telehealth Act, all provisions; H.R. 3432, Telemental Health Care Access Act, all provisions; H.R. 3875, the Expanded Telehealth Access Act, all provisions; H.R. 5611, Helping Ensure Access to Local Telehealth (HEALTH) Act of 2023, all provisions; H.R. 6033, Patient Education and Knowledge (SPEAK) Act of 2023, all provisions; H.R. 5541, the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions; H.R. 7863, To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program, all provisions; H.R. 134, To amend title XVIII of the Social Security Act to remove geographic requirements and expand originating sites for telehealth services, all provisions; H.R. 8261, The Preserving Telehealth, Hospital, and Ambulance Access Act, Issues pertaining to Telehealth, Hospital at Home, and MDH-LVA; S.4350 / H.R. 8260, Hospital Inpatient Services, Modernization Act of 2024, all provisions; H.R. 8235, Rural Physician Workforce Preservation Act, all provisions; S. 2016/ H.R. 4189, The CONNECT for Health Act of 2023, Specifically telehealth waivers, geographic restrictions, originating site requirements, in person requirement behavioral health, RHCs and FQHCs access; S. 1110, the Rural Hospital Support Act, all provisions; S. 1673 / H.R. 1666, Protecting Access to Ground Ambulance Medical Services Act of 2023, all provisions; H.R. 6430, Assistance for Rural Community Hospitals (ARCH)Act, all provisions; S. 803, Save Rural Hospitals Act, all provisions; H.R. 4968, GOLD Card Act of 2023, all provisions; H.R. 3173 / S. 4532, Improving Seniors' Timely Access to Care, all provisions; H.R. 5013/S. 3503, Value in Health Care Act, all provisions; HR 2389/ S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions; Draft Bill, Graduate Medical Education Bill, Issues pertaining to proposed changes to the Medicare Graduate Medical Education program and solutions to address workforce shortages in rural areas; H.J.Res. 139 / S.J. Res 91, A joint resolution for congressional disapproval of a rule relating to "Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting", all provisions; HR 1565, Critical Access Hospital Relief Act of 2023, all provisions; H.R. 7623, Telehealth Modernization Act, Issues pertaining to Telehealth, Hospital at Home, Unique Health Identifier; H.R.1128, Rural Health Care Access Act of 2023, all provisions; S.1571, Rural Hospital Closure Relief Act of 2023, all provisions; S. 470 / H.R. 977, The Patient Access to Higher Quality Health Care Act, all provisions; Draft Bill, Keeping Obstetrics Local Act, all provisions;H.R.5378, Lower Costs, More Transparency Act, Issues related to site neutral payment cuts, hospital price transparency, unique health identifier, 340B Program; Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule for the inpatient psychiatric facility (IPF) prospective payment system (PPS), Issues pertaining to payment policy proposals for inpatient psychiatric facilities (IPFs); Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule for skilled nursing facility prospective payment system , Issues pertaining to payment policy proposals for skilled nursing facilities (SNFs); Centers for Medicare & Medicaid Services (CMS)FY25 proposed rule for inpatient rehabilitation facility prospective payment system, Issues pertaining to payment policy proposals for inpatient rehabilitation facilities (IRFs); Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule Hospital Inpatient Prospective Payment Systems , Issues pertaining to payment policy proposals for acute-care hospitals; Centers for Medicare & Medicaid Services (CMS), FY25 proposed rule Long-Term Care Hospital Prospective Payment System, Issues pertaining to payment policy proposals for long term acute-care hospitals; Centers for Medicare & Medicaid Services (CMS), Transforming Episode Accountability Model (TEAM), Deadline expansion and proposed mandatory alternative payment model; Centers for Medicare & Medicaid Services (CMS), Medicare Advantage Data RFI, Issues pertaining to enforcement and accountability of MA plans, prompt payment, gold carding, Standarization, penalties, and plan oversight; Centers for Medicare & Medicaid Services (CMS); Anomalous DME Spending in MSSP, accountable care models; Centers for Medicare & Medicaid Services (CMS), Accrediting Organizations (AO's), Feedback to strengthen accrediting organizations oversight; Provider Reimbursements, Issues related to provider reimbursement, site neutral payment cuts, Medicare/Medicaid program funding, facility fees; Site Neutral Payments, for Q2 2024, Issues related to site neutral payment cuts for drug administration; Valued Based Care, for Q2 2024, Specifically on alternative payment models, MACRA reform, feedback on proposed TEAM model; Rural Hospitals, Issues pertaining to the sustainability of MDHS, CAHs, SCHs, and REHs; Physician Payments, Issues pertaining to proposed solutions to improve MACRA, alternative payment models, mental health of workforce; LTCH High Cost Outlier Threshold, Issues concerning High Cost Outlier in LTCH payment policy; Organ Transplant Model, Issues pertaining to Value Based Care; Rural Health Clinic Payments, Issues related to increasing payments for rural health clinics; Chronic Care Management, Issues pertaining to chronic care management for Medicare beneficiaries.

