FAIR Act

Issues related to NIH research funding and Graduate Medical Education, including Fair Access in Residency (FAIR) Act (H.R. 751)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3046, Medical Student Education Authorization Act of 2023, all provisions S. 1403, Medical Student Education Authorization Act of 2023, all provisions H.R. 1202, Resident Education Deferred Interest (REDI) Act, all provisions S. 704, Resident Education Deferred Interest (REDI) Act, all provisions H.R. 2761, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions S. 705, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions H.R. 7050, Substance Use Disorder Workforce Act, all provisions H.R. 7258, Community TEAMS Act of 2024, all provisions S. 3968, Community TEAMS Act of 2024, all provisions S. 3022, IHS Workforce Parity Act of 2023, all provisions H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions H.R. 751, Fair Access In Residency (FAIR) Act, all provisions H.R. 8318, Tribal Tax and Investment Reform Act of 2024, provisions relating to sections 12 and 13 H.R. 4829, Physical Therapist Workforce and Patient Access Act of 2023, all provisions H.R. 7725, To amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion, all provisions S. 4115, Embracing anti-Discrimination, Unbiased Curricula, and Advancing Truth in Education (EDUCATE) Act, all provisions H.R. 8235, Rural Physician Workforce Preservation Act, all provisions Opioid Workforce Act/draft Pathways to Practice GME cap flexibility GME funding Liaison Committee on Medical Education Medical education/Artificial Intelligence (AI)

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

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

Fair Access In Residency (FAIR) Act (H.R. 751) Rural Physician Workforce Production Act (S. 230/H.R. 834) Resident Physician Shortage Reduction Act of 2023 (S. 1302/H.R. 2389) Council on Graduate Medical Education Medicare Payment Advisory Commission Inpatient Prospective Payment System (SCH/MDH Issue) Consolidated Appropriations Act, 2021 (PL 116-260) Community Training, Education and Access for Medical Students (Community TEAMS) Act (S. 3968, H.R. 7258) National Health Service Corps Teaching Health Centers Graduate Medical Education NIH Osteopathic Funding and Representation Substance Use Disorder Workforce Act of 2024 (H.R. 7050) Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (S. 3679, H.R. 7153) Medically Tailored Home-Delivered Meals Demonstration Pilot Act (S. 2133, H.R. 6780) Rural Physician Workforce Preservation Act (H.R. 8235) Rural Residency Planning and Development Act of 2024 (H.R. 7855) Physician Preceptor Tax Credit Pandemic and All-Hazards Preparedness Act (PL 109-417) Public Health Infrastructure Saves Lives Act (S. 1995)

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

Fair Access In Residency (FAIR) Act (H.R. 751) Rural Physician Workforce Production Act (S. 230, H.R. 834) Resident Physician Shortage Reduction Act of 2023 (S. 1302, H.R. 2389) Council on Graduate Medical Education Medicare Payment Advisory Commission Consolidated Appropriations Act, 2021 (PL 116-260) Community Training, Education and Access for Medical Students (Community TEAMS) Act (S. 3968, H.R. 7258) National Health Service Corps Teaching Health Centers Graduate Medical Education 21st Century Cures Act and Cures 2.0 Substance Use Disorder Workforce Act of 2024 (H.R. 7050) Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (S. 3679, H.R. 7153) Rural Physician Workforce Preservation Act (H.R. 8235) Rural Residency Planning and Development Act of 2024 (H.R. 7855) Physician Preceptor Tax Credit Pandemic and All-Hazards Preparedness Act (PL 109-417) Public Health Infrastructure Saves Lives Act (S. 1995) Physician Fee Stabilization Act (S.4935) Rural Health Preceptor Tax Fairness Act (H.R.8738) Telehealth Modernization Act of 2024 (H.R.7623, S.3967) Bipartisan Primary Care and Health Workforce Act (S. 2850) Rural Hospital Flexibility Act (S.5308, H.R.10187) Strengthening Pathways to Health Professions Act (H.R.10280)

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

H.R. 2389: Resident Physician Shortage Reduction Act of 2023 To amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions, and for other purposes (ALL). H.R. 751: Fair Access in Residency (FAIR) Act To amend title XVIII of the Social Security Act to require as a condition of satisfying the definition of an approved medical residency training program for purposes of payments under Medicare for costs related to graduate medical education for hospitals operating such a program to submit information to encourage more equitable treatment of osteopathic and allopathic candidates in the residency application and review process, and for other purposes (ALL). H.R. 7725 and S. 4115: Embracing Anti-Discrimination, Unbiased Curriculum, and Advancing Truth in Education (EDUCATE) Act To amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion (ALL). H.R. 7213: Autism CARES Act of 2024 To amend the Public Health Service Act to enhance activities of the National Institutes of Health with respect to research on autism spectrum disorder and enhance programs relating to autism / reauthorize certain programs with respect to autism spectrum disorder, and for other purposes (ALL).

Client expense: $70,000 · Firm income: Not reported

Issues related to NIH research funding and Graduate Medical Education, including Fair Access in Residency (FAIR) Act (H.R. 751)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Higher Education Reauthorization Act (Title IV), H.R. 751- The FAIR Act - requires hospitals to certify that they accept residency applications from both osteopathic and allopathic medical schools

