PEERS Act of 2023

S. 198, H.R. 3730 ~ Rural Health Clinic Burden Reduction Act ~ Cost Neutral Legislation to Modernize the RHC Statute Medicare Advantage Payment Policy for Rural Health Clinics ~ Securing a wrap-around payment policy for RHCs similar to what FQHCs have. Telehealth Issues ~ extending Medicare coverage of telehealth in the RHC setting and paying RHCs normally for telehealth services H.R. 5611 ~ extending and fixing telehealth payment policy for Rural Health Clinics Creating value-based payments for Rural Health Clinics S. 3967 / H.R. 7623 - Telehealth Modernization Act Primary Care Team Education Centers Act Improving Seniors' Timely Access to Care Act Improving Measurements for Loneliness and Isolation Act - H.R. 6284 H.R. 4829 - Physical Therapist Workforce and Patient Access Act of 2023 H.R. 7855 - Rural Residency Planning and Development Act of 2024 H.R. 6748 - Promoting Effective and Empowering Recovery Services in Medicare Act of 2023 H.R. 8738 - Rural Health Preceptor Tax Fairness Act H.R. 2829 - Chronic Care Management Improvement Act H.R. 1712, S. 953 - Rural Health Innovation Act of 2023 S. 940 - Rural America Health Corps Act H.R. 833 - Save America's Rural Hospitals

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

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

Chronic Care Management Improvement Act of 2023 (H.R.2829) Removes cost-sharing responsibilities for CCM services under the Medicare program. Rural Health Innovation Act of 2023 (S.953 and H.R.1712) Creates grant programs under HRSA to expand urgent/triage care in rural communities (RHCs and FQHCs eligible); $500,000 for existing facilities and $750,000 for new facilities. Rural America Health Corps Act (S.940) Creates a loan repayment program called NHSC Rural Provider Loan Repayment Program; includes NPs and PAs as providers eligible for the program; specifically aimed at rotating graduates through underserved areas. Save Americas Rural Hospitals (H.R.833) Primarily hospital related but Sec.113 makes permanent Medicare telehealth in RHCs/FQHCs and allows for telehealth visits to be reimbursed at parity with in-person visits. Home-Based Telemental Health Care Act of 2023 (S.1077) Grant demonstration program through USDA for increasing mental health and substance abuse services in rural, medically underserved populations. Patients' Right to Know Their Medication Act of 2023 (H.R.1173) RPM Cost Sharing Elimination Study Act of 2023 (H.R.6801) Primary Care Team Education Centers Act Creates further investment in the establishment of clinical training sites for primary care providers. RHCs would be eligible entities for this funding. Improving Seniors Timely Access to Care Act Modernize Medicare Advantage prior authorization processes. Rural Residency Planning and Development Act of 2024 Officially authorizes the RRPD program that has been around since 2019. RHCs are eligible entities for participation in RRPD programs. Improving Measurements for Loneliness and Isolation Act of 2023 (H.R.6284) Create a working group within the Department of Health and Human Services tasked with developing standards to measure loneliness and isolation, with the goal of tackling this growing issue. Promoting Effective and Empowering Recovery Services Under the Medicare Program (H.R.6748/S.3498) Provides for Medicare coverage of peer support services as RHC services. Physical Therapist Workforce and Patient Access Act of 2023 (H.R.4829) Establishes physical therapy services as RHC services (reimbursable at RHC AIR) Rural Health Preceptor Tax Fairness Act (H.R.8738) Creates a $1,000 tax credit for health preceptors of various health professionals in rural areas. Kid Proof Act (S.3364/H.R. 6663) Strengthening Pathways to Health Professions Act (H.R. 10280)

