Protecting Rural Seniors’ Access to Care Act

340B Drug Discount Program ---H.R.8574: 340B Affording Care for Communities and Ensuring a Strong Safety-net Act ---S.1133: 340B Accountability Act ---Executive Order on Access to Affordable Life-Saving Medications ---Program Implementation & Oversight ---PROTECT 340B Act ---SUSTAIN 340B Act Accelerated Approval Access to non-human Primates (NHPs) Artificial Intelligence (AI) Alternative Funding Programs Biodefense Research, Development and Procurement Issues (Non-Funding) ---H.R.3577: Medical and Health Stockpile Accountability Act of 2023 ---H.R.3631: State Strategic Stockpile Act of 2023 ---H.R.3703: Helping Evaluate Appropriate Logistical Infrastructure for National Government (HEALING) Response Act of 2023 ---H.R.3742: To direct the Comptroller General of the United States to evaluate the Federal Governments collection and sharing of public health data to respond to public health emergencies. ---H.R.3791: Improving Data Accessibility Through Advancements (DATA) in Public Health Act ---H.R.3795: To amend the Public Health Service Act to require the development of a diagnostic testing preparedness plan to be used during public health emergencies, and for other purposes. ---H.R.3832: Disease X Act of 2023 ---H.R.7085: BIOSECURE Act ---S.4667: Risky Research Review Act ---Bio COMPETES (Draft) ---Biosecurity Infrastructure for Operational (BIO) Early Warning Act (Discussion Draft) ---House GOP RFI on Supply Chain ---Implementation of Medical Countermeasure Innovation Act of 2016 ---Implementation of Pandemic and All-Hazards Preparedness and Advancing Innovation (PAHPAI) Act of 2019 ---American Pandemic Preparedness Plan (AP3) ---Gain of function (Viral Gain of Function Research Moratorium Act, Risky Research Act) ---MCM PRV Program ---NDAA ---Reasonable Pricing Clauses in BARDA Contracts ---Reauthorization of Pandemic and All-Hazards Preparedness and Advancing (PAHPA) ---Tropical Disease Priority Review Voucher (PRV) Program ---VICP Loopholes ---White House National Biodefense Strategy ---WHO Pandemic Preparedness Accord Biosimilars ---S.142: Preserve Access to Affordable Generics and Biosimilars Act ---S.2305: Biosimilar Red Tape Elimination Act ---Bio COMPETES (Draft) ---Biosimilar Copay ---House GOP RFI on Supply Chain ---Interchangeability and Pharmacy Substitution Cell & Gene Therapy Climate Change Clinical Trial Data in China Data Privacy ---H.R.7085: BIOSECURE Act ---H.R.7520: Protecting Americans Data from Foreign Adversaries Act of 2024 ---S.3558: A bill to prohibit contracting with certain biotechnology providers, and for other purposes. ---H.R.8818: American Privacy Rights Act of 2025 ---Bio COMPETES (Draft) ---Executive Order on Preventing Access to Americans Bulk Sensitive Personal Data and United States Government-Related Data by Countries of Concern ---House GOP RFI on Supply Chain Diagnostics and Personalized Medicine Regulation and Oversight Diversity & Inclusion ---Decentralized Clinical Trials ---Implementation of Prepare for and Respond to Existing Viruses, Emerging New Threats and (PREVENT) Pandemics Act Drug Evaluation and Review ---S.1906: Promising Pathway Act Drug Importation Drug Manufacturing, Quality & Distribution ---Advanced Manufacturing ---Drug Shortages ---Executive Order on Advancing Biotechnology and Biomanufacturing Innovation for a Sustainable, Safe, and Secure American Bioeconomy ---Supply Chain Integrity and Traceability Drug Patenting ---S.79/H.R.1717: Interagency Patent Coordination and Improvement Act of 2023 ---S.113: Prescription Pricing for the People Act of 2023 ---S.142: Preserve Access to Affordable Generics and Biosimilars Act ---S.148: Stop STALLING Act ---S.150: Affordable Prescriptions for Patients Act of 2023 ---S.1128: A bill to establish special rules relating to information provided with respect to drug applications concerning method of use patents. ---S.2780: Medication Affordability & Patient Integrity Act ---S.3583/H.R.6986: A bill to address patent thickets ---S.5573: A bill to amend title 35, United States Code, to provide for a safe harbor from infringement of a method of use patent relating to drugs or biological products. ---Affordable Prescriptions for Patients Act ---Interagency Patent Coordination and Improvement Act ---Restrictions on Intellectual Property Rights Drug Pricing ---H.R.133: Mandating Exclusive Review of Individual Treatments (MERIT) Act ---H.R.2148/S.909: Prescription Drug Price Relief Act ---H.R.2408: Access to Innovative Treatments Act of 2023 ---H.R.4895: Lowering Drug Costs for American Families Act ---H.R.5539/S.3131: ORPHAN Cures Act ---H.R.5547/S.476: Maintaining Investments and New Innovation (MINI) Act ---H.R.6283: DRUG Act ---H.R.7174: Ensuring Pathways to Innovative Cures (EPIC) Act ---S.79/H.R.1717: Interagency Patent Coordination and Improvement Act of 2023 ---S.113: Prescription Pricing for the People Act of 2023 ---S.127: Pharmacy Benefit Manager Transparency Act of 2023 ---S.142: Preserve Access to Affordable Generics and Biosimilars Act ---S.148: Stop STALLING Act ---S.150: Affordable Prescriptions for Patients Act of 2023 ---S.775: Increasing Transparency in Generic Drug Application ---S.1067: Ensuring Timely Access to Generics ---S.1128: A bill to establish special rules relating to information provided with respect to drug applications concerning method of use patents. ---S.2305: Biosimilar Red Tape Elimination Act ---S.2973: Modernizing and Ensuring PBM Accountability (MEPA) Act ---H.R.2408: Access to Innovative Treatments Act ---CMMI Authority ---COVID-19 Pricing Related Provisions ---Implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act for FY 2020 ---Implementation of the Inflation Reduction Act (IRA) of 2022 ---Medicare Negotiation and Competitive Licensing Act ---National Coverage Determination ---Patients Before Monopolies (PBM) Act ---PBM Reform ---Patient Cost-Sharing and Implementation ---Strengthening Innovation in Medicare and Medicaid Act Efforts to expand the Bio Economy & Bio Manufacturing Foreign Drug Data Protection Laws ---H.R.7085: BIOSECURE Act ---H.R.7520: Protecting Americans Data from Foreign Adversaries Act of 2024 ---S.3558: A bill to prohibit contracting with certain biotechnology providers, and for other purposes. ---Bio COMPETES (Draft) ---Executive Order on Preventing Access to Americans Bulk Sensitive Personal Data and United States Government-Related Data by Countries of Concern ---House GOP RFI on Supply Chain Funding for Antimicrobial Resistance (AMR) Programs ---FY 2025 Appropriations ---H.R.2940/S.1355: Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act Funding for Biodefense/Biomedical/Emergency Preparedness Research, Development and Procurement ---FY 2025 Appropriations ---Funding for Strategic National Stockpile ---Implementation of the Inflation Reduction Act (IRA) of 2022 ---MCM PRV ---Reauthorization of Pandemic and All-Hazards Preparedness and Advancing (PAHPA) Funding for the Centers for Disease Control and Prevention Vaccine Programs ---FY 2025 Appropriations ---VICP Funding for FDA ---FY 2025 Appropriations ---Creating Hope Reauthorization Act ---Prescription Drug User Fee Act (PDUFA) VII Implementation Funding for Health Resources and Services Administration (HRSA) ---FY 2025 Appropriations Funding for the HHS Office of Infectious Disease and HIV/AIDS Policy ---FY 2025 Appropriations Funding for National Institutes of Health ---FY 2025 Appropriations ---Advanced Research Projects Agency for Health (ARPA-H) ---Funding for Womens Health Research Generic Drug Entry ---H.R.6973: Generic Drug Application Review Reforms ---S.148: Stop STALLING Act ---S.4351: Enhanced Access to Affordable Medicines Act Issues Relating to Medical Research and Animal Testing Models ---H.R.7248: FDA Modernization Act 3.0 Medicaid ---H.R.2666: The Medicaid VBPs for Patients (MVP) Act ---H.R.4758: Accelerating Kids Access to Care Act ---S.127: Pharmacy Benefit Manager Transparency Act of 2023 ---S.2973: Modernizing and Ensuring PBM Accountability (MEPA) Act ---Alternative Payment Arrangements for Gene Therapies ---Coverage of Accelerated Approval Products ---Drug Benefit Design ---Medicaid Drug Rebate Program Rule ---Pricing and Rebates ---Value-Based Purchasing (VBP) Rule National Defense ---National Defense Authorization Act of 2025 Opioid Crisis ---H.R.4531/S.2933: Support for Patients and Communities Reauthorization Act ---Non-Opioid Analgesics ---Coverage and Reimbursement Orphan Drug Issues ---H.R.3433: Give Kids a Chance Act ---H.R.5539/S.3131: ORPHAN Cures Act ---H.R.6664: Innovation in Pediatric Drugs Act of 2023 ---H.R.6731/S.3464: Finding Orphan-Disease Remedies with Antifungal Research and Development (FORWARD) Act ---S.1214: Retaining Access and Restoring Exclusivity (RARE) Act ---Implementation of the Inflation Reduction Act (IRA) of 2022 ---Orphan Drug Tax Credit Pandemic Preparedness ---Drug Supply Chain Management ---Implementation of the Prepare for and Respond to Existing Viruses ---Emerging New Threats and (PREVENT) Pandemics Act ---Monoclonal Antibody Coverage and Utilization ---R&D Funding for Medical Countermeasures ---Restrictions on Intellectual Property Rights ---Supply Chain Issues ---Temporarily Refundable R&D Credit ---TRIPS Waiver ---WHO Pandemic Preparedness Accord Precision Medicine Initiative Rare Pediatric Disease Priority Review ---H.R.7384/S4583: Creating Hope Reauthorization Act of 2024 ---Helping Experts Accelerate Rare Treatments (HEART)Act ---Rare Disease Pilot Program ---Speeding Therapy Access Today (STAT) Act Reimbursement and Coverage of Innovative Products ---H.R.133: Mandating Exclusive Review of Individual Treatments (MERIT) Act ---H.R.830/S.1375: HELP Copays Act ---H.R.2139/S.908: Medicare Drug Price Negotiation Act ---H.R.2148/S.909: Prescription Drug Price Relief Act ---H.R.2408: Access to Innovative Treatments Act of 2023 ---H.R.2630/S.652: SAFE STEP Act ---H.R.2666: The Medicaid VBPs for Patients (MVP) Act ---H.R.4895: Lowering Drug Costs for American Families Act ---H.R.5378: Lower Costs, More Transparency Act ---H.R.5796/S424: Protect our Seniors Act ---Administration Rebate Rule ---CMMI Authority ---Implementation of the Inflation Reduction Act (IRA) of 2022 ---In-Home Administration of Part B Drugs ---Lower Costs, More Cures Act ---Medicare Part B Physician-Administered Products ---National Coverage Determination ---Patient Cost-Sharing and Smoothing ---Protected Classes ---H.R.5260: Reduced Costs and Continued Cures Act ---Step Therapy ---Support of Patient Premiums and Cost-Sharing Obligations ---Value-based Contracting and Communications ---Value-Based Purchasing (VBP) Rule Vaccines and Infectious Diseases ---FY 2025 Appropriations ---H.R.133: Mandating Exclusive Review of Individual Treatments (MERIT) Act ---H.R.2408: Access to Innovative Treatments Act of 2023 ---H.R.2630/S.652: SAFE STEP Act ---H.R.2940/S.1355: Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act ---H.R.5142: Vaccine Injury Compensation Modernization Act of 2023 ---H.R.5143: Vaccine Access Improvement Act of 2023 ---H.R.6731/S.3464: Finding Orphan-Disease Remedies with Antifungal Research and Development (FORWARD) Act ---Adult Immunization ---Maternal Immunization ---MCM Manufacturing & Capacity ---MCM R&D Incentives ---Monoclonal Antibody Coverage and Utilization ---National Coverage Determination ---Vaccine and Antimicrobial Resistance Product Development and Incentives ---Vaccine Injury Compensation Program ---Vaccine Quality Measure ---Vaccine Safety ---Vaccine Safety net and Vaccine Infrastructure ---Value of Vaccines and Vaccine Confidence Vaccine Injury Compensation Program ---FY 2025 Appropriations ---H.R.5142: Vaccine Injury Compensation Modernization Act of 2023 ---H.R.5143: Vaccine Access Improvement Act of 2023 ---S.3810: Countermeasure Injury Compensation Fund Amendment Act ---VICP CICP (Discussion Draft)