Client expense: $9,080,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Natl Drug Control Policy (NDCP), SENATE, White House Office

H.R. 8235 the Rural Physician Workforce Preservation Act H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act HR 3171/S. 3018 The Improving Seniors Timely Access to Care Act H.R. 1110, KEEP Telehealth Options Act of 2023 H.R. 3875, Expanded Telehealth Access Act H.R. 5541, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act H.R. 5611, Helping Ensure Access to Local TeleHealth (HEALTH) Act of 2023 H.R. 6033, Supporting Patient Education And Knowledge (SPEAK) Act of 2023 H.R. 7149, Equal Access to Specialty Care Everywhere (EASE) Act of 2024 H.R. 7623, The Telehealth Modernization Act of 2024 H.R. 7711, To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program H.R. 7858, Telehealth Enhancement for Mental Health Act of 2024 H.R. 7863, To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program H.R. 5386, Cutting Copays Act H.R. 5380, To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage H.R. 5372, Expanding Seniors Access to Lower Cost Medicines Act of 2023 S. 3059 the REAL Health Provider Act (Bennet, Tillis) S. 2973 Modernizing and Ensuring PBM Accountability Act H.R. 2880, the Protecting Patients Against PBM Abuses Act S.1002 - No UPCODE Act H.R. 3282, the Promoting Transparency and Healthy Competition in Medicare Act H.R. 3284, the Providers and Payers COMPETE Act H.R. 3237, To amend title XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department Legislation and regulation related to the Medicare Advantage program and Medicare/Medicaid coverage, care delivery and financing.

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

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

H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act Implementation/Expansion of CDC Falls Program Physician self-referral/Stark Law 21st Century Cures Act Health Information Technology Medicaid Expansion MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Opioid Epidemic/Pain Management DOL/OSHA Nominations to NQF committees Primary Care Administrative Burden/Prior Authorizations 1332 Empowerment Waivers Affordable Care Act Primary Health Services Enhancement Act Protecting Student Athletes from Concussions Act 1115 Waivers Student and Student Athlete Opioid Misuse Prevention Act Personal Health Investment Today Act Promoting Physical Activity for Americans Act Establishment of an Office of Falls Prevention in the Administration on Aging H.R. 1310 States Handling Access to Reciprocity for Employment (SHARE) Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 3875/S. 2880 - Expanded Telehealth Access Act H.R. 4829 Physical Therapy Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R. 2217/S. 4519 - IDEA Act H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 7279 Reduce Duplicative Unnecessary Clerical Exchanges (REDUCE) Act H.R. 7623 Telehealth Modernization Act (TMA) H.R. 7307 Health Care Workforce Innovation Act H.R. 8151 to Expand eligible practitioners to furnish telehealth services S. 4556 to establish the Office of Falls Prevention of the Department of Veterans Affairs

Client expense: $238,054 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), White House Office

Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Medicare Orthotics and Prosthetics Patient-Centered Care Act Medicare Private Contracting Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act Improving Seniors Timely Access to Care Act Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule Support Medicare Providers Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 4878/S. 2459 - EMPOWER Act (PTA/OTA Supervision) H.R. 1617/S.793 Prevent Interruptions in Physical Therapy Act H.R. 3875/S. 2880 Expanded Telehealth Access Act H.R. 4829 Physical Therapist Workforce and Patient Access Act H.R. 2474 Strengthening Medicare for Patients and Providers Act H.R. 2217/S. 4519 - IDEA Act H.R. 2480 Optimizing Postpartum Outcomes Act H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 7279 Reduce Duplicative Unnecessary Clerical Exchanges (REDUCE) Act H.R. 7623 Telehealth Modernization Act (TMA) H.R. 8151 to Expand eligible practitioners to furnish telehealth services