S. 2016 HR. 4189: Connect for Health Act: expand the use of telehealth and remote patient monitoring services in Medicare, toward the goal of cost savings and quality care improvement. HR 4056 Ensuring Medicaid Continuity of Children in Foster Care Act: Ensuring that Medicaid is available for foster children who are placed in qualified residential treatment programs maintaining beneficiary access to the full range of available medications under Medicare Part D by protecting consumer access to Medicare Part D's Six Protected Classes Supporting new quality measures in Medicare's FY 2024 Inpatient psychiatric facility prospective payment system Objecting to new potential work requirements for Medicare and other public assistance programs H.R. 5510: Helping our patients for emotional and mental well-being Act. Requires coverage of 3 primary care visits without cost-sharing each year under the Medicare S. 2129: Ensuring Access to Lower-Cost Medicines for Seniors Act: To amend the Social Security Act to require PDP sponsors of a prescription drug plan and Medicare Advantage organizations offering an MA-PD plan under part D of the Medicare program that use a formulary to include certain generic drugs and biosimilar biological products on such formulary H.R. 4771 The CHIPP Act: permanently extend the Childrens Health Insurance Program S.838/H.R.1638: Improving Access to Mental Health Act: Increases the Medicare reimbursement rate for clinical social worker services. H.R. 4892 & S. 3921: Medicaid Bump Act: Increase Medicaid payments to certain providers H.R. 6748 & S. 3498: Peers IN Medicaid Act: requiring Medicare to cover peer support services at certain facilities S. 3892: Community Health Workers Access Act: Increase access to community health workers under the Medicare and Medicaid H.R. 8575 Michelle Go Act: Increase the number of inpatient beds that can be reimbursed under the IMD provision. H.R. 8487/S.3018 Improving Seniors Timely Access to Care Act: Reform prior authorization process in Medicare advantage plans H.R. 6748/S.3498 Peers In Medicare Act: Allows for Medicare reimbursement for peer supourt specialist

Mental Health (mental health parity, mental health workforce, school-based behavioral services, H.R.7808 - Early Minds Act, S.4041 - CARE for Students Mental Health Act, S.3498/H.R.6748 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023, caregivers of individuals with mental illness and caregiver mental health including the Office of Caregiver Health, 988 suicide/crisis line georouting of calls), H.R.8702/S.4532 Improving Seniors Timely Access to Care Act)

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Executive Office of the President (EOP), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Mental Health (mental health parity, mental health workforce, school-based behavioral services, caregivers of individuals with mental illness and caregiver mental health, S.3498/H.R.6748 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023), H.R.8702/S.4532 Improving Seniors Timely Access to Care Act)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare reimbursement for addiction counselors Medicare coverage for substance use disorder treatment services Consolidated Appropriations Act, 2023 implementation (S.923) Better Mental Health Care for Americans Act (H.R.2400/S.1165) Reentry Act (H.R. 1638/S. 838) Improving Access to Mental Health Act (S.3921/H.R. 4892) Medicaid Bump Act (H.R.6928) CONNECT Act of 2024 Gaps in substance use disorder services Issues surrounding peer support services (H.R. 6748/S. 3498) PEERS in Medicare Act Issues surrounding Medicare Part B (H.R. 9232/S. 4860) Residential Recovery for Seniors MHPAEA Application to Medicare (H.R.2400/S.1165) Reentry Act of 2023 (H.R.3074/S.971) Due Process Continuity of Care Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Ensuring Excellence in Mental Health Act (CCBHC 2.0) (S. 2993/H.R. 8543), all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes. Mental Health Access Improvement Act (S. 828/H.R. 432), all provisions related to allowing marriage and family therapists and mental health counselors to directly bill Medicare for their services. Medicaid Reentry Act (H.R. 2400/S. 1165), all provisions related to allowing Medicaid coverage for eligible incarcerated individuals to be re-established up to 30 days before their release from jail or prison. Due Process Continuity of Care Act (H.R. 3074/S. 971), all provisions related to the removal of the Medicaid coverage exclusion for inmates in custody pending disposition of charges. ADAPT Act (S.2511), all provisions related to allowing certain supervised psychology trainees to provide mental health services and bill Medicare, Medicaid and CHIP. PEERS in Medicare Act (H.R. 6748/S. 3498), all provisions related to creating a definition of peers in the Medicare program and making peer services reimbursable through Medicare in certain community-based settings. Residential Recovery for Seniors Act (S. 4860/H.R. 9232), all provisions related to establishing Medicare coverage for residential addiction treatment programs meeting nationally recognized standards. Language to expand NHSC allowable use of hours of service delivered outside clinic walls, all provisions related to expanding allowable use for hours of service.

Client expense: $112,806 · Firm income: Not reported

- Telehealth, reforming barriers to access to services. Extending flexibilities and repealing the 6-month in person visit requirement. - Telemental Health Care Access Act, H.R. 3432/S. 3651 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act, S.3498/ H.R. 6748 - Coverage of peer support specialists services

Client expense: $84,902 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

Ensuring Excellence in Mental Health Act (CCBHC 2.0) (S. 2993/H.R. 8543), all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes. Mental Health Access Improvement Act (S. 828/H.R. 432), all provisions related to allowing marriage and family therapists and mental health counselors to directly bill Medicare for their services. Medicaid Reentry Act (H.R. 2400/S. 1165), all provisions related to allowing Medicaid coverage for eligible incarcerated individuals to be re-established up to 30 days before their release from jail or prison. Due Process Continuity of Care Act (H.R. 3074/S. 971), all provisions related to the removal of the Medicaid coverage exclusion for inmates in custody pending disposition of charges. ADAPT Act (S.2511), all provisions related to allowing certain supervised psychology trainees to provide mental health services and bill Medicare, Medicaid and CHIP. PEERS in Medicare Act (H.R. 6748/S. 3498), all provisions related to creating a definition of peers in the Medicare program and making peer services reimbursable through Medicare in certain community-based settings. Residential Recovery for Seniors Act (S. 4860/H.R. 9232), all provisions related to establishing Medicare coverage for residential addiction treatment programs meeting nationally recognized standards. Language to expand NHSC allowable use of hours of service delivered outside clinic walls, all provisions related to expanding allowable use for hours of service.

Client expense: $154,891 · Firm income: Not reported

S. 3059 & H.R. 7708 - REAL Health Providers Act - MHA has lobbied in support of this bill, which would require Medicare Advantage plans to regularly verify their provider directories and would require CMS to establish an accuracy score for each MA plan's provider directory. S. 1378 & H.R. 5819 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care - MHA has lobbied in support of this bill, which would increase the reimbursement rates in Medicare for the behavioral health integration billing codes. S. 3498 & H.R. 6748 - Promoting Effective and Empowering Recovery Services in Medicare Act of 2023 - MHA has lobbied in support of this bill, which would establish reimbursement for peer support services at community mental health centers, rural health centers, federally qualified health centers, and certified community behavioral health clinics. S. 4338 - Pay PCPs Act - MHA has lobbied for modifications to this bill, which would establish a hybrid per-member-per-month payment structure in Medicare for primary care providers contingent upon them incorporating several treatment areas into their core practice function, including behavioral health integration. MHA has specifically lobbied for the hybrid payment structure to feature multiple tiers of payment, with the higher payment tiers corresponding with greater levels of behavioral health integration.

Client expense: $22,000 · Firm income: Not reported

Mental Health (mental health parity, mental health workforce, school-based behavioral services, caregivers of individuals with mental illness and caregiver mental health, S.3498/H.R.6748 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023), H.R.8702/S.4532 Improving Seniors Timely Access to Care Act)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Mental Health (mental health parity, mental health workforce, school-based behavioral services, H.R.7808 - Early Minds Act, S.4041 - CARE for Students Mental Health Act, S.3498/H.R.6748 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023, caregivers of individuals with mental illness and caregiver mental health including the Office of Caregiver Health, 988 suicide/crisis line georouting of calls), H.R.8702/S.4532 Improving Seniors Timely Access to Care Act)

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Executive Office of the President (EOP), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Chronic Care Management Improvement Act of 2023 (H.R.2829) Removes cost-sharing responsibilities for CCM services under the Medicare program. Rural Health Innovation Act of 2023 (S.953 and H.R.1712) Creates grant programs under HRSA to expand urgent/triage care in rural communities (RHCs and FQHCs eligible); $500,000 for existing facilities and $750,000 for new facilities. Rural America Health Corps Act (S.940) Creates a loan repayment program called NHSC Rural Provider Loan Repayment Program; includes NPs and PAs as providers eligible for the program; specifically aimed at rotating graduates through underserved areas. Save Americas Rural Hospitals (H.R.833) Primarily hospital related but Sec.113 makes permanent Medicare telehealth in RHCs/FQHCs and allows for telehealth visits to be reimbursed at parity with in-person visits. Home-Based Telemental Health Care Act of 2023 (S.1077) Grant demonstration program through USDA for increasing mental health and substance abuse services in rural, medically underserved populations. Patients' Right to Know Their Medication Act of 2023 (H.R.1173) RPM Cost Sharing Elimination Study Act of 2023 (H.R.6801) Primary Care Team Education Centers Act Creates further investment in the establishment of clinical training sites for primary care providers. RHCs would be eligible entities for this funding. Improving Seniors Timely Access to Care Act Modernize Medicare Advantage prior authorization processes. Rural Residency Planning and Development Act of 2024 Officially authorizes the RRPD program that has been around since 2019. RHCs are eligible entities for participation in RRPD programs. Improving Measurements for Loneliness and Isolation Act of 2023 (H.R.6284) Create a working group within the Department of Health and Human Services tasked with developing standards to measure loneliness and isolation, with the goal of tackling this growing issue. Promoting Effective and Empowering Recovery Services Under the Medicare Program (H.R.6748/S.3498) Provides for Medicare coverage of peer support services as RHC services. Physical Therapist Workforce and Patient Access Act of 2023 (H.R.4829) Establishes physical therapy services as RHC services (reimbursable at RHC AIR) Rural Health Preceptor Tax Fairness Act (H.R.8738) Creates a $1,000 tax credit for health preceptors of various health professionals in rural areas.