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE

H.R. 6445, Medicare Audiology Access Improvement Act, all provisions S. 2377, Medicare Audiology Access Improvement Act, all provisions H.R. 1610, Chiropractic Medicare Coverage Modernization Act, all provisions S. 799, Chiropractic Medicare Coverage Modernization Act, all provisions H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions S. 2016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions H.R. 1770, Equitable Community Access to Pharmacist Services Act, all provisions S. 2477, Equitable Community Access to Pharmacist Services Act, all provisions H.R. 751, Fair Access In Residency (FAIR) Act, all provisions H.R. 4968, GOLD CARD Act, all provisions H.R. 2713, Improving Care and Access to Nurses (I CAN) Act, all provisions S. 2418, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 2583, Increasing Access to Quality Cardiac Rehabilitation Care Act, all provisions H.R. 6487, No Fees for EFTs Act, all provisions S. 3805, No Fees for EFTs Act, all provisions H.R. 977, Patient Access to Higher Quality Health Care Act of 2023, all provisions S. 470, Patient Access to Higher Quality Health Care Act of 2023, all provisions H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions H.R. 2630, Safe Step Act, all provisions S. 652, Safe Step Act, all provisions H.R. 7050, Substance Use Disorder Workforce Act, all provisions H.R. 7623, Telehealth Modernization Act of 2024, all provisions H.R. 2474, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 6371, Provider Reimbursement Stability Act of 2023, all provisions H.R. 6545, Physician Fee Schedule Update and Improvements Act, all provisions H.R. 5378, Lower Costs, More Transparency Act, all provisions H.R. 6683, Preserving Seniors Access to Physicians Act of 2023, all provisions H.R. 5013, Value in Health Care Act of 2023, all provisions S. 3503, Value in Health Care Act of 2023, all provisions H.R. 8702, Improving Seniors Timely Access to Care Act of 2024, all provisions S. 4532, Improving Seniors Timely Access to Care Act of 2024, all provisions S. 4935, Physician Fee Stabilization Act, all provisions H.R. 10073, Medicare Patient Access and Practice Stabilization Act of 2024, all provisions H.R. 7856, PREVENT DIABETES Act, all provisions H.R. 3838, Preventing Maternal Deaths Reauthorization Act of 2023, all provisions S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023, all provisions H.R. 8532, Connected MOM Act, all provisions S. 712, Connected MOM Act, all provisions H.R. 6369, To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models, all provisions H.R. 8404, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions S. 4330, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions H.R. 8235, Rural Physician Workforce Preservation Act, all provisions H.R. 1745, Medicare Fraud Detection and Deterrence Act of 2023, all provisions H.R. 1746, Preventing Medicare Telefraud Act, all provisions H.R. 8261, Preserving Telehealth, Hospital, and Ambulance Access Act, all provisions S. 1491, Pharmacy and Medically Underserved Areas Enhancement Act, all provisions S. 669, Increasing Mental Health Options Act of 2023, all provisions H.R. 7618, Stopping Addiction and Falls for the Elderly (SAFE) Act, all provisions H.R. 3730, Rural Health Clinic Burden Reduction Act, all provisions H.R. 7279, Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act, all provisions H.R. 6230, Doctor Knows Best Act of 2023, all provisions H.R. 9572, Enhanced Enforcement of Health Coverage Act, all provisions H.R. 9001, Physician Led and Rural Access to Quality Care Act, all provisions S. 5218, Health Infrastructure Security and Accountability Act of 2024, all provisions S. 4054, Health Care Cybersecurity Improvement Act of 2024, all provisions H.R. 9572, Enhanced Enforcement of Health Coverage Act, all provisions Supporting Health Moms and Babies Act/draft Fewer Burdens for Better Healthcare Act/draft Medicaid Primary Care Improvement Act/Senate draft Opioid Workforce Act of 2021/Senate draft Electronic clinical quality measures (eCQM) reporting/draft Medicare program: Medicare physician payment/2.83% cut for FY2025 Medicare program: Payment reform/Medicare Part B cuts Medicare program: Medicare Economic Index (MEI) inflation update Medicare program: Budget neutrality reforms Medicare program: Merit-based Incentive Payment System (MIPS) reforms and penalties Medicare program: G2211 inherent complexity codes Medicare program: Protecting Access to Medicare Act (PAMA 2014)/clinical lab cut reforms Medicare Program: Medicare Access and CHIP Reauthorization Act (MACRA) physician burdens Medicare program: Alternative Payment Models (APMs) Medicare program: Advanced APMs reporting requirements Medicare program: APMs for rural physicians Medicare program: Graduate Medical Education (GME) cap flexibility Medicare program: Physician-owned hospitals Medicare program: Telehealth Medicare program: Prior Authorization Medicare program: Site neutral payment Medicare program: Physician-Focused Payment Model Technical Advisory Committee (PTAC) reform Medicare program: Sunsetting of web interface Medicare program: Access to claims data Medicare program: Coding Medicare program: Accountable Care Organization (ACO)/APM/Medicare Shared Savings Program Medicare program: Medicare Diabetes Prevention Program Medicare program: Physician burden Medicare program: Promoting Interoperability (PI) program Medicare program: Quality Payment Program Medicare program: Certified electronic health record technology and PI Medicare program: Shared Savings program Medicare program: Public Health Reporting and Data Exchange Medicare program: Patient engagement Medicare program: Medicare Advantage plans/Prior Authorization Medicare program: Physician-owned hospitals Medicare program: Medigap/modified community rating Medicare and Medicaid programs: Artificial intelligence Medicare and Medicaid programs: Substance use disorder Medicare and Medicaid programs: Cybersecurity/health care clearinghouses Medicare and Medicaid programs: Health IT Medicare and Medicaid programs: Interoperability Medicare and Medicaid programs: Mandatory models Medicaid and Medicare programs: Quality programs/physician choice Medicaid program: Maternal health Medicaid program: Maternal mortality

Medicare-funded Graduate Medical Education; NIH Osteopathic Funding and Representation; H.R.751, Fair Access in Residency Act; H.R.7258/S.3968, Community TEAMS Act of 2024; H.R.8070/S.4638, National Defense Authorization Act for Fiscal Year 2025; H.R.9029/S.4942, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025; H.R.8774/S.4921, Department of Defense Appropriations Act, 2025.

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

H.R.2389/S.1302 - Resident Physician Shortage Reduction Act of 2023 H.R.7050 - Substance Use Disorder Workforce Act Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for GME. Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.751 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.834/S.230 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals. GME Data Transparency Act of 2024 Issue: Educate Congress on teaching health system and hospital GME data collection practices and concerns related to duplicative reporting requirements. H.R.2584/S.2768 - Safety From Violence for Healthcare Employees (SAVE) Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. H.R.5378 - Lower Costs, More Transparency Act Issue: Oppose legislation that pays for workforce investments and mitigation of DSH cuts paid for by cuts to hospital outpatient departments. H.R.5013 - Value in Health Care Act Issue: Support legislation that ensures the continued move to value-based care. H.R.8235 - Rural Physician Workforce Preservation Act Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported GME slots from the CAA, 2021 and 2023. Issue: Educate Congress on status of CMS distribution of the 1,000 new GME slots authorized by the Consolidated Appropriations Act, 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare DGME/IME payments. Issue: Oppose the redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Draft Senate Finance Medicare Physician Fee Schedule request for information Issue: Support efforts to reform the Medicare physician fee schedule. H.R.2474 - Strengthening Medicare for Patients and Providers Act Issue: Support legislation that reforms the Medicare Physician Fee Schedule by providing an annual inflation-based payment update based on the Medicare Economic Index (MEI). S.4338 - Pay PCPs Act Issue: Respond to Senate request for information on hybrid payments for Medicare physicians. P.L.118-42 - Consolidated Appropriations Act, 2024 H.R. 10445 - Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025 P.L. 118-158 American Relief Act, 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. H.R.2665 - The Supporting Safety Net Hospitals Act Issue: Support elimination of two years of scheduled reductions to the Medicaid DSH program. H.R.9351 - The Save Our Safety-Net Hospitals (SOS) Act Issue: Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on potential financial implications of entitlement reform on teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. H.R.1397 - The Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). H.R.2377/S.1000 - The Saving Access to Laboratory Services (SALSA) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. H.R.2829 - Chronic Care Management Improvement Act of 2023 Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare.

H.R.2389/S.1302 - Resident Physician Shortage Reduction Act of 2023 H.R.7050 - Substance Use Disorder Workforce Act Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for GME. Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.751 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.834/S.230 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals. H.R.2584/S.2768 - Safety From Violence for Healthcare Employees (SAVE) Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. H.R.5378 - Lower Costs, More Transparency Act Issue: Oppose legislation that pays for workforce investments and mitigation of DSH cuts paid for by cuts to hospital outpatient departments. H.R.5013 - Value in Health Care Act Issue: Support legislation that ensures the continued move to value-based care. H.R.8235 - Rural Physician Workforce Preservation Act Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported GME slots from the CAA, 2021 and 2023. Issue: Educate Congress on status of CMS distribution of the 1,000 new GME slots authorized by the Consolidated Appropriations Act, 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare DGME/IME payments. Issue: Oppose the redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Draft Senate Finance Medicare Physician Fee Schedule request for information Issue: Support efforts to reform the Medicare physician fee schedule. H.R.2474 - Strengthening Medicare for Patients and Providers Act Issue: Support legislation that reforms the Medicare Physician Fee Schedule by providing an annual inflation-based payment update based on the Medicare Economic Index (MEI). S.4338 - Pay PCPs Act Issue: Respond to Senate RFI on hybrid payments for Medicare physicians. P.L.118-42 - Consolidated Appropriations Act, 2024 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. H.R.2665 - The Supporting Safety Net Hospitals Act Issue: Support eliminating two years worth of scheduled reductions to the Medicaid DSH program. H.R.9351 - The Save Our Safety-Net Hospitals (SOS) Act Issue: Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on potential financial implications of entitlement reform on teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. H.R.1397 - The Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). H.R.2377/S.1000 - The Saving Access to Laboratory Services (SALSA) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. H.R.2829 - Chronic Care Management Improvement Act of 2023 Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare.

H.R.2389/S.1302 - Resident Physician Shortage Reduction Act of 2023 H.R.7050 - Substance Use Disorder Workforce Act Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for GME. Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.751 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.834/S.230 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals. H.R.2584/S.2768 - Safety From Violence for Healthcare Employees (SAVE) Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. H.R.5378 - Lower Costs, More Transparency Act Issue: Oppose legislation that pays for workforce investments and mitigation of DSH cuts paid for by cuts to hospital outpatient departments. H.R.5013 - Value in Health Care Act Issue: Support legislation that ensures the continued move to value-based care. H.R.8235 - Rural Physician Workforce Preservation Act Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported GME slots from the CAA, 2021 and 2023. Issue: Educate Congress on status of CMS distribution of the 1,000 new GME slots authorized by the Consolidated Appropriations Act, 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare DGME/IME payments. Issue: Oppose the redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Draft Senate Finance Medicare Physician Fee Schedule request for information Issue: Support efforts to reform the Medicare physician fee schedule. H.R.2474 - Strengthening Medicare for Patients and Providers Act Issue: Support legislation that reforms the Medicare Physician Fee Schedule by providing an annual inflation-based payment update based on the Medicare Economic Index (MEI). S.4338 - Pay PCPs Act Issue: Respond to Senate RFI on hybrid payments for Medicare physicians. P.L.118-42 - Consolidated Appropriations Act, 2024 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. H.R.2665 - The Supporting Safety Net Hospitals Act Issue: Support eliminating two years worth of scheduled reductions to the Medicaid DSH program. H.R.9351 - The Save Our Safety-Net Hospitals (SOS) Act Issue: Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on potential financial implications of entitlement reform on teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. H.R.1397 - The Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). H.R.2377/S.1000 - The Saving Access to Laboratory Services (SALSA) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. H.R.2829 - Chronic Care Management Improvement Act of 2023 Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare.

H.R. 3046, Medical Student Education Authorization Act of 2023, all provisions S. 1403, Medical Student Education Authorization Act of 2023, all provisions H.R. 1202, Resident Education Deferred Interest (REDI) Act, all provisions S. 704, Resident Education Deferred Interest (REDI) Act, all provisions H.R. 2761, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions S. 705, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions H.R. 7050, Substance Use Disorder Workforce Act, all provisions H.R. 7258, Community TEAMS Act of 2024, all provisions S. 3968, Community TEAMS Act of 2024, all provisions S. 3022, IHS Workforce Parity Act of 2023, all provisions H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions H.R. 751, Fair Access In Residency (FAIR) Act, all provisions H.R. 8318, Tribal Tax and Investment Reform Act of 2024, provisions relating to sections 12 and 13 H.R. 4829, Physical Therapist Workforce and Patient Access Act of 2023, all provisions H.R. 7725, To amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion, all provisions S. 4115, Embracing anti-Discrimination, Unbiased Curricula, and Advancing Truth in Education (EDUCATE) Act, all provisions H.R. 8235, Rural Physician Workforce Preservation Act, all provisions Opioid Workforce Act/draft Pathways to Practice GME cap flexibility GME funding Liaison Committee on Medical Education Medical education/Artificial Intelligence (AI)

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

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

Medicare-funded Graduate Medical Education; NIH Osteopathic Funding and Representation; H.R.751, Fair Access in Residency Act; H.R.7258/S.3968, Community TEAMS Act of 2024; H.R.8070/S.4638, National Defense Authorization Act for Fiscal Year 2025; H.R.9029/S.4942, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025; H.R.8774/S.4921, Department of Defense Appropriations Act, 2025.

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

Issues related to NIH research funding and Graduate Medical Education, including Fair Access in Residency (FAIR) Act (H.R. 751)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2389: Resident Physician Shortage Reduction Act of 2023 To amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions, and for other purposes (ALL). H.R. 751: Fair Access in Residency (FAIR) Act To amend title XVIII of the Social Security Act to require as a condition of satisfying the definition of an approved medical residency training program for purposes of payments under Medicare for costs related to graduate medical education for hospitals operating such a program to submit information to encourage more equitable treatment of osteopathic and allopathic candidates in the residency application and review process, and for other purposes (ALL). H.R. 7725 and S. 4115: Embracing Anti-Discrimination, Unbiased Curriculum, and Advancing Truth in Education (EDUCATE) Act To amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion (ALL). H.R. 7213: Autism CARES Act of 2024 To amend the Public Health Service Act to enhance activities of the National Institutes of Health with respect to research on autism spectrum disorder and enhance programs relating to autism / reauthorize certain programs with respect to autism spectrum disorder, and for other purposes (ALL).

Client expense: $80,000 · Firm income: Not reported

Higher Education Reauthorization Act (Title IV), H.R. 751- The FAIR Act - requires hospitals to certify that they accept residency applications from both osteopathic and allopathic medical schools

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE

Fair Access In Residency (FAIR) Act (H.R. 751) Rural Physician Workforce Production Act (S. 230/H.R. 834) Resident Physician Shortage Reduction Act of 2023 (S. 1302/H.R. 2389) Council on Graduate Medical Education Medicare Payment Advisory Commission Inpatient Prospective Payment System Consolidated Appropriations Act, 2021 (PL 116-260) Community Training, Education and Access for Medical Students (Community TEAMS) Act (S. 3968, H.R. 7258) National Health Service Corps Teaching Health Centers Graduate Medical Education NIH Osteopathic Funding and Representation 21st Century Cures Act and Cures 2.0 Substance Use Disorder Workforce Act of 2024 (H.R. 7050) Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (S. 3679, H.R. 7153) Rural Physician Workforce Preservation Act (H.R. 8235) Rural Residency Planning and Development Act of 2024 (H.R. 7855) Physician Preceptor Tax Credit Pandemic and All-Hazards Preparedness Act (PL 109-417) Public Health Infrastructure Saves Lives Act (S. 1995) Physician Fee Stabilization Act (S.4935) Rural Health Preceptor Tax Fairness Act (H.R.8738) Telehealth Modernization Act of 2024 (H.R.7623/S.3967)

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

Support the Community Training, Education, and Access for Medical Students Act (Community TEAMS Act) (H.R. 7528 / S. 3968). Support the Fair Access In Residency Act (H.R. 751) which would provide transparency by reporting annually on the number of DO and MD applicants and accepted residents; and affirm that DO applications and the COMLEX-USA are accepted for consideration. Support the Rural Physician Workforce Production Act (H.R. 834/S.230) which would increase the physician workforce in rural areas by improving Medicare reimbursement for rural residency training. Support a five-year reauthorization at $300 million per year to provide sustainable funding for existing Teaching Health Center programs and support the development of new programs.

Client expense: Not reported · Firm income: $21,600

Government targets: HOUSE OF REPRESENTATIVES

H.R. 2389: Resident Physician Shortage Reduction Act of 2023 To amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions, and for other purposes (ALL). H.R. 751: Fair Access in Residency (FAIR) Act To amend title XVIII of the Social Security Act to require as a condition of satisfying the definition of an approved medical residency training program for purposes of payments under Medicare for costs related to graduate medical education for hospitals operating such a program to submit information to encourage more equitable treatment of osteopathic and allopathic candidates in the residency application and review process, and for other purposes (ALL). H.R. 7725 and S. 4115: Embracing Anti-Discrimination, Unbiased Curriculum, and Advancing Truth in Education (EDUCATE) Act To amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion (ALL). H.R. 7213: Autism CARES Act of 2024 To amend the Public Health Service Act to enhance activities of the National Institutes of Health with respect to research on autism spectrum disorder and enhance programs relating to autism / reauthorize certain programs with respect to autism spectrum disorder, and for other purposes (ALL).

Client expense: $100,000 · Firm income: Not reported

Higher Education Reauthorization Act (Title IV), H.R. 751- The FAIR Act - requires hospitals to certify that they accept residency applications from both osteopathic and allopathic medical schools

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE

H.R.2389/S.1302 - Resident Physician Shortage Reduction Act of 2023 H.R.7050 - Substance Use Disorder Workforce Act Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). H.R.751 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.834/S.230 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals. H.R.2584/S.2768 - Safety From Violence for Healthcare Employees (SAVE) Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. H.R.5378 - Lower Costs, More Transparency Act Issue: Oppose legislation that pays for workforce investments and mitigation of DSH cuts paid for by cuts to hospital outpatient departments. H.R.5013 - Value in Health Care Act Issue: Support legislation that ensures the continued move to value-based care. H.R.8235 - Rural Physician Workforce Preservation Act Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported GME slots from the CAA, 2021 and 2023. Issue: Educate Congress on status of CMS distribution of the 1,000 new GME slots authorized by the Consolidated Appropriations Act, 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare GME/IME payments. Issue: Oppose the redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Draft Senate Finance Medicare Physician Fee Schedule request for information Issue: Support efforts to reform the Medicare physician fee schedule. H.R.2474 - Strengthening Medicare for Patients and Providers Act Issue: Support legislation that reforms the Medicare Physician Fee Schedule by providing an annual inflation-based payment update based on the Medicare Economic Index (MEI). S.4338 - Pay PCPs Act Issue: Respond to Senate RFI on hybrid payments for Medicare physicians. P.L.118-42 - Consolidated Appropriations Act, 2024 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. H.R.2665 - The Supporting Safety Net Hospitals Act Issue: Support eliminating two years worth of scheduled reductions to the Medicaid DSH program. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on potential financial implications of entitlement reform on teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. H.R.1397 - The Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. H.R.2377/S.1000 - The Saving Access to Laboratory Services (SALSA) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. H.R.2829 - Chronic Care Management Improvement Act of 2023 Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare.

Medicare-funded Graduate Medical Education; NIH Osteopathic Funding and Representation; H.R.751, Fair Access in Residency Act; H.R.7258/S.3968, Community TEAMS Act of 2024; FY2025 National Defense Authorization Act (H.R.8070); FY2025 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations process; FY2025 Department of Defense Appropriations Act (H.R.8774).

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

H.R. 3046, Medical Student Education Authorization Act of 2023, all provisions S. 1403, Medical Student Education Authorization Act of 2023, all provisions H.R. 1202, Resident Education Deferred Interest (REDI) Act, all provisions S. 704, Resident Education Deferred Interest (REDI) Act, all provisions H.R. 2761, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions S. 705, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions H.R. 7258, Community Training, Education, and Access for Medical Students (Community TEAMS) Act of 2024, all provisions S. 3968, Community Training, Education, and Access for Medical Students (Community TEAMS) Act of 2024, all provisions S. 3022, IHS Workforce Parity Act of 2023, all provisions H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions H.R. 751, Fair Access In Residency (FAIR) Act, all provisions H.R. 7050, Substance Use Disorder Workforce Act, all provisions H.R. 4829, Physical Therapist Workforce and Patient Access Act of 2023, provisions relating to National Health Service Corps Loan Repayment program H.R. 7725, To amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion, all provisions S. 4115, Embracing anti-Discrimination, Unbiased Curricula, and Advancing Truth in Education (EDUCATE) Act, all provisions H.R. 8318, Tribal Tax and Investment Reform Act of 2024, provisions relating to student loans H.R. 8235, Rural Physician Workforce Preservation Act, provisions relating to GME H.R. 7855, Rural Residency Planning and Development Act of 2024, all provisions Opioid Workforce Act/draft IHS Health Professions Tax Fairness Act/draft Childrens Hospitals Graduate Medical Education (CHGME) program/FY 2025 funding Pathways to Practice GME cap flexibility Rural health care

H.R. 6445, Medicare Audiology Access Improvement Act of 2023, all provisions S. 2377, Medicare Audiology Access Improvement Act of 2023, all provisions H.R. 1610, Chiropractic Medicare Coverage Modernization Act of 2023, all provisions S. 799, Chiropractic Medicare Coverage Modernization Act of 2023, all provisions H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023, all provisions S. 2016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023, all provisions S. 712, Connected MOM Act, all provisions H.R. 5066, Tech to Save Moms Act, all provisions H.R. 1770, Equitable Community Access to Pharmacist Services Act, all provisions S. 2477, Equitable Community Access to Pharmacist Services Act, all provisions H.R. 751, Fair Access In Residency (FAIR) Act, all provisions H.R. 4968, Getting Over Lengthy Delays in Care As Required by Doctors (GOLD CARD) Act of 2023 H.R. 2713, Improving Care and Access to Nurses (ICAN) Act, all provisions S. 2418, Improving Care and Access to Nurses (ICAN) Act, all provisions H.R. 2583, Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023, all provisions H.R. 977, Patient Access to Higher Quality Health Care Act of 2023, all provisions S. 470, Patient Access to Higher Quality Health Care Act of 2023, all provisions H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions H.R. 7050, Substance Use Disorder Workforce Act, all provisions H.R. 7623, Telehealth Modernization Act of 2024, all provisions S. 3967, Telehealth Modernization Act, all provisions H.R. 2474, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 6371, Provider Reimbursement Stability Act of 2023, all provisions H.R. 6545, Physician Fee Schedule Update and Improvements Act, all provisions H.R. 5378, Lower Costs, More Transparency Act, all provisions H.R. 6683, Preserving Seniors Access to Physicians Act of 2023, all provisions H.R. 5013, Value in Health Care Act of 2023, all provisions S. 3503, Value in Health Care Act of 2023, all provisions H.R. 7856, Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies (PREVENT DIABETES) Act, all provisions S. 4094, Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies (PREVENT DIABETES) Act, all provisions H.R. 8702, To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, all provisions S. 4532, A bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans, all provisions H.R. 6366, To amend title XVIII of the Social Security Act with respect to the work geographic index for physician payments under the Medicare program, and to revise the phase-in of clinical laboratory test payment changes under such program, all provisions S. 4338, Pay PCPs Act of 2024, all provisions H.R. 8261, Preserving Telehealth, Hospital, and Ambulance Access Act, all provisions S. 1491, Pharmacy and Medically Underserved Areas Enhancement Act, all provisions S. 669, Increasing Mental Health Options Act of 2023, all provisions H.R. 7618, Stopping Addiction and Falls for the Elderly (SAFE) Act, all provisions H.R. 7254, Hearing Device Coverage Clarification Act, all provisions S. 3059, Requiring Enhanced & Accurate Lists of Health Providers Act, all provisions H.R. 7708, To amend title XVIII of the Social Security Act to require MA organizations offering network-based plans to maintain an accurate provider directory, and for other purposes, all provisions S. 4054, Health Care Cybersecurity Improvement Act of 2024, all provisions H.R. 1691, Ensuring Patient Access to Critical Breakthrough Products Act of 2023, all provisions H.R. 2407, Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act, all provisions H.R. 4818, Treat and Reduce Obesity Act of 2023, all provisions H.R. 8816, American Medical Innovation and Investment Act of 2024, all provisions H.R. 6369, To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models, all provisions H.R. 7665, ACO Assignment Improvement Act of 2024, all provisions S. 3939, ACO Assignment Improvement Act of 2024, all provisions H.R. 8404, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions S. 4330, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions H.R. 8235, Rural Physician Workforce Preservation Act, all provisions H.R. 1745, Medicare Fraud Detection and Deterrence Act of 2023, provisions related to telehealth H.R. 1746, Preventing Medicare Telefraud Act, all provisions H.R. 8532, To identify and address barriers to coverage of remote physiologic devices under State Medicaid programs to improve maternal and child health outcomes for pregnant and postpartum women, all provisions S. 4350, Hospital Inpatient Services Modernization Act, all provisions H.R. 134, To amend title XVIII of the Social Security Act to remove geographic requirements and expand originating sites for telehealth services, all provisions H.R. 7279, Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act, all provisions S. 971, Due Process Continuity of Care Act, all provisions Data-Driven Performance Payment System/draft Fewer Burdens for Better Healthcare Act/draft Supporting Healthy Moms and Babies Act/draft Medicare program: Improving Seniors Timely Access to Care Act implementation Medicare program: No Surprises Act implementation Medicare program: 21st Century Cures Act implementation Medicare program: Medicare physician payment reform Medicare program: Medicare Access and CHIP Reauthorization Act (MACRA)/physician burdens Medicare program: Merit-based Incentive Payment System (MIPS) Medicare program: MIPS Value Pathways Medicare program: MIPS/timely, actionable data Medicare program: Site neutral payments Medicare program: Information blocking Medicare program: Alternative Payment Models (APMs) Medicare program: Physician payment/inflation/practice costs Medicare program: High-cost disposable services/payment Medicare program: Prior authorization Medicare program: Hospital-at-Home Extension Medicare program: Prescriber-facing real-time benefit tools Medicare program: Accountable Care Organizations (ACO) Medicare program: ACO/APM flexibilities Medicare program: Medicare Shared Savings Program/regulatory changes Medicare program: Shared Savings Program/Promoting Interoperability/Certified EHR Technology Medicare program: Primary care payment reform Medicare program: Chronic care Medicare program: Diabetes Prevention Program Medicare program: Graduate Medical Education Medicare program: Medicare Administrative Contractors (MACs)/Local Coverage Article (LCA)/Local Coverage Determination (LCD) Medicare program: Quality Payment Program/physician burdens Medicare program: Medicare Shared Savings Program/Advanced APM reporting requirements Medicare program: Patient engagement Medicare program: Health IT/physician burdens Medicare program: Provider feedback/quality and efficiency measures Medicare and Medicaid programs: CHANGE Healthcare cyberattack Medicare and Medicaid programs: Rural health care Medicare and Medicaid programs: Data privacy Medicare and Medicaid programs: Pharmacy Benefit Managers Medicaid program: Maternal mortality

Issues related to NIH research funding and Graduate Medical Education, including Fair Access in Residency (FAIR) Act (H.R. 751)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Fair Access In Residency (FAIR) Act (H.R. 751) Rural Physician Workforce Production Act (S. 230/H.R. 834) Resident Physician Shortage Reduction Act of 2023 (S. 1302/H.R. 2389) Council on Graduate Medical Education Medicare Payment Advisory Commission Inpatient Prospective Payment System (SCH/MDH Issue) Consolidated Appropriations Act, 2021 (PL 116-260) Community Training, Education and Access for Medical Students (Community TEAMS) Act (S. 3968, H.R. 7258) National Health Service Corps Teaching Health Centers Graduate Medical Education NIH Osteopathic Funding and Representation Substance Use Disorder Workforce Act of 2024 (H.R. 7050) Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (S. 3679, H.R. 7153) Medically Tailored Home-Delivered Meals Demonstration Pilot Act (S. 2133, H.R. 6780) Rural Physician Workforce Preservation Act (H.R. 8235) Rural Residency Planning and Development Act of 2024 (H.R. 7855) Physician Preceptor Tax Credit Pandemic and All-Hazards Preparedness Act (PL 109-417) Public Health Infrastructure Saves Lives Act (S. 1995)

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

Higher Education Reauthorization Act (Title IV), H.R. 751- The FAIR Act - requires hospitals to certify that they accept residency applications from both osteopathic and allopathic medical schools

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

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES, SENATE

Medicare-funded Graduate Medical Education; NIH Osteopathic Funding and Representation; H.R.751, Fair Access in Residency Act; H.R.7258/S.3968, Community TEAMS Act of 2024; FY2025 National Defense Authorization Act; FY2025 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations process.

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

Issues related to NIH research funding and Graduate Medical Education, including Fair Access in Residency (FAIR) Act (H.R. 751)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2389: Resident Physician Shortage Reduction Act of 2023 To amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions, and for other purposes (ALL). H.R. 751: Fair Access in Residency (FAIR) Act To amend title XVIII of the Social Security Act to require as a condition of satisfying the definition of an approved medical residency training program for purposes of payments under Medicare for costs related to graduate medical education for hospitals operating such a program to submit information to encourage more equitable treatment of osteopathic and allopathic candidates in the residency application and review process, and for other purposes (ALL). H.R. 7725: Embracing Anti-Discrimination, Unbiased Curriculum, and Advancing Truth in Education (EDUCATE) Act To amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion (ALL). H.R. 7213: Autism CARES Act of 2024 To amend the Public Health Service Act to enhance activities of the National Institutes of Health with respect to research on autism spectrum disorder and enhance programs relating to autism / reauthorize certain programs with respect to autism spectrum disorder, and for other purposes (ALL).

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

H.R. 6445, Medicare Audiology Access Improvement Act, all provisions S. 2377, Medicare Audiology Access Improvement Act, all provisions H.R. 1610, Chiropractic Medicare Coverage Modernization Act , all provisions S. 799, Chiropractic Medicare Coverage Modernization Act , all provisions H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions S. 2016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions S. 799, Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act, all provisions S. 712, Connected MOM Act, all provisions H.R. 5066, Tech to Save Moms Act, all provisions H.R. 1770, Equitable Community Access to Pharmacist Services Act, all provisions S. 2477, Equitable Community Access to Pharmacist Services Act, all provisions H.R. 751, Fair Access In Residency (FAIR) Act, all provisions H.R. 4968, Getting Over Lengthy Delays in Care As Required by Doctors (GOLD CARD) Act, all provisions H.R. 2713, Improving Care and Access to Nurses (ICAN) Act, all provisions S. 2418, Improving Care and Access to Nurses (ICAN) Act, all provisions H.R. 2583, Increasing Access to Quality Cardiac Rehabilitation Care Act, all provisions H.R. 977, Patient Access to Higher Quality Health Care Act, all provisions S. 470, Patient Access to Higher Quality Health Care Act, all provisions H.R. 7050, Substance Use Disorder Workforce Act, all provisions H.R. 7623, Telehealth Modernization Act of 2024, all provisions H.R. 2474, Strengthening Medicare for Patients and Providers Act, provisions relating to Medicare MEI update H.R. 6371, Provider Reimbursement Stability Act, provisions relating to reforming Medicare budget neutrality process and MIPS program H.R. 6545, Physician Fee Schedule Update and Improvements Act, all provisions H.R. 5378, Lower Costs, More Transparency Act, all provisions H.R. 6683, Preserving Seniors Access to Physicians Act, all provisions H.R. 5013, Value in Health Care Act, provisions relating to extension of Medicare bonus payment for APM participation S. 3503, Value in Health Care Act, provisions relating to extension of Medicare bonus payment for APM participation H.R. 4366, Consolidated Appropriations Act, 2024, provisions relating to mitigating physician payment cuts S. 2226, National Defense Authorization Act for Fiscal Year 2024, provisions relating to extension of sequester H.R. 6366, To amend title XVIII of the Social Security Act with respect to the work geographic index for physician payments under the Medicare program, and to revise the phase-in of clinical laboratory test payment changes under such program, all provisions H.R. 6369, To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models, all provisions H.R. 7665, ACO Assignment Improvement Act of 2024, all provisions S. 3939, ACO Assignment Improvement Act of 2024, all provisions H.R. 4829, Physical Therapist Workforce and Patient Access Act, all provisions H.R. 1745, Medicare Fraud Detection and Deterrence Act, all provisions H.R. 1746, Preventing Medicare Telefraud Act, all provisions S. 1491, Pharmacy and Medically Underserved Areas Enhancement Act, all provisions S. 669, Increasing Mental Health Options Act, all provisions H.R. 3173, Improving Seniors Timely Access to Care Act of 2021/possible reintroduction S. 4054, A bill to require entities to meet minimum cybersecurity standards to be eligible for Medicare accelerated and advance payment programs if the reason for the need for such payments is due to a cybersecurity incident, all provisions H.R. 7708, To amend title XVIII of the Social Security Act to require MA organizations offering network-based plans to maintain an accurate provider directory, and for other purposes, all provisions S. 3458, Seniors Access to Critical Medications Act of 2023, all provisions H.R. 5526, Seniors Access to Critical Medications Act of 2023, all provisions S. 971, Due Process Continuity of Care Act, all provisions H.R. 134, To amend title XVIII of the Social Security Act to remove geographic requirements and expand originating sites for telehealth services, all provisions Fewer Burdens for Better Care Act/draft IHS Health Professions Tax Fairness Act/drafts Opioid Workforce Act/Senate draft Hospital Inpatient Services Modernization Act/drafts Draft of bill to establish a new technical advisory committee on relative value updates and revisions Improving Access to Emergency Medical Services Act of 2024/draft PREVENT Diabetes Act/draft Medicare program: No Surprises Act implementation Medicare program: 21st Century Cures Act implementation Medicare program: Medicare physician payment Medicare program: Prior Authorization Medicare program: CY 2024 3.37% Medicare Part B provider cuts Medicare program: RUC technical advisory committee Medicare program: Medicare Advantage equity issues Medicare program: Merit-based Incentive Payment System (MIPS)/quality, cost, improvement activities/promoting interoperability Medicare program: MIPS Value Pathways Medicare program: Alternative Payment Models Medicare program: MIPS hardship exception/CHANGE Healthcare cyberattack Medicare program: EHR certification Medicare program: Health IT physician burdens Medicare program: HIPAA/electronic records Medicare program: Accountable Care Organizations (ACOs)/Alternative Payment Model (APM) Medicare program: Diabetes Prevention Program Medicare program: Transitions of care Medicare program: Coverage determinations process Medicare program: Acute Hospital Care at Home waiver program Medicare program: Care at home access/rural and underserved communities Medicare program: Provider compliance and regulatory relief Medicare program: Provider Enrollment, Chain, and Ownership System (PECOS) Enrollment/Revalidation Medicare program: Open Payments Medicare program: Nursing home staff mandate Medicare program: Post-acute care/skilled nursing facility Medicare program: Provider directory Medicare and Medicaid programs: Mental Health Parity and Addiction Equity Act/ implementation Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: MACRA physician burdens Medicare and Medicaid programs: Information blocking Medicare and Medicaid programs: Cybersecurity Medicare and Medicaid programs: Data privacy Medicare and Medicaid programs: Site neutral payment policies Medicare and Medicaid programs: Substance use disorder Medicare and Medicaid programs: CHANGE Healthcare cyberattack Medicaid program: Transforming Maternal Health (TMaH) program Medicaid program: Barriers to Medicaid and CHIP/immigrants Medicaid program: Medicaid/post-COVID Unwinding Medicaid program: Maternal mortality and morbidity Medicaid program: Emergency Medical Treatment and Labor Act (EMTALA)/abortion

H.R. 1202, Resident Education Deferred Interest (REDI) Act, all provisions S. 704, Resident Education Deferred Interest (REDI) Act, all provisions H.R. 751, Fair Access In Residency (FAIR) Act, all provisions H.R. 3046, Medical Student Education Authorization Act of 2023, all provisions S. 1403, Medical Student Education Authorization Act of 2023, all provisions H.R. 2761, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions S. 705, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions H.R. 4829, Physical Therapist Workforce and Patient Access Act of 2023, all provisions Medicare Student Education Authorization Act/draft Opioid Workforce Act (Senate)/draft Substance Use Disorder Workforce Act (House)/draft Indian Health Service Health Professions Tax Fairness Act/draft Indian Health Service/access to care/Office of Academic Affiliations Pathways to practice Graduate Medical Education (GME)/cap flexibility

Client expense: $7,280,000 · Firm income: Not reported

H.R.2389/S.1302 - Resident Physician Shortage Reduction Act of 2023 H.R.7050 - Substance Use Disorder Workforce Act Issue: Support increased Medicare funding for graduate medical education (GME). H.R.751 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.834/ S.230 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals. H.R.2584/S.2768 - Safety From Violence for Healthcare Employees (SAVE) Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. H.R.5378 - Lower Costs, More Transparency Act Issue: Oppose legislation that pays for workforce investments and mitigation of DSH cuts if it is paid for by cuts to hospital outpatient departments. H.R.5013 - Value in Health Care Act Issue: Support legislation that ensures the continued move to value-based care. H.R.2474 - Strengthening Medicare for Patients and Providers Act Issue: Support legislation that reforms the Medicare Physician Fee Schedule by providing an annual inflation-based payment update based on the Medicare Economic Index (MEI). Issue: Educate Congress on status of CMS distribution of the 1,000 new GME slots authorized by the Consolidated Appropriations Act, 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare GME/IME payments. Issue: Oppose the redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. P.L.118-42 - Consolidated Appropriations Act, 2024 Issue: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Issue: Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Issue: Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments Issue: Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule cuts. Issue: Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Issue: Support extension of alternative payment model (APM) bonus. H.R.2665 - The Supporting Safety Net Hospitals Act Issue: Support eliminating two years worth of scheduled reductions to the Medicaid DSH program. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on potential financial implications of entitlement reform on teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. H.R.1397 - The Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. H.R.2377/S.1000 - The Saving Access to Laboratory Services (SALSA) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. H.R.2829 - Chronic Care Management Improvement Act of 2023 Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare.

Fair Access In Residency (FAIR) Act (H.R. 751) Rural Physician Workforce Production Act (S. 230/H.R. 834) Resident Physician Shortage Reduction Act of 2023 (S. 1302/H.R. 2389) Council on Graduate Medical Education Medicare Payment Advisory Commission Inpatient Prospective Payment System Consolidated Appropriations Act, 2021 (PL 116-260) Community Training, Education and Access for Medical Students (Community TEAMS) Act (S. 3968, H.R. 7258) National Health Service Corps Teaching Health Centers Graduate Medical Education NIH Osteopathic Funding and Representation Substance Use Disorder Workforce Act of 2024 (H.R. 7050) Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (S. 3679, H.R. 7153) Medically Tailored Home-Delivered Meals Demonstration Pilot Act (S. 2133, H.R. 6780)

Client expense: $100,000 · Firm income: Not reported

Medicare-funded Graduate Medical Education; NIH Osteopathic Funding and Representation; Fair Access in Residency Act (H.R.751)

Client expense: Not reported · Firm income: Not reported

Medicare-funded Graduate Medical Education; NIH Osteopathic Funding and Representation; Fair Access in Residency Act (H.R.751)

Client expense: Not reported · Firm income: Not reported

H.R.2389/S.1302 - Resident Physician Shortage Reduction Act of 2023 Issue: Support increased Medicare funding for graduate medical education (GME). H.R.751 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. S.230/H.R.834 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals. Issue: Provide feedback to CMS and Congress on CMS distribution of the 1,000 new GME slots authorized be the Consolidated Appropriations Act, 2021 (P.L. 116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare GME/IME payments. Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Issue: Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Issue: Oppose Medicare hospital, physician, and provider cuts. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. H.R.2665 - The Supporting Safety Net Hospitals Act Issue: Support eliminating two years worth of scheduled reductions to the Medicaid DSH program. Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support permanent extension of Medicare telehealth waivers. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support permanent extension of current Covid telehealth flexibilities. Issue: Support efforts to expand patient access to telehealth. H.R.1397 - The Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support extension of alternative payment model (APM) bonus. Issue: Support providing funds for rural teaching hospitals to expand their residency programs. H.R.8188/S.4449 - The Saving Access to Laboratory Services (SALSA) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments.

H.R. 2389: Resident Physician Shortage Reduction Act of 2023 To amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions, and for other purposes (ALL). H.R. 751: Fair Access in Residency (FAIR) Act To amend title XVIII of the Social Security Act to require as a condition of satisfying the definition of an approved medical residency training program for purposes of payments under Medicare for costs related to graduate medical education for hospitals operating such a program to submit information to encourage more equitable treatment of osteopathic and allopathic candidates in the residency application and review process, and for other purposes (ALL).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1202, Resident Education Deferred Interest (REDI) Act, all provisions S. 704, Resident Education Deferred Interest (REDI) Act, all provisions H.R. 751, Fair Access In Residency (FAIR) Act, all provisions H.R. 3046, Medical Student Education Authorization Act of 2023, all provisions S. 1403, Medical Student Education Authorization Act of 2023, all provisions H.R. 2761, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions S. 705, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions H.R. 4829, Physical Therapist Workforce and Patient Access Act of 2023, all provisions Medicare Student Education Authorization Act/draft Opioid Workforce Act (Senate)/draft Substance Use Disorder Workforce Act (House)/draft Indian Health Service Health Professions Tax Fairness Act/draft Indian Health Service/access to care/Office of Academic Affiliations Pathways to practice Graduate Medical Education (GME)/cap flexibility

Client expense: $5,740,000 · Firm income: Not reported

H.R. 2474, Strengthening Medicare for Patients and Providers Act, provisions relating to Medicare Economic Index inflation updates H.R. 6371, Provider Reimbursement Stability Act of 2023, provisions relating to budget neutrality, MIPS, and G2211 code H.R. 1610, Chiropractic Medicare Coverage Modernization Act of 2023, all provisions S. 799, Chiropractic Medicare Coverage Modernization Act of 2023, all provisions H.R. 751, Fair Access In Residency (FAIR) Act, all provisions H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023, all provisions S. 2016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023, all provisions H.R. 2829, Chronic Care Management Improvement Act of 2023, all provisions H.R. 1770, Equitable Community Access to Pharmacist Services Act, all provisions S. 2477, Equitable Community Access to Pharmacist Services Act, all provisions H.R. 2713, Improving Care and Access to Nurses (I CAN) Act, all provisions S. 2418, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 977, Patient Access to Higher Quality Health Care Act of 2023, all provisions S. 470, Patient Access to Higher Quality Health Care Act of 2023, all provisions H.R. 2377, Saving Access to Laboratory Services Act, all provisions S. 1000, Saving Access to Laboratory Services Act, all provisions H.R. 3432, Telemental Health Care Access Act of 2023, all provisions H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions S. 712, Connected MOM Act, all provisions H.R. 4968, Getting Over Lengthy Delays in Care As Required by Doctors (GOLD CARD) Act of 2023, all provisions H.R. 2474, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 6683, Preserving Seniors Access to Physicians Act of 2023, all provisions H.R. 1610, Chiropractic Medicare Coverage Modernization Act of 2023, all provisions S. 799, Chiropractic Medicare Coverage Modernization Act of 2023, all provisions H.R. 6445, Medicare Audiology Access Improvement Act of 2023, all provisions S. 2377, Medicare Audiology Access Improvement Act of 2023, all provisions H.R. 6545, Physician Fee Schedule Update and Improvements Act, all provisions H.R. 6369, To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models, all provisions H.R. 6364, Medicare Telehealth Privacy Act of 2023, all provisions H.R. 4822, Health Care Price Transparency Act of 2023, all provisions H.R. 4839, Hospital and ASC Price Transparency Act of 2023, all provisions H.R. 5378, Lower Costs, More Transparency Act, all provisions H.R. 5013, Value in Health Care Act of 2023, all provisions S. 3503, Value in Health Care Act of 2023, all provisions H.R. 6545, Physician Fee Schedule Update and Improvements Act, all provisions H.R. 6366, To amend title XVIII of the Social Security Act with respect to the work geographic index for physician payments under the Medicare program, and to revise the phase-in of clinical laboratory test payment changes under such program, all provisions S. 1491, Pharmacy and Medically Underserved Areas Enhancement Act, all provisions S. 669, Increasing Mental Health Options Act of 2023, all provisions H.R. 2583, Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023, all provisions H.R. 5958, Drug-price Transparency for Consumers Act of 2023, all provisions H.R. 3074, Due Process Continuity of Care Act, all provisions S. 971, Due Process Continuity of Care Act, all provisions H.R. 1694, Emergency Care Improvement Act, all provisions H.R. 1745, Medicare Fraud Detection and Deterrence Act of 2023, all provisions H.R. 1746, Preventing Medicare Telefraud Act, all provisions H.R. 497, Freedom for Health Care Workers Act, all provisions H.R. 5506, Hospitals As Naloxone Distribution Sites (HANDS) Act, all provisions H.R. 5388, Supporting Innovation for Seniors Act, all provisions H.R. 8863, Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023, provisions relating to eliminating 3.37 Medicare cuts S. 198, Rural Health Clinic Burden Reduction Act, all provisions H.R. 4882, Clinical Laboratory Price Transparency Act of 2023, provisions relating to Section 101 H.R. 6475, Health Disparity Zones Act of 2023, all provisions H.R. 6230, Doctor Knows Best Act of 2023, all provisions S. 127, Pharmacy Benefit Manager Transparency Act of 2023, all provisions H.R. 3284, Providers and Payers COMPETE Act, all provisions H.R. 4828, Imaging Services Price Transparency Act of 2023, all provisions Improving Seniors Timely Access to Care Act of 2022 SURS Extension Act, provisions related to renewal of technical support for small practices in the Quality Payment Program Fewer Burdens for Better Care Act/drafts Medicare Student Education Authorization Act/drafts Medicare program: 21st Century Cures Act implementation Medicare program: No Surprises Act implementation Medicare program: Medicare Access and CHIP Reauthorization Act (MACRA)/physician burden Medicare program: MACRA/Broad reform Medicare program: Medicare Payment Advisory Commission (MedPAC)/Physician payment inflationary update Medicare program: Physician payment Medicare program: Provider Enrollment, Chain, and Ownership System (PECOS)/Revalidation Medicare program: Provider Relief Fund recoupment Medicare program: Open Payments Medicare program: Budget neutrality Medicare program: Merit-based Incentive Payment System (MIPS)/Cost performance category Medicare program: MIPS/quality/cost/promoting interoperability Medicare program: Quality/Diabetes measure Medicare program: Site neutral payment policies Medicare program: Physician-Owned Hospitals Medicare program: 3.37% CY 2024 Medicare cut Medicare program: Nursing home staff mandate Medicare program: Quality payment program/physician burdens Medicare program: Health IT/physician burdens Medicare program: EHR certification Medicare program: Miller-Meeks, Bera, Bucshon and Schrier letter/2024 Medicare cut Medicare program: Alternative payment models for specialists Medicare program: Medicare Advantage cuts/Advanced Rate Notice Medicare program: Scope of practice Medicare program: Prescription drug pricing and payment Medicare program: G2211 utilization Medicare program: Provider compliance and regulatory relief Medicaid program: Information blocking/reproductive health and penalties Medicare program: In-office pharmacies/Part B prescriptions/Stark Law Medicare program: Part B/geographic payment disparities Medicare and Medicaid programs: Data privacy Medicare and Medicaid programs: Lung cancer/low-dose computed tomography coverage expansion Medicare and Medicaid programs: Wheelchair repairs/barriers to timely access Medicare and Medicaid programs: Street medicine/place of service code Medicaid program: Medicaid unwinding/data collection Medicaid program: Maternal health

H.R.2389/S.1302 - Resident Physician Shortage Reduction Act of 2023 Issue: Support increased Medicare funding for graduate medical education (GME). H.R.751 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. S.230/H.R.834 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals. S.2768/H.R.2584 - Safety From Violence for Healthcare Employees (SAVE) Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. H.R.5378 - Lower Costs, More Transparency Act Issue: Oppose legislation that pays for workforce investments and mitigation of DSH cuts if it is paid for by cuts to hospital outpatient departments. H.R.5013 - Value in Health Care Act Issue: Support legislation that ensures the continued move to value-based care. H.R.2474 - Strengthening Medicare for Patients and Providers Act Issue: Support legislation that reforms the Medicare Physician Fee Schedule by providing an annual inflation-based payment update based on the Medicare Economic Index (MEI). Issue: Provide feedback to CMS and Congress on CMS distribution of the 1,000 new GME slots authorized by the Consolidated Appropriations Act, 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare GME/IME payments. Issue: Oppose the redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Issue: Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Issue: Oppose Medicare hospital, physician, and provider cuts. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. H.R.2665 - The Supporting Safety Net Hospitals Act Issue: Support eliminating two years worth of scheduled reductions to the Medicaid DSH program. Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support permanent extension of Medicare telehealth waivers. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support permanent extension of current Covid telehealth flexibilities. Issue: Support efforts to expand patient access to telehealth. H.R.1397 - The Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support extension of alternative payment model (APM) bonus. H.R.2377/S.1000 - The Saving Access to Laboratory Services (SALSA) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments.

S.470/H.R.977, Patient Access to Higher Quality Health Care Act: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. S. 2377, Medicare Audiology Access Improvement Act: Opposing the expansion of the scope of practice of audiologists in Medicare H.R.751, Fair Access in Residency (FAIR) Act: To encourage more equitable treatment of osteopathic and allopathic candidates in the residency application and review process. H.R.2389, Resident Physician Shortage Reduction Act: To provide for the distribution of additional residency positions H.R. 2474, Strengthening Medicare for Patients and Providers Act: To provide an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index. H.R. 4968, the GOLD CARD Act of 2023: Prior authorization reform in Medicare Advantage H.R. 6371, Provider Reimbursement Stability Act: Medicare physician payment system budget neutrality reform. H.R. 6545, the Physician Fee Schedule Update and Improvements Act: To mitigate the 3.37% Medicare physician payment system and modify the budget neutrality rules. H.R. 6683, Preserving Seniors' Access to Physicians Act: To prevent the 3.37% Medicare physician payment cut. No bill: Prior authorization reform legislation in Medicare Advantage. No bill: Legislation to halt the implementation of Healthcare Common Procedure Coding Systems add-on code G2211

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

S.470/H.R.977, Patient Access to Higher Quality Health Care Act: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. S. 2377, Medicare Audiology Access Improvement Act: Opposing the expansion of the scope of practice of audiologists in Medicare H.R.751, Fair Access in Residency (FAIR) Act: To encourage more equitable treatment of osteopathic and allopathic candidates in the residency application and review process. H.R.2389, Resident Physician Shortage Reduction Act: To provide for the distribution of additional residency positions H.R. 2474, Strengthening Medicare for Patients and Providers Act: To provide an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index. H.R. 4968, the GOLD CARD Act of 2023: Prior authorization reform in Medicare Advantage H.R. 6371, Provider Reimbursement Stability Act: Medicare physician payment system budget neutrality reform. H.R. 6545, the Physician Fee Schedule Update and Improvements Act: To mitigate the 3.37% Medicare physician payment system and modify the budget neutrality rules. H.R. 6683, Preserving Seniors' Access to Physicians Act: To prevent the 3.37% Medicare physician payment cut. No bill: Prior authorization reform legislation in Medicare Advantage. No bill: Legislation to halt the implementation of Healthcare Common Procedure Coding Systems add-on code G2211

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