Choices for Increased Mobility Act of 2023

Issues pertaining to durable medical equipment including competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Issues related to Medicare sequestration paygo relief legislation; Issues related to the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas. S.1294 - Competitive Bidding Relief Act of 2023; Issues related to the COVID-19 public health emergency and expansion of telehealth act; Implementation of the Better Wound Care at Home Act of 2021; H.R.4189 - CONNECT for Health Act of 2023; H.R.5555 - DEMPOS Relief Act of 2023; H.R.5371/S.5154 - Choices for Increased Mobility Act of 2023; S.3630/H.R.7147 - Medicare Transaction Fraud Prevention Act.

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

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

Modifications/repeal of QBAI and FDII; H.R. 5371, S. 1077 which seeks to extend EBITDA calculation for interest deductibility; Issues associated with the R&D tax credit, bonus depreciation and modifying the corporate tax rate.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Congressional and regulatory efforts related to competitive bidding and coding coverage for complex rehabilitation technology; S.5154, Choices for Increased Mobility Act of 2024; H.R.5371, Choices for Increased Mobility Act of 2023.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare durable medical equipment payment rates in competitive bidding and non-competitive bidding areas, including S. 1294, the Competitive Bidding Relief Act of 2023, S. 3430, Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 and H.R. 5555, the DMEPOS Relief Act of 2023. Issues related to durable medical equipment ordering, payment, telehealth, home oxygen, non invasive ventilator, wound care, diabetes supplies, and program integrity. Issues related to titanium/carbon wheelchair upgrades, including S. 5154 / H.R. 5371, the Choices for Increased Mobility Act of 2023.

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

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

Issues related to Medicare reimburs4ement cuts in DME noncompetitive bidding. DEMPOS Relief Act of 2023 (H.R. 5555/S. 1294). Issues related to catheter reimbursement cording. Issues related to non-invasive ventilator reimbursement. Legislation to provide Medicare beneficiaries with access to titanium and carbon fiber wheelchairs (H.R. 5371).

Client expense: Not reported · Firm income: $45,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare reimburs4ement cuts in DME noncompetitive bidding. DEMPOS Relief Act of 2023 (H.R. 5555/S. 1294). Issues related to catheter reimbursement cording. Issues related to non-invasive ventilator reimbursement. Legislation to provide Medicare beneficiaries with access to titanium and carbon fiber wheelchairs (H.R. 5371).

Client expense: Not reported · Firm income: $45,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Protect access to Complex Rehabilitation Technology (CRT) through telehealth evaluation and management; Coverage, coding and reimbursement of power standing and seat elevation; addressing supply chain and inflation concerns; HR 5555 DMEPOS Relief Act; HR 5371 Choices for Increased Mobility Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare durable medical equipment payment rates in competitive bidding and non-competitive bidding areas, including S. 1294, the Competitive Bidding Relief Act of 2023, S. 3430, Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 and H.R. 5555, the DMEPOS Relief Act of 2023. Issues related to durable medical equipment ordering, payment, telehealth, home oxygen, non invasive ventilator, wound care, diabetes supplies, and program integrity. Issues related to titanium/carbon wheelchair upgrades, including H.R. 5371, the Choices for Increased Mobility Act of 2023.

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

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

Modifications/repeal of QBAI and FDII; H.R. 5371, S. 1077 which seeks to extend EBITDA calculation for interest deductibility; Issues associated with the R&D tax credit, bonus depreciation and modifying the corporate tax rate.