S. 198, H.R. 3730 ~ Rural Health Clinic Burden Reduction Act ~ Cost Neutral Legislation to Modernize the RHC Statute Medicare Advantage Payment Policy for Rural Health Clinics ~ Securing a wrap-around payment policy for RHCs similar to what FQHCs have. Telehealth Issues ~ extending Medicare coverage of telehealth in the RHC setting and paying RHCs normally for telehealth services H.R. 5611 ~ extending and fixing telehealth payment policy for Rural Health Clinics Creating value-based payments for Rural Health Clinics S. 3967 / H.R. 7623 - Telehealth Modernization Act Primary Care Team Education Centers Act Improving Seniors' Timely Access to Care Act Improving Measurements for Loneliness and Isolation Act - H.R. 6284 H.R. 4829 - Physical Therapist Workforce and Patient Access Act of 2023 H.R. 7855 - Rural Residency Planning and Development Act of 2024 H.R. 6748 - Promoting Effective and Empowering Recovery Services in Medicare Act of 2023 H.R. 8738 - Rural Health Preceptor Tax Fairness Act H.R. 2829 - Chronic Care Management Improvement Act H.R. 1712, S. 953 - Rural Health Innovation Act of 2023 S. 940 - Rural America Health Corps Act H.R. 833 - Save America's Rural Hospitals

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

Medicare reimbursement for addiction counselors Medicare coverage for substance use disorder treatment services Consolidated Appropriations Act, 2023 implementation (S.923) Better Mental Health Care for Americans Act (H.R.2400/S.1165) Reentry Act (H.R. 1638/S. 838) Improving Access to Mental Health Act (S.3921/H.R. 4892) Medicaid Bump Act (H.R.6928) CONNECT Act of 2024 Gaps in substance use disorder services Issues surrounding peer support services (H.R. 6748/S. 3498) PEERS in Medicare Act Issues surrounding Medicare Part B (H.R. 9232/S. 4860) Residential Recovery for Seniors

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2016 HR. 4189: Connect for Health Act: expand the use of telehealth and remote patient monitoring services in Medicare, toward the goal of cost savings and quality care improvement. HR 4056 Ensuring Medicaid Continuity of Children in Foster Care Act: Ensuring that Medicaid is available for foster children who are placed in qualified residential treatment programs maintaining beneficiary access to the full range of available medications under Medicare Part D by protecting consumer access to Medicare Part D's Six Protected Classes Supporting new quality measures in Medicare's FY 2024 Inpatient psychiatric facility prospective payment system Objecting to new potential work requirements for Medicare and other public assistance programs H.R. 5510: Helping our patients for emotional and mental well-being Act. Requires coverage of 3 primary care visits without cost-sharing each year under the Medicare S. 2129: Ensuring Access to Lower-Cost Medicines for Seniors Act: To amend the Social Security Act to require PDP sponsors of a prescription drug plan and Medicare Advantage organizations offering an MA-PD plan under part D of the Medicare program that use a formulary to include certain generic drugs and biosimilar biological products on such formulary H.R. 4771 The CHIPP Act: permanently extend the Childrens Health Insurance Program S.838/H.R.1638: Improving Access to Mental Health Act: Increases the Medicare reimbursement rate for clinical social worker services. H.R. 4892 & S. 3921: Medicaid Bump Act: Increase Medicaid payments to certain providers H.R. 6748 & S. 3498: Peers IN Medicaid Act: requiring Medicare to cover peer support services at certain facilities S. 3892: Community Health Workers Access Act: Increase access to community health workers under the Medicare and Medicaid H.R. 8575 Michelle Go Act: Increase the number of inpatient beds that can be reimbursed under the IMD provision. H.R. 8487/S.3018 Improving Seniors Timely Access to Care Act: Reform prior authorization process in Medicare advantage plans H.R. 6748/S.3498 Peers In Medicare Act: Allows for Medicare reimbursement for peer supourt specialist

