Telehealth Modernization Act of 2024

Issues: Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Medicaid Cuts; Mental Health Care, Youth Mental Health; Site neutral payment reform; Healthy Equity Index reward factor; Value Base Care Bills: H.R. 7149, Equal Access to Specialty Care Everywhere (EASE) Act of 2024 To amend title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries. Sponsor: Rep. Steel, Michelle [R-CA-45] S.4078 - EASE Act of 2024 To amend title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries. Sponsor: Sen. Mullin, Markwayne [R-OK] H.R.5746 - Addressing Whole Health in Medicare Advantage Act To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. Sponsor: Rep. Bilirakis, Gus M. [R-FL-12] H.R. 7623, Telehealth Modernization Act To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R. 7996, Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.2556 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Carper, Thomas R. [D-DE] H.R.1227 - Alternatives to PAIN Act To amend title XVIII of the Social Security Act to ensure appropriate access to non-opioid pain management drugs under part D of the Medicare program. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 To ensure that prior authorization medical decisions under Medicare are determined by physicians. Sponsor: Rep. Green, Mark E. [R-TN-7]

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

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

Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Medicaid Cuts; Mental Health Care, Youth Mental Health; Site neutral payment reform; Health Equity Index reward factor; Health Equity Index for MA plans; Value Base Care; MA Reform H.R.2533 - EASE Act of 2025 To amend title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries. Sponsor: Rep. Arrington, Jodey C. [R-TX-19] S.1248 - EASE Act of 2024 To amend title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries. Sponsor: Sen. Mullin, Markwayne [R-OK] H.R.5746 - Addressing Whole Health in Medicare Advantage Act To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. Sponsor: Rep. Bilirakis, Gus M. [R-FL-12] H.R. 7623, Telehealth Modernization Act To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R. 7996, Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.2556 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Carper, Thomas R. [D-DE] H.R.1227 - Alternatives to PAIN Act To amend title XVIII of the Social Security Act to ensure appropriate access to non-opioid pain management drugs under part D of the Medicare program. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 To ensure that prior authorization medical decisions under Medicare are determined by physicians. Sponsor: Rep. Green, Mark E. [R-TN-7] H.R.1 - One Big Beautiful Bill Act This bill reduces taxes, reduces or increases spending for various federal programs, increases the statutory debt limit, and otherwise addresses agencies and programs throughout the federal government. Sponsor: Rep. Arrington, Jodey C. [R-TX-19] S.1105 - No UPCODE Act To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage. Sponsor: Sen. Cassidy, Bill [R-LA]

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

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

Regulatory and legislative healthcare issues related to pharmaceutical development, approval, reimbursement, and patient access. Issues related to the screening, diagnosis, and treatment of Tardive Dyskinesia. Issues related to telehealth including the Telemental Health Care Access Act of 2023, H.R. 3432, and the Telehealth Modernization Act of 2024, H.R. 7623. Issues related to the Rare Pediatric Priority Review Voucher Program.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Medicaid Cuts; Mental Health Care, Youth Mental Health; Site neutral payment reform; Health Equity Index reward factor; Health Equity Index for MA plans; Value Base Care; MA Reform H.R.2533 - EASE Act of 2025 To amend title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries. Sponsor: Rep. Arrington, Jodey C. [R-TX-19] S.1248 - EASE Act of 2024 To amend title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries. Sponsor: Sen. Mullin, Markwayne [R-OK] H.R.5746 - Addressing Whole Health in Medicare Advantage Act To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. Sponsor: Rep. Bilirakis, Gus M. [R-FL-12] H.R. 7623, Telehealth Modernization Act To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R. 7996, Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.2556 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Carper, Thomas R. [D-DE] H.R.1227 - Alternatives to PAIN Act To amend title XVIII of the Social Security Act to ensure appropriate access to non-opioid pain management drugs under part D of the Medicare program. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 To ensure that prior authorization medical decisions under Medicare are determined by physicians. Sponsor: Rep. Green, Mark E. [R-TN-7] H.R.1 - One Big Beautiful Bill Act This bill reduces taxes, reduces or increases spending for various federal programs, increases the statutory debt limit, and otherwise addresses agencies and programs throughout the federal government. Sponsor: Rep. Arrington, Jodey C. [R-TX-19] S.1105 - No UPCODE Act To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage. Sponsor: Sen. Cassidy, Bill [R-LA]

Client expense: $1,210,000 · Firm income: Not reported

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

Issues: Site neutral payment reform; Health Equity Index reward factor; Health Equity Index for MA plans; Value Base Care; MA Reform Bills: H.R.5746 - Addressing Whole Health in Medicare Advantage Act To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. Sponsor: Rep. Bilirakis, Gus M. [R-FL-12] H.R. 7623, Telehealth Modernization Act To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R.1 - One Big Beautiful Bill Act This bill reduces taxes, reduces or increases spending for various federal programs, increases the statutory debt limit, and otherwise addresses agencies and programs throughout the federal government. Sponsor: Rep. Arrington, Jodey C. [R-TX-19] S.1105 - No UPCODE Act To amend title XVIII of the Social Security Act to improve risk adjustment under Medicare Advantage. Sponsor: Sen. Cassidy, Bill [R-LA]

Client expense: $265,983 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Discuss with Congressional staff and HHS staff support for Medicare GME expansion and changes to GME program: the Resident Physician Shortage Reduction Act, the Pathway to Practice Act of 2021, the Substance Use Disorder Workforce Act; additional GME slots in CAA, 2021 and CAA, 2023; Rural Residency Planning and Development Act; concerns on Rural Physician Workforce Preservation Act; Senate Finance Committee proposals to increase GME slots. Discuss with Congressional staff opposition to Medicaid proposals in H.R.1: work requirements as a condition of coverage, changes to state-directed payments, reductions to Federal matching funds, reductions to the safe harbor threshold for provider taxes, sunsetting uniform tax waivers, rescission of Medicaid Eligibility rule and Medicaid/CHIP Access rule, reductions to retroactive coverage, reduction of reasonable opportunity window. Discuss technical amendment to CAA, 2021, Sec. 131 pertaining to Medicare GME with Congressional staff. Discuss with Congressional staff distribution methodology for Medicare GME slots created in the CAA, 2021. Discuss expiring COVID-19 Public Health Emergency (PHE) Medicare flexibilities with Congressional staff and HHS staff and support legislative proposals to extend PHE telehealth flexibilities and Acute Hospital Care at Home Waiver. Support extension of Medicare Dependent Hospital and Low-Volume Adjustment programs. Discuss opposition to Medicare site-neutral payment policies with Congressional staff. Oppose changes to NPIs for hospital outpatient departments (118th Congress: H.R. 7623, H.R. 4509, H.R. 7623 as amended, H.R. 4822). Discuss FY 2024 IPPS comments with Congressional, HHS staff: to increase payment update to hospitals, Transforming Episodic Accountability Model, AHEAD Model, and CAA, 2023 Sec 4122 GME slot distribution methodology. Discuss proposals that stabilize long-term care and post-acute care providers: establish a temporary per diem Medicare payment to ease capacity issues and address financial challenges from slow discharges (support), make permanent three-day hospital stay waiver (support) and other COVID-19 PHE regulatory flexibilities. Support certain changes to Medicaid DSH payments: support two-year elimination of Medicaid DSH cut scheduled for January 1, 2025; support Save Our Safety Net Hospitals Act to restore pre-CAA, 2021 DSH cap calculation methodology and include dual-eligible patients in state DSH cap calculation. Discuss Medicaid waiver with Congressional staff and HHS. Discuss CMMI initiatives on global budgets and primary care in NYS Medicaid waiver. Discuss Medicaid IMD exclusion policies with Congressional staff. Support legislation to increase Medicaid payment rates for labor and delivery services for certain hospitals (118th Congress: S.5236). Oppose CMS final rule to establish minimum nurse staffing in Medicare- and Medicaid-certified long-term care facilities (89 FR 40876) and support legislative efforts to repeal rule. Support Medicare Advantage prior authorization reforms - Improving Seniors Timely Access to Care Act (H.R. 3514/S. 1816). Discuss wage index issues with Congressional staff: H.R. 8561 to address MA local area growth under projection, FY 2025 IPPS/LTCH interim final rule, indirect medical education (IME) payments to hospitals. Meet with CMS leadership to discuss Medicare and Medicaid issues: prior authorization and MA insurance denials, concerns on mandatory participation for AHEAD and TEAM models, Medicare support for health care workforce; support for telehealth flexibilities and Acute Hospital Care at Home waiver extension. Discuss Medicare wage index issues with CMS. Discuss Medicaid Section 1332 waiver with Congressional staff. Urge delayed enforcement of CMS final rule prohibiting nurses from performing glucose tests using high-complexity devices in point-of-care situations.

Client expense: $570,000 · Firm income: Not reported

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

Behavioral Health H. 8526, Elementary and Secondary School Counseling Act Childcare Issues related to childcare - no specific bill Gun Safety Issues related to gun safety - no specific bill H.R. 4283, Gun Violence Prevention and Community Safety Act Health Care S. 4503, A bill to prevent exploitative private equity practices, and for other purposes Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care - no specific bill Issues related to Private Equity/Healthcare - no specific bill H.R. 9001, Physician Led and Rural Access to Quality Care Act Support of community water fluoridation - no specific bill Health Care Workforce Issues related to health care workforce shortages - no specific bill Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project - no specific bill Demographic data collection - no specific bill H.R. 929/S.266 the Lorna Breen Health Care Provider Protection Reauthorization Act H.R.2483 the SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 2389/S. 1302, the Resident Physician Shortage Reduction Act H.R. 6205/S. 3211, the Healthcare Workforce Resilience Act HIV/AIDS Presidents Emergency Plan for AIDS Relief (PEPFAR) Immigration Issues related to Immigration - no specific bill H.R.1585/S.709 the Conrad State 30 and Physician Access Reauthorization Act Protecting Immigrant Families (PIF) Campaign Infrastructure Issues related to broadband access - no specific bill Issues related to the Build Back Better framework - no specific bill Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Maternal Health and Reproductive Health S. 4381, Right to Contraception Act S. 4368, IVF Protection Act S.4304/H.R.8317 MAMAS First Act S.1834 - Supporting Healthy Moms and Babies Act Issues related to maternal health - no specific bill S. 712, The Connected Maternal Online Monitoring (MOM) Act Medical Education Issues related to the affordability of medical education - no specific bill Issues related to student loan forgiveness - no specific bill Support for physicians, residents and medical students - no specific bill Medicare/Medicaid S. 4532 / H.R. 8702, Seniors Timely Access to Care Act Cigna Modifier 25 Budget neutrality rules in the Medicare Physician Fee Schedule - no specific bill H.R. 6445 / S. 2377, Medicare Audiology Access Improvement Act H.R. 2474 the Strengthening Medicare for Patients and Providers Act H.R. 6545 Physician Fee Schedule Update and Improvements Act H.R. 6683 Preserving Seniors Access to Physicians Act of 2023 H.R.2173 the Improving Care and Access to Nurses Act H.R.2670 - National Defense Authorization Act for Fiscal Year 2024 H.R. 6371, the Provider Reimbursement Stability Act H.R. 5013/S. 3503, the Value in Health Care (VALUE) Act S. 4935, Physician Fee Stabilization Act H.R. 879 the Medicare Patient Access and Practice Stabilization Act H.R. 8816, the American Medical Innovation and Investment Act of 2024 H.R. 2474, the Strengthening Medicare for Patients and Providers Act Issues related to Medicare physician payment - no specific bill Issues related to Medicare/Medicaid - no specific bill H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025 Issues related to Medicare Advantage - no specific bill H.R. 1, One Big Beautiful Bill Act H.R. 2757, Medicare Audiology Access Improvement Act  S. 106/H.R. 539, the Chiropractic Medicare Coverage Modernization Act of 2025 Nutrition Issues related to nutrition and food security - no specific bill Issues related to SNAP funding - - no specific bill (including H.R.1) Opioids/ Substance Use Disorder LABEL Opioids Act of 2023 MATE ACT Adds New Education Mandate for 8 Hours of Continuing Education on Opioid Treatment S.1785, STOP Fentanyl Overdoses Act of 2023 H.R. 4531/S.3393 Support for Patients and Communities Reauthorization Act S. 644 - the Modernizing Opioid Treatment Access Act (MOTAA) S. 3418 Comprehensive Addiction Resources Emergency (CARE) Act Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill S. 470/HR 977, The Patient Access to Higher Quality Health Care Act Publications Open access to information based on publicly funded research - no specific bill Request for Information for NIH Plan to Enhance Public Access to the Results of NIH-Supported Research Issues related to scholarly and scientific publishing and public access - no specific bill H.R. 9378, Sunshine Act of 2023 Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Health disparities and protecting vulnerable populations - no specific bill Issues related to equitable policies around blood, tissue donations - no specific bill Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act - no specific bill Telehealth H.R.8261, the Preserving Telehealth, Hospital, and Ambulance Access Act H.R.4189, the CONNECT for Health Act of 2023 H.R.7623, the Telehealth Modernization Act of 2024 H.R.1843, the Telehealth Expansion Act of 2023 Issues related to telehealth - no specific bill Issues related to telebehavioral health access - no specific bill Issues related to physician licensing - no specific bill Issues related to telehealth PHE flexibilities/waivers - no specific bill Tobacco Issues related to prohibiting sale of menthol cigarettes and flavored cigars - no specific bill Issues related to increasing awareness about lung cancer screening on cigarette packages - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory FDA's proposed rule to eliminate menthol cigarettes Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to Medicare Advantage Star Rating Health Equity Index calculation HIPAA-related Reporting Requirements Involving the Change Healthcare Cyber Incident Marketplace Integrity and Affordability Proposed Rule (CMS-9884-P) Medicaid Program; Preserving Medicaid Funding for Vulnerable Populations-Closing a Health Care-Related Tax Loophole Proposed Rule (CMS-2448-P)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Science & Technology Policy (OSTP), SENATE, Veterans Affairs, Dept of (VA)

Behavioral Health H. 8526, Elementary and Secondary School Counseling Act Childcare Issues related to childcare - no specific bill Gun Safety Issues related to gun safety - no specific bill H.R. 4283, Gun Violence Prevention and Community Safety Act Health Care S. 4503, A bill to prevent exploitative private equity practices, and for other purposes Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care - no specific bill Issues related to Private Equity/Healthcare - no specific bill H.R. 9001, Physician Led and Rural Access to Quality Care Act Support of community water fluoridation - no specific bill Health Care Workforce Issues related to health care workforce shortages - no specific bill Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project - no specific bill Demographic data collection - no specific bill H.R. 929/S.266 the Lorna Breen Health Care Provider Protection Reauthorization Act H.R.2483 the SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 2389/S. 1302, the Resident Physician Shortage Reduction Act H.R. 6205/S. 3211, the Healthcare Workforce Resilience Act HIV/AIDS Presidents Emergency Plan for AIDS Relief (PEPFAR) Immigration Issues related to Immigration - no specific bill H.R.1585/S.709 the Conrad State 30 and Physician Access Reauthorization Act Protecting Immigrant Families (PIF) Campaign Infrastructure Issues related to broadband access - no specific bill Issues related to the Build Back Better framework - no specific bill Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Maternal Health and Reproductive Health S. 4381, Right to Contraception Act S. 4368, IVF Protection Act S.4304/H.R.8317 MAMAS First Act S.1834 - Supporting Healthy Moms and Babies Act Issues related to maternal health - no specific bill S. 712, The Connected Maternal Online Monitoring (MOM) Act Medical Education Issues related to the affordability of medical education - no specific bill Issues related to student loan forgiveness - no specific bill Support for physicians, residents and medical students - no specific bill Medicare/Medicaid S. 4532 / H.R. 8702, Seniors Timely Access to Care Act Cigna Modifier 25 Budget neutrality rules in the Medicare Physician Fee Schedule - no specific bill H.R. 6445 / S. 2377, Medicare Audiology Access Improvement Act H.R. 2474 the Strengthening Medicare for Patients and Providers Act H.R. 6545 Physician Fee Schedule Update and Improvements Act H.R. 6683 Preserving Seniors Access to Physicians Act of 2023 H.R.2173 the Improving Care and Access to Nurses Act H.R.2670 - National Defense Authorization Act for Fiscal Year 2024 H.R. 6371, the Provider Reimbursement Stability Act H.R. 5013/S. 3503, the Value in Health Care (VALUE) Act S. 4935, Physician Fee Stabilization Act H.R. 879 the Medicare Patient Access and Practice Stabilization Act H.R. 8816, the American Medical Innovation and Investment Act of 2024 H.R. 2474, the Strengthening Medicare for Patients and Providers Act Issues related to Medicare physician payment - no specific bill Issues related to Medicare/Medicaid - no specific bill H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025 Issues related to Medicare Advantage - no specific bill H.R. 1, One Big Beautiful Bill Act H.R. 2757, Medicare Audiology Access Improvement Act  S. 106/H.R. 539, the Chiropractic Medicare Coverage Modernization Act of 2025 Nutrition Issues related to nutrition and food security - no specific bill Issues related to SNAP funding - - no specific bill (including H.R.1) Opioids/ Substance Use Disorder LABEL Opioids Act of 2023 MATE ACT Adds New Education Mandate for 8 Hours of Continuing Education on Opioid Treatment S.1785, STOP Fentanyl Overdoses Act of 2023 H.R. 4531/S.3393 Support for Patients and Communities Reauthorization Act S. 644 - the Modernizing Opioid Treatment Access Act (MOTAA) S. 3418 Comprehensive Addiction Resources Emergency (CARE) Act Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill S. 470/HR 977, The Patient Access to Higher Quality Health Care Act Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Health disparities and protecting vulnerable populations - no specific bill Issues related to equitable policies around blood, tissue donations - no specific bill Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act - no specific bill Telehealth H.R.8261, the Preserving Telehealth, Hospital, and Ambulance Access Act H.R.4189, the CONNECT for Health Act of 2023 H.R.7623, the Telehealth Modernization Act of 2024 H.R.1843, the Telehealth Expansion Act of 2023 Issues related to telehealth - no specific bill Issues related to telebehavioral health access - no specific bill Issues related to physician licensing - no specific bill Issues related to telehealth PHE flexibilities/waivers - no specific bill Tobacco Issues related to prohibiting sale of menthol cigarettes and flavored cigars - no specific bill Issues related to increasing awareness about lung cancer screening on cigarette packages - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory FDA's proposed rule to eliminate menthol cigarettes Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to Medicare Advantage Star Rating Health Equity Index calculation HIPAA-related Reporting Requirements Involving the Change Healthcare Cyber Incident Marketplace Integrity and Affordability Proposed Rule (CMS-9884-P) Medicaid Program; Preserving Medicaid Funding for Vulnerable Populations-Closing a Health Care-Related Tax Loophole Proposed Rule (CMS-2448-P)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

Cybersecurity, including S. 4054, the Healthcare Cybersecurity Improvement Act of 2024, 340B Drug Pricing Program, Site-neutral payment policy proposals, including the Lower Costs, More Transparency Act (H.R. 5378), Telehealth Modernization Act of 2023 (H.R. 7623), Medicaid Disproportionate Share Hospital Cuts, FEMA payment of COVID-19 provider payments, Reauthorization of the All-Hazards Preparedness Act, Medicare Advantage prior authorization

Client expense: Not reported · Firm income: Not reported

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

Cybersecurity, including S. 4054, the Healthcare Cybersecurity Improvement Act of 2024, 340B Drug Pricing Program, Site-neutral payment policy proposals, including the Lower Costs, More Transparency Act (H.R. 5378), Telehealth Modernization Act of 2023 (H.R. 7623), Medicaid Disproportionate Share Hospital Cuts, FEMA payment of COVID-19 provider payments, Reauthorization of the All-Hazards Preparedness Act, Medicare Advantage prior authorization

Client expense: Not reported · Firm income: Not reported

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

Cybersecurity, including S. 4054, the Healthcare Cybersecurity Improvement Act of 2024, 340B Drug Pricing Program, Site-neutral payment policy proposals, including the Lower Costs, More Transparency Act (H.R. 5378), Telehealth Modernization Act of 2023 (H.R. 7623), Medicaid Disproportionate Share Hospital Cuts, FEMA payment of COVID-19 provider payments, Reauthorization of the All-Hazards Preparedness Act, Medicare Advantage prior authorization

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

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

The DRUG Act, H.R.6283/S.1542 (generally, no specific provisions) The DOC Access Act, H.R.1385/S.1424 (generally, no specific provisions) The ACCESS Act, H.R.5608 (generally, no specific provisions) The ORPHAN Cures Act, H.R.5539/S.3131 (generally, no specific provisions) H.R. 3433, Give Kids a Chance Act of 2024 (generally, no specific provisions) H.R. 7623, Telehealth Modernization Act of 2024 (generally, no specific provisions) S. 2780, Medication Affordability and Patent Integrity Act (generally, no specific provisions) S. 4583, Creating Hope Reauthorization Act of 2024 (generally, no specific provisions)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Regulatory and legislative healthcare issues related to pharmaceutical development, approval, reimbursement, and patient access. Issues related to the screening, diagnosis, and treatment of Tardive Dyskinesia. Issues related to telehealth including the Telemental Health Care Access Act of 2023, H.R. 3432, and the Telehealth Modernization Act of 2024, H.R. 7623. Issues related to the Rare Pediatric Priority Review Voucher Program.

Client expense: $910,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues: Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Medicaid Cuts; Mental Health Care, Youth Mental Health; Site neutral payment reform; Healthy Equity Index reward factor; Value Base Care Bills: H.R. 7149, Equal Access to Specialty Care Everywhere (EASE) Act of 2024 To amend title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries. Sponsor: Rep. Steel, Michelle [R-CA-45] S.4078 - EASE Act of 2024 To amend title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries. Sponsor: Sen. Mullin, Markwayne [R-OK] H.R.5746 - Addressing Whole Health in Medicare Advantage Act To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. Sponsor: Rep. Bilirakis, Gus M. [R-FL-12] H.R. 7623, Telehealth Modernization Act To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R. 7996, Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.2556 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Carper, Thomas R. [D-DE] H.R.1227 - Alternatives to PAIN Act To amend title XVIII of the Social Security Act to ensure appropriate access to non-opioid pain management drugs under part D of the Medicare program. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 To ensure that prior authorization medical decisions under Medicare are determined by physicians. Sponsor: Rep. Green, Mark E. [R-TN-7]

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

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

Issues: Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Medicaid Cuts; Mental Health Care, Youth Mental Health; Site neutral payment reform; Healthy Equity Index reward factor; Value Base Care Bills: H.R. 7149, Equal Access to Specialty Care Everywhere (EASE) Act of 2024 To amend title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries. Sponsor: Rep. Steel, Michelle [R-CA-45] S.4078 - EASE Act of 2024 To amend title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries. Sponsor: Sen. Mullin, Markwayne [R-OK] H.R.5746 - Addressing Whole Health in Medicare Advantage Act To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. Sponsor: Rep. Bilirakis, Gus M. [R-FL-12] H.R. 7623, Telehealth Modernization Act To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R. 7996, Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.2556 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Carper, Thomas R. [D-DE] H.R.1227 - Alternatives to PAIN Act To amend title XVIII of the Social Security Act to ensure appropriate access to non-opioid pain management drugs under part D of the Medicare program. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 To ensure that prior authorization medical decisions under Medicare are determined by physicians. Sponsor: Rep. Green, Mark E. [R-TN-7]

Client expense: Not reported · Firm income: Not reported

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

Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Medicaid Cuts; Mental Health Care, Youth Mental Health; Site neutral payment reform; Healthy Equity Index reward factor; Value Base Care H.R. 7149, Equal Access to Specialty Care Everywhere (EASE) Act of 2024 To amend title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries. Sponsor: Rep. Steel, Michelle [R-CA-45] S.4078 - EASE Act of 2024 To amend title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries. Sponsor: Sen. Mullin, Markwayne [R-OK] H.R.5746 - Addressing Whole Health in Medicare Advantage Act To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. Sponsor: Rep. Bilirakis, Gus M. [R-FL-12] H.R. 7623, Telehealth Modernization Act To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R. 7996, Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.2556 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Carper, Thomas R. [D-DE] H.R.1227 - Alternatives to PAIN Act To amend title XVIII of the Social Security Act to ensure appropriate access to non-opioid pain management drugs under part D of the Medicare program. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 To ensure that prior authorization medical decisions under Medicare are determined by physicians. Sponsor: Rep. Green, Mark E. [R-TN-7]

Client expense: $1,200,000 · Firm income: Not reported

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

Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Medicaid Cuts; Mental Health Care, Youth Mental Health; Site neutral payment reform; Healthy Equity Index reward factor; Value Base Care , Prior Authorization H.R. 7149, Equal Access to Specialty Care Everywhere (EASE) Act of 2024 To amend title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries. Sponsor: Rep. Steel, Michelle [R-CA-45] S.4078 - EASE Act of 2024 To amend title XI of the Social Security Act to require the Center for Medicare and Medicaid Innovation to test a model to improve access to specialty health services for certain Medicare and Medicaid beneficiaries. Sponsor: Sen. Mullin, Markwayne [R-OK] H.R.5746 - Addressing Whole Health in Medicare Advantage Act To amend title XVIII of the Social Security Act to expand the availability of supplemental benefits to certain Medicare Advantage enrollees. Sponsor: Rep. Bilirakis, Gus M. [R-FL-12] H.R. 7623, Telehealth Modernization Act To amend title XVIII of the Social Security Act to make permanent certain telehealth flexibilities under the Medicare program. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] H.R. 7996, Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.2556 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Carper, Thomas R. [D-DE] H.R.1227 - Alternatives to PAIN Act To amend title XVIII of the Social Security Act to ensure appropriate access to non-opioid pain management drugs under part D of the Medicare program. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 To ensure that prior authorization medical decisions under Medicare are determined by physicians. Sponsor: Rep. Green, Mark E. [R-TN-7]

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

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

Behavioral Health H. 8526, Elementary and Secondary School Counseling Act Childcare Issues related to childcare - no specific bill Gun Safety Issues related to gun safety - no specific bill H.R. 4283, Gun Violence Prevention and Community Safety Act Health Care S. 4503, A bill to prevent exploitative private equity practices, and for other purposes Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care - no specific bill Issues related to Private Equity/Healthcare - no specific bill H.R. 9001, Physician Led and Rural Access to Quality Care Act Health Care Workforce Issues related to health care workforce shortages - no specific bill Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project - no specific bill Demographic data collection - no specific bill H.R. 929/S.266 the Lorna Breen Health Care Provider Protection Reauthorization Act H.R.2483 the SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 2389/S. 1302, the Resident Physician Shortage Reduction Act H.R. 6205/S. 3211, the Healthcare Workforce Resilience Act HIV/AIDS Presidents Emergency Plan for AIDS Relief (PEPFAR) Immigration Issues related to Immigration - no specific bill H.R.1585/S.709 the Conrad State 30 and Physician Access Reauthorization Act Protecting Immigrant Families (PIF) Campaign Infrastructure Issues related to broadband access - no specific bill Issues related to the Build Back Better framework - no specific bill Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Maternal Health and Reproductive Health S. 4381, Right to Contraception Act S. 4368, IVF Protection Act S.4304/H.R.8317MAMAS First Act Issues related to maternal health - no specific bill S. 712, The Connected Maternal Online Monitoring (MOM) Act Medical Education Issues related to the affordability of medical education - no specific bill Issues related to student loan forgiveness - no specific bill Support for physicians, residents and medical students - no specific bill Medicare/Medicaid S. 4532 / H.R. 8702, Seniors Timely Access to Care Act Cigna Modifier 25 Budget neutrality rules in the Medicare Physician Fee Schedule - no specific bill H.R. 6445 / S. 2377, Medicare Audiology Access Improvement Act H.R. 2474 the Strengthening Medicare for Patients and Providers Act H.R. 6545 Physician Fee Schedule Update and Improvements Act H.R. 6683 Preserving Seniors Access to Physicians Act of 2023 H.R.2173 the Improving Care and Access to Nurses Act H.R.2670 - National Defense Authorization Act for Fiscal Year 2024 H.R. 6371, the Provider Reimbursement Stability Act H.R. 5013/S. 3503, the Value in Health Care (VALUE) Act S. 4935, Physician Fee Stabilization Act H.R. 879 the Medicare Patient Access and Practice Stabilization Act H.R. 8816, the American Medical Innovation and Investment Act of 2024 H.R. 2474, the Strengthening Medicare for Patients and Providers Act Issues related to Medicare physician payment - no specific bill Issues related to Medicare/Medicaid - no specific bill H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025 Issues related to Medicare Advantage - no specific bill Nutrition Issues related to nutrition and food security - no specific bill Issues related to SNAP funding - - no specific bill Opioids/ Substance Use Disorder LABEL Opioids Act of 2023 MATE ACT Adds New Education Mandate for 8 Hours of Continuing Education on Opioid Treatment S.1785, STOP Fentanyl Overdoses Act of 2023 H.R. 4531/S.3393 Support for Patients and Communities Reauthorization Act S. 644 - the Modernizing Opioid Treatment Access Act (MOTAA) S. 3418 Comprehensive Addiction Resources Emergency (CARE) Act Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill S. 470/HR 977, The Patient Access to Higher Quality Health Care Act Publications Open access to information based on publicly funded research - no specific bill Request for Information for NIH Plan to Enhance Public Access to the Results of NIH-Supported Research Issues related to scholarly and scientific publishing and public access - no specific bill H.R. 9378, Sunshine Act of 2023 Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Health disparities and protecting vulnerable populations - no specific bill Issues related to equitable policies around blood, tissue donations - no specific bill Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act - no specific bill Telehealth H.R.8261, the Preserving Telehealth, Hospital, and Ambulance Access Act H.R.4189, the CONNECT for Health Act of 2023 H.R.7623, the Telehealth Modernization Act of 2024 H.R.1843, the Telehealth Expansion Act of 2023 Issues related to telehealth - no specific bill Issues related to telebehavioral health access - no specific bill Issues related to physician licensing - no specific bill Issues related to telehealth PHE flexibilities/waivers - no specific bill Tobacco Issues related to prohibiting sale of menthol cigarettes and flavored cigars - no specific bill Issues related to increasing awareness about lung cancer screening on cigarette packages - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory FDA's proposed rule to eliminate menthol cigarettes Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to Medicare Advantage Star Rating Health Equity Index calculation HIPAA-related Reporting Requirements Involving the Change Healthcare Cyber Incident

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Science & Technology Policy (OSTP), SENATE, Veterans Affairs, Dept of (VA)

Behavioral Health H. 8526, Elementary and Secondary School Counseling Act Childcare Issues related to childcare - no specific bill Gun Safety Issues related to gun safety - no specific bill H.R. 4283, Gun Violence Prevention and Community Safety Act Health Care S. 4503, A bill to prevent exploitative private equity practices, and for other purposes Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care - no specific bill Issues related to Private Equity/Healthcare - no specific bill H.R. 9001, Physician Led and Rural Access to Quality Care Act Health Care Workforce Issues related to health care workforce shortages - no specific bill Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project - no specific bill Demographic data collection - no specific bill H.R. 929/S.266 the Lorna Breen Health Care Provider Protection Reauthorization Act H.R.2483 the SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 2389/S. 1302, the Resident Physician Shortage Reduction Act H.R. 6205/S. 3211, the Healthcare Workforce Resilience Act HIV/AIDS Presidents Emergency Plan for AIDS Relief (PEPFAR) Immigration Issues related to Immigration - no specific bill H.R.1585/S.709 the Conrad State 30 and Physician Access Reauthorization Act Protecting Immigrant Families (PIF) Campaign Infrastructure Issues related to broadband access - no specific bill Issues related to the Build Back Better framework - no specific bill Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Maternal Health and Reproductive Health S. 4381, Right to Contraception Act S. 4368, IVF Protection Act S.4304/H.R.8317MAMAS First Act Issues related to maternal health - no specific bill S. 712, The Connected Maternal Online Monitoring (MOM) Act Medicare/Medicaid S. 4532 / H.R. 8702, Seniors Timely Access to Care Act Cigna Modifier 25 Budget neutrality rules in the Medicare Physician Fee Schedule - no specific bill H.R. 6445 / S. 2377, Medicare Audiology Access Improvement Act H.R. 2474 the Strengthening Medicare for Patients and Providers Act H.R. 6545 Physician Fee Schedule Update and Improvements Act H.R. 6683 Preserving Seniors Access to Physicians Act of 2023 H.R.2173 the Improving Care and Access to Nurses Act H.R.2670 - National Defense Authorization Act for Fiscal Year 2024 H.R. 6371, the Provider Reimbursement Stability Act H.R. 5013/S. 3503, the Value in Health Care (VALUE) Act S. 4935, Physician Fee Stabilization Act H.R. 879 the Medicare Patient Access and Practice Stabilization Act H.R. 8816, the American Medical Innovation and Investment Act of 2024 H.R. 2474, the Strengthening Medicare for Patients and Providers Act Issues related to Medicare physician payment - no specific bill Issues related to Medicare/Medicaid - no specific bill H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025 Issues related to Medicare Advantage - no specific bill Nutrition Issues related to nutrition and food security - no specific bill Issues related to SNAP funding - - no specific bill Opioids/ Substance Use Disorder LABEL Opioids Act of 2023 MATE ACT Adds New Education Mandate for 8 Hours of Continuing Education on Opioid Treatment S.1785, STOP Fentanyl Overdoses Act of 2023 H.R. 4531/S.3393 Support for Patients and Communities Reauthorization Act S. 644 - the Modernizing Opioid Treatment Access Act (MOTAA) S. 3418 Comprehensive Addiction Resources Emergency (CARE) Act Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill S. 470/HR 977, The Patient Access to Higher Quality Health Care Act Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Health disparities and protecting vulnerable populations - no specific bill Issues related to equitable policies around blood, tissue donations - no specific bill Surprise Billing Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act - no specific bill Telehealth H.R.8261, the Preserving Telehealth, Hospital, and Ambulance Access Act H.R.4189, the CONNECT for Health Act of 2023 H.R.7623, the Telehealth Modernization Act of 2024 H.R.1843, the Telehealth Expansion Act of 2023 Issues related to telehealth - no specific bill Issues related to telebehavioral health access - no specific bill Issues related to physician licensing - no specific bill Issues related to telehealth PHE flexibilities/waivers - no specific bill Tobacco Issues related to prohibiting sale of menthol cigarettes and flavored cigars - no specific bill Issues related to increasing awareness about lung cancer screening on cigarette packages - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory FDA's proposed rule to eliminate menthol cigarettes Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to Medicare Advantage Star Rating Health Equity Index calculation HIPAA-related Reporting Requirements Involving the Change Healthcare Cyber Incident

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

Cybersecurity, including S. 4054, the Healthcare Cybersecurity Improvement Act of 2024, 340B Drug Pricing Program, Site-neutral payment policy proposals, including the Lower Costs, More Transparency Act (H.R. 5378), Telehealth Modernization Act of 2023 (H.R. 7623), Medicaid Disproportionate Share Hospital Cuts, FEMA payment of COVID-19 provider payments, Reauthorization of the All-Hazards Preparedness Act, Medicare Advantage prior authorization

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

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

Cybersecurity, including S. 4054, the Healthcare Cybersecurity Improvement Act of 2024, 340B Drug Pricing Program, Site-neutral payment policy proposals, including the Lower Costs, More Transparency Act (H.R. 5378), Telehealth Modernization Act of 2023 (H.R. 7623), Medicaid Disproportionate Share Hospital Cuts, FEMA payment of COVID-19 provider payments, Reauthorization of the All-Hazards Preparedness Act, Medicare Advantage prior authorization

Client expense: Not reported · Firm income: Not reported

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

Discuss with Congressional staff and HHS staff support for Medicare GME expansion and changes to GME program: the Resident Physician Shortage Reduction Act, the Pathway to Practice Act of 2021, the Substance Use Disorder Workforce Act (H.R. 7050); additional GME slots in CAA, 2021 and CAA, 2023; Rural Residency Planning and Development Act (H.R. 7855); concerns on Rural Physician Workforce Preservation Act; Senate Finance Committee proposals to increase GME slots. Discuss technical amendment to CAA, 2021, Sec. 131 pertaining to Medicare GME with Congressional staff. Discuss with Congressional staff distribution methodology for Medicare GME slots created in the CAA, 2021. Discuss expiring COVID-19 Public Health Emergency (PHE) Medicare flexibilities with Congressional staff and HHS staff and support legislative proposals to extend PHE telehealth flexibilities and Acute Hospital Care at Home Waiver. Support extension of Medicare Dependent Hospital and Low-Volume Adjustment programs. Support proposals to reduce payment cut in CY 2025 Physician Fee Schedule final rule. Discuss opposition to Medicare site-neutral payment policies with Congressional staff. Oppose changes to NPIs for hospital outpatient departments (H.R. 7623, H.R. 4509, H.R. 7623 as amended, H.R. 4822). Comment on FY 2024 IPPS rule to increase payment update to hospitals, Transforming Episodic Accountability Model, AHEAD Model, and CAA, 2023 Sec 4122 GME slot distribution methodology, and discuss comments with Congressional staff and CMS staff. Discuss proposals that stabilize long-term care and post-acute care providers: establish a temporary per diem Medicare payment to ease capacity issues and address financial challenges from slow discharges (support), make permanent three-day hospital stay waiver (support) and other COVID-19 PHE regulatory flexibilities. Discuss with Congressional staff opposition to proposals to reduce the Medicaid program: work requirements as a condition of coverage, changes to state-directed payments, block grants, per capita caps, reductions to federal matching funds, reductions to the safe harbor threshold for provider taxes, rescission of Medicaid Eligibility rule and Medicaid/CHIP Access rule. Support certain changes to Medicaid DSH payments: support two-year elimination of Medicaid DSH cut scheduled for January 1, 2025; support Save Our Safety Net Hospitals Act (H.R. 9351) to restore pre-CAA, 2021 DSH cap calculation methodology and include dual-eligible patients in state DSH cap calculation. Discuss Medicaid waiver proposal with Congressional staff and HHS. Discuss CMMI initiatives on global budgets and primary care in NYS Medicaid waiver. Discuss Medicaid IMD exclusion policies with Congressional staff. Support legislation to increase Medicaid payment rates for labor and delivery services for certain hospitals (118th Congress: S.5236). Discuss with Congressional staff support for CMS approval of Medicaid managed care organization tax proposed in New York State budget. Oppose CMS final rule to establish minimum nurse staffing in Medicare- and Medicaid-certified long-term care facilities (89 FR 40876) and support legislative efforts to repeal rule. Support Medicare Advantage prior authorization reforms - Improving Seniors Timely Access to Care Act (118th Congress: S. 4532/H.R. 8702). Discuss wage index issues with Congressional staff: H.R. 8561 to address MA local area growth under projection, FY 2025 IPPS/LTCH interim final rule, indirect medical education (IME) payments to hospitals. Meet with CMS leadership to discuss Medicare and Medicaid issues: prior authorization and MA insurance denials, concerns on mandatory participation for AHEAD and TEAM models, Medicare support for health care workforce; support for telehealth flexibilities and Acute Hospital Care at Home waiver extension. Discuss Medicare wage index issues with CMS. Discuss Medicare Part B payment for unlicensed physicians with CMS. Support New York State Essential Plan (Medicaid Section 1332 Waiver) and oppose proposals to reduce coverage. Urge delayed enforcement of CMS final rule prohibiting nurses from performing glucose tests using high-complexity devices in point-of-care situations.

Client expense: $530,000 · Firm income: Not reported

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

Issues related to health data privacy and security, patient access to data, real-time benefit tools, and clinical decision support software, including the American Privacy Rights Act; Issues related to health data interoperability, standards, information blocking, and the access, exchange, and use of health data; access to and coverage of telehealth services, including mental and behavioral health services, broadband access and infrastructure development, including the Telehealth Modernization Act (H.R. 7623); Issues related to the use of artificial intelligence in health care.

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

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

Extension of Acute Hospital Care at Home waiver program; Hospital Inpatient Services Modernization Act (H.R.8260/S.4350); AINS to H.R.7623, the Telehealth Modernization Act; AINS to H.R.8261, the Preserving Telehealth, Hospital, and Ambulance Access Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Improve integration of behavioral health and primary care; advance value-based care; address workforce shortages and improve data collection under Graduate Medical Education program; adequate physician reimbursement; issues related to Centers for Medicare and Medicaid Innovation; H.R.7623 Telehealth Modernization Act

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

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

Access to preventative health; HR 5378 The Lower Costs, More Transparency Act to extend funding for Community Health Centers, Teaching Health Centers GME and the National Health Service Corps; Bipartisan Primary Care and Health Workforce Act; S 2840 the Primary Care and Health Workforce Act; and other workforce improvements; HR 7623 the Telehealth Modernization Act

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

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

Extending funding for Community Health Centers and preserving and enhancing federal reimbursement methodologies; ensuring continued access to telehealth services; HR 7623 Telehealth Modernization Act; Medicare National Coverage Determination on HIV Pre-exposure Prophylaxis (PrEP)

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

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

Sustaining Outpatient Services Act (H.R. 955/S. 1849) Regulations from the Executive in Need of Scrutiny (REINS) Act of 2023 (HR 277/S 184) Increasing Access to Quality Cardiac Rehabilitative Care Act (HR 2583/S. 3481) Black Maternal Health Momnibus Act (S. 1606/HR 3305) Medicare Dental Benefit Act (HR 4146/S. 2012) Accelerating Kids Access to Care Act (H.R. 4758/S. 2372) Amputation Reduction and Compassion Act (H.R. 4261) CONNECT for Health Act (S. 2016, H.R. 4189) Kickstarting Innovative Demonstrations Supporting (KIDS) Health Act of 2023 (HR 3805/ S. 1769) Expanding Remote Monitoring Access Act (H.R.5394) Physical Activity Omnibus Legislation (No Bill Number) Preventing Maternal Deaths Reauthorization Act of 2023 (H.R. 3838/S. 2415) PREEMIE Reauthorization Act of 2023 (H.R. 3226/S. 1573) Sustainable Cardiopulmonary Rehabilitation Services in the Home Act (S. 3021) Supporting Innovation for Seniors Act (H.R. 5388) Supporting Patient Education And Knowledge (SPEAK) Act of 2023 (H.R. 6033) Wearable Equipment Opposed Medicaid per capita caps, block grants, and work requirements Mobile stroke units Telehealth Modernization Act (H.R 7623/S.3967)

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

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

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

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

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

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

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

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

Supported H.R. 7623, the Telehealth Modernization Act of 2024 Supported H.R. 7858, Telehealth Enhancement for Mental Health Act and the Telehealth Modernization Act: Supported the ALS Better Care Act Advocated for the protection of the Medicaid program to the White House and Congress Supported H.R. 4758, Accelerating Kids Access to Care Act Supported the introduction of legislation that increases access to genetic testing and genetic counselors Supported the Access to Genetic Counseling Services Act Advocated for provisions addressing problems within the pharmacy benefit manager industry Joined coalition Comments to Congressional Leadership on Potential Changes to Medicaid (12.19.24) Joined an Amicus Brief in American Association of Ancillary Benefits v. Becerra (12.18.24) Joined Coalition Comments to Centers for Medicare and Medicaid Services on Long-Term Care (LTC) Pharmacies (12.17.24) Joined Coalition Comments to Centers for Medicare and Medicaid Services on Federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Program (12.16.24) Joined Coalition Comments to Congressional Leadership on Partnership to Protect Coverage Healthcare Priorities (12.10.24) Joined Coalition Comments to House Budget Committee and Senate Budget Committee Leadership on Protection of and Potential Cuts to Medicaid (12.10.24) Joined Amicus Briefs Filed in Response to Challenges to Section 1557 of the Affordable Care Act (ACA) Final Rule from U.S. Department of Health and Human Services: Texas v. Becerra (12.4.24) and Tennessee v. Becerra (11.26.24) Joined Coalition Comments to Congressional Leadership on Diagnostic Medical Equipment (DME) Access (12.2.24) Joined Coalition Comments to HHS on Notice of Benefit and Payment Parameters for 2026 (11.12.24) Joined Coalition Comments in Response to Proposed Data Collection on Proprietary Guidelines and Medicare Advantage Plan Audit Protocol (11.12.24) Joined Coalition Comments to Support S.5070, the Ensuring Access to Medicaid Buy-In Programs Act (11.12.24) Joined Coalition Comments on Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2026; Basic Health Program (11.12.24) Joined Coalition Comments on Access to Assistive Technology, Auxiliary Aids, Services, and Accommodations (11.6.24) Joined Coalition Comments to UnitedHealthcare on Changes to Prior Authorization Policies for Outpatient Rehabilitation Therapy Services (10.22.24) Joined Coalition Comments to Centers for Medicare & Medicaid Services (CMS) on Service Level Data Collection for Medicare Advantage Plans (10.8.24) Supported efforts to reform the Inflation Reduction Acts provisions on Medicare negotiation for orphan drugs

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

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

Supported the ALS Better Care Act Advocated for the protection of the Medicaid program to the White House and Congress Supported the MINI Act Supported H.R. 4758, Accelerating Kids Access to Care Act Supported the introduction of legislation that increases access to genetic testing and genetic counselors Encouraged action on telehealth legislation to the Energy and Commerce Committee Supported H.R. 7623, the Telehealth Modernization Act of 2024 Supported H.R. 7858, Telehealth Enhancement for Mental Health Act and the Telehealth Modernization Act: Supported the Access to Genetic Counseling Services Act Joined coalition Comments to Congressional Leadership on Potential Changes to Medicaid (12.19.24) Joined Coalition Comments to Centers for Medicare and Medicaid Services on Long-Term Care (LTC) Pharmacies (12.17.24) Joined Coalition Comments to Centers for Medicare and Medicaid Services on Federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Program (12.16.24) Joined Coalition Comments to Congressional Leadership on Partnership to Protect Coverage Healthcare Priorities (12.10.24) Joined Coalition Comments to House Budget Committee and Senate Budget Committee Leadership on Protection of and Potential Cuts to Medicaid (12.10.24) Joined Coalition Comments to Congressional Leadership on Diagnostic Medical Equipment (DME) Access (12.2.24) Joined Coalition Comments in Response to Proposed Data Collection on Proprietary Guidelines and Medicare Advantage Plan Audit Protocol (11.12.24) Joined Coalition Comments to Support S.5070, the Ensuring Access to Medicaid Buy-In Programs Act (11.12.24) Joined Coalition Comments to Centers for Medicare & Medicaid Services (CMS) on Service Level Data Collection for Medicare Advantage Plans (10.8.24) Supported efforts to reform the Inflation Reduction Acts provisions on Medicare negotiation for orphan drugs

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

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

Encouraged action on telehealth legislation to the Energy and Commerce Committee Supported H.R. 7623, the Telehealth Modernization Act of 2024 Supported H.R. 7858, Telehealth Enhancement for Mental Health Act and the Telehealth Modernization Act: Supported H.R. 7383, Retaining Access and Restoring Exclusivity (RARE) Act Supported H.R. 7384, Creating Hope Reauthorization Act of 2024 Supported the amended Give Kids a Chance Act Supported the introduction of legislation that increases access to genetic testing and genetic counselors Advocated for provisions addressing problems within the pharmacy benefit manager industry Supported the introduction of legislation that amends the anti-kickback statute to allow companies to cover the costs of traveling to obtain therapies Prepared for the reauthorization of the ACT for ALS Joined an Amicus Brief in American Association of Ancillary Benefits v. Becerra (12.18.24) Joined Coalition Comments to Centers for Medicare and Medicaid Services on Long-Term Care (LTC) Pharmacies (12.17.24) Joined Coalition Comments to Centers for Medicare and Medicaid Services on Federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Program (12.16.24) Joined Coalition Comments to Congressional Leadership on Partnership to Protect Coverage Healthcare Priorities (12.10.24) Joined Coalition Comments to HHS on Notice of Benefit and Payment Parameters for 2026 (11.12.24) Supported efforts to reform the Inflation Reduction Acts provisions on Medicare negotiation for orphan drugs

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

Prepared efforts for reauthorization of the Newborn Screening Saves Lives Reauthorization Act Encouraged action on telehealth legislation to the Energy and Commerce Committee Supported H.R. 7623, the Telehealth Modernization Act of 2024 Supported H.R. 7858, Telehealth Enhancement for Mental Health Act and the Telehealth Modernization Act: Supported the ALS Better Care Act Advocated for the protection of the Medicaid program to the White House and Congress Supported H.R. 7383, Retaining Access and Restoring Exclusivity (RARE) Act Supported H.R. 7384, Creating Hope Reauthorization Act of 2024 Supported the amended Give Kids a Chance Act Supported the MINI Act Supported the NIH Clinical Trial Diversity Act Supported H.R. 4758, Accelerating Kids Access to Care Act Supported the Access to Genetic Counseling Services Act Advocated for provisions addressing problems within the pharmacy benefit manager industry Supported the introduction of legislation that amends the anti-kickback statute to allow companies to cover the costs of traveling to obtain therapies Supported robust funding for NCATS Supported robust funding for NIAMS Prepared for the reauthorization of the ACT for ALS Joined coalition Comments to Congressional Leadership on Potential Changes to Medicaid (12.19.24) Joined an Amicus Brief in American Association of Ancillary Benefits v. Becerra (12.18.24) Joined Coalition Comments to Centers for Medicare and Medicaid Services on Long-Term Care (LTC) Pharmacies (12.17.24) Joined Coalition Comments to Centers for Medicare and Medicaid Services on Federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Program (12.16.24) Joined Coalition Comments to Congressional Leadership on Partnership to Protect Coverage Healthcare Priorities (12.10.24) Joined Coalition Comments to House Budget Committee and Senate Budget Committee Leadership on Protection of and Potential Cuts to Medicaid (12.10.24) Joined Amicus Briefs Filed in Response to Challenges to Section 1557 of the Affordable Care Act (ACA) Final Rule from U.S. Department of Health and Human Services: Texas v. Becerra (12.4.24) and Tennessee v. Becerra (11.26.24) Joined Coalition Comments to Congressional Leadership on Diagnostic Medical Equipment (DME) Access (12.2.24) Joined Coalition Comments to HHS on Notice of Benefit and Payment Parameters for 2026 (11.12.24) Joined Coalition Comments in Response to Proposed Data Collection on Proprietary Guidelines and Medicare Advantage Plan Audit Protocol (11.12.24) Joined Coalition Comments to Support S.5070, the Ensuring Access to Medicaid Buy-In Programs Act (11.12.24) Joined Coalition Comments on Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2026; Basic Health Program (11.12.24) Joined Coalition Comments on Access to Assistive Technology, Auxiliary Aids, Services, and Accommodations (11.6.24) Joined Coalition Comments to UnitedHealthcare on Changes to Prior Authorization Policies for Outpatient Rehabilitation Therapy Services (10.22.24) Joined Coalition Comments to Centers for Medicare & Medicaid Services (CMS) on Service Level Data Collection for Medicare Advantage Plans (10.8.24) Supported efforts to reform the Inflation Reduction Acts provisions on Medicare negotiation for orphan drugs

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

H.R. 10545 American Relief Act, 2025 S.2840, Bipartisan Primary Care and Health Workforce Act H.R.7635, The 340B PATIENTS Act of 2024 H.R.5829, Health Care Practitioner Disaster Protection Act H.R.5378, Lower Costs, More Transparency Act H.R.1072, Health Center Community Transformation Hub Act H.R.9029, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025 H.R.7623, Telehealth Modernization Act of 2024, including a joint letter with the National Association of Rural Health Clinics H.R.8574, 340B ACCESS Act Keeping Obstetrics Local Act SUSTAIN Act Issues related to Community health center funding and potential lame duck legislative packages prior to the final passage of HR 10545 Issues related to incoming Trump Administrations stance on community health center and primary care workforce funding as outlined in the Paragon Health Institutes policy brief Issues related to disaster relief funding package and carving out specific funds to HRSA for FQHC-related payments Issues related to health center electronic health records privacy and other health-related cyber security issues Issues related to the 340B program (including 340C) Issues related to the Developing the Community Health Workforce Act Issues related to the Emergency Preparedness for Underserved Populations Act Issues related to Food as medicine policy proposals Issues related to value-based care options for federally qualified health centers and safety net settings including the AHEAD model at CMMI and Making Care Primary model at CMS Issues related to the Transforming Maternal Health model at CMMI Issues related to community health center workforce data with the Health Resources and Services Administration Issues related to maternal health in community health centers Issues related to 340B provisions in the Inflation Reduction Act Issues related to the 340B rebate model

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

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

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

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

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

Improve integration of behavioral health and primary care; advance value-based care; address workforce shortages and improve data collection under Graduate Medical Education program; adequate physician reimbursement in Medicare; H.R.7623 Telehealth Modernization Act, H.R. 10545, the "American Relief Act, 2025

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Sustaining Outpatient Services Act (H.R. 955/S. 1849) Regulations from the Executive in Need of Scrutiny (REINS) Act of 2023 (HR 277/S 184) Increasing Access to Quality Cardiac Rehabilitative Care Act (HR 2583/S. 3481) Black Maternal Health Momnibus Act (S. 1606/HR 3305) Medicare Dental Benefit Act (HR 4146/S. 2012) Accelerating Kids Access to Care Act (H.R. 4758/S. 2372) Amputation Reduction and Compassion Act (H.R. 4261) CONNECT for Health Act (S. 2016, H.R. 4189) Kickstarting Innovative Demonstrations Supporting (KIDS) Health Act of 2023 (HR 3805/ S. 1769) Expanding Remote Monitoring Access Act (H.R.5394) Physical Activity Omnibus Legislation (No Bill Number) Preventing Maternal Deaths Reauthorization Act of 2023 (H.R. 3838/S. 2415) PREEMIE Reauthorization Act of 2023 (H.R. 3226/S. 1573) Sustainable Cardiopulmonary Rehabilitation Services in the Home Act (S. 3021) Supporting Innovation for Seniors Act (H.R. 5388) Supporting Patient Education And Knowledge (SPEAK) Act of 2023 (H.R. 6033) Wearable Equipment Opposed Medicaid per capita caps, block grants, and work requirements Mobile stroke units Telehealth Modernization Act (H.R 7623/S.3967)

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

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

H.R. 7623 - Telehealth Modernization Act H.R. 10126 - Public Health Funding Restoration Act H.R. 3838/S. 2415 - Preventing Maternal Deaths Reauthorization Act of 2023 Reauthorization of the Pandemic and All-Hazards Preparedness Act Drug Shortages Chronic Disease Prevention and Health Promotion Tobacco Control Finalization of Menthol and Cigar Rule ASPR Hospital Preparedness Program HIV/AIDS, Viral Hepatitis, and STDs, Vaccinations

Client expense: $45,774 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Extension of Medicare and Medicaid waivers beyond the COVID-19 public health emergency Medicare and Medicaid restrictions related to telehealth services Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures H.R. 704/S. 260, Promoting Access to Diabetic Shoes Act H.R. 2583/S. 3481, Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023 H.R. 3432/S. 3651, Telemental Health Care Access Act H.R. 7623/S. 3967, Telehealth Modernization Act H.R. 7711, Advancing Access to Telehealth Act H.R. 10073, Medicare Patient Access and Practice Stabilization Act of 2024 S. 198, Rural Health Clinic Burden Reduction Act S. 2016/H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 S. 1586/H.R. 3623, Educating Future Nurses Act

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

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

Legislation and policies related to: Physician/nurse practitioner reimbursement Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Extension of Medicare and Medicaid waivers beyond the COVID-19 public health emergency Medicare and Medicaid restrictions related to telehealth services Medicaid maintenance of effort requirements Medicaid eligibility expansion and state options Medicaid waiver application procedures H.R. 704/S.260, Promoting Access to Diabetic Shoes Act H.R. 2583/S. 3481, Increasing Access to Quality Cardiac Rehabilitation Care Act of 2023 H.R. 2474, Strengthening Medicare for Patients and Providers Act H.R. 3432/S. 3651, Telemental Health Care Access Act H.R. 3836, Medicaid Primary Care Improvement Act H.R. 5434/S. 3138, Stabilize Medicaid and CHIP Coverage Act H.R. 7623/S. 3967, Telehealth Modernization Act H.R. 7711, Advancing Access to Telehealth Act H.R. 10073, Medicare Patient Access and Practice Stabilization Act of 2024 S. 198, Rural Health Clinic Burden Reduction Act S. 2016/H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2023 S. 1586/H.R. 3623, Educating Future Nurses Act

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

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

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

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

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

H.R. 10515 - American Relief Act - Re: Site Neutral and Hospital Price Transparency H.R. 3173/ S.5044 - "Improving Seniors' Timely Access to Care Act" - Re: Medicare Advantage Prior Authorization provisions H.R. 6430/ S.1110 - "The Assistance for Rural Community Hospitals (ARCH) Act" - Re: Discussions around Medicare rural extenders (LVH/MDH) H.R. 8246 - Second Chances for Rural Hospitals Act; S.4322 "Rural Emergency Hospital Designation Improvement Act" Re: discussions on protecting access to rural hospitals Payment delays and denials - Re: Medicare Advantage coverage requirements Discussions around Medicaid DSH funding - Re: Medicaid DSH cut delay H.R. 7623/ S. 3967 - "Telehealth Modernization Act of 2024"; H.R. 8261 Preserving Telehealth, Hospital, and Ambulance Access Act; H.R. 4189/S. 2016 - "CONNECT for Health Act of 2023"; H.R. 3432/ S. 3651 - "Telemental Health Care Access Act of 2023" - Re: Telehealth flexibilities S. 5026 - SEPSIS Act re: sepsis prevention Discussions re: post-acute reimbursement and network adequacy

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Regulatory and legislative healthcare issues related to pharmaceutical development, approval, reimbursement, and patient access. Issues related to the diagnosis and treatment of Tardive Dyskinesia. Issues related to telehealth including the Telemental Health Care Access Act of 2023, H.R. 3432, and the Telehealth Modernization Act of 2024, H.R. 7623. H.R. 7085 - BIOSECURE Act.

Client expense: $830,000 · Firm income: Not reported

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