GOLD CARD Act of 2023

S. 4532--A bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans--Prior Authorization in Medicare Advantage H.R. 8702--To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans--Prior Authorization in Medicare Advantage S. 3573--Medicare Advantage Supplemental Benefits Transparency Act--Improving Supplemental Benefits for MA beneficiaries H.R. 5380--To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage--Improving Supplemental Benefits for MA beneficiaries S. 3307--Encounter Data Enhancement Act--Encounter Data in MA H.R. 5746--Addressing Whole Health in Medicare Advantage Act--Supplemental Benefits for chronically ill enrollees H.R. 4968--Gold Card Act of 2023--Exemptions to Prior Authorization in Medicare Advantage S. 3950--Delivering Unified Access to Lifesaving Services Act (DUALS Act) of 2024--Care Delivery for those eligible for Medicare and Medicaid Issues related to data collection and sharing among health plans, providers, and community-based organizations issues In-home Heath Risk Assessments issues Issues related to mental and behavioral health issues in Medicare Advantage S 3059--Required Enhanced & Accurate Lists of Health Providers Act (REAL)--Reporting issues

Client expense: $730,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment reform Counting observation stays as satisfying Medicare three-day inpatient stay prerequisite for skilled nursing facility (SNF) coverage Eliminating prior authorization requirements in Medicare Advantage H.R. 1128-Rural Health Care Access Act of 2023, to eliminate the 35-mile requirement to qualify as a critical access hospital H.R. 1129-Rural ER Access Act, to require the Centers for Medicare and Medicaid Services to repeal the 35-mile requirement for off-campus facilities H.R. 2474-Strengthening Medicare for Patients and Providers Act, to add an inflationary adjustment to physician payments under the Medicare Physician Fee Schedule H.R. 4189-CONNECT for Health Act, to expand access to telehealth services H.R.4366-Consolidated Appropriations Act, to provide appropriations for several federal departments and agencies and to provide an increase for the calendar year 2024 physician fee schedule conversion factor H.R. 4968-GOLD CARD Act of 2023, to improve prior authorization processes under Medicare Advantage for physicians with high approval rates H.R. 5213-Reducing Medically Unnecessary Delays in Care Act of 2023, to ensure that prior authorization medical decisions under Medicare are determined by physicians H.R. 6371-Provider Reimbursement Stability Act, to reform the Medicare budget neutrality process H.R. 6545-Physician Fee Schedule Update and Improvements Act, to provide a 1.25 percent adjustment to the 2024 Medicare Physician Fee Schedule conversion factor and update the budget neutrality threshold H.R. 6683-Preserving Seniors Access to Physicians Act of 2023, to fully eliminate the 3.37 percent conversion factor adjustment for calendar year 2024 H.R. 7432-Sickle Cell Comprehensive Care Act, to allow Medicaid programs to cover home health services for those with sickle cell disease H.R. 8702-Improving Seniors Timely Access to Care Act, to improve and streamline prior authorization under Medicare Advantage Plans H.R.---- -Fewer Burdens for Better Care Act of 2023, to provide for multi-stakeholder input on removal of quality and efficiency measures in Medicare reporting H.R. 10073-Medicare Patient Access and Practice Stabilization Act, to fully eliminate the 2024 Physician Fee Schedule conversion factor adjustment and provide an inflationary update S. 996- H.R. 7432-Sickle Cell Comprehensive Care Act, to allow Medicaid programs to cover home health services for those with sickle cell disease S.2016-CONNECT for Health Act, to expand access to telehealth services S. 3430-Better Mental Health Care, Lower-Cost Drugs and Extenders Act, to provide a 1.25 percent adjustment to the 2024 Medicare Physician Fee Schedule conversion factor, and other provisions H.R. 4532-Improving Seniors Timely Access to Care Act, to improve and streamline prior authorization under Medicare Advantage Plans

Client expense: $407,855 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

No Surprises Act implementation Eliminating prior authorization requirements in Medicare Advantage H.R. 4968-GOLD CARD Act of 2023, to improve prior authorization processes under Medicare Advantage for physicians with high approval rates H.R. 9572-the Enhanced Enforcement of Health Coverage Act, to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements under the No Surprises Act

Client expense: $407,855 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Recovery audit contractor reform. Medicare regulatory reform, including Medicare physician fee schedule and sequestration relief and payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment; and (4) HR ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025-related to physician payment adjustment of 2.5%. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act, and H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Advocacy related to H.R. 8246, Second Chances for Rural Hospitals Act, and access to physician-led entities.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L. 111-148 Affordable Care Act, modifications Prior authorization utilization policies Medicare Access and CHIP Reauthorization Act (P.L. 114-10) Improvement Issues Medicare Physician Payment Issues Drug Pricing and Shortages Issues Medicare Part B Drug Price Issues Expansion of Telehealth Services Vision Research Funding Implementation of No Surprises Act S. 652/H.R. 2630, the Safe Step Act The Ensuring Lasting Smiles Act Medicare Coverage for Low Vision Devices S. 1573/H.R. 3226 - Preemie Reauthorization Act of 2023 H.R.2474 - Strengthening Medicare for Patients and Providers Act Healthcare Workforce Issues H.R. 6545, the Physician Fee Schedule Update and Improvements Act H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023 H.R. 6487/S. 3805, the No Fees for EFTs Act H.R. 4968, the GOLD CARD Act H.R. 830/S. 1375, the Help Ensure Lower Patient Copays Act (HELP Copays Act) H.R. 2748, the Contact Lens Prescription Verification Modernization Act H.R. 1503, the Prescription Information Modernization Act of 2023 H.R. 7745, the Embracing Anti-Discrimination, Unbiased Curriculum, and Advancing Truth in Education (EDUCATE) Act Funding for the Pediatric Specialty Loan Repayment Program H.R. 8400, the Early Detection of Vision Impairments for Children Act of 2024 (EDVI Act) H.R. 8702/S. 4532, the Improving Seniors Timely Access to Care Act H.R.9747 - Continuing Appropriations and Extensions Act, 2025

Client expense: $258,819 · 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.977 - Patient Access to Higher Quality Health Care Act of 2023 To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. Michael Burgess, (R-TX) Henry Cuellar (D-TX) HR 2474: Strengthening Medicare for Patients and Providers Act Reps. Raul Ruiz, MD (D-CA); Larry Bucshon, MD (R-IN); Ami Bera, MD (D-CA); Mariannette Miller-Meeks, MD (R-IA) Provides an annual Medicare physician payment update tied to inflation as measured by the Medicare Economic Index (MEI). HR 4968, the GOLD CARD Act of 2023 Reps Michael Burgess (R-TX); Vincente Gonzalez (D-TX) Exempts physicians who in the previous year received approval for at least 90 percent of their prior authorization requests, from the prior authorization approval process under Medicare Advantage plans. HR 6683: Preserving Seniors Access to Physicians Act Reps. Greg Murphy, MD (R-NC); Brad Wenstrup, DPM (R-OH); Michael Burgess, MD (R-TX); Larry Bucshon, MD (R-IN); Danny Davis (D-IL); Jimmy Panetta (D-CA) Prevents the full 3.4% Medicare physician fee schedule cuts from being implemented on January 1, 2024. Support implementation of the No Surprises Act (NSA) according to congressional intent The NSA aimed to fix the problem of unanticipated medical bills and remove patients from the middle of out-of-network billing disputes. However, the Administration crafted rules that disregard congressional intent and insurers are not being held accountable under current policies. HR 8702 and S 4532: Improving Seniors Timely Access to Care Act: To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. HR 8702--Mike Kelly (R-PA) and Susan DelBene (D-WA). S 4532--Sen. Sinema, Kyrsten (I-AZ) Sen. Thune, John (R-SD) Sen. Brown, Sherrod (D-OH) 06/13/2024 H.R.9001 - Physician Led and Rural Access to Quality Care Act: Reps Tony Cardenas(D-CA); Morgan Griffith (R-VA); Vicente Gonzalez (D-TX) To amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals.

Client expense: $518,655 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobby members of Congress regarding issues related to telemedicine. Advocate for a stable supply of medications and for mitigation of drug shortages, including lidocaine. Advocate for increased transparency regarding drug pricing. Advocate for reducing barriers to entry of generic drugs into the marketplace. Advocate for transparency on the part of pharmaceutical benefit managers. Advocate for patient access to compounded medications. Advocate for reducing the burdens of utilization management tools, including step therapy and prior authorization for pharmaceuticals and services. Advocate for a stable supply of medications and mitigate drug shortages. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H.R. 2630/S. 652, Safe Step Act. Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Advocate for the continued and increased funding of Community Health Centers. Advocate for implementation of surprise medical billing legislation (enacted as part of P.L. 116-260, Consolidated Appropriations Act, 2021, H.R. 133) as intended by Congress. Support H.R. 5894/S. 2624. Support H.R. 1202/S. 704, Resident Education Deferred Interest Act or the REDI Act Support H.R. 2389/S1032, the Resident Physician Shortage Reduction Act Lobbied Congress on physician workforce, administrative burden, and workforce diversity issues Advocate for the FDA to implement the 2015 rule, General and Plastic Surgery Devices: Restricted Sale, Distribution, and Use of Sunlamp Products; and the Sunlamp Products Proposed; Amendment to Performance Standard, which would ban minors under the age of 18 from using tanning beds. Advocate for implementation of language to direct the Secretary of Health and Human Services to open a public docket for the submission of public comments regarding factors that should be taken into consideration when reviewing a proposed modification to an approved risk evaluation and mitigation strategy, and for other purposes (enacted as part of P.L. 117-328, Consolidated Appropriations Act, 2023, H.R. 2617). Advocate to replace scheduled and anticipated cuts in Medicare payments with positive, inflationary-based updates, eliminate the anticipated conversion factor cut in the CMS proposed rule for the 2024 Medicare Physician Fee Schedule (MPFS) associated with budget neutrality adjustments tied to Evaluation & Management (E/M) Code MPFS policy changes Advocate against H.R 618, Improving Access to Workers Compensation for Injured Federal Workers Act, which expands the role of nurse practitioners and physician assistants in providing services to injured federal workers under the federal workers' compensation program. Lobbied Congress on impact of the burden of small business issues impacting small physician practices, including Medicare reimbursement cuts. Advocate for H. Res. 365, in support of efforts to curb the incidences of skin cancer beginning with childhood skin protection. Support H.R.2474, Strengthening Medicare for Patients and Providers Act. Support H.R. 2761, S. 705, Specialty Physicians Advancing Rural Care Act (SPARC Act). Support H.R. 4402, Protecting and Continuing Physician Education and Patient Care Act Support H.R. 830/S. 1375, the Help Ensure Lower Patient (HELP) Copays Act. Support H.R. 3674, the Providing Relief and Stability for Medicare Patients Act of 2023. Support S. 935, the Fair Accountability & Innovative Research (FAIR) Drug Pricing Act. Support H.R. 4968, Getting Over Lengthy Delays in Care as Required by Doctors (GOLD CARD) Act. Support H.R.2389/S.1302, the Resident Physicians Shortage Reduction Act. Advocate regarding matters related to Merit-based Incentive Payment System (MIPS), MIPS Value Pathways (MVPs), and Qualified Clinical Data Registries. Advocate regarding AADA efforts in skin cancer prevention and AADA skin cancer prevention programs and initiatives. H.R.7153/S.3679, the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. S.Res.567/H.Res.1089, a resolution recognizing the seriousness of widespread health care worker burnout in the United States and the need to strengthen health workforce well-being, and expressing support for the designation of March 18, 2024, as the inaugural "Health Workforce Well-Being Day of Awareness".; H.R. 2819, Good Samaritan Health Professionals Act; S. 4349, Electronic Prior Authorization for Prescription Drugs Act