- Telehealth, reforming barriers to access to services. - Telemental Health Care Access Act, H.R. 3432/S. 3651 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act, S.3498/ H.R. 6748 - Coverage of peer support specialists services

Client expense: $82,011 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Extension of Medicare and Medicaid waivers beyond the COVID-19 public health emergency Medicare and Medicaid restrictions related to telehealth services Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures H.R. 704/S.260, Promoting Access to Diabetic Shoes Act H.R. 2583/S. 3481, Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023 H.R. 3432/S. 3651, Telemental Health Care Access Act H.R. 6748/S. 3498, Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023 H.R. 7623/S. 3967, Telehealth Modernization Act H.R. 7711, Advancing Access to Telehealth Act S. 198, Rural Health Clinic Burden Reduction Act S. 2016/H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 S. 1586/H.R. 3623, Educating Future Nurses Act

Client expense: Not reported · Firm income: $27,400

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

Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Extension of Medicare and Medicaid waivers beyond the COVID-19 public health emergency Medicare and Medicaid restrictions related to telehealth services Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures H.R. 704/S.260, Promoting Access to Diabetic Shoes Act H.R. 2583/S. 3481, Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023 H.R. 3432/S. 3651, Telemental Health Care Access Act H.R. 3836, Medicaid Primary Care Improvement Act H.R. 5434/S. 3138, Stabilize Medicaid and CHIP Coverage Act H.R. 6683, Preserving Seniors Access to Physicians Act of 2023 H.R. 6748/S. 3498, Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023 H.R. 7623/S. 3967, Telehealth Modernization Act H.R. 7711, Advancing Access to Telehealth Act S. 198, Rural Health Clinic Burden Reduction Act S. 2016/H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 S. 1586/H.R. 3623, Educating Future Nurses Act

Client expense: Not reported · Firm income: $24,000

Increasing access to mental health and substance use treatment Mental health & substance use disorder workforce Modernizing Opioid Treatment Access Act (H.R. 1359/S.644) Federal funding for mental health and substance use programs, research and training Make Medicare telehealth flexibilities permanent Medicaid Bump Act (H.R. 4892/S. 3921) PEERS in Medicare Act (H.R. 6748 / S.3498) SUPPORT RX Act ( S.4429) Streamline utilization management protocols in Medicare; Improving Senior's Timely Access to Care Act (S. 4578)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3059 & H.R. 7708 - REAL Health Providers Act - MHA has lobbied in support of this bill, which would require Medicare Advantage plans to regularly verify their provider directories and would require CMS to establish an accuracy score for each MA plan's provider directory. S. 1378 & H.R. 5819 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care - MHA has lobbied in support of this bill, which would increase the reimbursement rates in Medicare for the behavioral health integration billing codes. S. 3498 & H.R. 6748 - Promoting Effective and Empowering Recovery Services in Medicare Act of 2023 - MHA has lobbied in support of this bill, which would establish reimbursement for peer support services at community mental health centers, rural health centers, federally qualified health centers, and certified community behavioral health clinics. S. 4338 - Pay PCPs Act - MHA has lobbied for modifications to this bill, which would establish a hybrid per-member-per-month payment structure in Medicare for primary care providers contingent upon them incorporating several treatment areas into their core practice function, including behavioral health integration. MHA has specifically lobbied for the hybrid payment structure to feature multiple tiers of payment, with the higher payment tiers corresponding with greater levels of behavioral health integration.