Client expense: $1,460,000 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Security Council (NSC), SENATE, State, Dept of (DOS), White House Office

(H.R.6033) - Supporting Patient Education and Knowledge (SPEAK) Act - Expressed support for the Supporting Patient Education and Knowledge. This legislation authorizes the Department of Health and Human Services to identify best practices and ways to improve telehealth access for patients with limited English proficiency and create new resources for telehealth providers. The bill outlines participation by health information technology providers, physicians, hospitals, insurance companies and language services providers in the process. Urged Congress to provide adequate resources including increased training and development programs to bolster the workforce, as well as to provide more flexibility in meeting staffing requirements and standards, including telehealth options. (H.R. 7623) Telehealth Modernization Act: Expressed support for the Telehealth Modernization Act - This legislation ensures that seniors and rural patients who may not have internet connectivity can receive the care they need through audio-only telehealth services, in addition to allowing health centers and rural health clinics to provide telehealth services. (H.R. 3305/S. 1606) Black Maternal Health Momnibus Act - Expressed support for the Black Maternal Health Momnibus Act. This legislation would make critical investments in the social determinants of health, address behavioral health needs, cultural competency, and gaps in the perinatal workforce, and bolster the collection of data to address every driver of maternal mortality, morbidity, and disparities in the United States. (H.R. 8245) Rural Hospital Stabilization Act: Expressed support for the Rural Hospital Stabilization Act. This legislation would ensure that healthcare providers in rural areas continue to provide services and meet their communities' needs. (H.R. 8244) Ensuring Seniors' Access to Care Act: Expressed support for the Ensuring Seniors' Access to Care Act. This legislation would allow nursing home providers, who have been prohibited from training staff to be certified nurse aids (CNA) because of compliance penalties, to begin training staff once they have demonstrated their return to compliance, rather than having to wait a full two years. Urged Congress to make essential telehealth flexibilities permanent well before the statutory deadline of Dec. 31, 2024. (S. 3410/H.R. 5796) The Protecting Rural Seniors' Access to Care Act - Expressed support for the Protecting Rural Seniors' Access to Care Act. This legislation would prohibit HHS from finalizing a proposed nursing home staffing requirement rule and establish an advisory panel on nursing home staffing. (H.R. 3226/S.1573) The PREMIE Reauthorization Act - Expressed support for the PREMIE Reauthorization Act. This legislation would reauthorize essential maternal and infant health programs and research at a time when maternal and infant death rates, especially in communities of color, have increased dramatically. (2584/S.2768) The Safety from Violence for Healthcare Employees Act - Expressed support for the Safety from Violence for Healthcare Employees Act. This legislation would address rising incidents of violence in healthcare settings by establishing stronger legal penalties for people who knowingly and intentionally assault or intimidate hospital employees. (H.R. 5568) The Care for Moms Act - Expressed support for the Care for Moms Act. This legislation supports the maternal health workforce, promotes access to prenatal and postpartum care, and provides essential resources to providers in rural areas. Urged Congress to support legislation on Proposed Nursing Home Staffing Requirements that prohibits the HHS Secretary from finalizing a proposed nursing home staffing rule. (H.R. 4771) - Children's Health Insurance Program Permanency (CHIPP) Act - Expressed support for the Children's Health Insurance Program Permanency (CHIPP) Act. This legislation would make the Children's Health Insurance Program (CHIP) permanent and place it on par with other federal public health insurance programs rather than needing periodic reauthorization. (S. 2415/H.R. 3838) - Preventing Maternal Deaths Reauthorization Act of 2023 - Expressed support for Preventing Maternal Deaths Reauthorization Act of 2023. This legislation continues crucial federal support for the state-based maternal mortality review committees (MMRCs) that review pregnancy-related deaths to identify causes and make recommendations for the prevention of future mortalities. Provided the Senate with information regarding the 340B program and expressed strong support for continuing to strengthen and protect this vital program. Urged Congress to provide a $1 billion increase for the Title V Maternal and Child Health (MCH) Services Block Grant in the FY2025 Labor, Health and Human Services, Education & Related Agencies Appropriations bill. Urged Congress to provide $100 million for the Surveillance for Emerging Threats to Mothers and Babies (SET-NET) at the Centers for Disease Control and Prevention (CDC). Urged Congress to bolster existing federal programs to build a strong health workforce and improve primary care to assist health providers in hiring and retaining workers. (H.R. 2389) - Resident Physician Shortage Reduction Act - Expressed support for the Resident Physician Shortage Reduction Act. (H.R. 3290) - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program-Expressed opposition. (H.R. 3561) Section 302 - Expressed opposition to Section 302. This legislative provision would reduce payments for the drug administration services furnished in off-campus provider-based departments. Urged Congress to support access to quality palliative care and appropriate effective pain management by prioritizing a Palliative Care, Trans-Institute Strategy by the National Institute of Aging (NIA) in the Labor, Health and Human Services, Education, and Related Agencies appropriations bill. Urged Congress to increase funding for federally qualified health centers (FQHCs) as part of the Community Health Center Fund reauthorization. (S.2243) - Palliative Care and Hospice Education and Training Act (PCHETA). Urged Congress to support the Palliative Care and Hospice Education and Training Act. This legislation would address the palliative care workforce shortage and help respond to pressing issues including appropriate pain management and pandemic preparedness.