Client expense: $238,054 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 4189/S.2016, CONNECT for Health Act of 2023 H.R. 4093, Remote Opioid Monitoring Act of 2023 H.R. 824, Telehealth Benefit Expansion for Workers Act of 2023 H.R.1843/S.1001, Telehealth Expansion Act of 2023 H.R. 3875, Expanded Telehealth Access Act H.R. 1458/S. 723, Access to Prescription Digital Therapeutics Act of 2023 H.R. 7623, Telehealth Modernization Act of 2024 H.R. 7856, PREVENT DIABETES Act S. 4094, PREVENT DIABETES Act General issues related to federal regulation of health technology - artificial intelligence, digital therapeutics

Client expense: $1,800,000 · Firm income: Not reported

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

Preserving Seniors Access to Physicians Act of 2023 (H.R. 6683); Medicare Payment Reform; Prevent Interruptions in Physical Therapy Act (H.R.1617/S. 793); Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act (H.R. 7279); Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation (EMPOWER) Act (H.R. 4878/S. 2459); Expanded Telehealth Act (H.R. 3875/S. 2880); Telehealth Modernization Act (H.R. 7623 / S. 3967); Stopping Addiction and Falls for the Elderly (SAFE) Act (H.R. 7618); Medicare Opt-Out; Improving Seniors Timely Access to Care Act (H.R. 8702 / S. 4532); Strengthening Medicare for Patients and Providers Act (H.R. 2474).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues surrounding Medicare reimbursement and coverage denials (H.R.4315/S.3977) Medicare Orthotics and Prosthetics Patient-Centered Care Act (H.R.2474) Strengthening Medicare for Patients and Providers Act (H.R.3875) Expanded Telehealth Access Act Implementation of Healthcare Common Procedure Coding Systems add-on code G2211 (H.R. 7279) Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act Issues surrounding local coverage determination and Contractor Advisory Committee processes (H.R. 7623) Telehealth Modernization Act of 2024

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

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

Continued access to occupational therapy services including in the Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act. Continued expansion of telehealth services in H.R. 3875, S.2880 - Expanded Telehealth Access Act and the Telehealth Modernization Act, H.R.8261 - Preserving Telehealth, Hospital, and Ambulance Access Act and S. 2016 - CONNECT for Health Act of 2023. Support of H.R.2474 - Strengthening Medicare for Patients and Providers Act. Issues related to MACRA reform. H.R. 4878, the EMPOWER Act, S.2459 - Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation Act H.R.7148 - Medicare Home Health Accessibility Act H.R.8261 - Preserving Telehealth, Hospital, and Ambulance Access Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare coverage of audiology services and the Medicare Audiology Access Improvement Act (H.R. 6445/S. 2377) Issues related to the provision of audiology and speech-language pathology services through telepractice, including the Expanded Telehealth Access Act (H.R. 3875/S. 2880), the CONNECT for Health Act (H.R. 4189/S. 2016) and the Telehealth Modernization Act (H.R. 7623). Issues related to Medicare Part B reimbursement of audiology and speech-language pathology services, including H.R. 2474, the Strengthening Medicare for Patients and Providers Act, H.R. 2474 Various issues related to CMS Actions surrounding: oAudits of medical records and claims for Part A and B services oProcedure code development and valuation of audiology and speech-language pathology services oQuality reporting under MIPS oImplementation of the IMPACT Act oMedicare physician fee schedule oProspective payments systems, including home health and skilled nursing facility policy and payment issues oAccountable Care Organizations oFederally-facilitated marketplace oMedicare Advantage oVarious issues related to interoperable health information, including the post-acute care interoperability project (PACIO) oMedicare telehealth coverage under Part A and B oImplementation of CARES Act (P.L. 116-136) oProvision and payment for Part A therapy oVarious issues related to implementation of ACA oIssues related to Medicare beneficiaries accessing services provided by audiologists without a physician order Issues related to the Center for Medicare and Medicaid Innovation (CMMI) actions related to value-based care Issues related to Medicaid work requirements, including H.R. 2811, the Limit, Save, Grow Act of 2023 The Long-Term Care Workforce Support Act (H.R. 7994/S. 4120) Issues related to the Medicaid program, including Medicaid and Medicaid managed care access, the Early and Periodic Screening, Diagnosis, and Treatment benefit, and school-based billing. Improving Seniors Timely Access to Care Act (H.R. 8702/S. 4532)