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

S. 198, H.R. 3730 ~ Rural Health Clinic Burden Reduction Act ~ Cost Neutral Legislation to Modernize the RHC Statute Medicare Advantage Payment Policy for Rural Health Clinics ~ Securing a wrap-around payment policy for RHCs similar to what FQHCs have. Telehealth Issues ~ extending Medicare coverage of telehealth in the RHC setting and paying RHCs normally for telehealth services H.R. 5611 ~ extending and fixing telehealth payment policy for Rural Health Clinics Creating value-based payments for Rural Health Clinics S. 3967 / H.R. 7623 - Telehealth Modernization Act Primary Care Team Education Centers Act Improving Seniors' Timely Access to Care Improving Measurements for Loneliness and Isolation Act - H.R. 6284 H.R. 8738 - To amend the Internal Revenue Code of 1986 to provide a credit against tax for certain health professionals providing clinical supervision to students in rural health professional shortage areas. H.R. 4829 - Physical Therapist Workforce and Patient Access Act of 2023 H.R.7855 - Rural Residency Planning and Development Act of 2024 H.R.6748 - Promoting Effective and Empowering Recovery Services in Medicare Act of 2023

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

Mental Health (mental health parity, mental health workforce, school-based behavioral services, H.R.7808 - Early Minds Act, S.4041 - CARE for Students Mental Health Act, S.3498/H.R.6748 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023, caregivers of individuals with mental illness and caregiver mental health including the Office of Caregiver Health, 988 suicide/crisis line georouting of calls)

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Executive Office of the President (EOP), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Mental Health (mental health parity, mental health workforce, school-based behavioral services, caregivers of individuals with mental illness and caregiver mental health, S.3498/H.R.6748 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act of 2023)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2016 HR. 4189: Connect for Health Act: expand the use of telehealth and remote patient monitoring services in Medicare, toward the goal of cost savings and quality care improvement. HR 4056 Ensuring Medicaid Continuity of Children in Foster Care Act: Ensuring that Medicaid is available for foster children who are placed in qualified residential treatment programs maintaining beneficiary access to the full range of available medications under Medicare Part D by protecting consumer access to Medicare Part D's Six Protected Classes Supporting new quality measures in Medicare's FY 2024 Inpatient psychiatric facility prospective payment system Objecting to new potential work requirements for Medicare and other public assistance programs H.R. 5510: Helping our patients for emotional and mental well-being Act. Requires coverage of 3 primary care visits without cost-sharing each year under the Medicare S. 2129: Ensuring Access to Lower-Cost Medicines for Seniors Act: To amend the Social Security Act to require PDP sponsors of a prescription drug plan and Medicare Advantage organizations offering an MA-PD plan under part D of the Medicare program that use a formulary to include certain generic drugs and biosimilar biological products on such formulary H.R. 4771 The CHIPP Act: permanently extend the Childrens Health Insurance Program S.838/H.R.1638: Improving Access to Mental Health Act: Increases the Medicare reimbursement rate for clinical social worker services. H.R. 4892 & S. 3921: Medicaid Bump Act: Increase Medicaid payments to certain providers H.R. 6748 & S. 3498: Peers IN Medicaid Act: requiring Medicare to cover peer support services at certain facilities S. 3892: Community Health Workers Access Act: Increase access to community health workers under the Medicare and Medicaid H.R. 8575 Michelle Go Act: Increase the number of inpatient beds that can be reimbursed under the IMD provision. H.R. 8487/S.3018 Improving Seniors Timely Access to Care Act: Reform prior authorization process in Medicare advantage plans H.R. 6748/S.3498 Peers In Medicare Act: Allows for Medicare reimbursement for peer supourt specialist

Medicare reimbursement for addiction counselors Medicare coverage for substance use disorder treatment services Consolidated Appropriations Act, 2023 implementation (S.923) Better Mental Health Care for Americans Act (H.R.2400/S.1165) Reentry Act (H.R. 1638/S. 838) Improving Access to Mental Health Act (S.3921/H.R. 4892) Medicaid Bump Act (H.R.6928) CONNECT Act of 2024 Gaps in substance use disorder services Issues surrounding peer support services (H.R. 6748/S. 3498) PEERS in Medicare Act Issues surrounding Medicare Part B

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

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

Ensuring Excellence in Mental Health Act (CCBHC 2.0) (S. 2993), all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes. Mental Health Access Improvement Act (S. 828/H.R. 432), all provisions related to allowing marriage and family therapists and mental health counselors to directly bill Medicare for their services. Medicaid Reentry Act (H.R. 2400/S. 1165), all provisions related to allowing Medicaid coverage for eligible incarcerated individuals to be re-established up to 30 days before their release from jail or prison. Due Process Continuity of Care Act (H.R. 3074/S. 971), all provisions related to the removal of the Medicaid coverage exclusion for inmates in custody pending disposition of charges. ADAPT Act (S.2511), all provisions related to allowing certain supervised psychology trainees to provide mental health services and bill Medicare, Medicaid and CHIP. PEERS in Medicare Act (H.R. 6748/S. 3498), all provisions related to creating a definition of peers in the Medicare program and making peer services reimbursable through Medicare in certain community-based settings. Ensuring Medicaid Continuity for Children in Foster Care Act of 2023 (H.R. 4056), all provisions relating to the allowance of Medicaid payment for services provided to children in foster care in residential treatment programs Language to expand NHSC allowable use of hours of service delivered outside clinic walls, all provisions related to expanding allowable use for hours of service.

Client expense: $149,440 · Firm income: Not reported

- Telehealth, reforming barriers to Medicare reimbursement and access to services. CONNECT Act S. 2016/H.R. 4189 - Telemental Health Care Access Act, H.R. 3432/S. 3651 - Promoting Effective and Empowering Recovery Services (PEERS) in Medicare Act, S.3498/ H.R. 6748 - Coverage of peer support specialists services

Client expense: $49,451 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, White House Office

S. 2016 HR. 4189: Connect for Health Act: expand the use of telehealth and remote patient monitoring services in Medicare, toward the goal of cost savings and quality care improvement. HR 4056 Ensuring Medicaid Continuity of Children in Foster Care Act: Ensuring that Medicaid is available for foster children who are placed in qualified residential treatment programs maintaining beneficiary access to the full range of available medications under Medicare Part D by protecting consumer access to Medicare Part D's Six Protected Classes Supporting new quality measures in Medicare's FY 2024 Inpatient psychiatric facility prospective payment system Objecting to new potential work requirements for Medicare and other public assistance programs H.R. 5510: Helping our patients for emotional and mental well-being Act. Requires coverage of 3 primary care visits without cost-sharing each year under the Medicare S. 2129: Ensuring Access to Lower-Cost Medicines for Seniors Act: To amend the Social Security Act to require PDP sponsors of a prescription drug plan and Medicare Advantage organizations offering an MA-PD plan under part D of the Medicare program that use a formulary to include certain generic drugs and biosimilar biological products on such formulary H.R. 4771 The CHIPP Act: permanently extend the Childrens Health Insurance Program S.838/H.R.1638: Improving Access to Mental Health Act: Increases the Medicare reimbursement rate for clinical social worker services. H.R. 4892 & S. 3921: Medicaid Bump Act: Increase Medicaid payments to certain providers H.R. 6748 & S. 3498: Peers IN Medicaid Act: requiring Medicare to cover peer support services at certain facilities S. 3892: Community Health Workers Access Act: Increase access to community health workers under the Medicare and Medicaid

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

Ensuring Excellence in Mental Health Act (CCBHC 2.0) (S. 2993), all provisions related to expansion grant funding for CCBHCs, childrens clinic grant funding, and CCBHC certification processes. Mental Health Access Improvement Act (S. 828/H.R. 432), all provisions related to allowing marriage and family therapists and mental health counselors to directly bill Medicare for their services. Medicaid Reentry Act (H.R. 2400/S. 1165), all provisions related to allowing Medicaid coverage for eligible incarcerated individuals to be re-established up to 30 days before their release from jail or prison. Due Process Continuity of Care Act (H.R. 3074/S. 971), all provisions related to the removal of the Medicaid coverage exclusion for inmates in custody pending disposition of charges. ADAPT Act (S.2511), all provisions related to allowing certain supervised psychology trainees to provide mental health services and bill Medicare, Medicaid and CHIP. PEERS in Medicare Act (H.R. 6748/S. 3498), all provisions related to creating a definition of peers in the Medicare program and making peer services reimbursable through Medicare in certain community-based settings. Language to expand NHSC allowable use of hours of service delivered outside clinic walls, all provisions related to expanding allowable use for hours of service.

Client expense: $140,770 · Firm income: Not reported