Client expense: $166,785 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Meetings, Letters, and Briefings in House and Senate on CMS Nursing Home Staffing Rule, and sharing SEIU strong Opposition to HR 5796, H.R. 7513, S. 3410, H.J. Res. 139 and S.J. Res. 91 that would prohibit the rule. Sent letter and held meetings with several House and Senate individual officers and Committee Staff of House Energy and Commerce, House Ways and Means and Senate Finance in Opposition to HR 6860/S.5018, the Restore Protections for Dialysis Patients Act (RPDPA).

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

HR 5796/S 3410 Protecting Rural Seniors Access to Care Act S.1749/HR 3227 Ensuring Seniors' Access to Quality Care Act S100/HR4131 Better Care Better Jobs Act HR 2713/S2418 Improving Care and Access to Nurses Act S 2137/HR5159 Preserving Access to Home Health Care Act S 3118 HCBS Relief Act H.R.7513 s 3307: encounter data enhancement act hr 9803 hospice care, accountability, reform, and enforcement act hr 8107 Ensuring Access to Medicaid Buy-in Programs Act of 2024 H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act Home Health Payment Adult Day Reimbursement Congressional Review Act -- Nursing home staffing mandate

Client expense: $11,995 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Workforce Training related issues and initiatives Child Labor Law, Violations related issues H.R.4046, Childrens Act for Responsible Employment and Farm Safety of 2023 Department of Labor Fiduciary Duty Rule H.R.6655, A Stronger Workforce for America Act, WIOA Reauthorization and generally Artificial Intelligence, Workforce related issues S.5031, Workforce of the Future Act Child Care Workforce related issues Monitor the following: Care Economy related issues and paid family leave and child care benefits Public Service Worker Protection Act Public Service Freedom to Negotiate Act, Entirety OSHA and Worker Safety related issues ESP and School Support Staff Family Leave Act School Staff Workforce related issues Department of Labor, Environmental, Social, Governance (ESG) rule related issues Paid Family Leave generally H.R.20/S.567, Richard L. Trumka Protecting the Right to Organize Act of 2023, Entirety Tax Fairness Workers Act, Entirety S.737, No Tax for Union Busting (NTBUB) Act, Entirety Department of Labor Enforcement; Apprenticeship; Workplace OSHA Safety related issues including heat Unemployment insurance issues NLRB issues FLRA related issues Workforce safety related issues Fair Labor Standards Act, Minimum Wage and Overtime Rules Family Medical Leave Act Teacher apprenticeship programs Disability employment policy Career Skills Training related issues Workforce violence related issues H.R.5796, the Protecting Rural Seniors' Access to Care Act, Nurse staffing related issues Department of Labor's Independent Contractor Rule and Fair Labor Standards Act National Institute of Innovation and Technology, Apprenticeship related issues

Client expense: $270,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

(H.R.6033) - Supporting Patient Education and Knowledge (SPEAK) Act - Expressed support for the Supporting Patient Education and Knowledge. This legislation authorizes the Department of Health and Human Services to identify best practices and ways to improve telehealth access for patients with limited English proficiency and create new resources for telehealth providers. The bill outlines participation by health information technology providers, physicians, hospitals, insurance companies and language services providers in the process. Urged Congress to provide adequate resources including increased training and development programs to bolster the workforce, as well as to provide more flexibility in meeting staffing requirements and standards, including telehealth options. (H.R. 7623) Telehealth Modernization Act: Expressed support for the Telehealth Modernization Act - This legislation ensures that seniors and rural patients who may not have internet connectivity can receive the care they need through audio-only telehealth services, in addition to allowing health centers and rural health clinics to provide telehealth services. (H.R. 3305/S. 1606) Black Maternal Health Momnibus Act - Expressed support for the Black Maternal Health Momnibus Act. This legislation would make critical investments in the social determinants of health, address behavioral health needs, cultural competency, and gaps in the perinatal workforce, and bolster the collection of data to address every driver of maternal mortality, morbidity, and disparities in the United States. (H.R. 8245) Rural Hospital Stabilization Act: Expressed support for the Rural Hospital Stabilization Act. This legislation would ensure that healthcare providers in rural areas continue to provide services and meet their communities' needs. (H.R. 8244) Ensuring Seniors' Access to Care Act: Expressed support for the Ensuring Seniors' Access to Care Act. This legislation would allow nursing home providers, who have been prohibited from training staff to be certified nurse aids (CNA) because of compliance penalties, to begin training staff once they have demonstrated their return to compliance, rather than having to wait a full two years. Urged Congress to make essential telehealth flexibilities permanent well before the statutory deadline of Dec. 31, 2024. (S. 3410/H.R. 5796) The Protecting Rural Seniors' Access to Care Act - Expressed support for the Protecting Rural Seniors' Access to Care Act. This legislation would prohibit HHS from finalizing a proposed nursing home staffing requirement rule and establish an advisory panel on nursing home staffing. (H.R. 3226/S.1573) The PREMIE Reauthorization Act - Expressed support for the PREMIE Reauthorization Act. This legislation would reauthorize essential maternal and infant health programs and research at a time when maternal and infant death rates, especially in communities of color, have increased dramatically. (2584/S.2768) The Safety from Violence for Healthcare Employees Act - Expressed support for the Safety from Violence for Healthcare Employees Act. This legislation would address rising incidents of violence in healthcare settings by establishing stronger legal penalties for people who knowingly and intentionally assault or intimidate hospital employees. (H.R. 5568) The Care for Moms Act - Expressed support for the Care for Moms Act. This legislation supports the maternal health workforce, promotes access to prenatal and postpartum care, and provides essential resources to providers in rural areas. Urged Congress to support legislation on Proposed Nursing Home Staffing Requirements that prohibits the HHS Secretary from finalizing a proposed nursing home staffing rule. (H.R. 4771) - Children's Health Insurance Program Permanency (CHIPP) Act - Expressed support for the Children's Health Insurance Program Permanency (CHIPP) Act. This legislation would make the Children's Health Insurance Program (CHIP) permanent and place it on par with other federal public health insurance programs rather than needing periodic reauthorization. (S. 2415/H.R. 3838) - Preventing Maternal Deaths Reauthorization Act of 2023 - Expressed support for Preventing Maternal Deaths Reauthorization Act of 2023. This legislation continues crucial federal support for the state-based maternal mortality review committees (MMRCs) that review pregnancy-related deaths to identify causes and make recommendations for the prevention of future mortalities. Provided the Senate with information regarding the 340B program and expressed strong support for continuing to strengthen and protect this vital program. Urged Congress to provide a $1 billion increase for the Title V Maternal and Child Health (MCH) Services Block Grant in the FY2025 Labor, Health and Human Services, Education & Related Agencies Appropriations bill. Urged Congress to provide $100 million for the Surveillance for Emerging Threats to Mothers and Babies (SET-NET) at the Centers for Disease Control and Prevention (CDC). Urged Congress to bolster existing federal programs to build a strong health workforce and improve primary care to assist health providers in hiring and retaining workers. (H.R. 2389) - Resident Physician Shortage Reduction Act - Expressed support for the Resident Physician Shortage Reduction Act. (H.R. 3290) - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program-Expressed opposition. (H.R. 3561) Section 302 - Expressed opposition to Section 302. This legislative provision would reduce payments for the drug administration services furnished in off-campus provider-based departments. Urged Congress to support access to quality palliative care and appropriate effective pain management by prioritizing a Palliative Care, Trans-Institute Strategy by the National Institute of Aging (NIA) in the Labor, Health and Human Services, Education, and Related Agencies appropriations bill. Urged Congress to increase funding for federally qualified health centers (FQHCs) as part of the Community Health Center Fund reauthorization. (S.2243) - Palliative Care and Hospice Education and Training Act (PCHETA). Urged Congress to support the Palliative Care and Hospice Education and Training Act. This legislation would address the palliative care workforce shortage and help respond to pressing issues including appropriate pain management and pandemic preparedness.

Client expense: $165,062 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

340B Drug Discount Program ---H.R.8574 - 340B Affording Care for Communities and Ensuring a Strong Safety-net Act ---S1133: 350B Accountability Act ---Executive Order on Access to Affordable Life-Saving Medications ---Program Implementation & Oversight ---PROTECT 340B Act ---SUSTAIN 340B Act Accelerated Approval Access to non-human Primates (NHPs) Artificial Intelligence (AI) Alternative Funding Programs Biodefense Research, Development and Procurement Issues (Non-Funding) ---H.R.3577: Medical and Health Stockpile Accountability Act of 2023 ---H.R.3631: State Strategic Stockpile Act of 2023 ---H.R.3703: Helping Evaluate Appropriate Logistical Infrastructure for National Government (HEALING) Response Act of 2023 ---H.R.3742: To direct the Comptroller General of the United States to evaluate the Federal Governments collection and sharing of public health data to respond to public health emergencies. ---H.R.3791: Improving Data Accessibility Through Advancements (DATA) in Public Health Act ---H.R.3795: To amend the Public Health Service Act to require the development of a diagnostic testing preparedness plan to be used during public health emergencies, and for other purposes. ---H.R.3832: Disease X Act of 2023 ---H.R.7085: BIOSECURE Act ---S. 4667 Risky Research Review Act ---Bio COMPETES (Draft) ---Biosecurity Infrastructure for Operational (BIO) Early Warning Act (Discussion Draft) ---House GOP RFI on Supply Chain ---Implementation of Medical Countermeasure Innovation Act of 2016 ---Implementation of Pandemic and All-Hazards Preparedness and Advancing Innovation (PAHPAI) Act of 2019 ---American Pandemic Preparedness Plan (AP3) ---Gain of function (Viral Gain of Function Research Moratorium Act, SAFE Risky Research Act) ---MCM PRV Program ---NDAA ---Reasonable Pricing Clauses in BARDA Contracts ---Reauthorization of Pandemic and All-Hazards Preparedness and Advancing (PAHPA) ---Tropical Disease Priority Review Voucher (PRV) Program ---VICP Loopholes ---White House National Biodefense Strategy ---WHO Pandemic Preparedness Accord Biosimilars ---S.142: Preserve Access to Affordable Generics and Biosimilars Act ---S.2305: Biosimilar Red Tape Elimination Act ---Bio COMPETES (Draft) ---Biosimilar Copay ---House GOP RFI on Supply Chain ---Interchangeability and Pharmacy Substitution ---Reimbursement Cell & Gene Therapy Climate Change ---FY 2025 Appropriations Clinical Trial Data in China Data Privacy ---H.R.7085: BIOSECURE Act ---H.R.7520: Protecting Americans Data from Foreign Adversaries Act of 2024 ---S.3558: A bill to prohibit contracting with certain biotechnology providers, and for other purposes. ---H.R. 8818: American Privacy Rights Act of 2025 ---Bio COMPETES (Draft) ---Executive Order on Preventing Access to Americans Bulk Sensitive Personal Data and United States Government-Related Data by Countries of Concern ---House GOP RFI on Supply Chain Diagnostics and Personalized Medicine Regulation and Oversight Diversity & Inclusion ---Decentralized Clinical Trials ---Implementation of Prepare for and Respond to Existing Viruses, Emerging New Threats and (PREVENT) Pandemics Act Drug Evaluation and Review ---S.1906: Promising Pathway Act ---COVID-19 Lessons Learned ---FDA Hiring Flexibility Drug Importation Drug Manufacturing, Quality & Distribution ---Advanced Manufacturing ---Drug Shortages ---Executive Order on Advancing Biotechnology and Biomanufacturing Innovation for a Sustainable, Safe, and Secure American Bioeconomy ---Supply Chain Integrity and Traceability Drug Patenting ---S.79/H.R.1717: Interagency Patent Coordination and Improvement Act of 2023 ---S.113: Prescription Pricing for the People Act of 2023 ---S.142: Preserve Access to Affordable Generics and Biosimilars Act ---S.148: Stop STALLING Act ---S.150: Affordable Prescriptions for Patients Act of 2023 ---S.1128: A bill to establish special rules relating to information provided with respect to drug applications concerning method of use patents ---S. 2780 Medication Affordability & Patient Integrity Act ---S.3583/H.R.6986: A bill to address patent thickets ---Affordable Prescriptions for Patients Act ---Interagency Patent Coordination and Improvement Act ---Restrictions on Intellectual Property Rights Drug Pricing ---FY 2025 Appropriations ---H.R.133: Mandating Exclusive Review of Individual Treatments (MERIT) Act ---H.R.1790: Biologics Competition Act of 2023 ---H.R.2139/S.908: Medicare Drug Price Negotiation Act ---H.R.2148/S.909: Prescription Drug Price Relief Act ---H.R.2408: Access to Innovative Treatments Act of 2023 ---H.R.4895: Lowering Drug Costs for American Families Act ---H.R.5539/S.3131: ORPHAN Cures Act ---H.R.5547/S.476: Maintaining Investments and New Innovation (MINI) Act ---H.R.6283: DRUG Act ---H.R.7174: Ensuring Pathways to Innovative Cures (EPIC) Act ---S.79/H.R.1717: Interagency Patent Coordination and Improvement Act of 2023 ---S.113: Prescription Pricing for the People Act of 2023 ---S.127: Pharmacy Benefit Manager Transparency Act of 2023 ---S.142: Preserve Access to Affordable Generics and Biosimilars Act ---S.148: Stop STALLING Act ---S.150: Affordable Prescriptions for Patients Act of 2023 ---S.775: Increasing Transparency in Generic Drug Application ---S.1067: Ensuring Timely Access to Generics ---S.1128: A bill to establish special rules relating to information provided with respect to drug applications concerning method of use patents, ---S.2305: Biosimilar Red Tape Elimination Act ---S.2973: Modernizing and Ensuring PBM Accountability (MEPA) Act ---H.R.2408: Access to Innovative Treatments Act ---CMMI Authority ---COVID-19 Pricing Related Provisions ---Implementation of the Inflation Reduction Act (IRA) of 2022 ---Medicare Negotiation and Competitive Licensing Act ---National Coverage Determination ---PBM Reform ---Patient Cost-Sharing and Implementation ---Strengthening Innovation in Medicare and Medicaid Act Efforts to expand the Bio Economy & Bio Manufacturing Foreign Drug Data Protection Laws ---H.R.7085: BIOSECURE Act ---H.R.7520: Protecting Americans Data from Foreign Adversaries Act of 2024 ---S.3558: A bill to prohibit contracting with certain biotechnology providers, and for other purposes. ---Bio COMPETES (Draft) ---Executive Order on Preventing Access to Americans Bulk Sensitive Personal Data and United States Government-Related Data by Countries of Concern ---House GOP RFI on Supply Chain Funding for Antimicrobial Resistance (AMR) Programs ---FY 2025 Appropriations ---H.R.2940/S.1355: Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act Funding for Biodefense/Biomedical/Emergency Preparedness Research, Development and Procurement ---FY 2025 Appropriations ---Funding for Strategic National Stockpile ---Implementation of the Inflation Reduction Act (IRA) of 2022 ---MCM PRV ---Reauthorization of Pandemic and All-Hazards Preparedness and Advancing (PAHPA) Funding for the Centers for Disease Control and Prevention Vaccine Programs ---FY 2025 Appropriations ---VICP Funding for FDA ---FY 2025 Appropriations ---Creating Hope Reauthorization Act ---Prescription Drug User Fee Act (PDUFA) VII Implementation Funding for Health Resources and Services Administration (HRSA) ---FY 2025 Appropriations Funding for the HHS Office of Infectious Disease and HIV/AIDS Policy ---FY 2025 Appropriations Funding for National Institutes of Health ---FY 2025 Appropriations ---Advanced Research Projects Agency for Health (ARPA-H) ---Funding for Womens Health Research Generic Drug Entry ---S.148: Stop STALLING Act ---S.775: Increasing Transparency in Generic Drug Applications Act ---S.4351: Enhanced Access to Affordable Medicines Act ---H.R 6973: Generic Drug Application Review Reforms ---Incentives for Generic Entry Issues Relating to Medical Research and Animal Testing Models ---H.R.7248: FDA Modernization Act 3.0 Medicaid ---H.R.2666: The Medicaid VBPs for Patients (MVP) Act ---S.127: Pharmacy Benefit Manager Transparency Act of 2023 ---S.2973: Modernizing and Ensuring PBM Accountability (MEPA) Act ---Alternative Payment Arrangements for Gene Therapies ---Average Manufacturer Price Calculations ---Coverage of Accelerated Approval Products ---Drug Benefit Design ---Encouraging Innovation Benefit Design to Lower Costs for Seniors Act ---Medicaid Drug Rebate Program Rule ---Pricing and Rebates ---Value-Based Purchasing (VBP) Rule National Defense ---National Defense Authorization Act of 2025 Opioid Crisis ---H.R.4531/2933: SUPPORT Act ---Non-Opioid Analgesics ---Transparency ---Coverage and Reimbursement Orphan Drug Issues ---H.R.3433 - Give Kids a Chance Act ---H.R.5539/S.3131: ORPHAN Cures Act ---H.R.6664: Innovation in Pediatric Drugs Act of 2023 ---H.R.6731/S.3464: Finding Orphan-Disease Remedies with Antifungal Research and Development (FORWARD) Act ---S.1214: Retaining Access and Restoring Exclusivity (RARE) Act ---Implementation of the Inflation Reduction Act (IRA) of 2022 ---Orphan Drug Tax Credit Pandemic Preparedness ---Drug Supply Chain Management ---Implementation of the Prepare for and Respond to Existing Viruses ---Emerging New Threats and (PREVENT) Pandemics Act ---Monoclonal Antibody Coverage and Utilization ---R&D Funding for Medical Countermeasures ---Restrictions on Intellectual Property Rights ---Supply Chain Issues ---Temporarily Refundable R&D Credit ---TRIPS Waiver ---WHO Pandemic Preparedness Accord Precision Medicine Initiative Rare Pediatric Disease Priority Review ---H.R.7384/S4583: Creating Hope Reauthorization Act of 2024 ---Helping Experts Accelerate Rare Treatments (HEART)Act ---Rare Disease Pilot Program ---Speeding Therapy Access Today (STAT) Act Reimbursement and Coverage of Innovative Products ---H.R.133: Mandating Exclusive Review of Individual Treatments (MERIT) Act ---H.R.830/S.1375: HELP Copays Act ---H.R.2139/S.908: Medicare Drug Price Negotiation Act ---H.R.2148/S.909: Prescription Drug Price Relief Act ---H.R.2408: Access to Innovative Treatments Act of 2023 ---H.R.2630/S.652: SAFE STEP Act ---H.R.2666: The Medicaid VBPs for Patients (MVP) Act ---H.R.4895: Lowering Drug Costs for American Families Act ---H.R.5378: Lower Costs, More Transparency Act ---H.R.5796/S424: Protect our Seniors Act ---Administration Rebate Rule ---CMMI Authority ---Implementation of the Inflation Reduction Act (IRA) of 2022 ---In-Home Administration of Part B Drugs ---Lower Costs, More Cures Act ---Medicare Part B Physician-Administered Products ---National Coverage Determination ---Patient Cost-Sharing and Smoothing ---Protected Classes ---H.R.5260: Reduced Costs and Continued Cures Act ---Step Therapy ---Support of Patient Premiums and Cost-Sharing Obligations ---Value-based Contracting and Communications ---Value-Based Purchasing (VBP) Rule Vaccines and Infectious Diseases ---FY 2025 Appropriations ---H.R.133: Mandating Exclusive Review of Individual Treatments (MERIT) Act ---H.R.2408: Access to Innovative Treatments Act of 2023 ---H.R.2630/S.652: SAFE STEP Act ---H.R.2940/S.1355: Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act ---H.R.5142: Vaccine Injury Compensation Modernization Act of 2023 ---H.R.5143: Vaccine Access Improvement Act of 2023 ---H.R.6731/S.3464: Finding Orphan-Disease Remedies with Antifungal Research and Development (FORWARD) Act ---H.R.7551: Let Injured Americans Be Legally Empowered (LIABLE) Act ---Adult Immunization ---Maternal Immunization ---MCM Manufacturing & Capacity ---MCM R&D Incentives ---Monoclonal Antibody Coverage and Utilization ---National Coverage Determination ---Vaccine and Antimicrobial Resistance Product Development and Incentives ---Vaccine Injury Compensation Program ---Vaccine Quality Measure ---Vaccine Safety ---Vaccine Safety net and Vaccine Infrastructure ---Value of Vaccines and Vaccine Confidence Vaccine Injury Compensation Program ---FY 2025 Appropriations ---H.R.5142: Vaccine Injury Compensation Modernization Act of 2023 ---H.R.5143: Vaccine Access Improvement Act of 2023 ---H.R.7551: Let Injured Americans Be Legally Empowered (LIABLE) Act ---S.3810: Countermeasure Injury Compensation Fund Amendment Act ---VICP CICP (Discussion Draft)

Client expense: $1,680,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Security Council (NSC), Patent & Trademark Office (PTO), SENATE, State, Dept of (DOS), U.S. Trade Representative (USTR), White House Office

Observation Stays and 3 Day Stay Issue Outreach to HHS/CMS/Administration Survey Relief/Civil Monetary Penalties CMS on Public Health Waiver and other waivers SNF Payment Rule OSHA Emergency Temporary Standards Care For Our Seniors Act Medicare Advantage H.R. 177 - To amend title XI of the Social Security Act to ensure nursing facilities report information on medical directors of such facilities. CDC/COVID Safety Guidance Outreach to hill, HHS and ONC on LTPAC health information technology needs (zoom meetings and letters) Outreach to hill on needed Physician Fee Schedule reforms (sign on letters only) Improve Access to Mental Access Act S838/HR1638 (sign on letters) Improving Access to Medicare Coverage Act of 2023 s.4137/H.R.5138 HR 5796, S. 3410 - Protecting Rural Seniors Access to Care Act Outreach to hill on needed telehealth reforms (sign on letters only) Improving Seniors Timely Access to Care Act

Client expense: $890,000 · Firm income: Not reported

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

S 4724, HR 9101- 9/11 Responder and Survivor Health Funding Correction Act of 2024 HR 5378- Lower Costs, More Transparency Act HR 4895- Lowering Drug Costs for American Families HR 5796- Protecting Rural Seniors Access to Care Act HR 7513- Protecting America's Seniors Access to Care Act HR 485- Protecting Health Care for All Patients Act S 3679- Lorna Breen Health Care Provider Protection Reauthorization Act HJ Res 139, SJ Res 91- CRA to rescind nursing home staffing rule HR 468, HR 9067- Building America's Health Care Workforce Act HR 3227- Ensuring Seniors' Access to Quality Care Act HJ Res 181- CRA to rescind the Association Health Plan Rule S 4671- Capping Prescription Costs Act S 4804, HR 9156- Health Over Wealth Act

Client expense: $720,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

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

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

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

Meetings, Letters, Press Conference and Briefings in House and Senate on CMS Nursing Home Staffing Rule, and sharing SEIU strong Opposition to HR 5796, H.R. 7513, S. 3410, H.J. Res. 139 and S.J. Res. 91 that would prohibit the rule. Sent letter and held meetings with several House and Senate individual officers and Committee Staff of House Energy and Commerce, House Ways and Means and Senate Finance in Opposition to HR 6860/S.5018, the Restore Protections for Dialysis Patients Act (RPDPA). Meetings with House Offices in Opposition to H.R. 3227, Ensuring Seniors' Access to Quality Care Act.

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S. 495/H.R. 1815 Expanding Veterans Options for Long Term Care Act - Seeking expanded flexibility and access to Assisted Living for Veterans; H.R. 6835 Caring Across Generations Act - Seeking additional support for funding of multigenerational programs in Long-Term care; S. 3410/H.R. 5796 Protecting Rural Seniors' Access to Care Act - establishing an advisory panel to support the nursing home workforce; H.R. 6025/S. 3211 Healthcare Workforce Resilience Act - Carrying forward unused visas from prior fiscal years for health care providers. S. 2853 Train More Nurses Act - Requiring the Secretary of HHS and Secretary of Labor to conduct a study and issue a report on grant programs to support the nursing workforce. H.R. 6586 Bipartisan Workforce Pell Act - Expanding Pell Grant coverage for healthcare workforce needs.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 5796/S 3410 Protecting Rural Seniors Access to Care Act S.1749/HR 3227 Ensuring Seniors' Access to Quality Care Act S100/HR4131 Better Care Better Jobs Act HR 2713/S2418 Improving Care and Access to Nurses Act S 2137/HR5159 Preserving Access to Home Health Care Act S 3118 HCBS Relief Act H.R.7513 s 3307: encounter data enhancement act Hospice Program Integrity and Reform (Hospice CARE Act discussion) Home Health Payment Adult Day Reimbursement Congressional Review Act -- Nursing home staffing mandate

Client expense: $11,563 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Observation Stays and 3 Day Stay Issue Outreach to HHS/CMS/Administration Survey Relief/Civil Monetary Penalties CMS on Public Health Waiver and other waivers SNF Payment Rule OSHA Emergency Temporary Standards Care For Our Seniors Act Medicare Advantage H.R. 177 - To amend title XI of the Social Security Act to ensure nursing facilities report information on medical directors of such facilities. CDC/COVID Safety Guidance Outreach to hill, HHS and ONC on LTPAC health information technology needs (zoom meetings and letters) Outreach to hill on needed Physician Fee Schedule reforms (sign on letters only) Improve Access to Mental Access Act S838/HR1638 (sign on letters) Improving Access to Medicare Coverage Act of 2023 HR 5138 HR 5796, S. 3410 - Protecting Rural Seniors Access to Care Act Outreach to hill on needed telehealth reforms (sign on letters only) Improving Seniors Timely Access to Care Act

Client expense: $1,020,000 · Firm income: Not reported

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

Workforce Training related issues and initiatives Child Labor Law, Violations related issues H.R.4046, Childrens Act for Responsible Employment and Farm Safety of 2023 Department of Labor Fiduciary Duty Rule H.R.6655, A Stronger Workforce for America Act, WIOA Reauthorization and generally Increasing Professional Development on Career Exploration and Local Technical Education Opportunities (draft bill) Care Economy related issues and paid family leave and child care benefits Public Service Worker Protection Act Artificial Intelligence, Workforce related issues Public Service Freedom to Negotiate Act, Entirety Monitor the following: OSHA and Worker Safety related issues Child Care Workforce related issues ESP and School Support Staff Family Leave Act School Staff Workforce related issues Department of Labor, Environmental, Social, Governance (ESG) rule related issues Paid Family Leave generally H.R.20/S.567, Richard L. Trumka Protecting the Right to Organize Act of 2023, Entirety Tax Fairness Workers Act, Entirety S.737, No Tax for Union Busting (NTBUB) Act, Entirety Department of Labor Enforcement; Apprenticeship; Workplace OSHA Safety related issues including heat Unemployment insurance issues NLRB issues FLRA related issues Workforce safety related issues Fair Labor Standards Act, Minimum Wage and Overtime Rules Family Medical Leave Act Teacher apprenticeship programs Disability employment policy Career Skills Training related issues Workforce violence related issues H.R.5796, the Protecting Rural Seniors' Access to Care Act, Nurse staffing related issues Department of Labor's Independent Contractor Rule and Fair Labor Standards Act National Institute of Innovation and Technology, Apprenticeship related issues

Client expense: $280,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Natl Economic Council (NEC), SENATE

S. 495/H.R. 1815 Expanding Veterans Options for Long Term Care Act - Seeking expanded flexibility and access to Assisted Living for Veterans; H.R. 6835 Caring Across Generations Act - Seeking additional support for funding of multigenerational programs in Long-Term care; S. 3410/H.R. 5796 Protecting Rural Seniors' Access to Care Act - establishing an advisory panel to support the nursing home workforce; H.R. 6025/S. 3211 Healthcare Workforce Resilience Act - Carrying forward unused visas from prior fiscal years for health care providers. S. 2853 Train More Nurses Act - Requiring the Secretary of HHS and Secretary of Labor to conduct a study and issue a report on grant programs to support the nursing workforce. H.R. 6586 Bipartisan Workforce Pell Act - Expanding Pell Grant coverage for healthcare workforce needs.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Urged Congress to provide adequate resources including increased training and development programs to bolster the workforce, as well as to provide more flexibility in meeting staffing requirements and standards, including telehealth options. (H.R. 7623) Telehealth Modernization Act: Expressed support for the Telehealth Modernization Act - This legislation ensures that seniors and rural patients who may not have internet connectivity can receive the care they need through audio-only telehealth services, in addition to allowing health centers and rural health clinics to provide telehealth services. (H.R. 3305/S. 1606) Black Maternal Health Momnibus Act - Expressed support for the Black Maternal Health Momnibus Act. This legislation would make critical investments in the social determinants of health, address behavioral health needs, cultural competency, and gaps in the perinatal workforce, and bolster the collection of data to address every driver of maternal mortality, morbidity, and disparities in the United States. (H.R. 8245) Rural Hospital Stabilization Act: Expressed support for the Rural Hospital Stabilization Act. This legislation would ensure that healthcare providers in rural areas continue to provide services and meet their communities' needs. (H.R. 8244) Ensuring Seniors' Access to Care Act: Expressed support for the Ensuring Seniors' Access to Care Act. This legislation would allow nursing home providers, who have been prohibited from training staff to be certified nurse aids (CNA) because of compliance penalties, to begin training staff once they have demonstrated their return to compliance, rather than having to wait a full two years. Urged Congress to make essential telehealth flexibilities permanent well before the statutory deadline of Dec. 31, 2024. (S. 3410/H.R. 5796) The Protecting Rural Seniors' Access to Care Act - Expressed support for the Protecting Rural Seniors' Access to Care Act. This legislation would prohibit HHS from finalizing a proposed nursing home staffing requirement rule and establish an advisory panel on nursing home staffing. (H.R. 3226/S.1573) The PREMIE Reauthorization Act - Expressed support for the PREMIE Reauthorization Act. This legislation would reauthorize essential maternal and infant health programs and research at a time when maternal and infant death rates, especially in communities of color, have increased dramatically. (2584/S.2768) The Safety from Violence for Healthcare Employees Act - Expressed support for the Safety from Violence for Healthcare Employees Act. This legislation would address rising incidents of violence in healthcare settings by establishing stronger legal penalties for people who knowingly and intentionally assault or intimidate hospital employees. (H.R. 5568) The Care for Moms Act - Expressed support for the Care for Moms Act. This legislation supports the maternal health workforce, promotes access to prenatal and postpartum care, and provides essential resources to providers in rural areas. Supports legislation on Proposed Nursing Home Staffing Requirements that prohibits the HHS Secretary from finalizing a proposed nursing home staffing rule. (H.R. 4771) - Children's Health Insurance Program Permanency (CHIPP) Act - Expressed support for the Children's Health Insurance Program Permanency (CHIPP) Act. This legislation would make the Children's Health Insurance Program (CHIP) permanent and place it on par with other federal public health insurance programs rather than needing periodic reauthorization. (S. 2415/H.R. 3838) - Preventing Maternal Deaths Reauthorization Act of 2023 - Expressed support for Preventing Maternal Deaths Reauthorization Act of 2023. This legislation continues crucial federal support for the state-based maternal mortality review committees (MMRCs) that review pregnancy-related deaths to identify causes and make recommendations for the prevention of future mortalities. Provided the Senate with information regarding the 340B program and expressed strong support for continuing to strengthen and protect this vital program. Urged Congress to provide a $1 billion increase for the Title V Maternal and Child Health (MCH) Services Block Grant in the FY2024 Labor, Health and Human Services, Education & Related Agencies Appropriations bill. Urged Congress to provide $100 million for the Surveillance for Emerging Threats to Mothers and Babies (SET-NET) at the Centers for Disease Control and Prevention (CDC). Provided written testimony for the House and Commerce Health Subcommittee hearing on Examining Existing Federal Programs to Build a Strong Health Workforce and Improve Primary Care. The testimony recommended several actions and pieces of legislation to assist health providers in hiring and retaining workers. (H.R. 2389) - Resident Physician Shortage Reduction Act - Expressed support for the Resident Physician Shortage Reduction Act. (H.R. 3290) - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program-Expressed opposition. (H.R. 3561) Section 302 - Expressed opposition to Section 302. This legislative provision would reduce payments for the drug administration services furnished in off-campus provider-based departments. Urged Congress to support access to quality palliative care and appropriate effective pain management by prioritizing a Palliative Care, Trans-Institute Strategy by the National Institute of Aging (NIA) in the Fiscal Year 2024 Labor, Health and Human Services, Education, and Related Agencies appropriations bill. Urged Congress to increase funding for federally qualified health centers (FQHCs) as part of the Community Health Center Fund reauthorization. (S.2243) - Palliative Care and Hospice Education and Training Act (PCHETA). Urged Congress to support the Palliative Care and Hospice Education and Training Act. This legislation would address the palliative care workforce shortage and help respond to pressing issues including appropriate pain management and pandemic preparedness.

Client expense: $171,047 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 4445- The Right to IVF Act HR 6283- Delinking Revenue from Unfair Gouging (DRUG) Act HR 5378- Lower Costs, More Transparency Act HR 4895- Lowering Drug Costs for American Families HR 5796- Protecting Rural Seniors Access to Care Act HR 7513- Protecting America's Seniors Access to Care Act HR 485- Protecting Care for All Patients Care Act S 3679- Lorna Breen Health Care Provider Protection Reauthorization Act HJ Res 139, SJ Res 91- CRA to rescind nursing home staffing rule

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Meetings, Letters, Press Conference and Briefings in House and Senate on CMS Nursing Home Staffing Rule, and sharing SEIU strong Opposition to HR 5796, H.R. 7513, S. 3410, H.J. Res. 139 and S.J. Res. 91 that would prohibit the rule. Meeting in House in Opposition to HR 6860, the Restore Protections for Dialysis Patients Act (RPDPA) Letter and meetings in Opposition to H.R. 8114, Legislation that would prohibit the Secretary of Health and Human Services from finalizing a rule proposed by the Centers for Medicare & Medicaid Services to place certain limitations on Medicaid payments for home or community-based services. Letter and meetings with House Offices in Opposition to H.R. 3227, Ensuring Seniors Access to Quality Care Act. Letter in Support for H.R. 7573, the Stop Unfair Medicaid Recoveries Act which seeks to halt unfair Medicaid recovery practices, and H.R. 8106 which proposes to remove institutional care criteria for Home and Community-Based Services (HCBS) eligibility, improving access and equity within the long-term care system.

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 5378 - Lower Costs, More Transparency Act - Re: Site Neutral and Hospital Price Transparency H.R. 5796/ S. 3410 - "The Protecting Rural Seniors' Access to Care Act" - Re: Skilled Nursing Facility Staffing Mandates H.R. 3173/ S.5044 - "Improving Seniors' Timely Access to Care Act" - Re: Medicare Advantage Prior Authorization provisions H.R. 6430/ S.1110 - "The Assistance for Rural Community Hospitals (ARCH) Act" - Re: Discussions around Medicare rural extenders (LVH/MDH) Payment delays and denials - Re: Medicare Advantage coverage requirements H.R. 8113 - "Transparency into State Directed Payments Act of 2024" - Re: Discussed importance of Medicaid payment adequacy Discussions around Medicaid DSH funding - Re: Medicare DSH cut delay H.R. 7623/ S. 3967 - "Telehealth Modernization Act of 2024"; H.R. 4189/ S. 2016 - "CONNECT for Health Act of 2023"; H.R. 3432/ S. 3651 - "Telemental Health Care Access Act of 2023" - Re: Telehealth flexibilities Mandatory CMMI Models - Re: Value-based Care

Client expense: $480,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 5796/S 3410 Protecting Rural Seniors Access to Care Act S.1749/HR 3227 Ensuring Seniors' Access to Quality Care Act S100/HR4131 Better Care Better Jobs Act HR 2713/S2418 Improving Care and Access to Nurses Act S 2137/HR5159 Preserving Access to Home Health Care Act S 3118 HCBS Relief Act Hospice Program Integrity Home Health Payment Adult Day Reimbursement

Client expense: $11,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

OSHA and Worker Safety related issues Workforce Training related issues and initiatives Child Labor Law, Violations related issues H.R.6655, A Stronger Workforce for America Act, WIOA Reauthorization and generally Department of Defense, Overseas Teacher Workforce related issues Child Care Workforce related issues ESP and School Support Staff Family Leave Act Artificial Intelligence, Workforce related issues Monitor the following: School Staff Workforce related issues Public Service Freedom to Negotiate Act, Entirety Department of Labor, Environmental, Social, Governance (ESG) rule related issues Paid Family Leave generally H.R.20/S.567, Richard L. Trumka Protecting the Right to Organize Act of 2023, Entirety Tax Fairness Workers Act, Entirety S.737, No Tax for Union Busting (NTBUB) Act, Entirety Department of Labor Enforcement; Apprenticeship; Work Place Safety related issues Unemployment insurance issues NLRB issues Workforce safety related issues Workforce violence related issues Fair Labor Standards Act, Minimum Wage and Overtime Rules OPM Proposal, Civil Servant Protection and Merit System Principal Department of Labor Succession Act Family Medical Leave Act, Reform related issues Teacher apprenticeship programs Disability employment policy Skilled Trades Expansion Act Career Skills Training related issues H.R.5796, the Protecting Rural Seniors' Access to Care Act, Nurse staffing related issues

Client expense: $270,000 · Firm income: Not reported

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

Observation Stays and 3 Day Stay Issue Outreach to HHS/CMS/Administration Survey Relief/Civil Monetary Penalties CMS on Public Health Waiver and other waivers SNF Payment Rule OSHA Emergency Temporary Standards Care For Our Seniors Act Medicare Advantage H.R. 177 - To amend title XI of the Social Security Act to ensure nursing facilities report information on medical directors of such facilities. CDC/COVID Safety Guidance Outreach to hill, HHS and ONC on LTPAC health information technology needs (zoom meetings and letters) Outreach to hill on needed Physician Fee Schedule reforms (sign on letters only) Improve Access to Mental Access Act S838/HR1638 (sign on letters) Improving Access to Medicare Coverage Act of 2023 HR 5138 HR 5796, S. 3410 - Protecting Rural Seniors Access to Care Act Outreach to hill on needed telehealth reforms (sign on letters only)

Client expense: $990,000 · Firm income: Not reported

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

HR 1737- Supporting Our First Responders Act HR 6283- Delinking Revenue from Unfair Gouging (DRUG) Act HR 5378- Lower Costs, More Transparency Act HR 4895- Lowering Drug Costs for American Families Act HR 5796- Protecting Rural Seniors Access to Care Act HR 7519- Protecting America's Seniors Access to Care Act HR 485- Protecting Care for All Patients Care Act

Client expense: $690,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 5796- Protecting Rural Seniors' Access to Care Act HR 6030, S 3113- Expanding Health Care Options for First Responders Act

Client expense: $690,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

Client expense: $101,570 · Firm income: Not reported

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

Urged Congress to make essential telehealth flexibilities permanent well before the statutory deadline of Dec. 31, 2024. (S. 3410/H.R. 5796) The Protecting Rural Seniors' Access to Care Act - Expressed support for the Protecting Rural Seniors' Access to Care Act. This legislation would prohibit HHS from finalizing a proposed nursing home staffing requirement rule and establish an advisory panel on nursing home staffing. (H.R. 3226/S.1573) The PREMIE Reauthorization Act - Expressed support for the PREMIE Reauthorization Act. This legislation would reauthorize essential maternal and infant health programs and research at a time when maternal and infant death rates, especially in communities of color, have increased dramatically. (2584/S.2768) The Safety from Violence for Healthcare Employees Act - Expressed support for the Safety from Violence for Healthcare Employees Act. This legislation would address rising incidents of violence in healthcare settings by establishing stronger legal penalties for people who knowingly and intentionally assault or intimidate hospital employees. (H.R. 5568) The Care for Moms Act - Expressed support for the Care for Moms Act. This legislation supports the maternal health workforce, promotes access to prenatal and postpartum care, and provides essential resources to providers in rural areas. Supports legislation on Proposed Nursing Home Staffing Requirements that prohibits the HHS Secretary from finalizing a proposed nursing home staffing rule. (H.R. 4771) - Children's Health Insurance Program Permanency (CHIPP) Act - Expressed support for the Children's Health Insurance Program Permanency (CHIPP) Act. This legislation would make the Children's Health Insurance Program (CHIP) permanent and place it on par with other federal public health insurance programs rather than needing periodic reauthorization. (S. 2415/H.R. 3838) - Preventing Maternal Deaths Reauthorization Act of 2023 - Expressed support for Preventing Maternal Deaths Reauthorization Act of 2023. This legislation continues crucial federal support for the state-based maternal mortality review committees (MMRCs) that review pregnancy-related deaths to identify causes and make recommendations for the prevention of future mortalities. Provided the Senate with information regarding the 340B program and expressed strong support for continuing to strengthen and protect this vital program. Urged Congress to provide a $1 billion increase for the Title V Maternal and Child Health (MCH) Services Block Grant in the FY2024 Labor, Health and Human Services, Education & Related Agencies Appropriations bill. Urged Congress to provide $100 million for the Surveillance for Emerging Threats to Mothers and Babies (SET-NET) at the Centers for Disease Control and Prevention (CDC). Provided written testimony for the House and Commerce Health Subcommittee hearing on Examining Existing Federal Programs to Build a Strong Health Workforce and Improve Primary Care. The testimony recommended several actions and pieces of legislation to assist health providers in hiring and retaining workers. (H.R. 2389) - Resident Physician Shortage Reduction Act - Expressed support for the Resident Physician Shortage Reduction Act. (H.R. 3290) - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program-Expressed opposition. (H.R. 3561) Section 302 - Expressed opposition to Section 302. This legislative provision would reduce payments for the drug administration services furnished in off-campus provider-based departments. Urged Congress to support access to quality palliative care and appropriate effective pain management by prioritizing a Palliative Care, Trans-Institute Strategy by the National Institute of Aging (NIA) in the Fiscal Year 2024 Labor, Health and Human Services, Education, and Related Agencies appropriations bill. Urged Congress to increase funding for federally qualified health centers (FQHCs) as part of the Community Health Center Fund reauthorization. (S.2243) - Palliative Care and Hospice Education and Training Act (PCHETA). Urged Congress to support the Palliative Care and Hospice Education and Training Act. This legislation would address the palliative care workforce shortage and help respond to pressing issues including appropriate pain management and pandemic preparedness.