Client expense: $240,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare reimburs4ement cuts in DME noncompetitive bidding. DEMPOS Relief Act of 2023 (H.R. 5555/S. 1294). Issues related to catheter reimbursement cording. Issues related to non-invasive ventilator reimbursement. Legislation to provide Medicare beneficiaries with access to titanium and carbon fiber wheelchairs (H.R. 5371).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare reimburs4ement cuts in DME noncompetitive bidding. DEMPOS Relief Act of 2023 (H.R. 5555/S. 1294). Issues related to catheter reimbursement cording. Issues related to non-invasive ventilator reimbursement. Legislation to provide Medicare beneficiaries with access to titanium and carbon fiber wheelchairs (H.R. 5371).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to durable medical equipment including competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Issues related to Medicare sequestration paygo relief legislation; Issues related to the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; S.1294 - Competitive Bidding Relief Act of 2023 (issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas); Issues related to the COVID-19 public health emergency; H.R.7623 - Telehealth Modernization Act of 2024; Consolidated Appropriations Act, 2022 (P.L. 117-103) (issues related to coding and payment for the new required benefit regarding disposable negative pressure wound therapy devices); H.R.4189 - CONNECT for Health Act of 2023; H.R.5555 - DEMPOS Relief Act of 2023; H.R.5371/S.5154 - Choices for Increased Mobility Act of 2023; H.R.7147/S.3630 - Medicare Transaction Fraud Prevention Act.

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

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Medicare sequestration paygo relief legislation; Issues related the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas (S. 1294); Issues related to the COVID-19 public health emergency and expansion of telehealth act; Implementation of the Better Wound Care at Home Act of 2021; H.R. 4189 - CONNECT for Health Act of 2023; H.R. 5555 - DEMPOS Relief Act of 2023; H.R. 5371 - Choices for Increased Mobility Act of 2023; S.3630/H.R. 7147 - Medicare Transaction Fraud Prevention Act.

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

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

Protect access to Complex Rehabilitation Technology (CRT) through telehealth evaluation and management; Coverage, coding and reimbursement of power standing and seat elevation; addressing supply chain and inflation concerns; HR 8816 American Medical Innovation and Investment Act; HR 5555 DMEPOS Relief Act; HR 5371 Choices for Increased Mobility Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Modifications/repeal of QBAI and FDII; H.R. 5371, S. 1077 which seeks to extend EBITDA calculation for interest deductibility; Issues associated with the R&D tax credit and bonus depreciation.

Client expense: $180,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare durable medical equipment payment rates in competitive bidding and non-competitive bidding areas, including S. 1294, the Competitive Bidding Relief Act of 2023, S. 3430, Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 and H.R. 5555, the DMEPOS Relief Act of 2023. Issues related to durable medical equipment ordering, payment, telehealth, home oxygen, non invasive ventilator, wound care, diabetes supplies, and program integrity. Issues related to titanium/carbon wheelchair upgrades, including H.R. 5371, the Choices for Increased Mobility Act of 2023.

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

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

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Medicare sequestration paygo relief legislation; Issues related the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas (S. 1294); Issues related to the COVID-19 public health emergency and expansion of telehealth act; Implementation of the Better Wound Care at Home Act of 2021; H.R. 4189 - CONNECT for Health Act of 2023; H.R. 5555 - DEMPOS Relief Act of 2023; H.R. 5371 - Choices for Increased Mobility Act of 2023; S.3630/H.R. 7147 - Medicare Transaction Fraud Prevention Act.

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

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

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Medicare sequestration paygo relief legislation; Issues related the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas (S. 1294); Issues related to the COVID-19 public health emergency and expansion of telehealth act; Implementation of the Better Wound Care at Home Act of 2021; H.R. 4189 - CONNECT for Health Act of 2023; H.R. 5555 - DEMPOS Relief Act of 2023; H.R. 5371 - Choices for Increased Mobility Act of 2023; S.3630/H.R. 7147 - Medicare Transaction Fraud Prevention Act.

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

Protect access to Complex Rehabilitation Technology (CRT) through telehealth evaluation and management; Coverage, coding and reimbursement of power standing and seat elevation; addressing supply chain and inflation concerns; HR 5371 Choices for Increased Mobility Act, HR 2882 Further Consolidated Appropriations Act of 2024, HR 4366 the Consolidated Appropriations Act of 2024

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Modifications/repeal of QBAI and FDII; H.R. 5371, S. 1077 which seeks to extend EBITDA calculation for interest deductibility; Issues associated with the R&D tax credit and bonus depreciation.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare durable medical equipment payment rates in competitive bidding and non-competitive bidding areas, including S. 1294, the Competitive Bidding Relief Act of 2023, S. 3430, Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 and H.R. 5555, the DMEPOS Relief Act of 2023. Issues related to durable medical equipment ordering, payment, telehealth, home oxygen, non invasive ventilator, wound care, diabetes supplies, and program integrity. Issues related to titanium/carbon wheelchair upgrades, including H.R. 5371, the Choices for Increased Mobility Act of 2023. H.R.2872, Further Additional Continuing Appropriations and Other Extensions Act, 2024, H.R.4366, Consolidated Appropriations Act, 2024, and H.R.2882, Further Consolidated Appropriations Act, 2024, as they relate to durable medical equipment payment rates.

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

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

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration; Medicare sequestration paygo relief legislation; Issues related the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas (S. 1294); Issues related to the COVID-19 public health emergency and expansion of telehealth act; Implementation of the Better Wound Care at Home Act of 2021; and H.R. 4189 - CONNECT for Health Act of 2023; H.R. 5555 -DEMPOS Relief Act of 2023; H.R. 5371 - Choices for Increased Mobility Act of 2023.

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

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

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, and sequestration; Medicare sequestration paygo relief legislation; Issues related the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas (S. 1294); Issues related to the COVID-19 public health emergency and expansion of telehealth act; Implementation of the Better Wound Care at Home Act of 2021; H.R. 4189 - CONNECT for Health Act of 2023; H.R. 5555 - DEMPOS Relief Act of 2023; H.R. 5371 - Choices for Increased Mobility Act of 2023.

Client expense: $230,000 · Firm income: Not reported

Protect access to Complex Rehabilitation Technology (CRT) through telehealth evaluation and management; Coverage, coding and reimbursement of power standing and seat elevation; addressing supply chain and inflation concerns; HR 5371 Choices for Increased Mobility Act, HR 6363 Further Continuing Appropriations and Other Extension Act of 2024

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

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

Oppose corporate tax rate increases; Extend EBITDA calculation for interest deductibility (H.R. 5371, S. 1077); oppose National Retail Sales Tax/VAT;;; Extend R&D; bonus depreciation.

Client expense: $2,150,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Issues related to Medicare durable medical equipment payment rates in competitive bidding and non-competitive bidding areas, including S. 1294, the Competitive Bidding Relief Act of 2023, S. 3430, Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 and H.R. 5555, the DMEPOS Relief Act of 2023. Issues related to durable medical equipment ordering, payment, telehealth, home oxygen, non invasive ventilator, wound care, diabetes supplies, and program integrity. Issues related to titanium/carbon wheelchair upgrades, including H.R. 5371, the Choices for Increased Mobility Act of 2023.

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

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

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration; Medicare sequestration paygo relief legislation; Issues related the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas (S. 1294); Issues related to the COVID-19 public health emergency and expansion of telehealth act; Implementation of the Better Wound Care at Home Act of 2021; and H.R. 4189 - CONNECT for Health Act of 2023; H.R. 5555 -DEMPOS Relief Act of 2023; H.R. 5371 - Choices for Increased Mobility Act of 2023.

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

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration; Medicare sequestration paygo relief legislation; Issues related the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas (S. 1294); Issues related to the COVID-19 public health emergency and expansion of telehealth act; Implementation of the Better Wound Care at Home Act of 2021; and H.R. 4189 - CONNECT for Health Act of 2023; H.R. 5555 -DEMPOS Relief Act of 2023; H.R. 5371 - Choices for Increased Mobility Act of 2023.

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

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

Modifications/repeal of QBAI and FDII; H.R. 5371, S. 1077 which seeks to extend EBITDA calculation for interest deductibility; Issues associated with the R&D tax credit and bonus depreciation.

Client expense: $230,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

On September 14th, United Spinal Association participated in a Complex Rehabilitation Technology (CRT) Product Expo on Capitol Hill for members of Congress and their staffs hosted by the National Coalition for Assistive and Rehab Technology (NCART) and the National Registry of Rehabilitation Technology Suppliers (NRRTS). Policy staff invited members of Congress and their staffs and explained how CRT makes our lives healthier and productive. Additionally, attendees could interact with CRT products, other CRT users, clinicians, providers, manufacturers, and other advocates provided demonstrations and answered questions. United Spinal Association commends the Centers for Medicare and Medicaid Services (CMS) for their announcement in May 2023 in support of Medicare coverage of seat elevation for power wheelchairs, and we are urging CMS to expand on this progress and hold to its commitment of swiftly opening a comment period for standing systems in power wheelchairs and to conduct a full review of its mobility device coverage, coverage, coding and payment policies. Additionally, due to the increasingly restrictive interpretation of Medicare's "in the home" language and the adoption of Medicare coverage policy by commercial insurers, wheelchair users face constant insurance denials and delays in obtaining appropriate equipment resulting in health injuries and secondary health conditions such as pressure injuries (pressure sores) and rotator cuff and carpal tunnel injuries, due to overuse of their upper extremities. United Spinal advocated for members of Congress to support a legislative or regulatory fix by asking that they join a House Dear Colleague Letter sent to CMS July 13, led by Rep. Debbie Dingell (D-MI) and Rep. Brian Fitzpatrick (R-PA) that requested: 1) CMS hold to its commitment of opening the comment period for Medicare coverage of standing systems; 2) lifting the "in the home" restriction on coverage of mobility devices that meet the medical and functional needs of all people with mobility disabilities; adding "and/or in the community" to the MAE language in the NCD; and 3) conducting a full review of current mobility device coverage, coding and payment policies. On September 26th, United Spinal policy staff participated in an ITEM Coalition meeting with the Centers for Medicare & Medicaid Services (CMS) to discuss the national coverage determination (NCD) request for standing systems in power wheelchairs. United Spinal Association advocated for and supported a letter Senators Maggie Hassan (D-NH), Marsha Blackburn (R-TN), Bob Casey (D-PA), and Tammy Duckworth (D-IL) sent the Centers for Medicare and Medicaid Services (CMS) request a full review of its 2005 National Coverage Determination for Mobility Assistive Equipment (MAE) for Medicare beneficiaries, including its interpretation of the in the home requirement. Current Medicare coverage limitations on equipment used outside the home can limit patients access to mobility equipment and to their communities. United Spinal submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the proposed rule addressing the CY 2024 update to the Home Health Prospective Payment System, [CMS-1780-P]. The comments focused solely on the proposed language under Definition of a Brace. United Spinal Association supports NCART and NRRTS legislative asks: Ask 1: CMS must move forward with establishing Medicare coverage for Power Standing Systems We are incredibly thankful to CMS for following the medical evidence and initiating coverage for Seat Elevation this past year. However, CMS has not yet moved forward on establishing coverage for Power Standing Systems used with CRT Power Wheelchairs. This request was submitted jointly with the request for power seat elevation in September 2020, but CMS separated the two technologies and opted to consider coverage individually. Clinical evidence shows that Power Standing Systems provide significant medical benefits and allow people with disabilities to maintain independence in their homes and communities. This delay is resulting in a denial of access for individuals with mobility impairments and we are asking Congress to contact CMS Administrator Brooks-LaSure to urge needed action. Ask 2: CMS must allow consumers equal opportunity to upgrade their own equipment For some Medicare enrollees, enhanced options like titanium or carbon fiber are available for the CRT equipment recommended by their clinical team. However, these upgrades are currently only available through a complicated process that does not allow Medicare beneficiaries to simply cover the difference in cost. This limits patient choice and forces individuals to either utilize equipment that may not be optimized for their medical needs or pay entirely out of pocket for equipment with the desired upgrades. HR 5371 introduced by Rep. John Joyce (R-PA) allows for code upgrades for titanium and carbon fiber wheelchairs under Medicare. We believe that individuals should have the right to utilize their insurance benefits while still being able to optimize their equipment if they choose to do so. This would not result in any additional cost to the Medicare program. We ask each Representative to contact Matt Joyce in Representative Joyces office to Cosponsor HR 5371 and allow this important change for individuals with disabilities. Ask 3: Congressional Support must be provided to maintain access to CRT equipment. Currently, providers are only reimbursed for a portion of the multi-layer process of supplying CRT equipment, which includes clinical evaluation, technology assessment, equipment simulation, assembly/configuration, delivery, fitting, programming, and training. Ongoing inflation and increased operating expenses further threaten access to needed equipment, repairs, and other services for individuals with disabilities. Relief is needed and we are asking Congress to discuss CRT stakeholder recommendations and pursue actions that support a strong provider network and secure access for individuals who rely on this life-changing equipment. Submitted comments to CMS re RFI on Home Health Aide Services. United Spinal Association met with CMS, with other stakeholders, to discuss the expansion of HCPCS coding for catheters. United Spinal Association, as a member of the ITEM Coalition, submitted comenmts on Transtioanl Coverage for Emerging Technologies (TCET). United Spnal Association, as part of the Coalition to Preserve Rehabilitation, submitted comments on the IRF Review Choice Demonstration. United Spinal Asociaton met with CMS to discuss the need for coverage of standing systems in wheelchairs and thanked CMS for the coverage of seat elevation under Medicare. United Spinal Asociaton met with ACL to discuss the need for coverage of standing systems in wheelchairs and thanked ACL's support for the coverage of seat elevation under Medicare.

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration; Medicare sequestration paygo relief legislation; Issues related the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas (S. 1294); Issues related to the COVID-19 public health emergency and expansion of telehealth act; Implementation of the Better Wound Care at Home Act of 2021; and H.R. 4189 - CONNECT for Health Act of 2023; H.R. 5555 -DEMPOS Relief Act of 2023; H.R. 5371 - Choices for Increased Mobility Act of 2023.

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

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

Oppose corporate tax rate increases; Extend EBITDA calculation for interest deductibility (H.R. 5371, S. 1077); oppose National Retail Sales Tax/VAT; Support Remote and Mobile Worker Relief Act (S. 1274); Oppose repeal of Sec. 199Adeduction; Extend R&D; bonus depreciation. 17. House(s) of Congress and Federal agencies

Client expense: $2,130,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of

Modifications/repeal of QBAI and FDII; H.R. 5371, S. 1077 which seeks to extend EBITDA calculation for interest deductibility; Issues associated with the R&D tax credit and bonus depreciation.

Client expense: $150,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare durable medical equipment payment rates in competitive bidding and non-competitive bidding areas, including S. 1294, the Competitive Bidding Relief Act of 2023, and H.R. 5555, the DMEPOS Relief Act of 2023. Issues related to durable medical equipment ordering, payment, telehealth, home oxygen, wound care, diabetes supplies, and program integrity. Issues related to titanium/carbon wheelchair upgrades, including H.R. 5371, the Choices for Increased Mobility Act of 2023.

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

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

Issues pertaining to durable medical equipment including: competitive bidding, power wheelchairs, oxygen, non-invasive ventilators, diabetic supplies, negative pressure wound therapy, Medicare audits, sequestration; Medicare sequestration paygo relief legislation; Issues related the non-application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs manual accessories, titanium/carbon upgrade legislation, and Medicare coverage of seat elevation and standing features; Issues related to Medicare reimbursement cuts in DME noncompetitive bidding areas (S. 1294); Issues related to the COVID-19 public health emergency and expansion of telehealth act; Implementation of the Better Wound Care at Home Act of 2021; and H.R. 4189 - CONNECT for Health Act of 2023; H.R. 5555 -DEMPOS Relief Act of 2023; H.R. 5371 - Choices for Increased Mobility Act of 2023.

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

Oppose corporate tax rate increases (Build Back Better Act); Oppose repeal of QBAI and FDII; Extend EBITDA calculation for interest deductibility (H.R. 5371, S. 1077); oppose National Retail Sales Tax/VAT; Support Remote and Mobile Worker Relief Act (S. 1274); Oppose repeal of Sec. 199Adeduction; Extend R&D; bonus depreciation. Provide comments on guidance on CAMT & green energy tax incentives to Treasury.

Client expense: $2,150,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), Natl Economic Council (NEC), SENATE, Treasury, Dept of