Client expense: $490,000 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Office of Science & Technology Policy (OSTP), SENATE, White House Office

S 765/HR 1526: Reducing Hereditary Cancer Act of 2023- provide hereditary cancer genetic testing Increasing access to telehealth S 2016/HR 4189: CONNECT for Health Act- expands access to telehealth services Medicare physician payment reforms HR 2474: Strengthening Medicare for Patients and Providers Act- physician reimbursement HR 5013: Value in Health Care Act of 2023 - provides a multi-year commitment to reforming care delivery by extending MACRA's 5 percent advanced APM incentives for an additional two years. S 3503: Value in Health Care Act of 2023 - A bill to direct the Secretary of Health and Human Services to revise certain regulations in relation to the Medicare shared savings program and other alternative payment arrangements to encourage participation in such program, and for other purposes HR 6371: Provider Reimbursement Stability Act of 2023 - To provide for certain adjustments to the physician fee schedule under the Medicare program. H.R. 6369: To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models - Extend incentive payments for participation in alternative payment models HR 3674: Providing Relief and Stability for Medicare Patients Act of 2023 - increase the nonfacility practice expense relative value units for specified services furnished under the Medicare program Reducing burdens caused by prior authorization requirements HR 4968: GOLD CARD Act of 2023 - exempt qualifying providers from prior authorization requirements under Medicare Advantage plans S 2372/HR 4758: Accelerating Kids' Access to Care Act - improve childrens access to needed out-of-state health care by streamlining Medicaid provider screening and enrollment processes. HR 6364: Medicare Telehealth Privacy Act of 2023 - To amend title XVIII of the Social Security Act to maintain certain telehealth flexibilities relating to provider privacy under the Medicare program S 2764/HR 5391: Protecting Patient Access to Cancer and Complex Therapies Act of 2023 - ensures patients will be able to access critical medications and providers will be reimbursed fairly, unaffected by drug pricing negotiations between Medicare and drug manufacturers. S 2345/HR 4714: Pediatricians Accelerate Childhood Therapies Act of 2023 - requires the National Institutes of Health (NIH) to make awards to support early-career pediatric researchers. It also provides statutory authority for the NIH Pediatric Research Consortium to coordinate pediatric research across national health research institutions. S 3967/HR 7623: Telehealth Modernization Act of 2024 - permanently extends telehealth flexibilities for Medicare beneficiaries. S 4518/HR 8702: To Amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans - prior authorization HR 7384: Creating Hope Reauthorization Act of 2024 - This bill extends until FY2029 a Food and Drug Administration program that awards priority review vouchers to manufacturers of drugs that treat rare pediatric diseases. HR 8412: Clinical Trial Modernization Act - To modernize clinical trials and remove barriers for participation in clinical trials, and for other purposes. S 2407/HR 4818: Treat and Reduce Obesity Act of 2023 - Expands Medicare coverage of intensive behavioral therapy for obesity. HR 6545: Physician Fee Schedule Update and Improvements Act - To amend title XVIII of the Social Security Act to make improvements to the physician fee schedule under the Medicare program. HR 6683: Preserving Seniors' Access to Physicians Act of 2023 - This bill increases payments under the Medicare physician fee schedule for 2024. S 4935: Physician Fee Stabilization Act - A bill to amend title XVIII of the Social Security Act to update the budget neutrality threshold under the Medicare physician fee schedule. S. 4905: Innovation in Pediatric Drugs Act of 2024 - Ensure that children with rare diseases can benefit from new and innovative treatments. H.R. 6664: Innovation in Pediatric Drugs Act of 2023 - To encourage innovation in the development of pediatric drugs, and for other purposes. S. 4349: Electronic Prior Authorization for Prescription Drugs Act - A bill to require private health plans to provide for secure electronic transmission of prior authorization requests for prescription drugs.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Q4 Lobbying Report (Oct.1 -Dec. 31) HCR Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program Resident Physician Shortage Act of 2023 (H.R. 2389) No Surprises Act regulations Food and Drug Amendments No Surprise Bills for New Moms Act (H.R. 3387) Securing the U.S. Organ Procurement and Transplantation Network Act (H.R. 2544) Promoting Access to Treatments and Increasing Extremely Needed Transparency Act (H.R. 3561) Medicaid VBPs for Patients (MVP) Act (H.R. 2666) Providers and Payers COMPETE Act (H.R. 3284) To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290) Transparent PRICE Act (H.R. 3281/H.R. 2691)) Resident Physician Shortage Reduction (S. 1302) Medical Student Education Authorization Act (H.R. 3046) Save Americas Rural Hospitals Act (H.R. 833) Chronic Care Management Improvement Act (H.R. 2829) Safety From Violence for Healthcare Employees Act (H.R. 2584) Supporting Safety Net Hospitals Act (H.R. 2665) Patient Access to Higher Quality Health Care Act (H.R. 977/S.470) FEMA re: COVID-19 related reimbursement Public Health Guidance Transparency and Accountability Act of 2023 (H.R. 4529) Public Health Emergency Congressional Review Act (H.R. 4381) CDC Leadership Accountability Act of 2023 (H.R. 3813) Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) Preparedness and Response Reauthorization Act (H.R. 4420) Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887) Health Care Price Transparency Act of 2023 (H.R. 4822) Providers and Payers COMPETE Act (H.R. 3284) Lower Costs, More Transparency Act (H.R. 5378 Transparency in Coverage Act (H.R. 4507) GOLD Card Act of 2023 (H.R. 4968) No Fees for EFTs Act (H.R.6487) Rural Health Care Facilities Revitalization Act (H.R. 5989) Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (H.R. 7153) To amend title XVIII of the Social Security Act to establish a definition of essential health system in statute (H.R. 7397) Substance Use Disorder Workforce Act (H.R. 7050) 340B PATIENTS Act (H.R. 7635) The 340B Affording Care for Communities and Ensuring a Strong Safety-net (ACCESS) Act (H.R. 8574) Improving Seniors Access to Timely Care Act (H.R. 8702/S.4532) The Preserving Emergency Access in Key Sites (PEAKS) Act (H.R. 7931) Rural Health Care Facilities Revitalization Act (H.R. 5989) MMM Accelerated and Advance Payment Program repayment flexibility Graduate Medical Education (GME) funding Telehealth flexibilities and payment Annual Prospective Payment System Rules Organ acquisition payment policies Californias Medicaid Hospital Quality Assurance Fee Program Medicare Advantage BUD FY 2025 Appropriations bills Nursing and allied health workforce funding FY 2025 budget request Further Continuing Appropriations and Other Extensions Act (H.R. 6363) Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R. 5894) Tax Relief for American Families and Workers Act of 2024 (H.R. 7024) Extension of Continuing Appropriations and Other Matters Act, 2024 (H.R. 7463) Submitted Comments Regulatory Comment Letters SUBJECT: CMS-10913, Medicare Part C Utilization Management Annual Data Submission and Audit Protocol Data Request; Notice, Agency Information Collection Activities: Proposed Collection; Comment Request; Federal Register (Vol 89, No 145), September 10, 2024

Client expense: $300,000 · Firm income: Not reported

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

No Bill No. - Congressional Primary Care Caucus No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Medicare Physician Payment Reform No Bill No. - MACRA Implementation No Bill No. - CY2024 Medicare Physician Fee Schedule No Bill No. - CY 2024 Medicare Inpatient Prospective Payment System No Bill No. - Site Neutrality and Consolidation No Bill No. - CMS Prior Authorization Rules No Bill No. - Tobacco Users Quiet Act No Bill No. - G2211 Code (Physician Fee Schedule) No Bill No. - Reducing Medically Unnecessary Delays in Care Act No Bill No. - G2211 implementation/modifier 25 No Bill No. - HEALTH for Mom Act No Bill No. - Pay PCP Act No Bill No. - Seniors Timely Access to Care Act No Bill No. - CY25 Medicare Physician Fee Schedule No Bill No. - Physician Fee Stabilization Act (H.R. 952) Kids Access to Primary Care Act (H.R. 2400/S. 1165) The Reentry Act (H.R. 3074) Due Process Continuity of Care Act (H.R. 3766) Extending Access to Addiction Treatment Act (H.R. 4950/S. 2841) Improve Addiction Care Act (H.R. 4771) Children's Health Insurance Program Permanency Act (H.R. 4968) GOLD Card Act of 2023 (S. 2556) Improving Care for Youth Act (H.R. 5013) Value in Health Care Act (S. 2816) Medicaid for Every Child Act (H.R. 6545) Physician Fee Schedule Update and Improvements Act (H.R. 5434/S.3138) Stabilize Medicaid and CHIP Coverage Act (H.R. 5395) SURS Extension Act (H.R. 3487/S. 3805) No Fees for EFTs Act (S. 1316) Save Children's Coverage Act (H.R. 6997/S. 3010) Nutrition CARE Act (H.R. 6780/S. 2133) - Medically Tailored Home-Delivered Meals Demonstration Pilot Act (H.R. 8235) - Rural Physician Workforce Preservation Act (H.R. 7512) - Real-Time Benefit Tool Implementation Act (H.R. 1770/S. 2477) - Equitable Community Access to Pharmacist Act (S. 4349) - Electronic Prior Authorization for Prescription Drugs Act (H.R. 5434/S. 3138) - Stabilize Medicaid and CHIP Coverage Act (S. 5432) - Medicaid Primary Care Improvement Act (S. 5236) - Keeping Obstetrics Local Act

Client expense: $1,072,997 · Firm income: Not reported

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

COVID-19 / Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) / Long COVID - S. 801 / H.R. 1616, the CARE for Long COVID Act of 2023 - H.R. 1114, the Long COVID Recovery Now Act of 2023 - H.R. 3258, the TREAT Long COVID Act of 2023 - S. 2560, the Long COVID Support Act of 2023 - H.R. 9907 / S. 4964, the Long COVID Research Moonshot Act of 2024 Funding for Rehabilitation Research Inpatient Rehabilitation Facility (IRF) Review Choice Demonstration (RCD) Project Streamlining access to rehabilitation for Medicare beneficiaries (SNF three day rule, IRF three hour rule) - H.R. 6110, the Access to Inpatient Rehabilitation Therapy Act of 2023 Prior Authorization Reform - H.R. H.R.8702 /S. 4532, the Improving Seniors' Timely Access to Care Act of 2024 - H.R. 4822, the Health Care Price Transparency Act of 2023 - H.R. 4968, the Getting Over Lengthy Delays in Care As Required by Doctors Act of 2023 - H.R. 5213, the Reducing Medically Unnecessary Delays in Care Act of 2023 Medicare Reimbursement / Physician Payment Schedule Cuts - H.R. 2474, the Strengthening Medicare for Patients and Providers Act of 2023 Scope of Practice - H.R. 2713, the Improving Care and Access to Nurses Act of 2023 - H.R. 618 / S. 131, the Improving Access to Workers' Compensation for Injured Federal Workers Act - National Standards of Practice at the Department of Veterans Affairs

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

Inpatient Rehabilitation Facility (IRF) Review Choice Demonstration (RCD) Project IRF Three-Hour Rule - H.R. 6110, the Access to Inpatient Rehabilitation Therapy Act of 2023 Prior Authorization Reform - H.R. H.R.8702/S. 4532, the Improving Seniors' Timely Access to Care Act of 2024 - H.R. 4822, the Health Care Price Transparency Act of 2023 - H.R. 4968, the Getting Over Lengthy Delays in Care As Required by Doctors Act of 2023 - H.R. 5213, the Reducing Medically Unnecessary Delays in Care Act of 2023 Medicare Reimbursement / Physician Payment Schedule Cuts - H.R. 2474, the Strengthening Medicare for Patients and Providers Act of 2023 Scope of Practice - H.R. 2713, the Improving Care and Access to Nurses Act of 2023 - H.R. 618 / S. 131, the Improving Access to Workers' Compensation for Injured Federal Workers Act - National Standards of Practice at the Department of Veterans Affairs

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

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

S.470/H.R.977, Patient Access to Higher Quality Health Care Act: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. S.4532/H.R. 8702), Improving Seniors Timely Access to Care Act: To streamline prior authorization in the Medicare Advantage program. H.R.2389, Resident Physician Shortage Reduction Act: To provide for the distribution of additional residency positions H.R. 2474, Strengthening Medicare for Patients and Providers Act: To provide an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index. H.R. 4968, the GOLD CARD Act of 2023: Prior authorization reform in Medicare Advantage H.R. 9001, Physician Led and Rural Access to Quality Care Act: To amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals and allow physician ownership of rural hospitals H.R.9805, Access to Claims Data Act: To require the Secretary of Health and Human Services to establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement. No bill: Graduate medical education policy reform ideas. No bill: Medicare physician payment reform policy ideas, need for legislation to prevent Medicare physician payment cuts and adopt an inflation-based payment update for 2025, modifications to Medicare's budget neutrality rules, increasing surgical global codes to incorporate increased RVUs for follow-up care w/in the global period, and improvements to value-based care payment models

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.470/H.R.977, Patient Access to Higher Quality Health Care Act: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. S.4532/H.R. 8702), Improving Seniors Timely Access to Care Act: To streamline prior authorization in the Medicare Advantage program. H.R.2389, Resident Physician Shortage Reduction Act: To provide for the distribution of additional residency positions H.R. 2474, Strengthening Medicare for Patients and Providers Act: To provide an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index. H.R. 4968, the GOLD CARD Act of 2023: Prior authorization reform in Medicare Advantage H.R. 9001, Physician Led and Rural Access to Quality Care Act: To amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals and allow physician ownership of rural hospitals H.R.9805, Access to Claims Data Act: To require the Secretary of Health and Human Services to establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement. No bill: Graduate medical education policy reform ideas. No bill: Medicare physician payment reform policy ideas, need for legislation to prevent Medicare physician payment cuts and adopt an inflation-based payment update for 2025, modifications to Medicare's budget neutrality rules, increasing surgical global codes to incorporate increased RVUs for follow-up care w/in the global period, and improvements to value-based care payment models

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare physician payment; new/alternative payment models; Medicare coverage, hospital payment of cardiovascular services; access to Medicare claims data; physician and hospital quality; Quality Payment Program; clinical data registries; health care quality; medical imaging and prior authorization; the Stark Law and the in-office ancillary services exception; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; graduate medical education policy including the Resident Physician Shortage Reduction Act of 2023 (HR 2389/S. 1302); oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy including the Physician Led Rural Access to Quality Care Act (HR 9001); COVID-19 public health emergency and the implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security Act; implementation of the Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); implementation of the Consolidated Appropriations Act of 2022; Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023 (H.R. 2583/S. 3481); Sustainable Cardiopulmonary Rehabilitation Services in the Home At (H.R. 1406/S. 3021); Strengthening Medicare for Patients and Providers (H.R. 2474); site-neutrality; Providing Relief and Stability for Medicare Patients Act (H.R. 3674); Connected Maternal Online Monitoring Act (Connected Mom) (S. 712); Charles Rochester Blood Clot Prevention and Treatment Act (H.R. 5699) Preserving Seniors Access to Physicians Act (H.R. 6683); Provider Reimbursement Stability Act (H.R. 6371); FY2024 Further Consolidated Appropriations Act (H.R. 2882); The Improving Seniors Timely Access to Care Act of 2024 (H.R. 8702/S. 4532); The Pay PCPs Act (S. 4338); the Electronic Prior Authorization for Prescription Drugs Act (S. 4349); FY 25 Labor-HHS Appropriations (H.R. 9029/S. 4942); The Physician Fee Stabilization Act (S. 4935); GOLD CARD Act (H.R. 4968); Access to Claims Data Act (H.R. 9805)

Client expense: $410,000 · 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 Management & Budget (OMB), SENATE

No Surprises Act implementation Eliminating prior authorization requirements in Medicare Advantage H.R. 4968-GOLD CARD Act of 2023, to improve prior authorization processes under Medicare Advantage for physicians with high approval rates H.R. 9572-the Enhanced Enforcement of Health Coverage Act, to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements under the No Surprises Act

Client expense: $428,634 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment reform Counting observation stays as satisfying Medicare three-day inpatient stay prerequisite for skilled nursing facility (SNF) coverage Eliminating prior authorization requirements in Medicare Advantage H.R. 1128-Rural Health Care Access Act of 2023, to eliminate the 35-mile requirement to qualify as a critical access hospital H.R. 1129-Rural ER Access Act, to require the Centers for Medicare and Medicaid Services to repeal the 35-mile requirement for off-campus facilities H.R. 2474-Strengthening Medicare for Patients and Providers Act, to add an inflationary adjustment to physician payments under the Medicare Physician Fee Schedule H.R. 4189-CONNECT for Health Act, to expand access to telehealth services H.R.4366-Consolidated Appropriations Act, to provide appropriations for several federal departments and agencies and to provide an increase for the calendar year 2024 physician fee schedule conversion factor H.R. 4968-GOLD CARD Act of 2023, to improve prior authorization processes under Medicare Advantage for physicians with high approval rates H.R. 5213-Reducing Medically Unnecessary Delays in Care Act of 2023, to ensure that prior authorization medical decisions under Medicare are determined by physicians H.R. 6371-Provider Reimbursement Stability Act, to reform the Medicare budget neutrality process H.R. 6545-Physician Fee Schedule Update and Improvements Act, to provide a 1.25 percent adjustment to the 2024 Medicare Physician Fee Schedule conversion factor and update the budget neutrality threshold H.R. 6683-Preserving Seniors Access to Physicians Act of 2023, to fully eliminate the 3.37 percent conversion factor adjustment for calendar year 2024 H.R. 7432-Sickle Cell Comprehensive Care Act, to allow Medicaid programs to cover home health services for those with sickle cell disease H.R. 8702-Improving Seniors Timely Access to Care Act, to improve and streamline prior authorization under Medicare Advantage Plans H.R.---- -Fewer Burdens for Better Care Act of 2023, to provide for multi-stakeholder input on removal of quality and efficiency measures in Medicare reporting S. 996- H.R. 7432-Sickle Cell Comprehensive Care Act, to allow Medicaid programs to cover home health services for those with sickle cell disease S.2016-CONNECT for Health Act, to expand access to telehealth services S. 3430-Better Mental Health Care, Lower-Cost Drugs and Extenders Act, to provide a 1.25 percent adjustment to the 2024 Medicare Physician Fee Schedule conversion factor, and other provisions H.R. 4532-Improving Seniors Timely Access to Care Act, to improve and streamline prior authorization under Medicare Advantage Plans

Client expense: $428,634 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 4532--A bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans--Prior Authorization in Medicare Advantage H.R. 8702--To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans--Prior Authorization in Medicare Advantage S. 3573--Medicare Advantage Supplemental Benefits Transparency Act--Improving Supplemental Benefits for Medicare Advantage beneficiaries HR. 5746--Addressing Whole Health in Medicare Advantage Act--Supplemental Benefits for chronically Ill enrollees H.R. 4968--Gold Card Act of 2023--Exemptions to Prior Authorization in Medicare Advantage S. 3950--Delivering Unified Access to Lifesaving Services Act of 2024 (DUALS Act)--Care Delivery for those eligible for Medicare and Medicaid Issues related to data collection and sharing among health plans, providers, and community-based organizations issues In-home Heath Risk Assessments issues Issues related to mental and behavioral health issues in Medicare Advantage

Client expense: $490,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6645, Medicare Audiology Access Improvement Act of 2023, all provisions S. 2377, Medicare Audiology Access Improvement Act of 2023, all provisions H.R. 1610, Chiropractic Medicare Coverage Modernization Act of 2023, all provisions S. 799, Chiropractic Medicare Coverage Modernization Act of 2023, all provisions H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023, all provisions S. 2016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023, all provisions H.R. 8532, Connected MOM Act, all provisions S. 712, Connected MOM Act, all provisions H.R. 1770, Equitable Community Access to Pharmacist Services Act, all provisions S. 2477, Equitable Community Access to Pharmacist Services Act, all provisions H.R. 751, Fair Access In Residency (FAIR) Act, all provisions H.R. 4968, Getting Over Lengthy Delays in Care As Required by Doctors (GOLD CARD) Act of 2023, all provisions H.R. 2713, Improving Care and Access to Nurses (I CAN) Act, all provisions S. 2418, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 2583, Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023, all provisions H.R. 6487, No Fees for EFTs Act, all provisions S. 3805, No Fees for EFTs Act, all provisions H.R. 977, Patient Access to Higher Quality Health Care Act of 2023, all provisions S. 470, Patient Access to Higher Quality Health Care Act of 2023, all provisions H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions H.R. 7050, Substance Use Disorder Workforce Act, all provisions H.R. 7623, Telehealth Modernization Act of 2024, all provisions H.R. 2474, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 830, Help Ensure Lower Patient (HELP) Copays Act, all provisions S. 1375, Help Ensure Lower Patient (HELP) Copays Act, all provisions H.R. 6371, Provider Reimbursement Stability Act of 2023, all provisions H.R. 6545, Physician Fee Schedule Update and Improvements Act, all provisions H.R. 5378, Lower Costs, More Transparency Act, all provisions H.R. 6683, Preserving Seniors Access to Physicians Act of 2023, all provisions H.R. 5013, Value in Health Care Act of 2023, all provisions S. 3503, Value in Health Care Act of 2023, all provisions H.R. 8702, Improving Seniors Timely Access to Care Act of 2024, all provisions S. 4532, Improving Seniors Timely Access to Care Act of 2024, all provisions S. 4518, Improving Seniors Timely Access to Care Act of 2024, all provisions S. 4935, Physician Fee Stabilization Act, all provisions H.R. 6366, To amend title XVIII of the Social Security Act with respect to the work geographic index for physician payments under the Medicare program, and to revise the phase-in of clinical laboratory test payment changes under such program, all provisions H.R. 7463, Extension of Continuing Appropriations and Other Matters Act, 2024, provisions relating to Medicare payments H.R. 7931, Preserving Emergency Access in Key Sites (PEAKS) Act, all provisions S. 4338, Pay PCPs Act of 2024, all provisions H.R. 8563, Preserving Access To Care in Hawaii (PATCH) Act, all provisions S. 4395, Protecting Access To Care in Hawaii (PATCH) Act, all provisions H.R. 6369, To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models, all provisions H.R. 7665, ACO Assignment Improvement Act of 2024, all provisions S. 3939, ACO Assignment Improvement Act of 2024, all provisions H.R. 8404, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions S. 4330, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions H.R. 4829, Physical Therapist Workforce and Patient Access Act of 2023, all provisions H.R. 8235, Rural Physician Workforce Preservation Act, all provisions H.R. 1745, Medicare Fraud Detection and Deterrence Act of 2023, all provisions H.R. 1746, Preventing Medicare Telefraud Act, all provisions H.R. 8261, Preserving Telehealth, Hospital, and Ambulance Access Act, all provisions S. 1491, Pharmacy and Medically Underserved Areas Enhancement Act, all provisions S. 669, Increasing Mental Health Options Act of 2023, all provisions H.R. 7618, Stopping Addiction and Falls for the Elderly (SAFE) Act, all provisions H.R. 3730, Rural Health Clinic Burden Reduction Act, all provisions H.R. 7279, Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act, all provisions H.R. 7708, Requiring Enhanced & Accurate Lists of (REAL) Health Providers Act, all provisions S. 3508, Requiring Enhanced & Accurate Lists of (REAL) Health Providers Act, all provisions H.R. 9001, Physician Led and Rural Access to Quality Care Act, all provisions S. 5218, A bill to amend titles XI and XVIII of the Social Security Act to strengthen, increase oversight of, and compliance with, security standards for health information, and for other purposes, all provisions S. 4054, Health Care Cybersecurity Improvement Act of 2024, all provisions H.R. 8588, Linking Seniors to Needed Legal Services Act of 2024, all provisions H.R. 5526, Seniors Access to Critical Medications Act of 2024, all provisions H.R. 9129, Patient Debt Relief Act, all provisions Fewer Burdens for Better Care Act/draft MACRA/MIPS program reform legislation/draft FY 2025 Medicare physician payment increase/draft Medical Chaperones in Medicare/draft Medicare program: No Surprises Act implementation Medicare program: 21st Century Cures Act implementation Medicare program: FY 2025 Physician payment cut Medicare program: Information Blocking Disincentives Medicare program: Merit-based Incentive Payment System (MIPS) reform Medicare program: Medicare Economic Index (MEI) Medicare program: Medicare Access and CHIP Reauthorization Act (MACRA) reform Medicare program: Budget neutrality reforms/Inflationary update Medicare program: G2211 Inherent complexity code Medicare program: Protecting Access to Medicare Act (PAMA 2014) lab cut reform Medicare program: High-cost disposable services payment Medicare program: Medicare Administrative Contractor/local-coverage determinations Medicare program: Making Care Primary alternative payment models (APM) Medicare program: Rural physicians APM Medicare program: Site neutral payment Medicare program: Physician-owned hospitals Medicare program: Graduate Medical Education (GME) funding Medicare program: Audio-visual supervision of residents/permanent expansion Medicare program: Conditions of Participation (COP)/Obstetrical service Medicare program: MACRA/physician burdens Medicare program: Health Information Technology/physician burdens Medicare program: Prior authorization/Medicare Advantage plans Medicare program: Interoperability/data sharing/information blocking/provider disincentives Medicare program: Promoting interoperability reporting Medicare program: Trusted exchange framework/common agreement Medicare program: Data segmentation Medicare program: Quality payment program Medicare program: Medicare Shared Savings Program/Advanced APM Medicare program: Public health reporting and data exchange Medicare program: Accountable Care Organizations/APM flexibilities Medicare program: Certified Electronic Health Record (EHR) Technology Medicare program: Physician Practice Information (PPI) survey/practice expense Medicare program: MIPS Value Pathways (MVPs)/APMs Medicare program: Telehealth flexibilities Medicare and Medicaid programs: Data Privacy and Cybersecurity Medicare and Medicaid programs: Health Insurance Portability and Accountability Act (HIPAA)/electronic records

Client expense: $5,330,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Science & Technology Policy (OSTP), SENATE, Veterans Affairs, Dept of (VA)

Recovery audit contractor reform. Medicare regulatory reform, including Medicare physician fee schedule and sequestration relief and payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act, and H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in H.R. 9001, the Physician Led and Rural Access to Quality Care Act, to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Advocacy related to H.R. 8246, Second Chances for Rural Hospitals Act, and access to physician-led entities.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Q3 Lobbying Report (July 1-Sept. 10) HCR Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program Resident Physician Shortage Act of 2023 (H.R. 2389) No Surprises Act regulations Food and Drug Amendments No Surprise Bills for New Moms Act (H.R. 3387) Securing the U.S. Organ Procurement and Transplantation Network Act (H.R. 2544) Promoting Access to Treatments and Increasing Extremely Needed Transparency Act (H.R. 3561) Medicaid VBPs for Patients (MVP) Act (H.R. 2666) Providers and Payers COMPETE Act (H.R. 3284) To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290) Transparent PRICE Act (H.R. 3281/H.R. 2691)) Resident Physician Shortage Reduction (S. 1302) Medical Student Education Authorization Act (H.R. 3046) Save Americas Rural Hospitals Act (H.R. 833) Chronic Care Management Improvement Act (H.R. 2829) Safety From Violence for Healthcare Employees Act (H.R. 2584) Supporting Safety Net Hospitals Act (H.R. 2665) Patient Access to Higher Quality Health Care Act (H.R. 977/S.470) FEMA re: COVID-19 related reimbursement Public Health Guidance Transparency and Accountability Act of 2023 (H.R. 4529) Public Health Emergency Congressional Review Act (H.R. 4381) CDC Leadership Accountability Act of 2023 (H.R. 3813) Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) Preparedness and Response Reauthorization Act (H.R. 4420) Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887) Health Care Price Transparency Act of 2023 (H.R. 4822) Providers and Payers COMPETE Act (H.R. 3284) Lower Costs, More Transparency Act (H.R. 5378 Transparency in Coverage Act (H.R. 4507) GOLD Card Act of 2023 (H.R. 4968) No Fees for EFTs Act (H.R.6487) Rural Health Care Facilities Revitalization Act (H.R. 5989) Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (H.R. 7153) To amend title XVIII of the Social Security Act to establish a definition of essential health system in statute (H.R. 7397) Substance Use Disorder Workforce Act (H.R. 7050) 340B PATIENTS Act (H.R. 7635) The 340B Affording Care for Communities and Ensuring a Strong Safety-net (ACCESS) Act (H.R. 8574) Improving Seniors Access to Timely Care Act (H.R. 8702/S.4532) The Preserving Emergency Access in Key Sites (PEAKS) Act (H.R. 7931) Rural Health Care Facilities Revitalization Act (H.R. 5989) MMM Accelerated and Advance Payment Program repayment flexibility Graduate Medical Education (GME) funding Telehealth flexibilities and payment Annual Prospective Payment System Rules Organ acquisition payment policies Californias Medicaid Hospital Quality Assurance Fee Program Medicare Advantage BUD FY 2024 Appropriations bills Nursing and allied health workforce funding FY 2024 budget request Further Continuing Appropriations and Other Extensions Act (H.R. 6363) Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R. 5894) Tax Relief for American Families and Workers Act of 2024 (H.R. 7024) Extension of Continuing Appropriations and Other Matters Act, 2024 (H.R. 7463) Submitted Comments Regulatory Comment Letters SUBJECT: CMS-1809-P, Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs, including the Hospital Inpatient Quality Reporting Program; Health and Safety Standards for Obstetrical Services in Hospitals and Critical Access Hospitals; Prior Authorization; Requests for Information; Medicaid and CHIP Continuous Eligibility; Medicaid Clinic Services Four Walls Exceptions; Individuals Currently or Formerly in Custody of Penal Authorities; Revision to Medicare Special Enrollment Period for Formerly Incarcerated Individuals; and All-Inclusive Rate Add-On Payment for High-Cost Drugs Provided by Indian Health Service and Tribal Facilities, (Vol 89, No 140), July 22, 2024 SUBJECT: CMS-1803-P, Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies, Federal Register (Vol. 89, No. 128), July 3, 2024 SUBJECT: CMS-5535-P, Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model, Federal Register (Vol. 89, No. 97), May 17, 2024 Legislative Comment Letters Letter to HHS on Johnson & Johnson's Proposed Changes to 340B Drug Discount Program, Sept. 19, 2024

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

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

H.R.977 - Patient Access to Higher Quality Health Care Act of 2023 To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. Michael Burgess, (R-TX) Henry Cuellar (D-TX) HR 2474: Strengthening Medicare for Patients and Providers Act Reps. Raul Ruiz, MD (D-CA); Larry Bucshon, MD (R-IN); Ami Bera, MD (D-CA); Mariannette Miller-Meeks, MD (R-IA) Provides an annual Medicare physician payment update tied to inflation as measured by the Medicare Economic Index (MEI). HR 4968, the GOLD CARD Act of 2023 Reps Michael Burgess (R-TX); Vincente Gonzalez (D-TX) Exempts physicians who in the previous year received approval for at least 90 percent of their prior authorization requests, from the prior authorization approval process under Medicare Advantage plans. HR 6683: Preserving Seniors Access to Physicians Act Reps. Greg Murphy, MD (R-NC); Brad Wenstrup, DPM (R-OH); Michael Burgess, MD (R-TX); Larry Bucshon, MD (R-IN); Danny Davis (D-IL); Jimmy Panetta (D-CA) Prevents the full 3.4% Medicare physician fee schedule cuts from being implemented on January 1, 2024. Support implementation of the No Surprises Act (NSA) according to congressional intent The NSA aimed to fix the problem of unanticipated medical bills and remove patients from the middle of out-of-network billing disputes. However, the Administration crafted rules that disregard congressional intent and insurers are not being held accountable under current policies. HR 8702 and S 4532: Improving Seniors Timely Access to Care Act: To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. HR 8702--Mike Kelly (R-PA) and Susan DelBene (D-WA). S 4532--Sen. Sinema, Kyrsten (I-AZ) Sen. Thune, John (R-SD) Sen. Brown, Sherrod (D-OH) 06/13/2024 H.R.9001 - Physician Led and Rural Access to Quality Care Act: Reps Tony Cardenas(D-CA); Morgan Griffith (R-VA); Vicente Gonzalez (D-TX) To amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals.

Client expense: $393,590 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 765/HR 1526: Reducing Hereditary Cancer Act of 2023- provide hereditary cancer genetic testing Increasing access to telehealth S 2016/HR 4189: CONNECT for Health Act- expands access to telehealth services Medicare physician payment reforms HR 2474: Strengthening Medicare for Patients and Providers Act- physician reimbursement HR 5013: Value in Health Care Act of 2023 - provides a multi-year commitment to reforming care delivery by extending MACRA's 5 percent advanced APM incentives for an additional two years. S 3503: Value in Health Care Act of 2023 - A bill to direct the Secretary of Health and Human Services to revise certain regulations in relation to the Medicare shared savings program and other alternative payment arrangements to encourage participation in such program, and for other purposes HR 6371: Provider Reimbursement Stability Act of 2023 - To provide for certain adjustments to the physician fee schedule under the Medicare program. H.R. 6369: To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models - Extend incentive payments for participation in alternative payment models HR 3674: Providing Relief and Stability for Medicare Patients Act of 2023 - increase the nonfacility practice expense relative value units for specified services furnished under the Medicare program Reducing burdens caused by prior authorization requirements HR 4968: GOLD CARD Act of 2023 - exempt qualifying providers from prior authorization requirements under Medicare Advantage plans S 2372/HR 4758: Accelerating Kids' Access to Care Act - improve childrens access to needed out-of-state health care by streamlining Medicaid provider screening and enrollment processes. HR 6364: Medicare Telehealth Privacy Act of 2023 - To amend title XVIII of the Social Security Act to maintain certain telehealth flexibilities relating to provider privacy under the Medicare program S 2764/HR 5391: Protecting Patient Access to Cancer and Complex Therapies Act of 2023 - ensures patients will be able to access critical medications and providers will be reimbursed fairly, unaffected by drug pricing negotiations between Medicare and drug manufacturers. S 2345/HR 4714: Pediatricians Accelerate Childhood Therapies Act of 2023 - requires the National Institutes of Health (NIH) to make awards to support early-career pediatric researchers. It also provides statutory authority for the NIH Pediatric Research Consortium to coordinate pediatric research across national health research institutions. S 3967/HR 7623: Telehealth Modernization Act of 2024 - permanently extends telehealth flexibilities for Medicare beneficiaries. S 4518/HR 8702: To Amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans - prior authorization HR 7384: Creating Hope Reauthorization Act of 2024 - This bill extends until FY2029 a Food and Drug Administration program that awards priority review vouchers to manufacturers of drugs that treat rare pediatric diseases. HR 8412: Clinical Trial Modernization Act - To modernize clinical trials and remove barriers for participation in clinical trials, and for other purposes. S 2407/HR 4818: Treat and Reduce Obesity Act of 2023 - Expands Medicare coverage of intensive behavioral therapy for obesity. HR 6545: Physician Fee Schedule Update and Improvements Act - To amend title XVIII of the Social Security Act to make improvements to the physician fee schedule under the Medicare program. HR 6683: Preserving Seniors' Access to Physicians Act of 2023 - This bill increases payments under the Medicare physician fee schedule for 2024. S 4935: Physician Fee Stabilization Act - A bill to amend title XVIII of the Social Security Act to update the budget neutrality threshold under the Medicare physician fee schedule.

Client expense: $120,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobby members of Congress regarding issues related to telemedicine. Advocate for a stable supply of medications and for mitigation of drug shortages, including lidocaine. Advocate for increased transparency regarding drug pricing. Advocate for reducing barriers to entry of generic drugs into the marketplace. Advocate for transparency on the part of pharmaceutical benefit managers. Advocate for patient access to compounded medications. Advocate for reducing the burdens of utilization management tools, including step therapy and prior authorization for pharmaceuticals and services. Advocate for a stable supply of medications and mitigate drug shortages. Lobby members of the House to join the Congressional Skin Cancer Caucus. Advocate for adequate and accurate network coverage for dermatologic care within health insurance exchange networks. Support H.R. 2630/S. 652, Safe Step Act. Advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. Advocate for the continued and increased funding of Community Health Centers. Advocate for implementation of surprise medical billing legislation (enacted as part of P.L. 116-260, Consolidated Appropriations Act, 2021, H.R. 133) as intended by Congress. Support H.R. 5894/S. 2624. Support H.R. 1202/S. 704, Resident Education Deferred Interest Act or the REDI Act Support H.R. 2389/S1032, the Resident Physician Shortage Reduction Act Lobbied Congress on physician workforce, administrative burden, and workforce diversity issues Advocate for the FDA to implement the 2015 rule, General and Plastic Surgery Devices: Restricted Sale, Distribution, and Use of Sunlamp Products; and the Sunlamp Products Proposed; Amendment to Performance Standard, which would ban minors under the age of 18 from using tanning beds. Advocate for implementation of language to direct the Secretary of Health and Human Services to open a public docket for the submission of public comments regarding factors that should be taken into consideration when reviewing a proposed modification to an approved risk evaluation and mitigation strategy, and for other purposes (enacted as part of P.L. 117-328, Consolidated Appropriations Act, 2023, H.R. 2617). Advocate to replace scheduled and anticipated cuts in Medicare payments with positive, inflationary-based updates, eliminate the anticipated conversion factor cut in the CMS proposed rule for the 2024 Medicare Physician Fee Schedule (MPFS) associated with budget neutrality adjustments tied to Evaluation & Management (E/M) Code MPFS policy changes Advocate against H.R 618, Improving Access to Workers Compensation for Injured Federal Workers Act, which expands the role of nurse practitioners and physician assistants in providing services to injured federal workers under the federal workers' compensation program. Lobbied Congress on impact of the burden of small business issues impacting small physician practices, including Medicare reimbursement cuts. Advocate for H. Res. 365, in support of efforts to curb the incidences of skin cancer beginning with childhood skin protection. Support H.R.2474, Strengthening Medicare for Patients and Providers Act. Support H.R. 2761, S. 705, Specialty Physicians Advancing Rural Care Act (SPARC Act). Support H.R. 4402, Protecting and Continuing Physician Education and Patient Care Act Support H.R. 830/S. 1375, the Help Ensure Lower Patient (HELP) Copays Act. Support H.R. 3674, the Providing Relief and Stability for Medicare Patients Act of 2023. Support S. 935, the Fair Accountability & Innovative Research (FAIR) Drug Pricing Act. Support H.R. 4968, Getting Over Lengthy Delays in Care as Required by Doctors (GOLD CARD) Act. Support H.R.2389/S.1302, the Resident Physicians Shortage Reduction Act. Advocate regarding matters related to Merit-based Incentive Payment System (MIPS), MIPS Value Pathways (MVPs), and Qualified Clinical Data Registries. Advocate regarding AADA efforts in skin cancer prevention and AADA skin cancer prevention programs and initiatives. H.R.7153/S.3679, the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. S.Res.567/H.Res.1089, a resolution recognizing the seriousness of widespread health care worker burnout in the United States and the need to strengthen health workforce well-being, and expressing support for the designation of March 18, 2024, as the inaugural "Health Workforce Well-Being Day of Awareness".; H.R. 2819, Good Samaritan Health Professionals Act; S. 4349, Electronic Prior Authorization for Prescription Drugs Act

Client expense: $1,060,000 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Office of Science & Technology Policy (OSTP), SENATE, White House Office

GOLD CARD Act of 2023 (H.R. 4968); pharmacy benefit manager policies and legislation; medication-assisted treatment expansion; telehealth controlled substances legislation; healthcare financial services policies; healthcare cybersecurity policies; S. 5218 (related to healthcare cybersecurity); Healthcare Cybersecurity Act of 2024 (S. 4697/H.R. 9412).

Client expense: $105,000 · Firm income: Not reported

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

P.L. 111-148 Affordable Care Act, modifications Prior authorization utilization policies Medicare Access and CHIP Reauthorization Act (P.L. 114-10) Improvement Issues Medicare Physician Payment Issues Drug Pricing and Shortages Issues Medicare Part B Drug Price Issues Expansion of Telehealth Services Vision Research Funding Implementation of No Surprises Act S. 652/H.R. 2630, the Safe Step Act The Ensuring Lasting Smiles Act Medicare Coverage for Low Vision Devices S. 1573/H.R. 3226 - Preemie Reauthorization Act of 2023 H.R.2474 - Strengthening Medicare for Patients and Providers Act Healthcare Workforce Issues H.R. 6545, the Physician Fee Schedule Update and Improvements Act H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023 H.R. 6487/S. 3805, the No Fees for EFTs Act H.R. 4968, the GOLD CARD Act H.R. 830/S. 1375, the Help Ensure Lower Patient Copays Act (HELP Copays Act) H.R. 2748, the Contact Lens Prescription Verification Modernization Act H.R. 1503, the Prescription Information Modernization Act of 2023 H.R. 7745, the Embracing Anti-Discrimination, Unbiased Curriculum, and Advancing Truth in Education (EDUCATE) Act Funding for the Pediatric Specialty Loan Repayment Program H.R. 8400, the Early Detection of Vision Impairments for Children Act of 2024 (EDVI Act) H.R. 8702/S. 4532, the Improving Seniors Timely Access to Care Act

Client expense: $295,134 · Firm income: Not reported

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

No Bill No. - Congressional Primary Care Caucus No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Medicare Physician Payment Reform No Bill No. - MACRA Implementation No Bill No. - CY2024 Medicare Physician Fee Schedule No Bill No. - CY 2024 Medicare Inpatient Prospective Payment System No Bill No. - Site Neutrality and Consolidation No Bill No. - CMS Prior Authorization Rules No Bill No. - Tobacco Users Quiet Act No Bill No. - G2211 Code (Physician Fee Schedule) No Bill No. - Reducing Medically Unnecessary Delays in Care Act No Bill No. - G2211 implementation/modifier 25 No Bill No. - HEALTH for Mom Act No Bill No. - Pay PCP Act No Bill No. - Seniors Timely Access to Care Act No Bill No. - CY25 Medicare Physician Fee Schedule No Bill No. - Physician Fee Stabilization Act (H.R. 952) Kids Access to Primary Care Act (H.R. 2400/S. 1165) The Reentry Act (H.R. 3074) Due Process Continuity of Care Act (H.R. 3766) Extending Access to Addiction Treatment Act (H.R. 4950/S. 2841) Improve Addiction Care Act (H.R. 4771) Children's Health Insurance Program Permanency Act (H.R. 4968) GOLD Card Act of 2023 (S. 2556) Improving Care for Youth Act (H.R. 5013) Value in Health Care Act (S. 2816) Medicaid for Every Child Act (H.R. 6545) Physician Fee Schedule Update and Improvements Act (H.R. 5434/S.3138) Stabilize Medicaid and CHIP Coverage Act (H.R. 5395) SURS Extension Act (H.R. 3487/S. 3805) No Fees for EFTs Act (S. 1316) Save Children's Coverage Act (H.R. 6997/S. 3010) Nutrition CARE Act (H.R. 6780/S. 2133) - Medically Tailored Home-Delivered Meals Demonstration Pilot Act (H.R. 8235) - Rural Physician Workforce Preservation Act (H.R. 7512) - Real-Time Benefit Tool Implementation Act (H.R. 1770/S. 2477) - Equitable Community Access to Pharmacist Act (S. 4349) - Electronic Prior Authorization for Prescription Drugs Act (H.R. 5434/S. 3138) - Stabilize Medicaid and CHIP Coverage Act

Client expense: $928,743 · Firm income: Not reported

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

No Bill No. - Congressional Primary Care Caucus No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Medicare Physician Payment Reform No Bill No. - MACRA Implementation No Bill No. - CY2024 Medicare Physician Fee Schedule No Bill No. - CY 2024 Medicare Inpatient Prospective Payment System No Bill No. - Site Neutrality and Consolidation No Bill No. - CMS Prior Authorization Rules No Bill No. - Tobacco Users Quiet Act No Bill No. - G2211 Code (Physician Fee Schedule) No Bill No. - Reducing Medically Unnecessary Delays in Care Act No Bill No. - G2211 implementation/modifier 25 No Bill No. - HEALTH for Mom Act No Bill No. - Pay PCP Act No Bill No. - Seniors Timely Access to Care Act (H.R. 952) Kids Access to Primary Care Act (H.R. 2400/S. 1165) The Reentry Act (H.R. 3074) Due Process Continuity of Care Act (H.R. 3766) Extending Access to Addiction Treatment Act (H.R. 4950/S. 2841) Improve Addiction Care Act (H.R. 4771) Children's Health Insurance Program Permanency Act (H.R. 4968) GOLD Card Act of 2023 (S. 2556) Improving Care for Youth Act (H.R. 5013) Value in Health Care Act (S. 2816) Medicaid for Every Child Act (H.R. 6545) Physician Fee Schedule Update and Improvements Act (H.R. 5434/S.3138) Stabilize Medicaid and CHIP Coverage Act (H.R. 5395) SURS Extension Act (H.R. 3487/S. 3805) No Fees for EFTs Act (S. 1316) Save Children's Coverage Act (H.R. 6997/S. 3010) Nutrition CARE Act (H.R. 6780/S. 2133) - Medically Tailored Home-Delivered Meals Demonstration Pilot Act (H.R. 8235) - Rural Physician Workforce Preservation Act (H.R. 7512) - Real-Time Benefit Tool Implementation Act

Client expense: $1,045,426 · Firm income: Not reported

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

HR 2474: Strengthening Medicare for Patients and Providers Act. Reps. Raul Ruiz, MD (D-CA); Larry Bucshon, MD (R-IN); Ami Bera, MD (D-CA); Mariannette Miller-Meeks, MD (R-IA). Provides an annual Medicare physician payment update tied to inflation as measured by the Medicare Economic Index (MEI). HR 4968, the GOLD CARD Act of 2023. Reps Michael Burgess (R-TX); Vincente Gonzalez (D-TX). Exempts physicians who in the previous year received approval for at least 90 percent of their prior authorization requests, from the prior authorization approval process under Medicare Advantage Plans. HR 6683: Preserving Seniors Access to Physicians Act. Reps. Greg Murphy, MD (R-NC); Brad Wenstrup, DPM (R-OH); Michael Burgess, MD (R-TX); Larry Bucshon, MD (R-IN); Danny Davis (D-IL); Jimmy Panetta (D-CA). Prevents the full 3.4% Medicare physician fee schedule cuts from being implemented on January 1, 2024. Support implementation of the No Surprises Act (NSA) according to congressional intent. The NSA aimed to fix the problem of unanticipated medical bills and remove patients from the middle of out-of-network billing disputes. However, the Administration crafted rules that disregard congressional intent and insurers are not being held accountable under current policies.

Client expense: $424,674 · Firm income: Not reported

Government targets: 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: $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

Inpatient Rehabilitation Facility (IRF) Review Choice Demonstration (RCD) Project IRF Three-Hour Rule - H.R. 6110, the Access to Inpatient Rehabilitation Therapy Act of 2023 Prior Authorization Reform - H.R. H.R.8702/S. 4532, the Improving Seniors' Timely Access to Care Act of 2024 - H.R. 4822, the Health Care Price Transparency Act of 2023 - H.R. 4968, the Getting Over Lengthy Delays in Care As Required by Doctors Act of 2023 - H.R. 5213, the Reducing Medically Unnecessary Delays in Care Act of 2023 Medicare Reimbursement / Physician Payment Schedule Cuts - H.R. 2474, the Strengthening Medicare for Patients and Providers Act of 2023 Scope of Practice - H.R. 2713, the Improving Care and Access to Nurses Act of 2023

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

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

COVID-19 / Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) / Long COVID - S. 801 / H.R. 1616, the CARE for Long COVID Act of 2023 - H.R. 1114, the Long COVID Recovery Now Act of 2023 - H.R. 3258, the TREAT Long COVID Act of 2023 - S. 2560, the Long COVID Support Act of 2023 Funding for Rehabilitation Research Inpatient Rehabilitation Facility (IRF) Review Choice Demonstration (RCD) Project Streamlining access to rehabilitation for Medicare beneficiaries (SNF three day rule, IRF three hour rule) - H.R. 6110, the Access to Inpatient Rehabilitation Therapy Act of 2023 Prior Authorization Reform - H.R. H.R.8702/S. 4532, the Improving Seniors' Timely Access to Care Act of 2024 - H.R. 4822, the Health Care Price Transparency Act of 2023 - H.R. 4968, the Getting Over Lengthy Delays in Care As Required by Doctors Act of 2023 - H.R. 5213, the Reducing Medically Unnecessary Delays in Care Act of 2023 Medicare Reimbursement / Physician Payment Schedule Cuts - H.R. 2474, the Strengthening Medicare for Patients and Providers Act of 2023 Scope of Practice - H.R. 2713, the Improving Care and Access to Nurses Act of 2023 - National Standards of Practice at the Department of Veterans Affairs

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE, Veterans Affairs, Dept of (VA)

S 765/HR 1526: Reducing Hereditary Cancer Act of 2023- provide hereditary cancer genetic testing Increasing access to telehealth S 2016/HR 4189: CONNECT for Health Act- expands access to telehealth services Medicare physician payment reforms HR 2474: Strengthening Medicare for Patients and Providers Act- physician reimbursement HR 5013: Value in Health Care Act of 2023 - provides a multi-year commitment to reforming care delivery by extending MACRA's 5 percent advanced APM incentives for an additional two years. S 3503: Value in Health Care Act of 2023 - A bill to direct the Secretary of Health and Human Services to revise certain regulations in relation to the Medicare shared savings program and other alternative payment arrangements to encourage participation in such program, and for other purposes HR 6371: Provider Reimbursement Stability Act of 2023 - To provide for certain adjustments to the physician fee schedule under the Medicare program. H.R. 6369: To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models - Extend incentive payments for participation in alternative payment models HR 3674: Providing Relief and Stability for Medicare Patients Act of 2023 - increase the nonfacility practice expense relative value units for specified services furnished under the Medicare program Reducing burdens caused by prior authorization requirements HR 4968: GOLD CARD Act of 2023 - exempt qualifying providers from prior authorization requirements under Medicare Advantage plans S 2372/HR 4758: Accelerating Kids' Access to Care Act - improve childrens access to needed out-of-state health care by streamlining Medicaid provider screening and enrollment processes. HR 6364: Medicare Telehealth Privacy Act of 2023 - To amend title XVIII of the Social Security Act to maintain certain telehealth flexibilities relating to provider privacy under the Medicare program S 2764/HR 5391: Protecting Patient Access to Cancer and Complex Therapies Act of 2023 - ensures patients will be able to access critical medications and providers will be reimbursed fairly, unaffected by drug pricing negotiations between Medicare and drug manufacturers. S 2345/HR 4714: Pediatricians Accelerate Childhood Therapies Act of 2023 - requires the National Institutes of Health (NIH) to make awards to support early-career pediatric researchers. It also provides statutory authority for the NIH Pediatric Research Consortium to coordinate pediatric research across national health research institutions. S 3967/HR 7623: Telehealth Modernization Act of 2024 - permanently extends telehealth flexibilities for Medicare beneficiaries. S 4518/HR 8702: To Amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans - prior authorization HR 7384: Creating Hope Reauthorization Act of 2024 - This bill extends until FY2029 a Food and Drug Administration program that awards priority review vouchers to manufacturers of drugs that treat rare pediatric diseases. HR 8412: Clinical Trial Modernization Act - To modernize clinical trials and remove barriers for participation in clinical trials, and for other purposes. S 2407/HR 4818: Treat and Reduce Obesity Act of 2023 - Expands Medicare coverage of intensive behavioral therapy for obesity.

Client expense: $540,000 · Firm income: Not reported

Government targets: 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

P.L. 111-148 Affordable Care Act, modifications Prior authorization utilization policies Medicare Access and CHIP Reauthorization Act (P.L. 114-10) Improvement Issues Medicare Physician Payment Issues Drug Pricing and Shortages Issues Medicare Part B Drug Price Issues Expansion of Telehealth Services Vision Research Funding Implementation of No Surprises Act S. 652/H.R. 2630, the Safe Step Act The Ensuring Lasting Smiles Act Medicare Coverage for Low Vision Devices S. 1573/H.R. 3226 - Preemie Reauthorization Act of 2023 H.R.2474 - Strengthening Medicare for Patients and Providers Act Healthcare Workforce Issues H.R. 6545, the Physician Fee Schedule Update and Improvements Act H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023 H.R. 6487/S. 3805, the No Fees for EFTs Act H.R. 4968, the GOLD CARD Act H.R. 830/S. 1375, the Help Ensure Lower Patient Copays Act (HELP Copays Act) H.R. 2748, the Contact Lens Prescription Verification Modernization Act H.R. 1503, the Prescription Information Modernization Act of 2023 H.R. 7745, the Embracing Anti-Discrimination, Unbiased Curriculum, and Advancing Truth in Education (EDUCATE) Act Funding for the Pediatric Specialty Loan Repayment Program H.R. 8400, the Early Detection of Vision Impairments for Children Act of 2024 (EDVI Act) H.R. 8702/S. 4532, the Improving Seniors Timely Access to Care Act Impacts of the Change Healthcare cyberattack on physician practices

Client expense: $300,425 · Firm income: Not reported

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

S. 4532--A bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans--Prior Authorization in Medicare Advantage H.R. 8702--To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans--Prior Authorization in Medicare Advantage S. 3573--Medicare Advantage Supplemental Benefits Transparency Act--Improving Supplemental Benefits for MA beneficiaries H.R. 5380--To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage--Improving Supplemental Benefits for MA beneficiaries S. 3307--Encounter Data Enhancement Act--Encounter Data in MA HR. 5746--Addressing Whole Health in Medicare Advantage Act--Supplemental Benefits for chronically Ill enrollees H.R. 4968--Gold Card Act of 2023--Exemptions to Prior Authorization in Medicare Advantage S. 3950--Delivering Unified Access to Lifesaving Services Act (DUALS) Act of 2024--Care Delivery for those eligible for Medicare and Medicaid Issues related to data collection and sharing among health plans, providers, and community-based organizations In-home Health Risk Assessments issues Issues related to mental and behavioral health issues in Medicare Advantage Issues related to oversight and governance of best practices related to misleading marketing practices and Third-Party Marketing Organizations (TPMO) Growth Rate and Normalization Factor in Calendar Year 2025 MA and Part D Advance Notice

Client expense: $470,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.470/H.R.977, Patient Access to Higher Quality Health Care Act: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. S.4532/H.R. 8702), Improving Seniors Timely Access to Care Act: To streamline prior authorization in the Medicare Advantage program. H.R.2389, Resident Physician Shortage Reduction Act: To provide for the distribution of additional residency positions H.R. 2474, Strengthening Medicare for Patients and Providers Act: To provide an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index. H.R. 4968, the GOLD CARD Act of 2023: Prior authorization reform in Medicare Advantage No bill: Graduate medical education policy reform ideas. No bill: Medicare physician payment reform policy ideas.

Client expense: $35,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.470/H.R.977, Patient Access to Higher Quality Health Care Act: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. S.4532/H.R. 8702), Improving Seniors Timely Access to Care Act: To streamline prior authorization in the Medicare Advantage program. H.R.2389, Resident Physician Shortage Reduction Act: To provide for the distribution of additional residency positions H.R. 2474, Strengthening Medicare for Patients and Providers Act: To provide an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index. H.R. 4968, the GOLD CARD Act of 2023: Prior authorization reform in Medicare Advantage No bill: Graduate medical education policy reform ideas. No bill: Medicare physician payment reform policy ideas.

Client expense: $35,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Recovery audit contractor reform. Medicare regulatory reform, including physician payment reforms, including Medicare physician payment provisions in: (1) S. 3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, Sec. 403 to extend work geographic index floor under Medicare; Sec. 404 to extend incentive payments for participation in eligible alternative payment models; and Sec. 407 to increase support for physicians and other professionals in adjusting to Medicare payment changes; (2) H.R. 6545, the Physician Fee Schedule Update and Improvements Act, including provisions to increase the work geographic index, increase the Medicare physician fee schedule conversion factor and extend and modify incentive payments for participation in eligible alternative payment models; and (3) H.R. 4366, the Consolidated Appropriations Act, 2024, P.L. 118-42: Sec. 304, Extending Incentive Payments for Participation in Eligible Alternative Payment Models; and Sec. 305, Temporary Payment Increase under the Medicare Physician Fee Schedule to Account for Exceptional Circumstances and Atypical Timing of Enactment. Network adequacy oversight, including Medicare Advantage plan provider directory accuracy issues, including provisions in S. 3430, the Better Mental Health Care, Lower Cost Drugs, and Extenders Act of 2023, in Sec. 109, to require MA plans to maintain accurate provider directories on a public website. Medicare accountable care organizations. Electronic health record interoperability and vendor accountability. Medicare Parts C and D prior authorization reforms, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Physician-led hospital barriers, including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act. Medicare physician fee schedule and sequestration relief, and Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor: (1) implementation of provisions in the Inflation Reduction Act of 2022 (P.L. 117-169), Subtitle B, Part 1, sec. (b), to modify Medicare Part B reimbursement by application of Maximum Fair Prices and Conforming Amendments, to selected Medicare Part B covered drugs; and (2) CMMI Medicare Part B drug demonstrations, including the Most Favored Nation demonstration.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Repeal Section 6001 of the Affordable Care Act - section 6001 prohibits expansion of physician-led hospitals - including related provisions in H.R. 977/S. 470, the Patient Access to Higher Quality Care Act; and in Draft Legislation by Rep. Burgess to amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals in rural areas; and related issues regarding hospital competition and consolidation. Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-led hospitals. Reform Medicare Advantage prior authorization, including related provisions in: H.R. 4968, the GOLD Card Act; H.R. 4822, the Health Care Price Transparency Act; H.R. 5378, the Lower Costs, More Transparency Act; and S. 4518/S. 4532/H.R. 8702, to establish requirements with respect to the use of prior authorization under Medicare Advantage plans.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

No Surprises Act implementation Eliminating prior authorization requirements in Medicare Advantage H.R. 4968-GOLD CARD Act of 2023, to improve prior authorization processes under Medicare Advantage for physicians with high approval rates

Client expense: $509,774 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment reform Counting observation stays as satisfying Medicare three-day inpatient stay prerequisite for skilled nursing facility (SNF) coverage Eliminating prior authorization requirements in Medicare Advantage H.R. 1128-Rural Health Care Access Act of 2023, to eliminate the 35-mile requirement to qualify as a critical access hospital H.R. 1129-Rural ER Access Act, to require the Centers for Medicare and Medicaid Services to repeal the 35-mile requirement for off-campus facilities H.R. 2474-Strengthening Medicare for Patients and Providers Act, to add an inflationary adjustment to physician payments under the Medicare Physician Fee Schedule H.R. 4189-CONNECT for Health Act, to expand access to telehealth services H.R.4366-Consolidated Appropriations Act, to provide appropriations for several federal departments and agencies and to provide an increase for the calendar year 2024 physician fee schedule conversion factor H.R. 4968-GOLD CARD Act of 2023, to improve prior authorization processes under Medicare Advantage for physicians with high approval rates H.R. 5213-Reducing Medically Unnecessary Delays in Care Act of 2023, to ensure that prior authorization medical decisions under Medicare are determined by physicians H.R. 6371-Provider Reimbursement Stability Act, to reform the Medicare budget neutrality process H.R. 6545-Physician Fee Schedule Update and Improvements Act, to provide a 1.25 percent adjustment to the 2024 Medicare Physician Fee Schedule conversion factor and update the budget neutrality threshold H.R. 6683-Preserving Seniors Access to Physicians Act of 2023, to fully eliminate the 3.37 percent conversion factor adjustment for calendar year 2024 H.R. 7432-Sickle Cell Comprehensive Care Act, to allow Medicaid programs to cover home health services for those with sickle cell disease H.R. 8702-Improving Seniors Timely Access to Care Act, to improve and streamline prior authorization under Medicare Advantage Plans H.R.---- -Fewer Burdens for Better Care Act of 2023, to provide for multi-stakeholder input on removal of quality and efficiency measures in Medicare reporting S. 996- H.R. 7432-Sickle Cell Comprehensive Care Act, to allow Medicaid programs to cover home health services for those with sickle cell disease S.2016-CONNECT for Health Act, to expand access to telehealth services S. 3430-Better Mental Health Care, Lower-Cost Drugs and Extenders Act, to provide a 1.25 percent adjustment to the 2024 Medicare Physician Fee Schedule conversion factor, and other provisions H.R. 4532-Improving Seniors Timely Access to Care Act, to improve and streamline prior authorization under Medicare Advantage Plans

Client expense: $509,774 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6445, Medicare Audiology Access Improvement Act of 2023, all provisions S. 2377, Medicare Audiology Access Improvement Act of 2023, all provisions H.R. 1610, Chiropractic Medicare Coverage Modernization Act of 2023, all provisions S. 799, Chiropractic Medicare Coverage Modernization Act of 2023, all provisions H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023, all provisions S. 2016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023, all provisions S. 712, Connected MOM Act, all provisions H.R. 5066, Tech to Save Moms Act, all provisions H.R. 1770, Equitable Community Access to Pharmacist Services Act, all provisions S. 2477, Equitable Community Access to Pharmacist Services Act, all provisions H.R. 751, Fair Access In Residency (FAIR) Act, all provisions H.R. 4968, Getting Over Lengthy Delays in Care As Required by Doctors (GOLD CARD) Act of 2023 H.R. 2713, Improving Care and Access to Nurses (ICAN) Act, all provisions S. 2418, Improving Care and Access to Nurses (ICAN) Act, all provisions H.R. 2583, Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023, all provisions H.R. 977, Patient Access to Higher Quality Health Care Act of 2023, all provisions S. 470, Patient Access to Higher Quality Health Care Act of 2023, all provisions H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions H.R. 7050, Substance Use Disorder Workforce Act, all provisions H.R. 7623, Telehealth Modernization Act of 2024, all provisions S. 3967, Telehealth Modernization Act, all provisions H.R. 2474, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 6371, Provider Reimbursement Stability Act of 2023, all provisions H.R. 6545, Physician Fee Schedule Update and Improvements Act, all provisions H.R. 5378, Lower Costs, More Transparency Act, all provisions H.R. 6683, Preserving Seniors Access to Physicians Act of 2023, all provisions H.R. 5013, Value in Health Care Act of 2023, all provisions S. 3503, Value in Health Care Act of 2023, all 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 (PREVENT DIABETES) Act, all provisions S. 4094, Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies (PREVENT DIABETES) Act, all provisions H.R. 8702, To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, all provisions S. 4532, A bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, all provisions H.R. 6366, To amend title XVIII of the Social Security Act with respect to the work geographic index for physician payments under the Medicare program, and to revise the phase-in of clinical laboratory test payment changes under such program, all provisions S. 4338, Pay PCPs Act of 2024, all provisions H.R. 8261, Preserving Telehealth, Hospital, and Ambulance Access Act, all provisions S. 1491, Pharmacy and Medically Underserved Areas Enhancement Act, all provisions S. 669, Increasing Mental Health Options Act of 2023, all provisions H.R. 7618, Stopping Addiction and Falls for the Elderly (SAFE) Act, all provisions H.R. 7254, Hearing Device Coverage Clarification Act, all provisions S. 3059, Requiring Enhanced & Accurate Lists of Health Providers Act, all provisions H.R. 7708, To amend title XVIII of the Social Security Act to require MA organizations offering network-based plans to maintain an accurate provider directory, and for other purposes, all provisions S. 4054, Health Care Cybersecurity Improvement Act of 2024, all provisions H.R. 1691, Ensuring Patient Access to Critical Breakthrough Products Act of 2023, all provisions H.R. 2407, Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act, all provisions H.R. 4818, Treat and Reduce Obesity Act of 2023, all provisions H.R. 8816, American Medical Innovation and Investment Act of 2024, all provisions H.R. 6369, To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models, all provisions H.R. 7665, ACO Assignment Improvement Act of 2024, all provisions S. 3939, ACO Assignment Improvement Act of 2024, all provisions H.R. 8404, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions S. 4330, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions H.R. 8235, Rural Physician Workforce Preservation Act, all provisions H.R. 1745, Medicare Fraud Detection and Deterrence Act of 2023, provisions related to telehealth H.R. 1746, Preventing Medicare Telefraud Act, all provisions H.R. 8532, To identify and address barriers to coverage of remote physiologic devices under State Medicaid programs to improve maternal and child health outcomes for pregnant and postpartum women, all provisions S. 4350, Hospital Inpatient Services Modernization Act, 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. 7279, Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act, all provisions S. 971, Due Process Continuity of Care Act, all provisions Data-Driven Performance Payment System/draft Fewer Burdens for Better Healthcare Act/draft Supporting Healthy Moms and Babies Act/draft Medicare program: Improving Seniors Timely Access to Care Act implementation Medicare program: No Surprises Act implementation Medicare program: 21st Century Cures Act implementation Medicare program: Medicare physician payment reform Medicare program: Medicare Access and CHIP Reauthorization Act (MACRA)/physician burdens Medicare program: Merit-based Incentive Payment System (MIPS) Medicare program: MIPS Value Pathways Medicare program: MIPS/timely, actionable data Medicare program: Site neutral payments Medicare program: Information blocking Medicare program: Alternative Payment Models (APMs) Medicare program: Physician payment/inflation/practice costs Medicare program: High-cost disposable services/payment Medicare program: Prior authorization Medicare program: Hospital-at-Home Extension Medicare program: Prescriber-facing real-time benefit tools Medicare program: Accountable Care Organizations (ACO) Medicare program: ACO/APM flexibilities Medicare program: Medicare Shared Savings Program/regulatory changes Medicare program: Shared Savings Program/Promoting Interoperability/Certified EHR Technology Medicare program: Primary care payment reform Medicare program: Chronic care Medicare program: Diabetes Prevention Program Medicare program: Graduate Medical Education Medicare program: Medicare Administrative Contractors (MACs)/Local Coverage Article (LCA)/Local Coverage Determination (LCD) Medicare program: Quality Payment Program/physician burdens Medicare program: Medicare Shared Savings Program/Advanced APM reporting requirements Medicare program: Patient engagement Medicare program: Health IT/physician burdens Medicare program: Provider feedback/quality and efficiency measures Medicare and Medicaid programs: CHANGE Healthcare cyberattack Medicare and Medicaid programs: Rural health care Medicare and Medicaid programs: Data privacy Medicare and Medicaid programs: Pharmacy Benefit Managers Medicaid program: Maternal mortality

Client expense: $5,120,000 · Firm income: Not reported

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