Client expense: $136,413 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 495/H.R. 1815 Expanding Veterans Options for Long Term Care Act - Seeking expanded flexibility and access to Assisted Living for Veterans; H.R. 6835 Caring Across Generations Act - Seeking additional support for funding of multigenerational programs in Long-Term care; S. 3410/H.R. 5796 Protecting Rural Seniors' Access to Care Act - establishing an advisory panel to support the nursing home workforce; H.R. 6025/S. 3211 Healthcare Workforce Resilience Act - Carrying forward unused visas from prior fiscal years for health care providers. S. 2853 Train More Nurses Act - Requiring the Secretary of HHS and Secretary of Labor to conduct a study and issue a report on grant programs to support the nursing workforce. H.R. 6586 Bipartisan Workforce Pell Act - Expanding Pell Grant coverage for healthcare workforce needs.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

CMS Nursing Home Staffing Rule/Opposition to HR 5796 Opposition to HR 6860, the Restore Protections for Dialysis Patients Act (RPDPA) Medicaid work requirements HR2811

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5378 - Lower Costs, More Transparency Act - Re: Site Neutral and Hospital Price Transparency H.R. 5796/ S. 3410 - "The Protecting Rural Seniors' Access to Care Act" - Re: Skilled Nursing Facility Staffing Mandates H.R. 3173/ S.5044 - "Improving Seniors' Timely Access to Care Act" - Re: Medicare Advantage Prior Authorization H.R. 4968 - The Gold Card Act of 2023 - Re: Reforms to the Medicare Prior Authorization Process H.R. 6430/ S.1110 - "The Assistance for Rural Community Hospitals (ARCH) Act" - Re: Making permanent rural payment programs (LVH/MDH) Re: Two-Midnight Rule - Medicare Advantage coverage requirements Re: Medicaid State Directed Payments Providing for the concurrence by the House in the Senate amendment to H.R. 4366, with an amendment (2024 Government Funding Bill) - Re: Medicare DSH cut delay H.R. 7623/ S. 3967 - "Telehealth Modernization Act of 2024"; H.R. 4189/ S. 2016 - "CONNECT for Health Act of 2023"; H.R. 3432/ S. 3651 - "Telemental Health Care Access Act of 2023" - Re: Extending telehealth provisions

Client expense: $650,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. S. 2584 - Supporting Our Seniors Act 2. S. 3410 / H.R. 5796 - Protecting Rural Seniors Access to Care Act

Client expense: $75,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3766/H.R. 7274, the Connecting Family Caregivers to Medicare Act. S. 3109, the Alleviating Barriers for Caregivers Act. S. 3410/HR 5796, the Protecting Rural Seniors Access to Care Act. H.R. 7513, the Protecting Americas Seniors Access to Care Act. No bill number. Discussed Medicare low-income outreach and enrollment programs. No bill number. Discussed medically necessary dental coverage in Medicare. No bill number. Discussed Medicare Advantage and Medicare Prescription Drug Benefit Programs for contract year 2025. No bill number. Discussed Medicare capitation rates, and Part C and Part A payment policies for contract year 2025. No bill number. Discussed the Medicare Prescription Payment Plan (MPPP) program. No bill number. Discussed nursing home staffing rule. No bill number. Discussed long-term care workforce issues. No bill number. Discussed proposed rule on observation status appeals. No bill number. Discussed coverage of Medicaid, Medicare, and dual eligibles. No bill number. Discussed primary care. No bill number. Discussed Appeal Rights for Certain Changes in Patient Status. No bill number. Discussed family caregivers and Hospital-at-Home programs. No bill number. Discussed Medicare hospice benefit and respite care. No bill number. Discussed family caregivers and Medicare. No bill number. Discussed family caregivers and Medicaid self-direction programs. No bill number. Discussed state Long-Term Services and Supports Scorecard. No bill number. Discussed Veterans Administration care and Medicare. No bill number. Discussed paid direct care workforce. No bill number. Discussed access to physicians in Medicare. No bill number. Discussed observation stays in Medicare. No bill number. Discussed GUIDE Model.

Client expense: $4,370,000 · Firm income: Not reported

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

HR 5796/S 3410 Protecting Rural Seniors Access to Care Act S.1749/HR 3227 Ensuring Seniors' Access to Quality Care Act S100/HR4131 Better Care Better Jobs Act HR 2713/S2418 Improving Care and Access to Nurses Act S 2137/HR5159 Preserving Access to Home Health Care Act S 3118 HCBS Relief Act Hospice Program Integrity Home Health Payment Adult Day Reimbursement

Client expense: $18,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Elder Justice Reauthorization and Modernization Act of 2023 AHCA/NCAL proposal of Care For Our Seniors Act Staff Agency Practices - Outreach to the Hill Immigration Delays - outreach to U.S. Departments of State, Homeland Security, & USCIS Advocating for providing temporary nurse aides a reasonable grace period as the public health emergency ends Administration nursing home reform plan Appropriations related outreach Support of the 21st Century Long-Term Care Caucus Outreach to DOL in support of LTC apprenticeship programs Outreach to LTC workforce related and appropriations matters Outreach to CMS and the Hill on the TNA waiver issue Outreach to CMS and the Hill on minimum staffing standards Outreach to DOE on SNF Loan Repayment Issues impacting the LTC workforce, including advocacy on the Care for Seniors Act H.R.468 - Building America's Health Care Workforce Act Senate HELP Comm Workforce RFI Comments 1749/H.R. 3227 -- Ensuring Seniors Access to Quality Care Act Joined coalition in support for the bipartisan resolution S.J.Res.49/H.J.Res.98 Support for the Protecting Rural Seniors Access to Care Act (S. 3410/H.R. 5796) Outreach to DOL and NLRB on regulatory related workforce matters impacting LTC providers

Client expense: $1,340,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, State, Dept of (DOS)

Observation Stays and 3 Day Stay Issue Outreach to HHS/CMS/Administration Survey Relief/Civil Monetary Penalties CMS on Public Health Waiver and other waivers SNF Payment Rule OSHA Emergency Temporary Standards Care For Our Seniors Act Medicare Advantage H.R. 177 - To amend title XI of the Social Security Act to ensure nursing facilities report information on medical directors of such facilities. CDC/COVID Safety Guidance Outreach to hill, HHS and ONC on LTPAC health information technology needs (zoom meetings and letters) Outreach to hill on needed Physician Fee Schedule reforms (sign on letters only) Improve Access to Mental Access Act S838/HR1638 (sign on letters) Improving Access to Medicare Coverage Act of 2023 HR 5138 HR 5796, S. 3410 - Protecting Rural Seniors Access to Care Act

Client expense: $1,340,000 · Firm income: Not reported

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

S.495 Expanding Veterans Options for Long Term Care Act - Seeking expanded flexibility and access to Assisted Living for Veterans; H.R. 6835 Caring Across Generations Act - Seeking additional support for funding of multigenerational programs in Long-Term care; S. 3410/H.R. 5796 Protecting Rural Seniors' Access to Care Act - establishing an advisory panel to support the nursing home workforce; H.R. 6025/S. 3211 Healthcare Workforce Resilience Act - Carrying forward unused visas from prior fiscal years for health care providers.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid work requirements HR2811 CMS Nursing Home Protecting Rural Seniors Access to Care Act, HR 5796 Reintroduction of the Restore Protections for Dialysis Patients Act (RPDPA) Medicaid Access Rule HR 5378, Health-Care Pricing Package

Client expense: $226,281 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE