Dr. Michael C. Burgess Preventive Health Savings Act

Advocate on issues related to regulation of, access to, and reimbursement for regenerative medicine companies and products. Value Based Payment legislation. CMS policies regarding Value Based legislation. FDA appropriations. FDA staffing. Prescription Drug User Fee Act (PDUFA). Medicaid reimbursement. Provider credentialing. Medicare reimbursement. NTAP. Medicaid VBPs for Patients (MVP) Act (H.R.2666/S.4204). Accelerating Kids Access to Care Act (S.2372/H.R.4758). MDRP. CMMI. Creating Hope Reauthorization Act of 2024 (H.R.7384/S.4583). Rare Pediatric Disease Designation and Priority Review Voucher (PRV) Programs. Preventive Health Savings Act (H.R.766/S.114). Patient Access Act of 2024 (H.R.9184).

Client expense: $200,000 · 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

H.R. 198: Drug Pricing Transparency and Accountability Act - Provisions related to the 340B Program H.R. 456: Fairness in Orphan Drug Exclusivity Act H.R. 766: Dr. Michael C. Burgess Preventive Health Savings Act H.R. 830: HELP Copays Act - To amend title XXVII of the Public Health Service Act to apply additional payments, discounts, and other financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes H.R. 1613: Drug Price Transparency in Medicaid Act of 2023 H.R. 1790: Biologics Competition Act of 2023 - To direct the Secretary of Health and Human Services to evaluate the extent to which the substitution of interchangeable biological products is impacted by differences between the system for determining a biological product to be interchangeable and the system for assigning therapeutic equivalence ratings to drugs, and for other purposes H.R. 2534: PROTECT 340B Act of 2023 - Provisions related to the 340B program H.R. 2679: Pharmacy Benefits Manager Accountability Act H.R. 2707: MADE in America Act H.R. 2816: Pharmacy Benefit Manager Sunshine and Accountability Act H.R. 2880: Protecting Patients Against PBM Abuses Act H.R. 3290: To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program H.R. 3433: Give Kids a Chance Act of 2024 H.R. 3561: Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or PATIENT Act of 2023 H.R. 3839: To amend the Federal Food, Drug, and Cosmetic Act to increase transparency in generic drug applications H.R. 4421: Preparing for All Hazards and Pathogens Reauthorization Act H.R. 4818: Treat and Reduce Obesity Act of 2023 H.R. 4895: Lowering Drug Costs for American Families Act - Provisions related to drug pricing H.R. 4988: Modern Authentication of Pharmaceuticals Act of 2023 H.R. 5376: Share the Savings with Seniors Act  H.R. 5378: Lower Costs, More Transparency Act H.R. 5391: Protecting Patient Access to Cancer and Complex Therapies Act H.R. 5539: ORPHAN Cures Act H.R. 6283: Delinking Revenue from Unfair Gouging or DRUG Act H.R. 6664: Innovation in Pediatric Drugs Act of 2023 H.R. 7024 Tax Relief for American Families and Workers Act of 2024 H.R. 7174: Ensuring Pathways to Innovative Cures (EPIC) Act: To amend title XI of the Social Security Act to equalize the negotiation period between small-molecule and biologic candidates under the Drug Price Negotiation Program H.R. 7248: FDA Modernization Act 3.0 H.R. 7623: Telehealth Modernization Act of 2024 H.R. 7635: The 340B PATIENTS Act of 2024 H.R. 8574: 340B Affording Care for Communities and Ensuring a Strong Safety-net (ACCESS) Act H.R. 9096: Pharmacists Fight Back Act S. 113: Prescription Pricing for the People Act of 2023 - Provisions related to PBMs S. 127: Pharmacy Benefit Manager Transparency Act of 2023 - Provisions related to PBMs S. 148: Stop STALLING Act - Provisions related to citizen petitions S. 1067: Ensuring Timely Access to Generics Act of 2023 S. 1130: Health Care PRICE Transparency Act S. 1264: SMART Prices Act - Provisions related to drug pricing reform S. 1339: Pharmacy Benefit Manager Reform Act - Provisions related to PBMs S. 1375: HELP Copays Act - To amend title XXVII of the Public Health Service Act to apply additional payments, discounts, and other financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes S. 1542: Delinking Revenue from Unfair Gouging Act or DRUG Act - Provisions related to PBMs S. 1589: Safeguarding Patients and Taxpayers Act S. 1967: PBM Act S. 2305: Biosimilar Red Tape Elimination Act S. 2333: Pandemic and All-Hazards Preparedness and Response Act S. 2474: Share the Savings with Seniors Act S. 2477: Equitable Community Access to Pharmacist Services Act S. 2973: Modernizing and Ensuring PBM Accountability Act (MEPA) S. 3393: SUPPORT for Patients and Communities Reauthorization Act S. 3430: Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 S. 5021: 340B PATIENTS Act of 2024 S. 5040: Protecting Patients from Deceptive Drugs Online Act S. 5459: Biosimilars Access and Affordability Act BioCompete Act (draft) Executive Order of February 28, 2024, Preventing Access to Americans' Bulk Sensitive Personal Data and United States Government-Related Data by Countries of Concern Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future (SUSTAIN) 340B Act (draft) User fee policy issues Inflation Reduction Act of 2022 (P.L. 117-169) IRA price negotiation expansion policy issues Pharmacy Benefit Manager reform and policy issues Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA) Cancer Moonshot Initiative 21st Century Cures 2.0 Drug cost and pricing policy issues Principles for drug pricing reform Drug importation policy issues Accelerated approval policy issues FDA regulatory approval authority policy issues Competition policy issues Orphan Drug Act policy issues Antimicrobial resistance (AMR) policy issues Supply chain policy issues Clinical trial diversity policy issues 340B drug discount program policy issues Patient assistance program policy issues Biosimilar approval and reimbursement policy issues Drug shortages policy issues  Pandemic preparedness policy issues Artificial intelligence policy issues Vaccine provisions of the Inflation Reduction Act Policy issues related to vaccines

Client expense: $920,000 · Firm income: Not reported

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

Health care workforce improvements; primary care access issues; physician payment and value-based care; Preventive Health Savings Act (S.114/H.R.766); H.R. 10545, the "American Relief Act, 2025; H.R.4531 - Support for Patients and Communities Reauthorization Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.766/S.114, Preventive Health Savings Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

- S.2333 - Pandemic and All-Hazards Preparedness and Response Act, provisions related to health care provider workforce - S.1176 & H.R.2663 - Workplace Violence Prevention for Health Care and Social Service Workers Act - S.4928 - Beryllium Testing Fairness Act - H.R.4897 & S.2501 - Asuncion Valdivia Heat Illness and Fatality Prevention Act - H.R.5420 & S.2948 - WORK (Workplace Overdose Reversal Kits) to Save Lives Act - H.R. 766 & S.114 - Dr. Michael C. Burgess Preventive Health Savings Act - Authorization legislation to establish a program to provide federal support to graduate medical education programs in occupational and environmental medicine. - Medicare GME system reforms to accommodate support for additional medical specialty residency funding support. - Support of Congressional oversight on issues related to occupational respirable crystalline silica exposures. - Support of Congressional oversight on issues related to occupational lead exposures. - Support of Congressional oversight on issues related to on-site workplace clinic illness and injury management.

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

Government targets: HOUSE OF REPRESENTATIVES, Occupational Safety & Health Administration (OSHA), SENATE

H.R. 766, Dr. Michael C. Burgess Preventive Health Savings Act, all provisions S. 114, Dr. Michael C. Burgess Preventive Health Savings Act, all provisions H.R. 3226, PREEMIE Reauthorization Act of 2023, all provisions S. 1573, PREEMIE Reauthorization Act of 2023, all provisions H.R. 8037, NIH IMPROVE Act, provisions relating to additional funding for research to reduce maternal mortality S. 4147, NIH IMPROVE Act, provisions relating to additional funding for research to reduce maternal mortality H.R. 7463, Extension of Continuing Appropriations and Other Matters Act, 2024, provisions relating to Medicare programs H.R. 4366, Consolidated Appropriations Act, 2024, provisions relating to physician payment cuts H.R. 10445, Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025, all provisions H.R. 10515, American Relief Act, 2025, provisions relating to Medicare, Continuing Resolution, Telehealth H.R. 9747, Continuing Appropriations and Extensions Act, 2025, provisions relating to CR through December 20 H.R. 3838, Preventing Maternal Deaths Reauthorization Act of 2023, all provisions S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023, all provisions

Client expense: $6,590,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Telehealth: H.R. 4189 / S.2016, the CONNECT for Health Act, would remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. Access to AEDS: H.R. 2370 / S. 1024, the Access to AEDs Act, would require the Department of Health and Human Services to award grants to promote student access to defibrillation in elementary and secondary schools. Preventative Health: H.R. 766 / S. 114, the Preventative Health Savings Act, would require the Congressional Budget Office, upon receipt of a request from congress, to determine if proposed legislation would reduce spending outside of the 10-year budget window through the use of preventative health services. Workplace Safety: H.R. 1202 / S. 2768, The Secure and Violence-Free Environments (SAVE) Act, would make it new a criminal offense for knowingly assaulting or intimidating hospital personnel during the performance of their official duties.

Client expense: $105,404 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Federal Affairs lobbies for Appropriations for health centers and related primary care workforce programs. This includes the House Appropriations Committee's Fiscal Year 2025 Department of Labor, Health and Human Services, and Education, and related agencies appropriations bills, the Lower Costs More Transparency Act (H.R. 5378); the Bipartisan Primary Care and Health Workforce Act (S.2840); the Preventative Health Savings Act (H.R. 766) (S. 114); the Health Care Workforce Innovation Act (H.R. 7307); the Health Workforce Innovation Act (S. 4957); the Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025; and the American Relief Act, 2025.

Client expense: $155,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE

Federal Affairs lobbies for Appropriations for health centers and related primary care workforce programs. This includes the House Appropriations Committee's Fiscal Year 2025 Department of Labor, Health and Human Services, and Education, and related agencies appropriations bills, the Lower Costs More Transparency Act (H.R. 5378); the Bipartisan Primary Care and Health Workforce Act (S.2840); the Preventative Health Savings Act (H.R. 766) (S. 114); the Health Care Workforce Innovation Act (H.R. 7307); the Health Workforce Innovation Act (S. 4957); the Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025; and the American Relief Act, 2025.

Client expense: $152,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE

Monitor implementation of healthcare quality, cost, and access and related health care reform efforts. Monitor implementation of health provisions in the American Rescue Plan Act, P.L. 117-2, and Inflation Reduction Act, P.L. 117-169. Enhance preventive health in health care, including related provisions in H.R. 766/S. 114, the Preventive Health Savings Act, to amend the Congressional Budget Act of 1974 with respect to the scoring of preventive health savings. Medicare reimbursement for telemedicine, including related provisions in: H.R. 7623, the Telehealth Modernization Act of 2024 - Sec. 101, Extension of Certain Telehealth Flexibilities; and H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act - Sec. 2, Extending Medicare Telehealth Flexibilities. Advocate for extending Medicare flexibilities in telehealth as part of H.R. ____ Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues surrounding the Medicare Shared Savings Program (MSSP) Funding for Fiscal Year 2024 for Title VIII Nursing Workforce Development Programs Funding for Fiscal Year 2024 for the National Institute of Nursing Research Funding for Fiscal Year 2025 for Title VIII Nursing Workforce Development Programs Funding for Fiscal Year 2025 for the National Institute of Nursing Research Funding relating to the mental and substance use disorder workforce Increased funding for Agency for Healthcare Research and Quality (AHRQ) S. 114 - the Preventive Health Savings Act H.R. 766 - Dr. Michael C. Burgess Preventive Health Savings Act H.R. 9029/S. 4942 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025 H.R. 10445 - Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025 H.R. 10545 - American Relief Act, 2025 H.R. 10515 - American Relief Act, 2025

Client expense: $470,000 · Firm income: Not reported

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

Incentivizing domestic manufacturing of critical medical supplies Issues related to health care costs and transparency Electronic prior authorization and administrative simplification Health care supply chain resiliency 340B Drug discount program Reauthorization of Pandemic and All Hazards Preparedness Act Hospital finance issues Healthcare workforce issues (graduate medical education, health professional training, recruitment and retention, minimum staffing requirements) Medicare payment policies Alternative payment models and related policies Medicare home infusion policy Reauthorization of Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act Expanding access to interoperable health tech in long term and post-acute care settings Maternal and infant health Health care workplace violence and worker safety S. 148 Stop STALLING Act S. 150 Affordable Prescriptions for Patients Act Medicaid Disproportionate Hospital Share cuts S. 2115, H.R. 4307 Medical Supply Chain Resiliency Act H.R. 4104, S. 1976 Preseving Patients Access to Home Infusion Act H.R. 2584, S. 2768 SAVE Act H.R. 3577 Medical and Health Stockpile Accountability Act H.R. 2665 Supporting Safety Net Hospitals Act H.R. 2389, S. 1302 Resident Physician Shortage Reduction Act H.R. 3346 IMPACT to Save Moms Act H.R. 5378 Lower Costs, More Transparency Act S. 2840 Bipartisan Primary Care and Health Workforce Act H.R. 5013, S. 3503 Value in Health Care Act H.R. 4942, S. 665 Conrad State 30 and Physician Access Reauthorization Act Artificial intelligence in healthcare H.R.766, S. 114 Preventive Health Savings Act H.R. 6205, S. 3211 Healthcare Workforce Resilience Act H.R. 7050 Substance Use Disorder Workforce Act H.R. 8702, S. 4532 Improving Seniors' Timely Access to Care Act H.R. 7855 Rural Residency Planning and Development Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.766/S.114 Preventive Health Savings Act Pandemic preparedness, life science innovation and competitiveness, preemptive health and medicine, biomanufacturing, next generation vaccines and therapeutics, PAPHA reauthorization, AI policy and regulation, AMR research, rare disease PRV, ag-biotech policy and regulation

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

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

No Bill No. - Congressional Primary Care Caucus NO Bill No. - Teaching Health Centers GME; Community Health Centers, National Health Service Corps No Bill No. - COVID-19 Vaccines No Bill No. - PAHPA Reauthorization NO Bill No. - Medicare Physician Payment Reform No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Physician Workforce No Bill No. - Prior authorization/reducing administrative burden NO Bill No. - Health care affordability, including Medicare physician payments and site neutral payments, anti-competitive contracting, and the No Surprises Act No Bill No. - Black Maternal Health Momnibus Act No Bill No. - DATA in Public Health Act No Bill No. - Complete Care Act No Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Tobacco Users Quit Act(S.704/H.R. 1202) REDI Act No Bill No. - FY2024 NDAA No Bill No. - Vaccine commercialization No Bill No. - VA Standards of Practice No Bill No. - MATE Improvement Act No Bill No. - SPEAK Act of 2023 No Bill No. - Access to Donor Milk Act NO Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Primary and Virtual Care Affordability Act No Bill No. - Advancing Menopause Care and Mid-Life Women's Health Act No Bill No. - Change Cyberattack No Bill No. - Inpatient prospective Payment Rule No Bill No. - Healthcare Cybersecurity Act No Bill No. - Protecting Communities Through Immunizations Act No Bill No. - Mental Health and MAMA Act No Bill No. - SEEK HELP Act No Bill No. - Access to Workers' Compensation for Injured Federal Workers Act No Bill No. - Protecting Patients from Deceptive Drugs Ad Online Act No Bill No. - Innovation in Pediatric Drugs Act of 2023 No Bill No. - BLOCKING Act No. Bill No. - Strengthening the Vaccines for Children Act (S. 230/H.R. 834) Rural Physician Workforce Production Act (S. 862) Restoring America's Health Care Workforce and Readiness Act (H.R. 498) 988 Lifeline Cybersecurity Responsibility Act (H.R. 1114) Long-COVID Recovery Now Act (S. 114/H.R. 766) Preventive Health Savings Act (S. 923) Better Mental Health for Americans (H.R. 286) Healthcare Providers' Safety Act (H.R. 2569) DOC Act (H.R. 1770) Equitable Community Access to Pharmacist Services Act (H.R. 2630/S.652) Safe Step Act (H.R. 3800) Chronic Disease Flexible Coverage Act (H.R. 3029) Primary Care Enhancement Act (H.R. 5378) Lower Cost More Transparency Act (H.R. 2584) Safety from Violence for Healthcare Employees Act (H.R. 4392/S.2188) PrEP Access and Coverage Act (H.R. 6067) Early Childhood Nutrition Improvement Act (S. 3295/H.R. 5569) Child Care Nutrition Enhancement Act (H.R. 1117) Advancing Safe Medications for Moms and Babies Act (H.R. 5909) Care for Grieving Families Act (H.R. 1616/S.807) Comprehensive Access to Resources and Education (CARE) for Long COVID Act (H.R. 3258) Targeting Resources for Equitable Access to Treatment (TREAT) Long COVID Act (S. 2560) Long COVID Support Act (H.R. 6038/S.3108) Teen E-Cigarette and Tobacco Addition (PROTECT) Act (H.R. 6103/S.3137) Support Through Loss Act (S. 3070) Youth Prevention and Recovery Reauthorization Act (H.R. 7381) - Healthcare Enhancement and Learning Through Harnessing Artificial Intelligence Act (S. Res. 597) - A Resolution Creating a Health Workforce Well-Being Day of Awareness (S. 3740) STRONGER Act (H.R. 6965) - EPIPEN Act (S.3779) - Child Suicide Prevention and Lethal Means Safety Act (S. 3679/H.R. 7153) - Lorna Breen Reauthorization Act (H.R. 3752) Parity Enforcement Act (S. 8) - Improving Health Insurance Affordability Act (H.R. 1692) - Health care Affordability Act (H.R. 5010) - Recognizing Gun Violence as a Public Health Emergency Act (H.R. 7891) - Kids Online Safety Act (H.R. 8383) - Rural Obstetrics Readiness Act (H.R. 7153/S.3679) - Dr. Lorna Breen Health Care Provider Protection Act (S. 4429) - Reducing Drug Prices for Seniors Act (H.R. 7681) - Primary and Virtual Care Affordability Act (H.R. 7808) - EARLY Minds Act (H.R. 7855) - Rural Residency Planning and Development Act of 2024 (H.R. 6664) - Innovation in Pediatric Drugs Act (H.R. 6412) - Healthcare Cybersecurity Act (H.R. 3800) - Chronic Disease Flexible Coverage Act (H.R. 618/S. 131) - Improving Access to Workers Compensation for Injured Federal Workers Act (H.R. 8839/S.5203) - Maternal and Infant Syphilis Prevention Act (H.R. 10129/S. 5330) - Prenatal Care for Military Families Act (H.R. 10098) - Family Plus Health Care Act (H.R. 1359/S. 644) - Modernizing Opioid Treatment Access Act (H.R. 9774/S. 5194) - Health Care Affordability Act

Client expense: $1,072,997 · Firm income: Not reported

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

H.R. 766, Preventive Health Savings Act S. 114, Preventive Health Savings Act H.R. 10545, American Relief Act, 2025 H.R. 2888, ONSHORE Manufacturing Act S. 44, ONSHORE Manufacturing Act H.R. 4307, Medical Supply Chain Resiliency Act S. 2115, Medical Supply Chain Resiliency Act H.R. 6033, Supporting Patient Education and Knowledge Act H.R. 7165, Credit for Caring Act S. 3702, Credit for Caring Act S. 2333, Pandemic and All-Hazards Preparedness and Response Act Office of the National Coordinator for Health Information Technology--Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) Proposed Rule (RIN 0955-AA06)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Expand Patient Access and Telehealth: Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported the Preserving Telehealth, Hospital, and Ambulance Access Act, which would extend these flexibilities for two years until the end of 2026. Also supported the Protecting Rural Telehealth Access Act, H.R. 3440, and the Telehealth Modernization Act of 2024, H.R. 7623, which facilitate access to care via telehealth permanently. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supports a similar bill, S. 5035, introduced by Sen. Boozman. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. We support aspects of legislation recently introduced by Senators Whitehouse and Cassidy, the Pay Primary Care Physicians (PCPs) Act, S. 4338, that would expand and accelerate the adoption of a hybrid per member per month (PMPM) payment model outside of the PFS. We believe this type of model can enhance innovation and improve the delivery of chronic care in primary care practices. ACP supported Dr. Michael C. Burgess Preventive Health Savings Act, H.R. 766, to enable CBO to capture cost-savings associated with preventive health care legislation beyond existing 10-year window, for two additional 10-year periods. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, by Rep. Underwood to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. We support similar legislation introduced by Sen. Shaheen in the Senate. FY2025 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2025 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vi, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include report language in the FY2025 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usage. While the House and Senate bills included language, we prefer the stronger House version language. Urged Congress to support year-end Continuing Resolution (CR) that contained PBM reform, averting Medicare physician payment cuts by 2.5%, provided bonus payment to physicians participating in APMs, and extended telehealth flexibilities adopted during the COVID-19 pandemic for 2 years. Also advocated that streamlined prior authorization process for Medicare Advantage plans be included in the CR. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. We support the Senate Title X spending for pregnancy and family planning over the Houses bill, which eliminates funding in its bill. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Support efforts of the bipartisan Senate Working Group to add 10,000 GME slots in legislation; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Social Determinants of Healthcare/DEI: Opposed the Educate Act, H.R. 7725/S. 4115, that will amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process in the reintroduced the Improving Seniors' Timely Access to Care Act, S.4532. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Data Privacy: Supported American Privacy Rights Act, H.R. 8818, nations first comprehensive federal consumer data privacy framework. Bill was considered by House Energy and Commerce and would expand data privacy protections to entities not currently subject to HIPAA privacy protections. ACP asked for provisions enabling consumers to opt-out of allowing companies to use algorithms based on their personal data, allow states to further protect their residents and fully inform subjects of the nature and risks of the research. Scope of Practice: Opposed the Equitable Community Access to Pharmacist Services Act, H.R. 1770/ S. 2477, which would expand Medicare coverage to permanently include select services provided by a pharmacist. Healthcare Worker Safety: Supported H.R. 6364, the Medicare Telehealth Privacy Act of 2023. This bill would ensure that HHS will not publicly post the addresses of participating telehealth practitioners to provide privacy protections for physicians so that they can effectively treat and care for patients via telehealth. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries. Cures 2.0: Reviewed and supported Cures 2.0 legislation.

Client expense: $242,106 · 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), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

Expand Patient Access and Telehealth: Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported the Preserving Telehealth, Hospital, and Ambulance Access Act, which would extend these flexibilities for two years until the end of 2026. Also supported the Protecting Rural Telehealth Access Act, H.R. 3440, and the Telehealth Modernization Act of 2024, H.R. 7623, which facilitate access to care via telehealth permanently. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supports a similar bill, S. 5035, introduced by Sen. Boozman. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. We support aspects of legislation recently introduced by Senators Whitehouse and Cassidy, the Pay Primary Care Physicians (PCPs) Act, S. 4338, that would expand and accelerate the adoption of a hybrid per member per month (PMPM) payment model outside of the PFS. We believe this type of model can enhance innovation and improve the delivery of chronic care in primary care practices. ACP supported Dr. Michael C. Burgess Preventive Health Savings Act, H.R. 766, to enable CBO to capture cost-savings associated with preventive health care legislation beyond existing 10-year window, for two additional 10-year periods. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, by Rep. Underwood to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. We support similar legislation introduced by Sen. Shaheen in the Senate. FY2025 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2025 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vi, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include report language in the FY2025 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usage. While the House and Senate bills included language, we prefer the stronger House version language. Urged Congress to support year-end Continuing Resolution (CR) that contained PBM reform, averting Medicare physician payment cuts by 2.5%, provided bonus payment to physicians participating in APMs, and extended telehealth flexibilities adopted during the COVID-19 pandemic for 2 years. Also advocated that streamlined prior authorization process for Medicare Advantage plans be included in the CR. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. We support the Senate Title X spending for pregnancy and family planning over the Houses bill, which eliminates funding in its bill. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Support efforts of the bipartisan Senate Working Group to add 10,000 GME slots in legislation; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Social Determinants of Healthcare/DEI: Opposed the Educate Act, H.R. 7725/S. 4115, that will amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process in the reintroduced the Improving Seniors' Timely Access to Care Act, S.4532. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Data Privacy: Supported American Privacy Rights Act, H.R. 8818, nations first comprehensive federal consumer data privacy framework. Bill was considered by House Energy and Commerce and would expand data privacy protections to entities not currently subject to HIPAA privacy protections. ACP asked for provisions enabling consumers to opt-out of allowing companies to use algorithms based on their personal data, allow states to further protect their residents and fully inform subjects of the nature and risks of the research. Scope of Practice: Opposed the Equitable Community Access to Pharmacist Services Act, H.R. 1770/ S. 2477, which would expand Medicare coverage to permanently include select services provided by a pharmacist. Healthcare Worker Safety: Supported H.R. 6364, the Medicare Telehealth Privacy Act of 2023. This bill would ensure that HHS will not publicly post the addresses of participating telehealth practitioners to provide privacy protections for physicians so that they can effectively treat and care for patients via telehealth. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries. Cures 2.0: Reviewed and supported Cures 2.0 legislation.

Client expense: $124,919 · 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), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

Physician payment issues (MEI, E/M Budget Neutrality, APMs, MIPS) including SFC white paper: Bolstering Chronic Care through Physician Payment: Current Challenges and Policy Options in Medicare Part B; Prior authorization in Medicare Advantage; HR 1770/S. 2477 Equitable Community Access to Pharmacist Services Act HR 766/S 144 Preventive Health Savings Act HR 618/ S 131 Improving Access to Workers' Compensation for Injured Federal Workers Act of 2023. S.1512 - CONNECT for Health Act of 2021 Monitoring PBM legislation - S. 1967 and S. 1038 H.R. 4822, Health Care Price Transparency Act of 2023; H.R. 2474, Strengthening Medicare for Patients and Providers Act; H.R. 3561, PATIENT Act of 2023; H.R. 3284, Providers and Payers COMPETE Act; S. 3503, Value in Healthcare Act;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Diabetes Prevention Program Expanding Access to DSMT (H.R. 3842/S. 1832) Federal Employee Benefits for Medical Nutrition Therapy Medical Nutrition Therapy Act (H.R. 6407/S. 3297) Medicare/Medicaid -- Access to MNT; IBT National Coverage Determination Reconsideration Medicaid -- Maternal Mortality and Access to Care Medically Tailored Meals/Food as Medicine - Coverage for OAA programs and Service Medically Tailored Home-Delivered Meals Demonstration Pilot Act (H.R.6780/S. 2133) Nutrition Care Act (H.R. 6961) Preventive Health Savings Act (H.R 766/S.114) Senior Nutrition (S. 2360, S. 2361, S. 1036) Strengthening Medicare for Patients and Providers Act (H.R. 2474) Telehealth Treat and Reduce Obesity Act (H.R. 4818/S.2407)

Client expense: $15,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Personnel Management (OPM), SENATE

Legislation and policies relating to: Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention H.R. 766/S 114, Dr. Michael C. Burgess Preventive Health Savings Act H.R. 1147/S. 1957, Whole Milk for Healthy Kids Act of 2023 H.R. 1843/S.1001, Telehealth Expansion Act of 2023 H.R. 2411/S. 1150, National Nursing Workforce Centers Act of 2023 H.R. 2663/S. 1176, Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 2713/S. 2418, Improving Care and Access to Nurses (I CAN) Act H.R. 2901, Food Labeling Modernization Act of 2023 H.R. 3073/S. 1452, Community Mental Wellness and Resilience Act of 2023 H.R 3226/S. 1573, PREEMIE Reauthorization Act of 2023 H.R. 3305/S. 1606, Black Maternal Health Momnibus Act H.R. 3331/S. 754, Improving Mental Health and Wellness in Schools Act H.R.3433, Give Kids a Chance Act H.R. 3633, Promoting Resources to Expand Vaccination, Education, and New Treatments for HPV Cancers (PREVENT HPV Cancers) Act of 2023 H.R. 4310/S. 2233, Youth Poisoning Protection Act H.R. 4581/S. 2231, Maternal and Child Health Stillbirth Prevention Act of 2023 H.R. 4758/S. 2372, Accelerating Kids Access to Care Act H.R. 4775, Helping Tobacco Users Quit Act H.R. 4892/S. 3921, Medicaid Bump Act H.R. 5012/S. 2647, Stillbirth Health Improvement and Education (SHINE) for Autumn Act of 2023 H.R. 5378, Lower Costs, More Transparency Act H.R. 5541, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act H.R. 6122/S. 2853, Train More Nurses Act H.R. 6149/S. 1291, Protecting Kids on Social Media Act H.R. 6766/S. 3512, Transparency, Readability, Understandability, Truth, and Helpfulness (TRUTH) in Labeling Act H.R. 6960/S. 3765, Emergency Medical Services for Children Reauthorization Act of 2024 H.R. 7002/S. 2815, Nurse Faculty Shortage Reduction Act of 2024 H.R. 7153/S. 3679, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 7224, To reauthorize the Stop, Observe, Ask, and Respond to Health and Wellness Training Program. H.R. 7808, Early Action and Responsiveness Lifts Youth (EARLY) Minds Act H.R. 8467, Farm, Food, and National Security Act of 2024 H.R. 8818, American Privacy Rights Act H.R. 9076, Protecting Americas Children by Strengthening Families Act H.R. 9425, Tobacco User Fee Modernization Act of 2024 H.R. 9774/S. 5194, Health Care Affordability Act of 2024 S. 397, Promoting Physical Activity for Americans Act S.644/H.R. 1359, Modernizing Opioid Treatment Access Act S. 1409/H.R. 7891, Kids Online Safety Act S. 1418/H.R. 7890, Children and Teens Online Privacy Protection Act S. 1840/H.R. 3916, Screening for Communities to Receive Early and Equitable Needed Services (SCREENS) for Cancer Act of 2023 S. 1884/H.R. 3713, Mental Health Services for Students Act of 2023 S. 2073, Kids Online Safety and Privacy Act S. 2840, Bipartisan Primary Care and Health Workforce Act S. 3085, Preventing Adverse Childhood Experiences (PACE) Act S. 3193/H.R. 5163, Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act S. 3393/H.R. 4531, SUPPORT for Patients and Communities Reauthorization Act S. 3770/H.R. 7266, Future Advancement of Academic Nursing (FAAN) Act S. 4041, Creating Access and Resources in Education (CARE) for Student Mental Health Act S. 4532/H.R. 8702, Improving Seniors Timely Access to Care Act S. 4745, Federal Food Administration 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

Advocate on issues related to regulation of, access to, and reimbursement for regenerative medicine companies and products. Value Based Payment legislation. CMS policies regarding Value Based legislation. FDA appropriations. FDA staffing. Prescription Drug User Fee Act (PDUFA). Medicaid reimbursement. Provider credentialing. Medicare reimbursement. NTAP. Medicaid VBPs for Patients (MVP) Act (H.R.2666/S.4204). Accelerating Kids Access to Care Act (S.2372/H.R.4758). MDRP. CMMI. Creating Hope Reauthorization Act of 2024 (H.R.7384/S.4583). Rare Pediatric Disease Designation and Priority Review Voucher (PRV) Programs. Preventive Health Savings Act (H.R.766/S.114). Patient Access Act of 2024 (H.R.9184).

Client expense: $150,000 · 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

H.R. 766 Dr. Michael Burgess Preventive Health Savings Act H.R. 4368: Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2024 H.R. 5894: Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2024 S. 2226: National Defense Authorization Act for Fiscal Year 2024 S. 2131: Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2024 S. 2624: Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2024 FY 2025 President's Budget Request H.R. 9027: Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2025 S. 4690: Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2025 H.R. 9029: Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025 S. 4942: Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025; provisions related to pharmaceutical industry H.R. 9026: Commerce, Justice, Science, and Related Agencies Appropriations Act, 2025 S. 4795: Commerce, Justice, Science, and Related Agencies Appropriations Act, 2025 Inflation Reduction Act of 2022 (P.L. 117-169); Vaccines Provisions H.R. 6833: Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023 (P.L. 117-180) H.R.7024 - Tax Relief for American Family and Workers Act of 2024 H.R. 8070: Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 S. 4638: National Defense Authorization Act for Fiscal Year 2025

Client expense: $1,540,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

Incentivizing domestic manufacturing of critical medical supplies Issues related to health care costs and transparency Electronic prior authorization and administrative simplification Health care supply chain resiliency 340B Drug discount program Reauthorization of Pandemic and All Hazards Preparedness Act Hospital finance issues Healthcare workforce issues (graduate medical education, health professional training, recruitment and retention, minimum staffing requirements) Medicare payment policies Alternative payment models and related policies Medicare home infusion policy Reauthorization of Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act Expanding access to interoperable health tech in long term and post-acute care settings Maternal and infant health Health care workplace violence and worker safety S. 148 Stop STALLING Act S. 150 Affordable Prescriptions for Patients Act Medicaid Disproportionate Hospital Share cuts S. 2115, H.R. 4307 Medical Supply Chain Resiliency Act H.R. 4104, S. 1976 Preseving Patients Access to Home Infusion Act H.R. 2584, S. 2768 SAVE Act H.R. 3577 Medical and Health Stockpile Accountability Act H.R. 2665 Supporting Safety Net Hospitals Act H.R. 2389, S. 1302 Resident Physician Shortage Reduction Act H.R. 3346 IMPACT to Save Moms Act H.R. 5378 Lower Costs, More Transparency Act S. 2840 Bipartisan Primary Care and Health Workforce Act H.R. 5013, S. 3503 Value in Health Care Act H.R. 4942, S. 665 Conrad State 30 and Physician Access Reauthorization Act Artificial intelligence in healthcare H.R.766, S. 114 Preventive Health Savings Act H.R. 6205, S. 3211 Healthcare Workforce Resilience Act H.R. 7050 Substance Use Disorder Workforce Act H.R. 8702, S. 4532 Improving Seniors' Timely Access to Care Act H.R. 7855 Rural Residency Planning and Development Act

Client expense: $173,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Telehealth: H.R. 4189 / S.2016, the CONNECT for Health Act, would remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. Access to AEDS: H.R. 2370 / S. 1024, the Access to AEDs Act, would require the Department of Health and Human Services to award grants to promote student access to defibrillation in elementary and secondary schools. Preventative Health: H.R. 766 / S. 114, the Preventative Health Savings Act, would require the Congressional Budget Office, upon receipt of a request from congress, to determine if proposed legislation would reduce spending outside of the 10-year budget window through the use of preventative health services. Workplace Safety: H.R. 1202 / S. 2768, The Secure and Violence-Free Environments (SAVE) Act, would make it new a criminal offense for knowingly assaulting or intimidating hospital personnel during the performance of their official duties.

Client expense: $157,711 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.766/S.114, Preventive Health Savings Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health care workforce improvements; primary care access issues; physician payment and value-based care; Healthy Competition for Better Care Act (HR3120); Preventive Health Savings Act (S.114/H.R.766)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

- S.2333 - Pandemic and All-Hazards Preparedness and Response Act, provisions related to health care provider workforce - S.1176 & H.R.2663 - Workplace Violence Prevention for Health Care and Social Service Workers Act - S.4928 - Beryllium Testing Fairness Act - H.R.4897 & S.2501 - Asuncion Valdivia Heat Illness and Fatality Prevention Act - H.R.5420 & S.2948 - WORK (Workplace Overdose Reversal Kits) to Save Lives Act - H.R. 766 & S.114 - Dr. Michael C. Burgess Preventive Health Savings Act - Authorization legislation to establish a program to provide federal support to graduate medical education programs in occupational and environmental medicine. - Medicare GME system reforms to accommodate support for additional medical specialty residency funding support. - Support of Congressional oversight on issues related to occupational respirable crystalline silica exposures. - Support of Congressional oversight on issues related to occupational lead exposures. - Support of Congressional oversight on issues related to on-site workplace clinic illness and injury management.

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

Government targets: HOUSE OF REPRESENTATIVES, Occupational Safety & Health Administration (OSHA), SENATE

H.R. 618, Improving Access to Workers Compensation for Injured Federal Workers Act, all provisions S. 131, Improving Access to Workers Compensation for Injured Federal Workers Act of 2023, all provisions H.R. 2923, Living Donor Protection Act of 2023, all provisions S. 1384, Living Donor Protection Act of 2023, all provisions H.R. 1359, Modernizing Opioid Treatment Access Act, all provisions S. 644, Modernizing Opioid Treatment Access Act, all provisions H.R. 766, Dr. Michael C. Burgess Preventive Health Savings Act, all provisions S. 114, Dr. Michael C. Burgess Preventive Health Savings Act, all provisions H.R. 2630, Safe Step Act, all provisions S. 652, Safe Step Act, all provisions S. 113, Prescription Pricing for the People Act of 2023, all provisions H.R. 7153, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions S. 3679, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions S. 2840, Bipartisan Primary Care and Health Workforce Act, all provisions S. 127, Pharmacy Benefit Manager Transparency Act of 2023, all provisions H.R. 8325, Physician and Patient Safety Act, all provisions S. 4278, Physician and Patient Safety Act, all provisions H.R. 3417, Facilitating Accountability In Reimbursements (FAIR) Act, provisions relating to site neutral payments H.R. 6033, Supporting Patient Education And Knowledge (SPEAK) Act of 2024, all provisions H.R. 2411, National Nursing Workforce Center Act of 2023, all provisions H.R. 6230, Doctor Knows Best Act of 2023, all provisions S. 4349, A bill to require private health plans to provide for secure electronic transmission of prior authorization requests for prescription drugs, all provisions H.R. 6881, AI Foundation Model Transparency Act of 2023, all provisions S. 5271, A bill to require the Administrator of the Drug Enforcement Administration to temporarily exempt buprenorphine from the Suspicious Orders Report System for the remainder of the opioid public health emergency, all provisions H.R. 206, Healthy Technology Act of 2023, all provisions Supporting Healthy Moms and Babies Act/draft Dr. Paul Farmer Global Health Training Act/draft Telehealth/Licensure portability Telehealth/Reserve Health Readiness Program South Asians in United States/Cardiovascular disease/high mortality rates OBGYN data/Georgia Health information technology/interoperability (HTI-2) Laboratory developed tests Telehealth/data needs Data Privacy and Cybersecurity Health Insurance Portability and Accountability Act (HIPAA)/electronic records Mental health parity/addiction equity CHANGE Healthcare cyberattack Cybersecurity incident reporting Nutrition/sodium reduction Maternal mortality Reproductive health Health equity Digital Health/AI Misinformation regulation Medical debt

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

Government targets: Consumer Financial Protection Bureau (CFPB), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of

Monitor implementation of healthcare quality, cost, and access and related health care reform efforts. Monitor implementation of health provisions in the American Rescue Plan Act, P.L. 117-2, and Inflation Reduction Act, P.L. 117-169. Enhance preventive health in health care, including related provisions in H.R. 766/S. 114, the Preventive Health Savings Act, to amend the Congressional Budget Act of 1974 with respect to the scoring of preventive health savings. Medicare reimbursement for telemedicine, including related provisions in: H.R. 7623, the Telehealth Modernization Act of 2024 - Sec. 101, Extension of Certain Telehealth Flexibilities; and H.R. 8261, the Preserving Telehealth, Hospital, and Ambulance Access Act - Sec. 2, Extending Medicare Telehealth Flexibilities.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues surrounding the Medicare Shared Savings Program (MSSP) Funding for Fiscal Year 2024 for Title VIII Nursing Workforce Development Programs Funding for Fiscal Year 2024 for the National Institute of Nursing Research Funding for Fiscal Year 2025 for Title VIII Nursing Workforce Development Programs Funding for Fiscal Year 2025 for the National Institute of Nursing Research Funding relating to the mental and substance use disorder workforce Increased funding for Agency for Healthcare Research and Quality (AHRQ) S. 114 - the Preventive Health Savings Act H.R.766 - Dr. Michael C. Burgess Preventive Health Savings Act H.R. 9029/S. 4942 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025

Client expense: $360,000 · Firm income: Not reported

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

Federal Affairs lobbies for Appropriations for health centers and related primary care workforce programs. This includes the House Appropriations Committee's Fiscal Year 2025 Department of Labor, Health and Human Services, and Education, and related agencies appropriations bills, the Lower Costs More Transparency Act (H.R. 5378); the Bipartisan Primary Care and Health Workforce Act (S.2840); the Preventative Health Savings Act (H.R. 766) (S. 114); the Health Care Workforce Innovation Act (H.R. 7307) and the Health Workforce Innovation Act (S. 4957)

Client expense: $152,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE

Federal Affairs lobbies for Appropriations for health centers and related primary care workforce programs. This includes the House Appropriations Committee's Fiscal Year 2025 Department of Labor, Health and Human Services, and Education, and related agencies appropriations bills, the Lower Costs More Transparency Act (H.R. 5378); the Bipartisan Primary Care and Health Workforce Act (S.2840); the Preventative Health Savings Act (H.R. 766) (S. 114); the Health Care Workforce Innovation Act (H.R. 7307) and the Health Workforce Innovation Act (S. 4957)

Client expense: $145,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE

H.R.766/S.114 Preventive Health Savings Act Pandemic preparedness, life science innovation and competitiveness, preemptive health and medicine, biomanufacturing, next generation vaccines and therapeutics, PAPHA reauthorization, AI policy and regulation, AMR research

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

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Expand Patient Access and Telehealth: Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported the Preserving Telehealth, Hospital, and Ambulance Access Act, which would extend these flexibilities for two years until the end of 2026. Also supported the Protecting Rural Telehealth Access Act, H.R. 3440, and the Telehealth Modernization Act of 2024, H.R. 7623, which facilitate access to care via telehealth permanently. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supports a similar bill, S. 5035, introduced by Sen. Boozman. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. We support aspects of legislation recently introduced by Senators Whitehouse and Cassidy, the Pay Primary Care Physicians (PCPs) Act, S. 4338, that would expand and accelerate the adoption of a hybrid per member per month (PMPM) payment model outside of the PFS. We believe this type of model can enhance innovation and improve the delivery of chronic care in primary care practices. ACP supported the Dr. Michael C. Burgess Preventive Health Savings Act, H.R. 766, to enable CBO to capture cost-savings associated with preventive health care legislation beyond existing 10-year window, for two additional 10-year periods. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, by Rep. Underwood to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. We support similar legislation introduced by Sen. Shaheen in the Senate. FY2025 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2025 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vi, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include report language in the FY2025 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usage. While the House and Senate bills included language, we prefer the stronger House version language. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. We support the Senate Title X spending for pregnancy and family planning over the Houses bill, which eliminates funding in its bill. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Support efforts of the bipartisan Senate Working Group to add 10,000 GME slots in legislation; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Social Determinants of Healthcare/DEI: Opposed the Educate Act, H.R. 7725/S. 4115, that will amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process in the reintroduced the Improving Seniors' Timely Access to Care Act, S.4532. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Data Privacy: Supported American Privacy Rights Act, H.R. 8818, nations first comprehensive federal consumer data privacy framework. Bill was considered by House Energy and Commerce and would expand data privacy protections to entities not currently subject to HIPAA privacy protections. ACP asked for provisions enabling consumers to opt-out of allowing companies to use algorithms based on their personal data, allow states to further protect their residents and fully inform subjects of the nature and risks of the research. Scope of Practice: Opposed the Equitable Community Access to Pharmacist Services Act, H.R. 1770/ S. 2477, which would expand Medicare coverage to permanently include select services provided by a pharmacist. Healthcare Worker Safety: Supported H.R. 6364, the Medicare Telehealth Privacy Act of 2023. This bill would ensure that HHS will not publicly post the addresses of participating telehealth practitioners to provide privacy protections for physicians so that they can effectively treat and care for patients via telehealth. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries.

Client expense: $243,888 · 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), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

Expand Patient Access and Telehealth: Urged Congress to pass H.R.2630/S. 652, the Safe Step Act, which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Supported H.R. 2829, the Chronic Care Management Improvement Act of 2023, that would remove the co-pay charged to patients who utilize chronic care management services. It would waive the beneficiary coinsurance to manage chronic care conditions and improve patients health. Supported the Protecting Rural Telehealth Access Act, H.R. 3440 and S. 1636. This bipartisan legislation would ensure rural and underserved community healthcare providers can permanently offer telehealth services, including audio-only telehealth appointments, that are set to expire in December 2024. The legislation would: 1) allow payment parity for audio-only health services for clinically appropriate appointments; 2) permanently waive the geographic restriction allowing patients to be treated from their homes; 3) permanently allow rural health clinics and Federally Qualified Health Centers to serve as distance sites for providing telehealth services; 4) lift the restrictions on store and forward technologies for telehealth; and 5) allow Critical Access Hospitals (CAHs) to directly bill for telehealth services. Supported the Preserving Telehealth, Hospital, and Ambulance Access Act, which would extend these flexibilities for two years until the end of 2026. Also supported the Protecting Rural Telehealth Access Act, H.R. 3440, and the Telehealth Modernization Act of 2024, H.R. 7623, which facilitate access to care via telehealth permanently. Supported CONNECT for Health Act of 2023, H.R. 4189 and S. 2016, to permanently remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. That legislation would: 1) help providers transition to the goals of the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) through using telehealth and remote patient monitoring (RPM) without most of the 42 U.S.C. Section 1834(m) telehealth restrictions; 2) allow telehealth and RPM to be used by qualifying participants in alternative payment models, without most of the 1834(m) restrictions; 3) permit the use of remote patient monitoring for certain patients with chronic conditions; 4) allow, as originating sites, telestroke evaluation and management sites, Native American health service facilities, and dialysis facilities for home dialysis patients in certain cases; and 5) permit further telehealth and RPM in community health centers and rural health clinics. Medicare Payments to Physicians (H.R. 2474): Urged Congress to pass H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments. Unlike other health care sectors, Medicare payment rates for physicians have not been updated based on the MEI. As a result, from 2001 to 2021, Medicare physician payments have decreased by 20 percent when adjusted for inflation. Supported H.R. 6545, the Physician Fee Schedule Update and Improvements Act before the House Energy and Commerce Committee. This bill includes an important provision that would allocate 3 percent to the 2024 Medicare conversion factor, which would represent a 1.75 percent increase to the approved level. H.R. 6545 also includes several provisions from H.R. 6371, the Provider Reimbursement Stability Act of 2023, that ACP supports. It would raise the budget neutrality threshold to $53 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years afterwards. Supported H.R. 6683, the Preserving Seniors Access to Physicians Act of 2023. That bill averts a 3.4 percent across-the-board cut to physician payment for 2024. ACP supports a similar bill, S. 5035, introduced by Sen. Boozman. ACP supported extending the work geographic practice costs index to improve the accuracy of geographic adjustment factors. Supported H.R. 6366 that would extend the work geographic practice costs index for another year to 1.00 for any locality where the index would be less than 1.00. We support aspects of legislation recently introduced by Senators Whitehouse and Cassidy, the Pay Primary Care Physicians (PCPs) Act, S. 4338, that would expand and accelerate the adoption of a hybrid per member per month (PMPM) payment model outside of the PFS. We believe this type of model can enhance innovation and improve the delivery of chronic care in primary care practices. ACP supported the Dr. Michael C. Burgess Preventive Health Savings Act, H.R. 766, to enable CBO to capture cost-savings associated with preventive health care legislation beyond existing 10-year window, for two additional 10-year periods. Support Value-Based Care: Urged support of the Value in Health Care Act of 2023. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that are scheduled to expire at the end of the year. It also gives the Centers for Medicare & Medicaid Services (CMS) authority to adjust APM qualifying thresholds so that the current one-size-fits-all approach does not serve as a disincentive to including rural, underserved, primary care or specialty practices in APMs. The bill removes revenue-based distinctions that disadvantage rural and safety net providers, which is critical to improving access to care and improving health equity. The bill also improves financial benchmarks so that APM participants are not penalized for their own success. To allow more clinicians to continue the transition to value, the bill establishes a voluntary track for accountable care organizations (ACOs) in the Medicare Shared Savings Program to take on higher levels of risk and provides technical assistance for clinicians new to APMs. Lastly, the bill seeks to provide parity between APMs and the Medicare Advantage (MA) program by studying ways to increase alignment that will ease burdens on physicians and ensure that both APMs and MA are attractive and sustainable options. ACP supports extending incentive payments for participation in eligible alternative payment models through 2026. This approach would help to maintain incentives that support physicians transition from a volume-based fee-for-service health care system to one that is based on the value and quality outcomes of health care delivered to the patient. Supported H.R. 6369 by Rep. Kim Schrier to extend incentive payments for participation in eligible alternative payment models. ACP supports H.R. 5395, the SURS Extension Act, which would extend the Quality Payment Program-Small Practice, Underserved, and Rural Support (QPP-SURS) program for fiscal years 2024-2029. This program was established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and has provided direct assistance to eligible clinicians required to participate in MIPS. ACP supports efforts to streamline the number of quality measures physicians must report on and enhance stakeholder engagement. Supported the Fewer Burdens for Better Care Act of 2023, which would emphasize multi-stakeholder input, with a 30-day comment period for stakeholders to comment on the removal of measures from the Medicare program. Pricing Transparency/Consolidation: Supported several provisions of H.R. 5378, Lower Costs, More Transparency Act, which are consistent with our policy and would improve access to and affordability of health care for patients. This bill brings together H.R. 4822, Health Care Price Transparency Act of 2023, H.R. 3561, Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023 and other related bills reported out of Ways and Means, Energy and Commerce and Education and Workforce Committees. Supported requiring disclosure of changes in hospital or health facility ownership to reveal when private equity firms acquire hospitals, larger physician practices or nursing homes, promote price transparency among hospitals, health plans and pharmacy benefit managers and promote site neutrality for Medicare and Medicare beneficiaries. We further supported the reauthorization and funding increases included for the Teaching Health Center Graduate Medical Education program, Community Health Center program and National Health Service Corps. Supported Section 4 of H.R. 2880, the Protecting Patients Against PBM Abuses Act, which aims to increase PBM data reporting to enhance transparency for Medicare Part D. Specifically, it would set out new requirements for PBMs to report data on rebates and administrative fees to HHS. It would also require that HHS deidentify the data and make it publicly available so that policy makers and the public will have a better understanding of how rebates and administrative fees impact the costs of drug plans. The Affordable Care Act (P.L. 111-148, P.L. 111-152): Urged legislation to extend permanently the premium tax subsidies afforded under the ACA. Supported H.R. 1692, the Health Care Affordability Act of 2023, by Rep. Underwood to permanently extend the premium tax credit subsidies under the ACA. The law provides consumers with subsidies (premium tax credits) that lower costs for households with incomes between 100 percent and 400 percent of the federal poverty level (FPL). It expands the Medicaid program to cover all adults with income below 138 percent of the FPL. Supportive of S. 8, Improving Health Insurance Affordability Act to expand the eligibility of taxpayers for the refundable tax credit for coverage under a qualified health plan and increase cost-sharing subsidies under the ACA. We support similar legislation introduced by Sen. Shaheen in the Senate. FY2025 Appropriations: Urged Congress to support funding for the Centers for Disease Control and Prevention's programs in the FY 2025 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for funding for the Health Resources Services Administration (HRSA); Title Vi, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA); National Health Service Corps (NHSC); Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention's (CDC) Office on Smoking and Health (OSH). Urged Congress to include report language in the FY2025 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usage. While the House and Senate bills included language, we prefer the stronger House version language. Women's Health: Urged HHS to support Title X funding and ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminate medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protect funding for and ensures consistent treatment of qualified service sites. Supported H.R. 459 and S. 323, the Secure Access for Essential Reproductive (SAFER) Health Act. This legislation would strengthen current health privacy laws to ensure that abortion-related health data cannot be shared without patient consent. It prohibits health care providers and insurance plans from disclosing in legal proceedings an individual's personal health information related to an abortion or pregnancy without the individual's valid authorization. The prohibition applies to federal, state, local, and tribal proceedings, including civil, criminal, administrative, and legislative proceedings. The bill provides limited exceptions such as if the information is necessary to investigate physical harm to the individual. We support the Senate Title X spending for pregnancy and family planning over the Houses bill, which eliminates funding in its bill. Primary Care and the Physician Workforce: Urged members of Congress to cosponsor and pass H.R. 2389, the Resident Physician Shortage Reduction Act of 2023, which increases the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years; Support efforts of the bipartisan Senate Working Group to add 10,000 GME slots in legislation; Cosponsor and pass S. 665, the Conrad State 30 and Physician Access Reauthorization Act, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement; Cosponsor and pass H.R. 1202/S. 704, the Resident Education Deferred Interest (REDI) Act, to make it possible for residents to defer interest on their loans; Support inclusion in FY2024 appropriations legislation funding for Title VII Primary Care and Training Enhancement (PCTE) at $71 million to support and expand the pipeline for individuals training in primary care. Supported H.R.4986/S. 2577, which would refinance the interest rate for all existing federal student loans to zero percent. Further, it would cap interest rates for future student loan borrowers, while considering their financial needs. Prescription Drug Reform: Reviewed proposals to implement guidance by HHS for implementation of Inflation Reduction Act's prescription drug negotiation provisions. Supported H.R. 4895, the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029. Supported H.R. 5385, the Medicare PBM Accountability Act. This legislation aims to lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans. It would require PBMs to submit annual reports to the Secretary of HHS on PBMs cost savings incurred from rebates, discounts, and price concessions. Supported H.R. 1352, the Increasing Access to Biosimilars Act of 2023. This legislation would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B. Supported H.R. 5386, the Cutting Copays Act. This legislation would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs. Supported H.R. 3009/S. 2362, the Drug Shortage Prevention Act of 2023, to require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. Social Determinants of Healthcare/DEI: Opposed the Educate Act, H.R. 7725/S. 4115, that will amend the Higher Education Act of 1965 to prohibit graduate medical schools from receiving Federal financial assistance if such schools adopt certain policies and requirements relating to diversity, equity, and inclusion. Firearm Safety: (S.117): Urged Congress to support the Handgun Permit to Purchase Act (S. 117), legislation that would authorize grants to states to support handgun purchaser licensing programs. To qualify for the grants, states must require gun purchasers to be at least the age of 2I and be subject to a criminal background check. Urged Congress to support the Bipartisan Background Checks Act, H.R. 715, and the Background Check Expansion Act, S. 494 and Ethans Law, H.R. 660 and S. 173, requiring gun owners to safely and securely store their firearms. Supported the Keep Americans Safe Act, H.R. 625 and S. 298, which would ban the importation, sale, manufacture, transfer, or possession of high-capacity gun magazines that hold more than fifteen rounds. Supported the Extreme Risk Protection Order Expansion Act, H.R. 768 and S. 247 empowering family members and law enforcement to prevent gun violence by petitioning a court to temporarily separate an at-risk individual from firearms. Supported the FY2024 funding gun violence prevention research contained in FY24 Senate Labor-HHS-Ed appropriations bill for inclusion in any final FY24 appropriations bills. Administrative Burden: Urged Congress to codify many of these proposed improvements to the prior authorization process in the reintroduced the Improving Seniors' Timely Access to Care Act, S.4532. This legislation was passed by the House in the last Congress and would reduce burdens associated with prior authorization in Medicare Advantage (MA) by: l) protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans; 2) requiring all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval; and 3) standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans. Urged members of Congress to cosponsor and pass H.R.2630/S. 652, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Data Privacy: Supported American Privacy Rights Act, H.R. 8818, nations first comprehensive federal consumer data privacy framework. Bill was considered by House Energy and Commerce and would expand data privacy protections to entities not currently subject to HIPAA privacy protections. ACP asked for provisions enabling consumers to opt-out of allowing companies to use algorithms based on their personal data, allow states to further protect their residents and fully inform subjects of the nature and risks of the research. Scope of Practice: Opposed the Equitable Community Access to Pharmacist Services Act, H.R. 1770/ S. 2477, which would expand Medicare coverage to permanently include select services provided by a pharmacist. Healthcare Worker Safety: Supported H.R. 6364, the Medicare Telehealth Privacy Act of 2023. This bill would ensure that HHS will not publicly post the addresses of participating telehealth practitioners to provide privacy protections for physicians so that they can effectively treat and care for patients via telehealth. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries.

Client expense: $124,919 · 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), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

No Bill No. - Congressional Primary Care Caucus NO Bill No. - Teaching Health Centers GME; Community Health Centers, National Health Service Corps No Bill No. - COVID-19 Vaccines No Bill No. - PAHPA Reauthorization NO Bill No. - Medicare Physician Payment Reform No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Physician Workforce No Bill No. - Prior authorization/reducing administrative burden NO Bill No. - Health care affordability, including Medicare physician payments and site neutral payments, anti-competitive contracting, and the No Surprises Act No Bill No. - Black Maternal Health Momnibus Act No Bill No. - DATA in Public Health Act No Bill No. - Complete Care Act No Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Tobacco Users Quit Act(S.704/H.R. 1202) REDI Act No Bill No. - FY2024 NDAA No Bill No. - Vaccine commercialization No Bill No. - VA Standards of Practice No Bill No. - MATE Improvement Act No Bill No. - SPEAK Act of 2023 No Bill No. - Access to Donor Milk Act NO Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Primary and Virtual Care Affordability Act No Bill No. - Advancing Menopause Care and Mid-Life Women's Health Act No Bill No. - Change Cyberattack No Bill No. - Inpatient prospective Payment Rule No Bill No. - Healthcare Cybersecurity Act No Bill No. - Protecting Communities Through Immunizations Act No Bill No. - Mental Health and MAMA Act No Bill No. - SEEK HELP Act No Bill No. - Access to Workers' Compensation for Injured Federal Workers Act No Bill No. - Protecting Patients from Deceptive Drugs Ad Online Act No Bill No. - Innovation in Pediatric Drugs Act of 2023 (S. 230/H.R. 834) Rural Physician Workforce Production Act (S. 862) Restoring America's Health Care Workforce and Readiness Act (H.R. 498) 988 Lifeline Cybersecurity Responsibility Act (H.R. 1114) Long-COVID Recovery Now Act (S. 114/H.R. 766) Preventive Health Savings Act (S. 923) Better Mental Health for Americans (H.R. 286) Healthcare Providers' Safety Act (H.R. 2569) DOC Act (H.R. 1770) Equitable Community Access to Pharmacist Services Act (H.R. 2630/S.652) Safe Step Act (H.R. 3800) Chronic Disease Flexible Coverage Act (H.R. 3029) Primary Care Enhancement Act (H.R. 5378) Lower Cost More Transparency Act (H.R. 2584) Safety from Violence for Healthcare Employees Act (H.R. 4392/S.2188) PrEP Access and Coverage Act (H.R. 6067) Early Childhood Nutrition Improvement Act (S. 3295/H.R. 5569) Child Care Nutrition Enhancement Act (H.R. 1117) Advancing Safe Medications for Moms and Babies Act (H.R. 5909) Care for Grieving Families Act (H.R. 1616/S.807) Comprehensive Access to Resources and Education (CARE) for Long COVID Act (H.R. 3258) Targeting Resources for Equitable Access to Treatment (TREAT) Long COVID Act (S. 2560) Long COVID Support Act (H.R. 6038/S.3108) Teen E-Cigarette and Tobacco Addition (PROTECT) Act (H.R. 6103/S.3137) Support Through Loss Act (S. 3070) Youth Prevention and Recovery Reauthorization Act (H.R. 7381) - Healthcare Enhancement and Learning Through Harnessing Artificial Intelligence Act (S. Res. 597) - A Resolution Creating a Health Workforce Well-Being Day of Awareness (S. 3740) STRONGER Act (H.R. 6965) - EPIPEN Act (S.3779) - Child Suicide Prevention and Lethal Means Safety Act (S. 3679/H.R. 7153) - Lorna Breen Reauthorization Act (H.R. 3752) Parity Enforcement Act (S. 8) - Improving Health Insurance Affordability Act (H.R. 1692) - Health care Affordability Act (H.R. 5010) - Recognizing Gun Violence as a Public Health Emergency Act (H.R. 7891) - Kids Online Safety Act (H.R. 8383) - Rural Obstetrics Readiness Act (H.R. 7153/S.3679) - Dr. Lorna Breen Health Care Provider Protection Act (S. 4429) - Reducing Drug Prices for Seniors Act (H.R. 7681) - Primary and Virtual Care Affordability Act (H.R. 7808) - EARLY Minds Act (H.R. 7855) - Rural Residency Planning and Development Act of 2024 (H.R. 6664) - Innovation in Pediatric Drugs Act (H.R. 6412) - Healthcare Cybersecurity Act (H.R. 3800) - Chronic Disease Flexible Coverage Act (H.R. 618/S. 131) - Improving Access to Workers Compensation for Injured Federal Workers Act

Client expense: $928,743 · Firm income: Not reported

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

H.R. 766/S. 114, Preventive Health Savings Act H.R. 2888/S. 44, ONSHORE Manufacturing Act H.R. 2940/S. 1355, Pioneering Antimicrobial Subscriptions to End Upsurging Resistance Act H.R. 4307/S. 2115, Medical Supply Chain Resiliency Act H.R. 6033, Supporting Patient Education and Knowledge Act S. 2333, Pandemic and All-Hazards Preparedness and Response Act 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 (RIN 0955-AA06)Office of the National Coordinator for Health Information Technology -Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) Proposed Rule FDA-2017-D-0154 Food and Drug Administration- Considerations in Demonstrating Interchangeability with a Reference Product: Update CISA-2022-0010, Department of Homeland Security, Cybersecurity and Infrastructure Security Agency - Cyber Incident Reporting for Critical Infrastructure Act (CIRCIA) Reporting Requirements

Client expense: $110,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), SENATE

340B Program; H.R.2534 Protect 340B Act; 340B Transparency and Oversight H.R.3290/S.1133; The PATIENT Act H.R.3561; Resident Physician Shortage Reduction Act H.R.2389; Preventive Health Savings Act S.114/H.R.766; Safety from Violence for Healthcare Employees "SAVE" Act H.R.2584; H.R.5378 Lower Costs, More Transparency Act; Stop Drug Shortages Act; H.R.5378 Lower Costs, More Transparency Act; Senate 340B RFI - responded; 340B Access Act;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

No Bill No. - Congressional Primary Care Caucus NO Bill No. - Teaching Health Centers GME; Community Health Centers, National Health Service Corps No Bill No. - COVID-19 Vaccines No Bill No. - PAHPA Reauthorization NO Bill No. - Medicare Physician Payment Reform No Bill No. - Black Maternal Health Momnibus Act No Bill No. - Physician Workforce No Bill No. - Prior authorization/reducing administrative burden NO Bill No. - Health care affordability, including Medicare physician payments and site neutral payments, anti-competitive contracting, and the No Surprises Act No Bill No. - Black Maternal Health Momnibus Act No Bill No. - DATA in Public Health Act No Bill No. - Complete Care Act No Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Tobacco Users Quit Act(S.704/H.R. 1202) REDI Act No Bill No. - FY2024 NDAA No Bill No. - Vaccine commercialization No Bill No. - VA Standards of Practice No Bill No. - MATE Improvement Act No Bill No. - SPEAK Act of 2023 No Bill No. - Access to Donor Milk Act NO Bill No. - Health Communication Access and Resources for Everyone Act No Bill No. - Primary and Virtual Care Affordability Act No Bill No. - Advancing Menopause Care and Mid-Life Women's Health Act No Bill No. - Change Cyberattack No Bill No. - Inpatient prospective Payment Rule No Bill No. - Healthcare Cybersecurity Act No Bill No. - Protecting Communities Through Immunizations Act No Bill No. - Mental Health and MAMA Act No Bill No. - SEEK HELP Act No Bill No. - Access to Workers' Compensation for Injured Federal Workers Act (S. 230/H.R. 834) Rural Physician Workforce Production Act (S. 862) Restoring America's Health Care Workforce and Readiness Act (H.R. 498) 988 Lifeline Cybersecurity Responsibility Act (H.R. 1114) Long-COVID Recovery Now Act (S. 114/H.R. 766) Preventive Health Savings Act (S. 923) Better Mental Health for Americans (H.R. 286) Healthcare Providers' Safety Act (H.R. 2569) DOC Act (H.R. 1770) Equitable Community Access to Pharmacist Services Act (H.R. 2630/S.652) Safe Step Act (H.R. 3800) Chronic Disease Flexible Coverage Act (H.R. 3029) Primary Care Enhancement Act (H.R. 5378) Lower Cost More Transparency Act (H.R. 2584) Safety from Violence for Healthcare Employees Act (H.R. 4392/S.2188) PrEP Access and Coverage Act (H.R. 6067) Early Childhood Nutrition Improvement Act (S. 3295/H.R. 5569) Child Care Nutrition Enhancement Act (H.R. 1117) Advancing Safe Medications for Moms and Babies Act (H.R. 5909) Care for Grieving Families Act (H.R. 1616/S.807) Comprehensive Access to Resources and Education (CARE) for Long COVID Act (H.R. 3258) Targeting Resources for Equitable Access to Treatment (TREAT) Long COVID Act (S. 2560) Long COVID Support Act (H.R. 6038/S.3108) Teen E-Cigarette and Tobacco Addition (PROTECT) Act (H.R. 6103/S.3137) Support Through Loss Act (S. 3070) Youth Prevention and Recovery Reauthorization Act (H.R. 7381) - Healthcare Enhancement and Learning Through Harnessing Artificial Intelligence Act (S. Res. 597) - A Resolution Creating a Health Workforce Well-Being Day of Awareness (S. 3740) STRONGER Act (H.R. 6965) - EPIPEN Act (S.3779) - Child Suicide Prevention and Lethal Means Safety Act (S. 3679/H.R. 7153) - Lorna Breen Reauthorization Act (H.R. 3752) Parity Enforcement Act (S. 8) - Improving Health Insurance Affordability Act (H.R. 1692) - Health care Affordability Act (H.R. 5010) - Recognizing Gun Violence as a Public Health Emergency Act (H.R. 7891) - Kids Online Safety Act (H.R. 8383) - Rural Obstetrics Readiness Act (H.R. 7153/S.3679) - Dr. Lorna Breen Health Care Provider Protection Act (S. 4429) - Reducing Drug Prices for Seniors Act (H.R. 7681) - Primary and Virtual Care Affordability Act (H.R. 7808) - EARLY Minds Act (H.R. 7855) - Rural Residency Planning and Development Act of 2024 (H.R. 6664) - Innovation in Pediatric Drugs Act

Client expense: $1,045,426 · Firm income: Not reported

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

Physician payment issues (MEI, E/M Budget Neutrality, APMs, MIPS) Prior authorization in Medicare Advantage; HR 1770/S. 2477 Equitable Community Access to Pharmacist Services Act HR 766/S 144 Preventive Health Savings Act HR 618/ S 131 Improving Access to Workers' Compensation for Injured Federal Workers Act of 2023. S.1512 - CONNECT for Health Act of 2021 Monitoring PBM legislation - S. 1967 and S. 1038 H.R. 4822, Health Care Price Transparency Act of 2023; H.R. 2474, Strengthening Medicare for Patients and Providers Act; H.R. 3561, PATIENT Act of 2023;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Diabetes Prevention Program Expanding Access to DSMT (H.R. 3842/S. 1832) Federal Employee Benefits for Medical Nutrition Therapy Medical Nutrition Therapy Act (H.R. 6407/S. 3297) Medicare/Medicaid -- Access to MNT; IBT National Coverage Determination Reconsideration Medicaid -- Maternal Mortality and Access to Care Medically Tailored Meals/Food as Medicine - Coverage for OAA programs and Service Medically Tailored Home-Delivered Meals Demonstration Pilot Act (H.R.6780/S. 2133) Nutrition Care Act (H.R. 6961) Preventive Health Savings Act (H.R 766/S.114) Senior Nutrition (S. 2360, S. 2361, S. 1036) Strengthening Medicare for Patients and Providers Act (H.R. 2474) Telehealth Treat and Reduce Obesity Act (H.R. 4818/S.2407)

Client expense: $15,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Personnel Management (OPM), SENATE

Legislation and policies relating to: Adoption of recommendations of the National Academy of Medicine report, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention H.R. 766/S 114, Dr. Michael C. Burgess Preventive Health Savings Act H.R. 1147/S. 1957, Whole Milk for Healthy Kids Act of 2023 H.R. 1843/S.1001, Telehealth Expansion Act of 2023 H.R. 1692, Health Care Affordability Act of 2023 H.R. 2411/S. 1150, National Nursing Workforce Centers Act of 2023 H.R. 2663/S. 1176, Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 2713/S. 2418, Improving Care and Access to Nurses (I CAN) Act H.R. 3073/S. 1452, Community Mental Wellness and Resilience Act of 2023 H.R 3226/S. 1573, PREEMIE Reauthorization Act of 2023 H.R. 3305/S. 1606, Black Maternal Health Momnibus Act H.R. 3331/S. 754, Improving Mental Health and Wellness in Schools Act H.R. 3633, Promoting Resources to Expand Vaccination, Education, and New Treatments for HPV Cancers (PREVENT HPV Cancers) Act of 2023 H.R. 4310/S. 2233, Youth Poisoning Protection Act H.R. 4581/S. 2231, Maternal and Child Health Stillbirth Prevention Act of 2023 H.R. 4758/S. 2372, Accelerating Kids Access to Care Act H.R. 4775, Helping Tobacco Users Quit Act H.R. 4892/S. 3921, Medicaid Bump Act H.R. 5012/S. 2647, Stillbirth Health Improvement and Education (SHINE) for Autumn Act of 2023 H.R. 5378, Lower Costs, More Transparency Act H.R. 6122/S. 2853, Train More Nurses Act H.R. 6149/S. 1291, Protecting Kids on Social Media Act H.R. 6766/S. 3512, Transparency, Readability, Understandability, Truth, and Helpfulness (TRUTH) in Labeling Act H.R. 6960/S. 3765, Emergency Medical Services for Children Reauthorization Act of 2024 H.R. 7002/S. 2815, Nurse Faculty Shortage Reduction Act of 2024 H.R. 7153/S. 3679, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 7224, To reauthorize the Stop, Observe, Ask, and Respond to Health and Wellness Training Program. H.R. 7808, Early Action and Responsiveness Lifts Youth (EARLY) Minds Act H.R. 8467, Farm, Food, and National Security Act of 2024 H.R. 8818, American Privacy Rights Act S. 8, Improving Health Insurance Affordability Act of 2023 S. 397, Promoting Physical Activity for Americans Act S.644/H.R. 1359, Modernizing Opioid Treatment Access Act S. 1409/H.R. 7891, Kids Online Safety Act S. 1418/H.R. 7890, Children and Teens Online Privacy Protection Act S. 1840/H.R. 3916, Screening for Communities to Receive Early and Equitable Needed Services (SCREENS) for Cancer Act of 2023 S. 1884/H.R. 3713, Mental Health Services for Students Act of 2023 S. 2840, Bipartisan Primary Care and Health Workforce Act S. 3085, Preventing Adverse Childhood Experiences (PACE) Act S. 3393/H.R. 4531, SUPPORT for Patients and Communities Reauthorization Act S. 3770/H.R. 7266, Future Advancement of Academic Nursing (FAAN) Act S. 4041, Creating Access and Resources in Education (CARE) for Student Mental Health Act S. 4532/H.R. 8702, Improving Seniors Timely Access to Care 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

Telehealth: H.R. 4189 / S.2016, the CONNECT for Health Act, would remove all geographic restrictions on telehealth services and expand originating sites to include the home and other sites. Access to AEDS: H.R. 2370 / S. 1024, the Access to AEDs Act, would require the Department of Health and Human Services to award grants to promote student access to defibrillation in elementary and secondary schools. Preventative Health: H.R. 766 / S. 114, the Preventative Health Savings Act, would require the Congressional Budget Office, upon receipt of a request from congress, to determine if proposed legislation would reduce spending outside of the 10-year budget window through the use of preventative health services. Workplace Safety: H.R. 1202 / S. 2768, The Secure and Violence-Free Environments (SAVE) Act, would make it new a criminal offense for knowingly assaulting or intimidating hospital personnel during the performance of their official duties.

Client expense: $179,303 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 198: Drug Pricing Transparency and Accountability Act - Provisions related to the 340B Program H.R. 456: Fairness in Orphan Drug Exclusivity Act H.R. 766: Dr. Michael C. Burgess Preventive Health Savings Act H.R. 830: HELP Copays Act - To amend title XXVII of the Public Health Service Act to apply additional payments, discounts, and other financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes H.R. 885: TRACK Act of 2023 H.R. 1613: Drug Price Transparency in Medicaid Act of 2023 H.R. 1770: Equitable Community Access to Pharmacist Services Act H.R. 1790: Biologics Competition Act of 2023 - To direct the Secretary of Health and Human Services to evaluate the extent to which the substitution of interchangeable biological products is impacted by differences between the system for determining a biological product to be interchangeable and the system for assigning therapeutic equivalence ratings to drugs, and for other purposes H.R. 2534: PROTECT 340B Act of 2023 - Provisions related to the 340B program Bayh-Done march in rights policy issues H.R. 2679: Pharmacy Benefits Manager Accountability Act H.R. 2707: MADE in America Act H.R. 2816: Pharmacy Benefit Manager Sunshine and Accountability Act H.R. 2880: Protecting Patients Against PBM Abuses Act H.R. 3008: Drug Shortage Prevention Act of 2023 H.R. 3093: Affordable Pricing for Taxpayer-Funded Prescription Drugs Act of 2023 H.R. 3290: To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program H.R. 3433: Give Kids a Chance Act of 2023 H.R. 3561: Promoting Access to Treatments and Increasing Extremely Needed Transparency Act of 2023 or PATIENT Act of 2023 H.R. 3839: To amend the Federal Food, Drug, and Cosmetic Act to increase transparency in generic drug applications H.R. 4421: Preparing for All Hazards and Pathogens Reauthorization Act H.R. 4895: Lowering Drug Costs for American Families Act - Provisions related to drug pricing H.R. 4988: Modern Authentication of Pharmaceuticals Act of 2023 H.R. 5376: Share the Savings with Seniors Act  H.R. 5378: Lower Costs, More Transparency Act H.R. 5391: Protecting Patient Access to Cancer and Complex Therapies Act H.R. 5539: ORPHAN Cures Act H.R. 5547: Maintaining Investments in New Innovation Act H.R. 6283: Delinking Revenue from Unfair Gouging or DRUG Act H.R. 6664: Innovation in Pediatric Drugs Act of 2023 H.R. 7024: Tax Relief for American Families and Workers Act of 2024 H.R. 7174: Ensuring Pathways to Innovative Cures (EPIC) Act: To amend title XI of the Social Security Act to equalize the negotiation period between small-molecule and biologic candidates under the Drug Price Negotiation Program H.R. 7248: FDA Modernization Act 3.0 H.R. 7623: Telehealth Modernization Act of 2024 H.R. 7635: The 340B PATIENTS Act of 2024 H.R. 8574: 340B Affording Care for Communities and Ensuring a Strong Safety-net (ACCESS) Act H.R. 8333 BIOSECURE Act H.R.8818 American Privacy Rights Act of 2024; Provisions related to pharmaceutical industry S. 113: Prescription Pricing for the People Act of 2023 - Provisions related to PBMs S. 127: Pharmacy Benefit Manager Transparency Act of 2023 - Provisions related to PBMs S. 148: Stop STALLING Act - Provisions related to citizen petitions S. 775: Increasing Transparency in Generic Drug Applications Act S. 935: Fair Accountability and Innovative Research Drug Pricing Act of 2023 - Provisions related to drug pricing S. 1067: Ensuring Timely Access to Generics Act of 2023 S. 1130: Health Care PRICE Transparency Act S. 1128: Ensuring Access to Generic Medications Act S. 1214: RARE Act - To set forth limitations on exclusive approval or licensure of drugs designated for rare diseases or conditions S. 1264: SMART Prices Act - Provisions related to drug pricing reform S. 1339: Pharmacy Benefit Manager Reform Act - Provisions related to PBMs; Transparency provisions, Medicare Part D Delinking; Commerical Marketplace Delinking S. 1355: PASTEUR Act of 2023 - Provisions related to antimicrobial resistance policy issues S. 1375: HELP Copays Act - To amend title XXVII of the Public Health Service Act to apply additional payments, discounts, and other financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes S. 1476: Pharmaceutical Research Transparency Act of 2023 S. 1542: Delinking Revenue from Unfair Gouging Act or DRUG Act - Provisions related to PBMs S. 1589: Safeguarding Patients and Taxpayers Act S. 1906: Promising Pathway Act - Approval pathway policy issues S. 1967: PBM Act S. 2305: Biosimilar Red Tape Elimination Act S. 2333: Pandemic and All-Hazards Preparedness and Response Act S. 2474: Share the Savings with Seniors Act S. 2897: Give Kids a Chance Act of 2023 S. 2973: Modernizing and Ensuring PBM Accountability Act (MEPA) S. 3393: SUPPORT for Patients and Communities Reauthorization Act BioCompete Act (draft) Executive Order of February 28, 2024, Preventing Access to Americans' Bulk Sensitive Personal Data and United States Government-Related Data by Countries of Concern Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future (SUSTAIN) 340B Act (draft) User fee policy issues Inflation Reduction Act of 2022 (P.L. 117-169) Vaccine provisions of the inflation reduction Act Pharmacy Benefit Manager reform and policy issues Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA) Cancer Moonshot Initiative 21st Century Cures 2.0 Drug cost and pricing policy issues Principles for drug pricing reform Drug importation policy issues Accelerated approval policy issues FDA regulatory approval authority policy issues Competition policy issues Orphan Drug Act policy issues Antimicrobial resistance (AMR) policy issues Supply chain policy issues Mental health policy issues Real world evidence policy issues Clinical trial diversity policy issues 340B drug discount program policy issues Patient assistance program policy issues Biosimilar approval and reimbursement policy issues Drug shortages policy issues  Pandemic preparedness policy issues Cybersecurity policy issues Artificial intelligence policy issues

Client expense: $1,510,000 · Firm income: Not reported

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