Client expense: $290,000 · Firm income: Not reported

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

No bill number - Supported efforts to include occupational therapy in new school-based Medicaid guidelines, where appropriate. HR 4315/S3977 - Medicare Orthotics & Prosthetics Patient Centered Care Act: Advocate for passage to stop fraud in the provision of orthotics and prosthetics and to ensure access to needed orthotic devices. HR 4878/S 2459 - EMPOWER Act: Advocate for passage of EMPOWER Act, which would change the Medicare supervision requirement for occupational therapy assistants (OTAs) and physical therapist assistants (PTAs) in private practice from "direct" supervision to match state standards and require GAO student of impact of 15% reimbursement cut for OTAs and PTAs in rural and medically underserved areas. H.R. 2474 - Strengthen Medicare for Patients and Providers Act: Support passage. No bill number - Advocate for introduction of legislation allowing occupational therapy practitioners to opt-out of Medicare. No bill number - Support legislation that will reverse the current Medicare multiple procedure payment reduction for therapy services. No bill number Support legislation that will improve the ability of therapy providers to participate in Medicare quality payment programs. HR 3875/S 2880 - Expanded Telehealth Access Act: Advocate for passage in the House and Senate to establish occupational therapists as telehealth providers in Medicare. H.R.7623/S.3967 - Telehealth Modernization Act: Advocated for passage of bill that would among other things establish occupational therapists as telehealth providers in Medicare. S. 2016 and HR 4189 - CONNECT for Health Act: Advocate to revise provisions of legislation to specifically establish occupational therapists as telehealth providers in Medicare. H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act: Advocate for passage of bill that would extend waivers allowing OTs to provide services via telehealth in Medicare. H.R.8151 - Telehealth Therapy Act: Advocate for passage of bill that would allow OTs to provide services via telehealth in Medicare on a permanent basis. H.R.7148 - Medicare Home Health Accessibility Act: Advocate for passage of legislation that would establish occupational therapy as a qualifying Medicare home health service and for introduction of similar bill in the Senate. S. 1592/H.R.8220 - Occupational Therapy in Mental Health Parity Act: Support passage. S. 2942 WELL Seniors Act - support passage H.R. 6371 Provider Reimbursement Stability Act - support passage H.R. 6545 Physician Fee Schedule Update and Improvements Act - support passage H.R. 6683 Preserving Seniors Access to Physicians Act - support passage S. 3430 Better Mental Health Care, Lower-Cost Drugs, and Extenders Act - support passage S. 2433/S. 3106/H.R. 4079 Substance-Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act - support passage H.R.7279 REDUCE Act: Supported introduction and passage. H.R. 7618 Stopping Addiction and Falls for the Elderly (SAFE) Act: Supported introduction and passage.

Client expense: $189,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1110, KEEP Telehealth Options Act of 2023 H.R. 3875, Expanded Telehealth Access Act H.R. 5541, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act H.R. 5611, Helping Ensure Access to Local TeleHealth (HEALTH) Act of 2023 H.R. 6033, Supporting Patient Education And Knowledge (SPEAK) Act of 2023 H.R. 7149, Equal Access to Specialty Care Everywhere (EASE) Act of 2024 H.R. 7623, The Telehealth Modernization Act of 2024 H.R. 7711, To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program H.R. 7858, Telehealth Enhancement for Mental Health Act of 2024 H.R. 7863, To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program H.R. 5386, Cutting Copays Act H.R. 5380, To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage H.R. 5372, Expanding Seniors Access to Lower Cost Medicines Act of 2023 S. 3059 the REAL Health Provider Act (Bennet, Tillis) S. 2973 Modernizing and Ensuring PBM Accountability Act H.R. 2880, the Protecting Patients Against PBM Abuses Act S.1002 - No UPCODE Act H.R. 3282, the Promoting Transparency and Healthy Competition in Medicare Act H.R. 3284, the Providers and Payers COMPETE Act H.R. 3237, To amend title XVIII of the Social Security Act to require each outpatient department of a provider to include a unique identification number on claims for services, and to require hospitals with an outpatient department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each outpatient department Legislation and regulation related to the Medicare Advantage program and Medicare/Medicaid coverage, care delivery and financing.

Client expense: $140,000 · Firm income: Not reported

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

Continued access to occupational therapy services including in the Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act. Continued expansion of telehealth services in H.R. 3875, S.2880 - Expanded Telehealth Access Act and the Telehealth Modernization Act, H.R.4189/S. 2016 - CONNECT for Health Act of 2023. Support of H.R.2474 - Strengthening Medicare for Patients and Providers Act. Issues related to MACRA reform. H.R. 4878, the EMPOWER Act, S.2459 - Enabling More of the Physical and Occupational Workforce to Engage in Rehabilitation Act H.R.7148 - Medicare Home Health Accessibility Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE