Rural Residency Planning and Development Act of 2024

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

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

Issues relating to long-term reform of the Medicare Physician payment system. Support for expansion of funding for Graduate Medical Education. Issues relating to physician practice consolidation and access to care. H.R. 2389, the Resident Physician Shortage Reduction Act. H.R. 2474, the Strengthening Medicare for Patients and Providers Act. H.R. 3674, the Providing Relief and Stability for Medicare Patients Act. H.R. 4261, the Amputation Reduction and Compassion (ARC) Act. Issues relating to site-neutral payments in the Medicare system. Issues relating to rural access to health care and health disparities. Support for easing administrative burdens on physicians. Support for H.R. 6683, the "Preserving Seniors Access to Physicians Act." Medical training concerns relating to H.R. 7725, the Embracing Anti-Discrimination, Unbiased Curriculum, and Advancing Truth in Education (EDUCATE) Act. Issues relating to MACRA reform; in general. Support for S. 4532/H.R. 8702, The Improving Seniors Timely Access to Care (Seniors) Act. Support for H.R. 7855, the Rural Residency Planning and Development Act of 2024. Issues relating to CMS-1807-P; Medicare and Medicaid Programs: Calendar Year 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies Support for the Provider Reimbursement Stability Act (H.R. 6371). Support for the Physician Stabilization Act (S. 4935). Support for H.R. 10073, the Medicare Patient Access and Practice Stabilization Act of 2024. Support for Medicare physician payment provisions slated for inclusion in year-end appropriations bill(s).

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

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

H.R. 1202/S.704, the Resident Education Deferred Interest Act or the REDI Act. H.R. 2389, the Resident Physician Shortage Reduction Act of 2023. Medical training concerns relating to H.R. 7725, the Embracing Anti-Discrimination, Unbiased Curriculum, and Advancing Truth in Education (EDUCATE) Act. Support for H.R. 7855, the Rural Residency Planning and Development Act of 2024.

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

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

S. 2333 - Pandemic and All-Hazards Preparedness and Response Act (PAHPA) H.R. 4420 - The Preparedness and Response Reauthorization Act H.R. 4421 - The Preparing for All Hazards and Pathogens Reauthorization Act H.R. 715/S. 494 - The Bipartisan Background Checks Act/Background Check Expansion Act S. 1140/H.R. 1781 - Ensuring Access to General Surgery Act H.R. 2416 - MISSION Zero Reauthorization S. 220/H.R. 731 - Workforce Mobility Act (Non-compete Legislation) S. 705/H.R. 2761 - The Specialty Physicians Advancing Rural Care (SPARC) Act S. 704/H.R. 1202 - The Resident Education Deferred Interest (REDI) Act S. 1653 - Prevent BLEEDing Act S. 2644 - Law Enforcement Sustaining Aid and Vital Emergency Resources (SAVER) Act H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 5213 - Reducing Medically Unnecessary Delays in Care H.R. 6487/S. 3805 - No Fees for EFTS H.R. 6960/S. 3765 - Emergency Medical Services for Children Act Reauthorization S. 3679/H.R.7153 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. RES. 567 - Resolution for Health Workforce Well-Being Day of Awareness S. 1447 - The Bipartisan Solution to Cyclical Violence Act H.R. 2819 - Good Samaritan Health Professionals Act H.R. 4366 - Consolidated Appropriations Act, 2024 S. 1894/H.R. 3382 - Colorectal Cancer Payment Fairness Act H.R. 3086 - Find it Early Act H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act H.R. 7855 - Rural Residency Planning and Development Act S. 2768/H.R. 2584 - Safety from Violence for Healthcare Employees (SAVE) Act H.R.9001 - Physician Led and Rural Access to Quality Care Act S. 4847 - Advancing Medical Readiness Act of 2024 H.R. 10073 - Medicare Patient Access and Practice Stabilization Act Scope of Practice Expansion Episodes of Care/Transforming Episode Accountability Model (TEAM) Physician-Focused Payment Model Technical Advisory Committee (PTAC) reform Telehealth issues MACRA reforms through MIPS e-prescribing Medicare Physician Fee Schedule CMS Quality Payment Program (QPP) Proposed Rule Safe opioid disposal policy Bilateral Exchange Visa Issues/Visas for physician educational and cultural exchange (Conrad-30 Waiver Program) Medicare Price Transparency Labor HHS Appropriations Medicare Physician Payment Cuts AI Taskforce Neglected Surgical Conditions Age Friendly Hospital Measure in IQR program Stop the Bleed program Cancer Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda National Trauma and Emergency Preparedness System (NTEPs) Administrative Burden/Prior Authorization Legislation Physician Burnout and Wellbeing Organ Transplant National Cancer Database (NCDB) updates Merit-based Incentive Payment System (MIPS) and MIPS Value Pathways (MVPs) Health Equity Firearm injury prevention research Global Code data collection Surgeon compensation studies Council on Graduate Medical Education (COGME) rural surgery studies Surgical Hospital Measures

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

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

S. 2333 - Pandemic and All-Hazards Preparedness and Response Act (PAHPA) H.R. 4420 - The Preparedness and Response Reauthorization Act H.R. 4421 - The Preparing for All Hazards and Pathogens Reauthorization Act H.R. 715/S. 494 - The Bipartisan Background Checks Act/Background Check Expansion Act S. 1140/H.R. 1781 - Ensuring Access to General Surgery Act H.R. 2416 - MISSION Zero Reauthorization S. 220/H.R. 731 - Workforce Mobility Act (Non-compete Legislation) S. 705/H.R. 2761 - The Specialty Physicians Advancing Rural Care (SPARC) Act S. 704/H.R. 1202 - The Resident Education Deferred Interest (REDI) Act S. 1653 - Prevent BLEEDing Act S. 2644 - Law Enforcement Sustaining Aid and Vital Emergency Resources (SAVER) Act H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 5213 - Reducing Medically Unnecessary Delays in Care H.R. 6487/S. 3805 - No Fees for EFTS H.R. 6960/S. 3765 - Emergency Medical Services for Children Act Reauthorization S. 3679/H.R.7153 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. RES. 567 - Resolution for Health Workforce Well-Being Day of Awareness S. 1447 - The Bipartisan Solution to Cyclical Violence Act H.R. 2819 - Good Samaritan Health Professionals Act H.R. 4366 - Consolidated Appropriations Act, 2024 S. 1894/H.R. 3382 - Colorectal Cancer Payment Fairness Act H.R. 3086 - Find it Early Act H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act H.R. 7855 - Rural Residency Planning and Development Act S. 2768/H.R. 2584 - Safety from Violence for Healthcare Employees (SAVE) Act H.R.9001 - Physician Led and Rural Access to Quality Care Act S. 4847 - Advancing Medical Readiness Act of 2024 H.R. 10073 - Medicare Patient Access and Practice Stabilization Act Scope of Practice Expansion Episodes of Care/Transforming Episode Accountability Model (TEAM) Physician-Focused Payment Model Technical Advisory Committee (PTAC) reform Telehealth issues MACRA reforms through MIPS e-prescribing Medicare Physician Fee Schedule CMS Quality Payment Program (QPP) Proposed Rule Safe opioid disposal policy Bilateral Exchange Visa Issues/Visas for physician educational and cultural exchange (Conrad-30 Waiver Program) Medicare Price Transparency Labor HHS Appropriations Medicare Physician Payment Cuts AI Taskforce Neglected Surgical Conditions Age Friendly Hospital Measure in IQR program Stop the Bleed program Cancer Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda National Trauma and Emergency Preparedness System (NTEPs) Administrative Burden/Prior Authorization Legislation Physician Burnout and Wellbeing Organ Transplant National Cancer Database (NCDB) updates Merit-based Incentive Payment System (MIPS) and MIPS Value Pathways (MVPs) Health Equity Firearm injury prevention research Global Code data collection Surgeon compensation studies Council on Graduate Medical Education (COGME) rural surgery studies Surgical Hospital Measures

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

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

S. 2333 - Pandemic and All-Hazards Preparedness and Response Act (PAHPA) H.R. 4420 - The Preparedness and Response Reauthorization Act H.R. 4421 - The Preparing for All Hazards and Pathogens Reauthorization Act H.R. 715/S. 494 - The Bipartisan Background Checks Act/Background Check Expansion Act S. 1140/H.R. 1781 - Ensuring Access to General Surgery Act H.R. 2416 - MISSION Zero Reauthorization S. 220/H.R. 731 - Workforce Mobility Act (Non-compete Legislation) S. 705/H.R. 2761 - The Specialty Physicians Advancing Rural Care (SPARC) Act S. 704/H.R. 1202 - The Resident Education Deferred Interest (REDI) Act S. 1653 - Prevent BLEEDing Act S. 2644 - Law Enforcement Sustaining Aid and Vital Emergency Resources (SAVER) Act H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 5213 - Reducing Medically Unnecessary Delays in Care H.R. 6487/S. 3805 - No Fees for EFTS H.R. 6960/S. 3765 - Emergency Medical Services for Children Act Reauthorization S. 3679/H.R.7153 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. RES. 567 - Resolution for Health Workforce Well-Being Day of Awareness S. 1447 - The Bipartisan Solution to Cyclical Violence Act H.R. 2819 - Good Samaritan Health Professionals Act H.R. 4366 - Consolidated Appropriations Act, 2024 S. 1894/H.R. 3382 - Colorectal Cancer Payment Fairness Act H.R. 3086 - Find it Early Act H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act H.R. 7855 - Rural Residency Planning and Development Act S. 2768/H.R. 2584 - Safety from Violence for Healthcare Employees (SAVE) Act H.R.9001 - Physician Led and Rural Access to Quality Care Act S. 4847 - Advancing Medical Readiness Act of 2024 H.R. 10073 - Medicare Patient Access and Practice Stabilization Act Scope of Practice Expansion Episodes of Care/Transforming Episode Accountability Model (TEAM) Physician-Focused Payment Model Technical Advisory Committee (PTAC) reform Telehealth issues MACRA reforms through MIPS e-prescribing Medicare Physician Fee Schedule CMS Quality Payment Program (QPP) Proposed Rule Safe opioid disposal policy Bilateral Exchange Visa Issues/Visas for physician educational and cultural exchange (Conrad-30 Waiver Program) Medicare Price Transparency Labor HHS Appropriations Medicare Physician Payment Cuts AI Taskforce Neglected Surgical Conditions Age Friendly Hospital Measure in IQR program Stop the Bleed program Cancer Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda National Trauma and Emergency Preparedness System (NTEPs) Administrative Burden/Prior Authorization Legislation Physician Burnout and Wellbeing Organ Transplant National Cancer Database (NCDB) updates Merit-based Incentive Payment System (MIPS) and MIPS Value Pathways (MVPs) Health Equity Firearm injury prevention research Global Code data collection Surgeon compensation studies Council on Graduate Medical Education (COGME) rural surgery studies Surgical Hospital Measures

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

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

S. 2333 - Pandemic and All-Hazards Preparedness and Response Act (PAHPA) H.R. 4420 - The Preparedness and Response Reauthorization Act H.R. 4421 - The Preparing for All Hazards and Pathogens Reauthorization Act H.R. 715/S. 494 - The Bipartisan Background Checks Act/Background Check Expansion Act S. 1140/H.R. 1781 - Ensuring Access to General Surgery Act H.R. 2416 - MISSION Zero Reauthorization S. 220/H.R. 731 - Workforce Mobility Act (Non-compete Legislation) S. 705/H.R. 2761 - The Specialty Physicians Advancing Rural Care (SPARC) Act S. 704/H.R. 1202 - The Resident Education Deferred Interest (REDI) Act S. 1653 - Prevent BLEEDing Act S. 2644 - Law Enforcement Sustaining Aid and Vital Emergency Resources (SAVER) Act H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 5213 - Reducing Medically Unnecessary Delays in Care H.R. 6487/S. 3805 - No Fees for EFTS H.R. 6960/S. 3765 - Emergency Medical Services for Children Act Reauthorization S. 3679/H.R.7153 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. RES. 567 - Resolution for Health Workforce Well-Being Day of Awareness S. 1447 - The Bipartisan Solution to Cyclical Violence Act H.R. 2819 - Good Samaritan Health Professionals Act H.R. 4366 - Consolidated Appropriations Act, 2024 S. 1894/H.R. 3382 - Colorectal Cancer Payment Fairness Act H.R. 3086 - Find it Early Act H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act H.R. 7855 - Rural Residency Planning and Development Act S. 2768/H.R. 2584 - Safety from Violence for Healthcare Employees (SAVE) Act H.R.9001 - Physician Led and Rural Access to Quality Care Act S. 4847 - Advancing Medical Readiness Act of 2024 H.R. 10073 - Medicare Patient Access and Practice Stabilization Act Scope of Practice Expansion Episodes of Care/Transforming Episode Accountability Model (TEAM) Physician-Focused Payment Model Technical Advisory Committee (PTAC) reform Telehealth issues MACRA reforms through MIPS e-prescribing Medicare Physician Fee Schedule CMS Quality Payment Program (QPP) Proposed Rule Safe opioid disposal policy Bilateral Exchange Visa Issues/Visas for physician educational and cultural exchange (Conrad-30 Waiver Program) Medicare Price Transparency Labor HHS Appropriations Medicare Physician Payment Cuts AI Taskforce Neglected Surgical Conditions Age Friendly Hospital Measure in IQR program Stop the Bleed program Cancer Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda National Trauma and Emergency Preparedness System (NTEPs) Administrative Burden/Prior Authorization Legislation Physician Burnout and Wellbeing Organ Transplant National Cancer Database (NCDB) updates Merit-based Incentive Payment System (MIPS) and MIPS Value Pathways (MVPs) Health Equity Firearm injury prevention research Global Code data collection Surgeon compensation studies Council on Graduate Medical Education (COGME) rural surgery studies Surgical Hospital Measures

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

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

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

Client expense: $350,000 · Firm income: Not reported

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

Advocate for proposals to provide direct financial support to safety net hospitals with Congressional staff. Discuss opposition to Medicare site-neutral payment policies with Congressional staff. Educate Congressional staff on hospital price transparency federal rule (84 FR 65602). Oppose changes to NPIs for hospital outpatient departments (H.R. 7623, H.R. 4509, H.R. 7623 as amended, H.R. 4822). Meet with Congressional staff to discuss H.R. 5378, the Lower Costs, More Transparency Act of 2023, and comment on following proposals in bill: support for delay of Medicaid DSH cut, codification and expansion of Federal price transparency rule, oppose National Provider Identifier (NPI) requirements for hospital outpatient departments, oppose changes to 340B drug pricing program, support reauthorization of Community Health Centers, support reauthorization of National Health Service Corps, support reauthorization of Teaching Health Center Graduate Medical Education funding. Discuss hospital and health provisions in CAA, 2024 (H.R. 4366) with HHS staff and Congressional staff: support public health extenders and elimination of Medicaid DSH cut. Discuss support for the 340B Drug Pricing Program with Congressional staff and discuss certain changes: oppose 340B ACCESS Act (H.R. 7635), comment on SUSTAIN 340B Act discussion draft, support PATIENTS Act (H.R. 7635); oppose back-end rebate proposals. Discuss legislative proposals with Congressional staff to stabilize long-term care and post-acute care providers: establish a temporary per diem Medicare payment to ease capacity issues and address financial challenges from slow discharges (support); make permanent three-day hospital stay waiver (support) and other COVID-19 PHE regulatory flexibilities. Discuss Medicare Graduate Medical Education (GME) provisions in the Consolidated Appropriations Act (CAA), 2021 and CAA, 2023 with HHS staff. Discuss with Congressional staff support for Medicare GME expansion and changes to GME program: the Resident Physician Shortage Reduction Act, the Pathway to Practice Act of 2021, the Substance Use Disorder Workforce Act (H.R. 7050); additional GME slots in CAA, 2021 and CAA, 2023; Rural Residency Planning and Development Act (H.R. 7855); concerns on Rural Physician Workforce Preservation Act and opposition to modifications to ongoing slot distribution; Senate Finance Committee draft proposals to increase GME slots. Discuss with HHS staff and Congressional staff recommendations to address workforce shortages for nursing and ancillary health care workforce: faculty recruitment and retention, additional financial support for supervision and precepting students, Medicare payment for nursing and allied health, testing new workforce models, establishing incentives and early recruitment strategies, providing funding for clinical training site, and immigration reforms that expedite entry for foreign health care workers. Support passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S.2768). Support revisions to Conrad 30 waiver program to increase the number of foreign physicians that may remain in the US after completing GME: S.665/H.R.4942, S.2719/H.R.6980, H.R. 4875. Discuss expiring COVID-19 Public Health Emergency Medicare flexibilities with Congressional staff and HHS staff and support legislative proposals to extend PHE telehealth flexibilities and Acute Hospital Care at Home Waiver: H.R. 7623. Oppose legislative proposals to impose financial penalties on hospitals relating to minimum cybersecurity standards (S.5218). Discuss legislative proposals to regulate the use of artificial intelligence in health care delivery with Congressional staff. Discuss FEMA COVID-19 Public Assistance payouts with Congressional staff. Support Improving Seniors Timely Access to Care Act (S. 4532/H.R. 8702). Discuss legislative proposals on consumer medical debt with Congressional staff. Outreach to HHS Assistant Secretary for Preparedness and Response urging certain regulatory flexibilities to alleviate IV fluid shortages.

Client expense: $350,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

H.R.3046/S.1403 - Medical Student Education Authorization Act of 2023 Issue: Support grants for primary care training in medically under-resourced communities. Draft Social Determinants Accelerator Act Issue: Support grants to address social determinants of health. H.R.9161/S.4773 - Health Equity and Accountability Act of 2024 Issue: Support programs to improve health equity and address social determinants of health. S.2333 - Pandemic and All-Hazards Preparedness and Response Act H.R.4420 - Preparedness and Response Reauthorization Act H.R.4421 - Preparing for All Hazards and Pathogens Reauthorization Act H.R.4697 - Protecting PAHPA Act of 2023 Issues: Support the reauthorization of the Pandemic and All-Hazards Preparedness Act with increased funding authorization levels. Issue: Support authorities to strengthen CDCs and ASPRs ability to prevent and respond to existing and emerging threats. S.1995 - Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Educate Congress on how the 340B Drug Pricing Program helps safety-net providers to fulfill their missions and care for patients and communities. Support measures to preserve and strengthen the 340B Drug Pricing Program. Oppose efforts to reduce the scope of the program and transition 340B into a rebate model. H.R.2534 - Preserving Rules Ordered for the Entities Covered Through 340B Act of 2023 (PROTECT 340B Act) Issue: Support measures to prevent pharmacy benefit managers and commercial insurers from imposing discriminatory reimbursement policies on 340B covered entities. H.R.7635 - 340B Pharmaceutical Access to Invest in Essential, Needed Treatments and Support (340B PATIENTS) Act Issue: Support amending the 340B statute to codify covered entities ability to use contract pharmacies. H.R.3290 - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. Issue: Oppose efforts to impose additional reporting requirements on 340B hospitals. Draft Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future of 340B (SUSTAIN 340B) Act Issue: Support efforts to prohibit pharmaceutical and pharmacy benefit manager (PBM) discrimination against covered entities. Oppose efforts to define patient in the context of the program. Oppose efforts to impose additional administrative and reporting requirements on 340B hospitals. H.R.8574 - 340B ACCESS Act Issue: Oppose efforts to restrict hospital eligibility for the 340B program. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Support policies to improve maternal health outcomes through expanded Medicaid coverage, enhanced data collection, and improved access to behavioral health care during the perinatal period. P.L. 118-159 - Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 S.4638 National Defense Authorization Act for Fiscal Year 2025 Issue: Oppose prohibition on coverage for gender affirming care. H.R.2369 - Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2023 Issue: Educate Congress on development of laboratory developed tests (LDTs) at academic medical centers and oppose policies that would increase burdensome regulations and negatively impact patients access to care by allowing FDA regulation of the development of LDTs at academic medical centers. Issue: Educate Congress on the medical education and training continuum, the annual residency Match, and the role of the National Resident Matching Program (NRMP) in medical education and residency. Issue: Provide guidance on the implementation of the No Surprises Act (P.L.116-260). Issue: Educate Congress and the administration on the role of academic medicine in the provision of mental and behavioral health care, including initiatives to respond to the opioid epidemic. Support policies to strengthen the behavioral health workforce, promote the uptake of integrated behavioral health models, advance mental health research, and ensure access to coverage and care. Issue: Educate Congress about the financial challenges facing academic medical centers, including reimbursement challenges, workforce challenges, inflation, and others. Issue: Educate Congress and the administration about the impact of the unwinding of the COVID-19 public health emergency on the academic medicine community and the patients they serve. H.R.3887 - Childrens Hospital GME Support Reauthorization Act of 2023 H.R.3841 - To amend title III of the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs. Issue: Support clean reauthorization of the Childrens Hospital GME program. Issue: Support reauthorization of the National Health Service Corps and Teaching Health Center Graduate Medical Education. Issue: Express concern regarding actions to inappropriately undermine FDA regulatory authority. Issue: Educate Congress and the administration about medical education on nutrition, hunger, and health; reproductive health; substance use disorders; medication assisted treatment for opioid use disorders; trans health; preventing fraud and abuse; diversity, equity, and inclusion; menopause management; health care for people with disabilities; and maternal health. Issue: Educate Congress and the administration about resident physician practice decision making post US SCOTUS decision in Dobbs. Issue: Educate Congress on resident expectations related to clinical practice and oppose so-called physician service mandates. H.R.7855 - Rural Residency Planning and Development Act of 2024 Issue: Support codification of HRSAs rural residency planning and development program. Issue: Support providing discretionary funds for rural teaching hospitals to expand their residency programs. Issue: Educate Congress on vaccine safety. Issue: Encourage changes to HRSA financial aid programs as a result of FAFSA updates. Issue: Educate Congress on the use of artificial intelligence (AI) in academic medicine. S.4031 - Providing Resources and Opportunities for Health Education and Learning (PRO-HEAL) Act Issue: Support HRSA grants to expand provider pipeline programs to create pathways to health care careers. H.R.7258/S.3968 - Community Training, Education, and Access for Medical Education, and Access for Medical Students (TEAMS) Act Issue: Support enhanced community-based training opportunities for medical students, particularly in rural and medically underserved areas, and fostering long-term sustainable physician practices in high-need communities. H.R.7153/S.3673 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act Issue: Support ability of HRSA to implement evidenced-based practices for preventing suicide and improving mental health and resiliency among health care professionals, and for training health care professionals in appropriate strategies to address substance use disorders. Issue: Provide input on Next Generation Cures initiative. Issue: Promote overdose prevention. H.R. 10047 The Closing the Substance Use Care Gap Act Issue: Support extension of SAMHSA harm reduction programs.

Client expense: $632,324 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Council on Disability, Natl Institutes of Health (NIH), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Vice President of the U.S., White House Office

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

Abortion access (general); Access to mifepristone (general); Contraception (general); IUD insertion (general); Maternal mortality and morbidity (general); H.R. 1117, Advancing Safe Medications for Moms and Babies Act; Inclusion of pregnant and lactating individuals in research (general); Obstetric and gynecologic care in rural and underserved areas (general); impact of closures of ob-gyn units in rural hospitals on patient access to care and maternal morbidity and mortality; Impact of abortion restrictions on patient outcomes and the ob-gyn workforce (general); H.R. 3305/S. 1606, Black Maternal Health Momnibus Act; H.R. 3310/S. 2239, Kira Johnson Act; H.R. 3312/S. 1602, Moms Matter Act; H.R. 3320/S. 1599, Data to Save Moms Act; H.R. 3523/S. 1710, Perinatal Workforce Act;; H.R. 2389/S. 1302, Resident Physician Shortage Reduction Act; H.R. 2569, Doctors of Community (DOC) Act; Teaching Health Center Graduate Medication Education (general); H.R. 3838/S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023; H.R. 3226/S. 1573, PREEMIE Reauthorization Act of 2023; Telemedicine (general); H.R. 5012/S. 2647, SHINE for Autumn Act; implementation of P.L. 118-69, Maternal and Child Health Stillbirth Prevention Act; Stillbirth prevention (general); S.___, Supporting Healthy Moms and Babies Act; S. 712/H.R. 8532, Connected MOM Act; S. 4079/H.R. 8383, Rural Obstetrics Readiness Act; Diversity, Equity, and Inclusion in medicine (general); S. 5236, Keep Obstetrics Local Act; H.R. 7855, H.R.___, Diane Powis Ovarian Cancer Testing Access Act;; S. 4445, Right to IVF Act; Implementation of P.L. 117-328, Pregnant Workers Fairness Act; National Health Service Corps (general); ; H.R. 8796/S. 4619, Stop Comstock Act; H.R. 8037/S. 4147, NIH Improve Act; H.R. 9886, Broadening Utilization of Proven and Effective Treatment for Recovery Act or the BUPE for Recovery Act; S. 4522, Dads Matter Act; H.R. 6716/S. 3509, Healthy MOM Act; H.R. 8839, Maternal and Infant Syphilis Prevention Act; H.R. 8223/S. 4246 Advancing Menopause Care and Mid-Life Womens Health Act; H.R. 3851/S. 2464, Access to Breast Cancer Diagnosis Act of 2023; S. 964, Mothers and Newborns Success Act; H.R. 4572/S. 2303, Stephanie Tubbs Jones Uterine Fibroid Research and Education Act of 2023; H.R. 4534/S. 2245, Women and Lung Cancer Research and Preventive Services Act of 2023; S. 3447, Pregnant and Postpartum Women Treatment Reauthorization Act; S. 3370, Promoting Maternal and Child Health Through Substance Use Prevention Act; H.R. 3946/S. 1800, FASD Respect Act; H.R. __ /S.__ Strengthening Pathways to Health Professions Act; Health Insurance Portability and Accountability Act (general); Patient-physician relationship (general); Alliance for Innovation on Maternal Health; Residency programs in obstetrics and gynecology (general); Abortion training in obstetrics and gynecology residency programs (general); Obstetrician-gynecologist workforce (general); Reproductive health data privacy (general); Substance use disorder during pregnancy (general); Maternal mental health (general); Coverage for infertility (general); Protections for in vitro fertilization (general); HPV vaccination (general); RSV vaccination (general); Remote patient monitoring (general); Fertility preservation services for sickle cell patients treated with cell and gene therapies; Prenatal supplements (general); Care for pregnant and postpartum incarcerated individuals (general); Gun violence as a public health issue (general);; H.Res.1448, Expressing the sense of the House of Representatives that every person has the basic right to emergency health care, including abortion care; CURES 2.0 Act; NIH restructuring (general); family care plans (general); FDA Advisory Committees (general); FDA Diversity Action Plan (general); NICHD Strategic Plan (general); physician liability (general); pharmacist-prescribed contraceptives (general); Task Force on Research Specific to Pregnant Women and Lactating Women (PRGLAC) recommendations (general); Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages (general); Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability rule (general).

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

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE, White House Office

H.R.3046/S.1403 - Medical Student Education Authorization Act of 2023 Issue: Support grants for primary care training in medically under-resourced communities. Draft Social Determinants Accelerator Act Issue: Support grants to address social determinants of health. H.R.9161/S.4773 - Health Equity and Accountability Act of 2024 Issue: Support programs to improve health equity and address social determinants of health. S.2333 - Pandemic and All-Hazards Preparedness and Response Act H.R.4420 - Preparedness and Response Reauthorization Act H.R.4421 - Preparing for All Hazards and Pathogens Reauthorization Act H.R.4697 - Protecting PAHPA Act of 2023 Issues: Support the reauthorization of the Pandemic and All-Hazards Preparedness Act with increased funding authorization levels. Issue: Support authorities to strengthen CDCs and ASPRs ability to prevent and respond to existing and emerging threats. S.1995 - Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Educate Congress on how the 340B Drug Pricing Program helps safety-net providers to fulfill their missions and care for patients and communities. Support measures to preserve and strengthen the 340B Drug Pricing Program. Oppose efforts to reduce the scope of the program, restrict the use of contract pharmacies, define patient in the context of the program, and impose additional reporting requirements on 340B hospitals. Oppose pharmaceutical industry efforts to transition 340B into a rebate model. H.R.2534 - Preserving Rules Ordered for the Entities Covered Through 340B Act of 2023 (PROTECT 340B Act) Issue: Support measures to prevent pharmacy benefit managers and commercial insurers from imposing discriminatory reimbursement policies on 340B covered entities. H.R.7635 - 340B Pharmaceutical Access to Invest in Essential, Needed Treatments and Support (340B PATIENTS) Act Issue: Support amending the 340B statute to codify covered entities ability to use contract pharmacies. H.R.3290 - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. Issue: Oppose efforts to impose additional reporting requirements on 340B hospitals. Draft Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future of 340B (SUSTAIN 340B) Act Issue: Support efforts to prohibit pharmaceutical and pharmacy benefit manager (PBM) discrimination against covered entities. Oppose efforts to define patient in the context of the program. Oppose efforts to impose additional administrative and reporting requirements on 340B hospitals. H.R.8574 - 340B ACCESS Act Issue: Oppose efforts to restrict hospital eligibility for the 340B program. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Support policies to improve maternal health outcomes through expanded Medicaid coverage, enhanced data collection, and improved access to behavioral health care during the perinatal period. H.R.2369 - Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2023 Issue: Educate Congress on development of laboratory developed tests (LDTs) at academic medical centers and oppose policies that would increase burdensome regulations and negatively impact patients access to care by allowing FDA regulation of the development of LDTs at academic medical centers. Issue: Educate Congress on the medical education and training continuum, the annual residency Match, and the role of the National Resident Matching Program (NRMP) in medical education and residency. Issue: Provide guidance on the implementation of the No Surprises Act (P.L.116-260). Issue: Educate Congress and the administration on the role of academic medicine in the provision of mental and behavioral health care, including initiatives to respond to the opioid epidemic. Support policies to strengthen the behavioral health workforce, promote the uptake of integrated behavioral health models, advance mental health research, and ensure access to coverage and care. Issue: Educate Congress about the financial challenges facing academic medical centers, including reimbursement challenges, workforce challenges, inflation, and others. Issue: Educate Congress and the administration about the impact of the unwinding of the COVID-19 public health emergency on the academic medicine community and the patients they serve. H.R.3887 - Childrens Hospital GME Support Reauthorization Act of 2023 H.R.3841 - To amend title III of the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs Issue: Support clean reauthorization of the Childrens Hospital GME program. Issue: Express concern regarding actions to inappropriately undermine FDA regulatory authority. Issue: Educate Congress and the administration about medical education on nutrition, hunger, and health; reproductive health; substance use disorders; medication assisted treatment for opioid use disorders; trans health; preventing fraud and abuse; diversity, equity, and inclusion; menopause management; health care for people with disabilities; and maternal health. Issue: Educate Congress and the administration about resident physician practice decision making post Dobbs. Issue: Educate Congress on resident expectations related to clinical practice and oppose so-called physician service mandates. H.R.7855 - Rural Residency Planning and Development Act of 2024 Issue: Support codification of HRSAs rural residency planning and development program. Issue: Educate Congress on vaccine safety. Issue: Encourage changes to HRSA financial aid programs as a result of FAFSA updates. Issue: Educate Congress on the use of artificial intelligence (AI) in academic medicine. S.4031 - Providing Resources and Opportunities for Health Education and Learning (PRO-HEAL) Act Issue: Support HRSA grants to expand provider pipeline programs to create pathways to health care careers. H.R.7258/S.3968 - Community Training, Education, and Access for Medical Education, and Access for Medical Students (TEAMS) Act Issue: Support enhanced community-based training opportunities for medical students, particularly in rural and medically underserved areas, and fostering long-term sustainable physician practices in high-need communities. H.R.7153/S.3673 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act Issue: Support ability of HRSA to implement evidenced-based practices for preventing suicide and improving mental health and resiliency among health care professionals, and for training health care professionals in appropriate strategies to address substance use disorders. Issue: Provide input on Next Generation Cures initiative. Issue: Promote overdose prevention.

Client expense: $617,103 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Council on Disability, Natl Institutes of Health (NIH), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Vice President of the U.S., White House Office

H.R.3046/S.1403 - Medical Student Education Authorization Act of 2023 Issue: Support grants for primary care training in medically under-resourced communities. Draft Social Determinants Accelerator Act Issue: Support grants to address social determinants of health. H.R.9161/S.4773 - Health Equity and Accountability Act of 2024 Issue: Support programs to improve health equity and address social determinants of health. S.2333 - Pandemic and All-Hazards Preparedness and Response Act H.R.4420 - Preparedness and Response Reauthorization Act H.R.4421 - Preparing for All Hazards and Pathogens Reauthorization Act H.R.4697 - Protecting PAHPA Act of 2023 Issues: Support the reauthorization of the Pandemic and All-Hazards Preparedness Act with increased funding authorization levels. Issue: Support authorities to strengthen CDCs and ASPRs ability to prevent and respond to existing and emerging threats. S.1995 - Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Educate Congress on how the 340B Drug Pricing Program helps safety-net providers to fulfill their missions and care for patients and communities. Support measures to preserve and strengthen the 340B Drug Pricing Program. Oppose efforts to reduce the scope of the program, restrict the use of contract pharmacies, define patient in the context of the program, and impose additional reporting requirements on 340B hospitals. Oppose pharmaceutical industry efforts to transition 340B into a rebate model. H.R.2534 - Preserving Rules Ordered for the Entities Covered Through 340B Act of 2023 (PROTECT 340B Act) Issue: Support measures to prevent pharmacy benefit managers and commercial insurers from imposing discriminatory reimbursement policies on 340B covered entities. H.R.7635 - 340B Pharmaceutical Access to Invest in Essential, Needed Treatments and Support (340B PATIENTS) Act Issue: Support amending the 340B statute to codify covered entities ability to use contract pharmacies. H.R.3290 - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. Issue: Oppose efforts to impose additional reporting requirements on 340B hospitals. Draft Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future of 340B (SUSTAIN 340B) Act Issue: Support efforts to prohibit pharmaceutical and pharmacy benefit manager (PBM) discrimination against covered entities. Oppose efforts to define patient in the context of the program. Oppose efforts to impose additional administrative and reporting requirements on 340B hospitals. H.R.8574 - 340B ACCESS Act Issue: Oppose efforts to restrict hospital eligibility for the 340B program. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Support policies to improve maternal health outcomes through expanded Medicaid coverage, enhanced data collection, and improved access to behavioral health care during the perinatal period. H.R.2369 - Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2023 Issue: Educate Congress on development of laboratory developed tests (LDTs) at academic medical centers and oppose policies that would increase burdensome regulations and negatively impact patients access to care by allowing FDA regulation of the development of LDTs at academic medical centers. Issue: Educate Congress on the medical education and training continuum, the annual residency Match, and the role of the National Resident Matching Program (NRMP) in medical education and residency. Issue: Provide guidance on the implementation of the No Surprises Act (P.L.116-260). Issue: Educate Congress and the administration on the role of academic medicine in the provision of mental and behavioral health care, including initiatives to respond to the opioid epidemic. Support policies to strengthen the behavioral health workforce, promote the uptake of integrated behavioral health models, advance mental health research, and ensure access to coverage and care. Issue: Educate Congress about the financial challenges facing academic medical centers, including reimbursement challenges, workforce challenges, inflation, and others. Issue: Educate Congress and the administration about the impact of the unwinding of the COVID-19 public health emergency on the academic medicine community and the patients they serve. H.R.3887 - Childrens Hospital GME Support Reauthorization Act of 2023 H.R.3841 - To amend title III of the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs Issue: Support clean reauthorization of the Childrens Hospital GME program. Issue: Express concern regarding actions to inappropriately undermine FDA regulatory authority. Issue: Educate Congress and the administration about medical education on nutrition, hunger, and health; reproductive health; substance use disorders; medication assisted treatment for opioid use disorders; trans health; preventing fraud and abuse; diversity, equity, and inclusion; menopause management; health care for people with disabilities; and maternal health. Issue: Educate Congress and the administration about resident physician practice decision making post Dobbs. Issue: Educate Congress on resident expectations related to clinical practice and oppose so-called physician service mandates. H.R.7855 - Rural Residency Planning and Development Act of 2024 Issue: Support codification of HRSAs rural residency planning and development program. Issue: Educate Congress on vaccine safety. Issue: Encourage changes to HRSA financial aid programs as a result of FAFSA updates. Issue: Educate Congress on the use of artificial intelligence (AI) in academic medicine. S.4031 - Providing Resources and Opportunities for Health Education and Learning (PRO-HEAL) Act Issue: Support HRSA grants to expand provider pipeline programs to create pathways to health care careers. H.R.7258/S.3968 - Community Training, Education, and Access for Medical Education, and Access for Medical Students (TEAMS) Act Issue: Support enhanced community-based training opportunities for medical students, particularly in rural and medically underserved areas, and fostering long-term sustainable physician practices in high-need communities. H.R.7153/S.3673 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act Issue: Support ability of HRSA to implement evidenced-based practices for preventing suicide and improving mental health and resiliency among health care professionals, and for training health care professionals in appropriate strategies to address substance use disorders. Issue: Provide input on Next Generation Cures initiative. Issue: Promote overdose prevention.

Client expense: $617,103 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Council on Disability, Natl Institutes of Health (NIH), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Vice President of the U.S., White House Office

Issues relating to long-term reform of the Medicare Physician payment system. Support for expansion of funding for Graduate Medical Education. Issues relating to physician practice consolidation and access to care. H.R. 2389, the Resident Physician Shortage Reduction Act. H.R. 2474, the Strengthening Medicare for Patients and Providers Act. H.R. 3674, the Providing Relief and Stability for Medicare Patients Act. H.R. 4261, the Amputation Reduction and Compassion (ARC) Act. Issues relating to site-neutral payments in the Medicare system. Issues relating to rural access to health care and health disparities. Support for easing administrative burdens on physicians. Support for H.R. 6683, the "Preserving Seniors Access to Physicians Act." Medical training concerns relating to H.R. 7725, the Embracing Anti-Discrimination, Unbiased Curriculum, and Advancing Truth in Education (EDUCATE) Act. Issues relating to MACRA reform; in general. Support for S. 4532/H.R. 8702, The Improving Seniors Timely Access to Care (Seniors) Act. Support for H.R. 7855, the Rural Residency Planning and Development Act of 2024. Issues relating to CMS-1807-P; Medicare and Medicaid Programs: Calendar Year 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies Support for the Provider Reimbursement Stability Act (H.R. 6371). Support for the Physician Stabilization Act (S. 4935).

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

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

H.R. 1202/S.704, the Resident Education Deferred Interest Act or the REDI Act. H.R. 2389, the Resident Physician Shortage Reduction Act of 2023. Medical training concerns relating to H.R. 7725, the Embracing Anti-Discrimination, Unbiased Curriculum, and Advancing Truth in Education (EDUCATE) Act. Support for H.R. 7855, the Rural Residency Planning and Development Act of 2024.

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

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

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

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

Advocate for proposals to provide direct financial support to safety net hospitals with Congressional staff. Discuss support for the 340B Drug Pricing Program with Congressional staff and discuss certain changes: oppose 340B ACCESS Act (H.R. 7635), comment on SUSTAIN 340B Act discussion draft, support PATIENTS Act (H.R. 7635). Discuss legislative proposals with Congressional staff to stabilize long-term care and post-acute care providers: establish a temporary per diem Medicare payment to ease capacity issues and address financial challenges from slow discharges (support); make permanent three-day hospital stay waiver (support) and other COVID-19 PHE regulatory flexibilities. Discuss Medicare Graduate Medical Education (GME) provisions in the Consolidated Appropriations Act (CAA), 2021 and CAA, 2023 with HHS staff. Discuss with Congressional staff support for Medicare GME expansion: the Resident Physician Shortage Reduction Act, the Pathway to Practice Act of 2021, the Substance Use Disorder Workforce Act (H.R. 7050); additional GME slots in CAA, 2021 and CAA, 2023; Rural Residency Planning and Development Act (H.R. 7855). Oppose Rural Physician Workforce Preservation Act (H.R. 8235) and modifications to ongoing distribution of CAA, 2021 Section 126 GME slots. Discuss with HHS staff and Congressional staff recommendations to address workforce shortages for nursing and ancillary health care workforce with Congressional staff: faculty recruitment and retention, additional financial support for supervision and precepting students, Medicare payment for nursing and allied health, testing new workforce models, establishing incentives and early recruitment strategies, providing funding for clinical training site, and immigration reforms that expedite entry for foreign health care workers. Support passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S.2768). Support revisions to Conrad 30 waiver program to increase the number of foreign physicians that may remain in the US after completing GME: S.665/H.R.4942, S.2719/H.R.6980, H.R. 4875. Meet with Congressional staff to discuss technical amendment to CAA, 2021, Section 131. Respond to Senate Finance Committee request for information on Medicare GME and offer recommendations. Discuss opposition to site-neutral payment policies with Congressional staff. Educate Congressional staff on hospital price transparency federal rule (84 FR 65602). Meet with Congressional staff to discuss H.R. 5378, the Lower Costs, More Transparency Act of 2023, and comment on following proposals in bill: support for delay of Medicaid DSH cut, codification and expansion of Federal price transparency rule, oppose National Provider Identifier (NPI) requirements for hospital outpatient departments, oppose changes to 340B drug pricing program, support reauthorization of Community Health Centers, support reauthorization of National Health Service Corps, support reauthorization of Teaching Health Center Graduate Medical Education funding. Oppose Medicare site-neutral cuts, Medicare sequester cuts, and NPI proposals in H.R. 4822. Oppose changes to NPIs for hospital outpatient departments (H.R. 7623, H.R. 4509, H.R. 7623 as amended). Comment on legislative proposals in S.2840, the Primary Care and Health Workforce Expansion Act: oppose eliminating facility fees, oppose requiring a separate identification number for off-campus hospital outpatient departments. Discuss S.3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, with Congressional staff. Discuss hospital and health provisions in CAA, 2024 (H.R. 4366) with HHS staff. Discuss expiring COVID-19 Public Health Emergency Medicare flexibilities with Congressional staff and HHS staff and support legislative proposals to extend PHE telehealth flexibilities and Acute Hospital Care at Home Waiver: H.R. 7623. Support public health extenders and elimination of Medicaid DSH cut in CAA, 2024 (H.R. 4366). Meet with Congressional staff to discuss proposals for financial relief for hospitals affected by the Change Healthcare cyberattack. Oppose legislative proposals to impose financial penalties on hospitals relating to minimum cybersecurity standards (S.5218). Discuss legislative proposals to regulate the use of artificial intelligence in health care delivery with Congressional staff. Support S.5026, SEPSIS Act. Discuss FEMA COVID-19 Public Assistance payouts with Congressional staff. Discuss FDA final rule to regulate laboratory developed tests (89 FR 37286) with Congressional staff. Support passage of Improving Seniors Timely Access to Care Act (S. 4532/H.R. 8702). Discuss legislative proposals on consumer medical debt with Congressional staff. Discuss life safety building code requirements with HHS.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

Discuss Medicare and Medicaid issues with HHS staff. Discuss with Congressional staff and HHS staff support for Medicare GME expansion: the Resident Physician Shortage Reduction Act, the Pathway to Practice Act of 2021, the Substance Use Disorder Workforce Act; additional GME slots in CAA, 2021 and CAA, 2023; Rural Residency Planning and Development Act (H.R. 7855). Discussion with CMS on the interpretation of CAA, 2021, Sec. 131, and resetting of GME caps pertaining to Sec. 131. Discuss technical amendment to CAA, 2021, Sec. 131 pertaining to Medicare GME with Congressional staff. Discuss with Congressional staff distribution methodology for Medicare GME slots created in the CAA, 2021. Discuss expiring COVID-19 Public Health Emergency (PHE) Medicare flexibilities with Congressional staff and HHS staff and support legislative proposals to extend PHE telehealth flexibilities and Acute Hospital Care at Home Waiver (H.R. 7623). Discuss legislation to provide financial support for safety net hospitals. Discuss opposition to Medicare site-neutral payment policies with Congressional staff. Support certain changes to Medicaid DSH: support two year elimination of Medicaid DSH cut scheduled for January 1, 2025; support Save Our Safety Net Hospitals Act (H.R. 9351) to restore pre-CAA, 2021 DSH cap calculation methodology and include dual-eligible patients in state DSH cap calculation. Discuss Medicaid waiver proposal with Congressional staff and HHS. Discuss CMMI initiatives on global budgets and primary care in NYS Medicaid waiver. Discuss Medicaid IMD exclusion policies with Congressional staff. Support legislation to increase Medicaid payment rates for labor and delivery services for certain hospitals (S.5236). Discuss with Congressional staff support for CMS approval of Medicaid managed care organization tax proposed in New York State budget. Discuss comments on FY 2024 IPPS proposed rule to increase payment update to hospitals, Transforming Episodic Accountability Model, AHEAD Model, and CAA, 2023 Sec 4122 GME slot proposed distribution methodology and discuss comments with Congressional staff and CMS staff. Discuss Medicare payment for nursing and allied health with Senate Finance Committee staff. Meet with CMS Regional Administrator to discuss the behavioral health care workforce. Meet with CMS to discuss hospital price transparency regulations. Discuss proposals that stabilize long-term care and post-acute care providers: establish a temporary per diem Medicare payment to ease capacity issues and address financial challenges from slow discharges (support), make permanent three-day hospital stay waiver (support) and other COVID-19 PHE regulatory flexibilities. Oppose CMS final rule to establish minimum nurse staffing in Medicare- and Medicaid-certified long-term care facilities (89 FR 40876) and support legislative efforts to repeal rule. Meet with CMS staff to discuss behavioral health coverage for commercial insurers. Discussion with HHS Health Insurance Administrator and CMS Hospital Quality, Safety, and Oversight Group on CMS Interpretive Guidance on Informed Consent. Support Medicare Advantage prior authorization reforms. Meet with CMS staff and CMS Regional Administrator to discuss Medicare Advantage (MA) plans and MA utilization management practices. Discuss wage index issues with Congressional staff: H.R. 8561 to address MA local area growth under projection, FY 2025 IPPS/LTCH interim final rule, indirect medical education (IME) payments to hospitals. Meet with CMS Innovation Center to discuss CMMI models of care. Meet with CMS leadership to discuss Medicare and Medicaid issues: prior authorization and MA insurance denials, concerns on mandatory participation for AHEAD and TEAM models, Medicare support for health care workforce; support for telehealth flexibilities and Acute Hospital Care at Home waiver extension. Meet with CMS/Acute Care regarding the definition of new residency programs.

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

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

S. 2333 - Pandemic and All-Hazards Preparedness and Response Act (PAHPA) H.R. 4420 - The Preparedness and Response Reauthorization Act H.R. 4421 - The Preparing for All Hazards and Pathogens Reauthorization Act H.R. 715/S. 494 - The Bipartisan Background Checks Act/Background Check Expansion Act S. 1140/H.R. 1781 - Ensuring Access to General Surgery Act H.R. 2416 - MISSION Zero Reauthorization S. 220/H.R. 731 - Workforce Mobility Act (Non-compete Legislation) S. 705/H.R. 2761 - The Specialty Physicians Advancing Rural Care (SPARC) Act S. 704/H.R. 1202 - The Resident Education Deferred Interest (REDI) Act S. 1653 - Prevent BLEEDing Act S. 2644 - Law Enforcement Sustaining Aid and Vital Emergency Resources (SAVER) Act H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 5213 - Reducing Medically Unnecessary Delays in Care H.R. 6487/S. 3805 - No Fees for EFTS H.R. 6960/S. 3765 - Emergency Medical Services for Children Act Reauthorization S. 3679/H.R.7153 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. RES. 567 - Resolution for Health Workforce Well-Being Day of Awareness S. 1447 - The Bipartisan Solution to Cyclical Violence Act H.R. 2819 - Good Samaritan Health Professionals Act H.R. 4366 - Consolidated Appropriations Act, 2024 S. 1894/H.R. 3382 - Colorectal Cancer Payment Fairness Act H.R. 3086 - Find it Early Act H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act H.R. 7855 - Rural Residency Planning and Development Act S. 2768/H.R. 2584 - Safety from Violence for Healthcare Employees (SAVE) Act H.R.9001 - Physician Led and Rural Access to Quality Care Act Episodes of Care/Transforming Episode Accountability Model (TEAM) Physician-Focused Payment Model Technical Advisory Committee (PTAC) reform Telehealth issues MACRA reforms through MIPS e-prescribing Medicare Physician Fee Schedule CMS Quality Payment Program (QPP) Proposed Rule Safe opioid disposal policy Bilateral Exchange Visa Issues/Visas for physician educational and cultural exchange (Conrad-30 Waiver Program) Medicare Price Transparency Labor HHS Appropriations Medicare Physician Payment Cuts AI Taskforce Neglected Surgical Conditions Age Friendly Hospital Measure in IQR program Stop the Bleed program Cancer Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda National Trauma and Emergency Preparedness System (NTEPs) Administrative Burden/Prior Authorization Legislation Physician Burnout and Wellbeing Organ Transplant National Cancer Database (NCDB) updates Merit-based Incentive Payment System (MIPS) and MIPS Value Pathways (MVPs) Health Equity Firearm injury prevention research Global Code data collection Surgeon compensation studies Council on Graduate Medical Education (COGME) rural surgery studies Surgical Hospital Measures

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

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

S. 2333 - Pandemic and All-Hazards Preparedness and Response Act (PAHPA) H.R. 4420 - The Preparedness and Response Reauthorization Act H.R. 4421 - The Preparing for All Hazards and Pathogens Reauthorization Act H.R. 715/S. 494 - The Bipartisan Background Checks Act/Background Check Expansion Act S. 1140/H.R. 1781 - Ensuring Access to General Surgery Act H.R. 2416 - MISSION Zero Reauthorization S. 220/H.R. 731 - Workforce Mobility Act (Non-compete Legislation) S. 705/H.R. 2761 - The Specialty Physicians Advancing Rural Care (SPARC) Act S. 704/H.R. 1202 - The Resident Education Deferred Interest (REDI) Act S. 1653 - Prevent BLEEDing Act S. 2644 - Law Enforcement Sustaining Aid and Vital Emergency Resources (SAVER) Act H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 5213 - Reducing Medically Unnecessary Delays in Care H.R. 6487/S. 3805 - No Fees for EFTS H.R. 6960/S. 3765 - Emergency Medical Services for Children Act Reauthorization S. 3679/H.R.7153 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. RES. 567 - Resolution for Health Workforce Well-Being Day of Awareness S. 1447 - The Bipartisan Solution to Cyclical Violence Act H.R. 2819 - Good Samaritan Health Professionals Act H.R. 4366 - Consolidated Appropriations Act, 2024 S. 1894/H.R. 3382 - Colorectal Cancer Payment Fairness Act H.R. 3086 - Find it Early Act H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act H.R. 7855 - Rural Residency Planning and Development Act S. 2768/H.R. 2584 - Safety from Violence for Healthcare Employees (SAVE) Act H.R.9001 - Physician Led and Rural Access to Quality Care Act Episodes of Care/Transforming Episode Accountability Model (TEAM) Physician-Focused Payment Model Technical Advisory Committee (PTAC) reform Telehealth issues MACRA reforms through MIPS e-prescribing Medicare Physician Fee Schedule CMS Quality Payment Program (QPP) Proposed Rule Safe opioid disposal policy Bilateral Exchange Visa Issues/Visas for physician educational and cultural exchange (Conrad-30 Waiver Program) Medicare Price Transparency Labor HHS Appropriations Medicare Physician Payment Cuts AI Taskforce Neglected Surgical Conditions Age Friendly Hospital Measure in IQR program Stop the Bleed program Cancer Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda National Trauma and Emergency Preparedness System (NTEPs) Administrative Burden/Prior Authorization Legislation Physician Burnout and Wellbeing Organ Transplant National Cancer Database (NCDB) updates Merit-based Incentive Payment System (MIPS) and MIPS Value Pathways (MVPs) Health Equity Firearm injury prevention research Global Code data collection Surgeon compensation studies Council on Graduate Medical Education (COGME) rural surgery studies Surgical Hospital Measures

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

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

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

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

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

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

H.R.3046/S.1403 - Medical Student Education Authorization Act of 2023 Issue: Support grants for primary care training in medically under-resourced communities. Draft Social Determinants Accelerator Act Issue: Support grants to address social determinants of health. Draft Health Equity and Accountability Act Issue: Support programs to improve health equity and address social determinants of health. S.2333 - Pandemic and All-Hazards Preparedness and Response Act H.R.4420 - Preparedness and Response Reauthorization Act H.R.4421 - Preparing for All Hazards and Pathogens Reauthorization Act H.R.4697 - Protecting PAHPA Act of 2023 Issues: Support the reauthorization of the Pandemic and All-Hazards Preparedness Act with increased funding authorization levels. Issue: Support authorities to strengthen CDCs and ASPRs ability to prevent and respond to existing and emerging threats. S.1995 - Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Educate Congress on how the 340B Drug Pricing Program helps safety-net providers to fulfill their missions and care for patients and communities. Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, restrict the use of contract pharmacies, define patient in the context of the program, and impose additional reporting requirements on 340B hospitals. H.R.2534 - Preserving Rules Ordered for the Entities Covered Through 340B Act of 2023 (PROTECT 340B Act) Issue: Support measures to prevent pharmacy benefit managers and commercial insurers from imposing discriminatory reimbursement policies on 340B covered entities. H.R.3290 - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. Issue: Oppose efforts to impose additional reporting requirements on 340B hospitals. Draft Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future of 340B (SUSTAIN 340B) Act Issue: Support efforts to prohibit pharmaceutical and pharmacy benefit manager (PBM) discrimination against covered entities. Oppose efforts to define patient in the context of the program. Oppose efforts to impose additional administrative and reporting requirements on 340B hospitals. H.R.8574 - 340B ACCESS Act Issue: Oppose efforts to restrict hospital eligibility for the 340B program. Issue: Educate Congress about the impacts of drug shortages on academic medical centers and the patients they serve. Support measures to address drug shortages and strengthen the pharmaceutical supply chain. Draft End Drug Shortages Act Issue: Support policies to increase visibility into the pharmaceutical supply chain. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Support policies to improve maternal health outcomes through expanded Medicaid coverage, enhanced data collection, and improved access to behavioral health care during the perinatal period. H.R.2369 - Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2023 Issue: Educate Congress on development of laboratory developed tests (LDTs) at academic medical centers and oppose policies that would increase burdensome regulations and negatively impact patients access to care by allowing FDA regulation of the development of LDTs at academic medical centers. Issue: Educate Congress on the medical education and training continuum, the annual residency Match, and the role of the National Resident Matching Program (NRMP) in medical education and residency. Issue: Provide guidance on the implementation of the No Surprises Act (P.L.116-260). Issue: Educate Congress and the administration on the role of academic medicine in the provision of mental and behavioral health care, including initiatives to respond to the opioid epidemic. Support policies to strengthen the behavioral health workforce, promote the uptake of integrated behavioral health models, advance mental health research, and ensure access to coverage and care. Issue: Educate Congress about the financial challenges facing academic medical centers, including reimbursement challenges, workforce challenges, inflation, and others. Issue: Educate Congress and the administration about the impact of the unwinding of the COVID-19 public health emergency on the academic medicine community and the patients they serve. H.R.3887 - Childrens Hospital GME Support Reauthorization Act of 2023 H.R.3841 - To amend title III of the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs Issue: Support clean reauthorization of the Childrens Hospital GME program. Issue: Express concern regarding actions to inappropriately undermine FDA regulatory authority. Issue: Educate Congress and the administration about medical education on nutrition, hunger, and health; reproductive health; substance use disorders; medication assisted treatment for opioid use disorders; trans health; preventing fraud and abuse; diversity, equity, and inclusion; menopause management; health care for people with disabilities; and maternal health. Issue: Educate Congress and the administration about resident physician practice decision making post Dobbs. Issue: Educate Congress on resident expectations related to clinical practice and oppose so-called physician service mandates. H.R.7855 - Rural Residency Planning and Development Act of 2024 Issue: Support codification of HRSAs rural residency planning and development program. Issue: Educate Congress on vaccine safety. Issue: Encourage changes to HRSA financial aid programs as a result of FAFSA updates. Issue: Educate Congress on the use of artificial intelligence (AI) in academic medicine. S.4031 - Providing Resources and Opportunities for Health Education and Learning (PRO-HEAL) Act Issue: Support HRSA grants to expand provider pipeline programs to create pathways to health care careers. H.R.7258/S.3968 - Community Training, Education, and Access for Medical Education, and Access for Medical Students (TEAMS) Act Issue: Support enhanced community-based training opportunities for medical students, particularly in rural and medically underserved areas, and fostering long-term sustainable physician practices in high-need communities. H.R.7153 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act Issue: Support ability of HRSA to implement evidenced-based practices for preventing suicide and improving mental health and resiliency among health care professionals, and for training health care professionals in appropriate strategies to address substance use disorders.

Client expense: $742,323 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Council on Disability, Natl Institutes of Health (NIH), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Vice President of the U.S., White House Office

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

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

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

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

Client expense: $5,120,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Abortion access (general); Access to mifepristone (general); Contraception (general); Maternal mortality and morbidity (general); H.R. 1117, Advancing Safe Medications for Moms and Babies Act; Obstetric and gynecologic care in rural and underserved areas (general); impact of closures of ob-gyn units in rural hospitals on patient access to care and maternal morbidity and mortality; Impact of abortion restrictions on patient outcomes and the ob-gyn workforce (general); H.R. 3305/S. 1606, Black Maternal Health Momnibus Act; H.R. 1202/S. 704, Resident Education Deferred Interest (REDI) Act; H.R. 2389/S. 1302, Resident Physician Shortage Reduction Act of 2023; H.R. 2569, Doctors of Community (DOC) Act; Teaching Health Center Graduate Medication Education (general); H.R. 3838/S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023; H.R. 3226/S. 1573, PREEMIE Reauthorization Act of 2023; Inclusion of pregnant and lactating individuals in research (general); Telemedicine (general); H.R. 5012/S. 2647, SHINE for Autumn Act; H.R. 4581/S. 2231, Maternal and Child Health Stillbirth Prevention Act; H.R. 7056/S. 3612, Access to Family Building Act; H.R. 7153/S. 3679, Dr. Lorna Breen Health Care Provider Protection Act; S.___, Supporting Healthy Moms and Babies Act; S. 712/H.R. 8532, Connected MOM Act; S. 4079/H.R. 8383, Rural Obstetrics Readiness Act; H.R.___, PRAMS for Dads Act; S. 4223, Access to Birth Control Act; H.Res.1248, National Menstrual Health Awareness Month Resolution; Diversity, Equity, and Inclusion in medicine (general); H.R 8715, NEST Act; S.___, Keep Obstetrics Local Act; H.R. 7855, Rural Residency Planning and Development Act; H.R.___, Diane Powis Ovarian Cancer Testing Access Act; H.R. 8247, Uterine Fibroids Intervention and Gynecological Health Treatment Act (UFIGHT); H.R. 4933/S. 462, Mental Health Professionals Workforce Shortage Loan Repayment Act; H.R. 7432, Sickle Cell Disease Comprehensive Care Act of 2024; S. 4445, Right to IVF Act; Implementation of P.L. 117-328, Pregnant Workers Fairness Act; H.R. 834/S. 230, Rural Physician Workforce Production Act; Rural Residency Planning and Development Program (general); National Health Service Corps (general); H.R. 3523/S. 1710, Perinatal Workforce Act; H.R. 3086, Find it Early Act; H.R. 8796/S. 4619, Stop Comstock Act; Health Insurance Portability and Accountability Act (general); Patient-physician relationship (general); Menopause research, training, and education (general); Alliance for Innovation on Maternal Health; Residency programs in obstetrics and gynecology (general); Abortion training in obstetrics and gynecology residency programs (general); Obstetrician-gynecologist workforce (general); Reproductive health data privacy (general); Substance use disorder during pregnancy (general); Physician burnout (general); Maternal mental health (general); Artificial intelligence in health care (general); Coverage for infertility (general); Protections for in vitro fertilization (general); Restrictions on menthol cigarettes and flavored cigars (general); Nicotine limits in cigarettes (general); White House Initiative on Womens Health Research (general); Pediatric Subspecialty Loan Repayment Program; Over-the-counter contraception (general); HPV vaccination (general); Cancer Moonshot Initiative; Remote patient monitoring (general); Fertility preservation services for sickle cell patients treated with cell and gene therapies; Prenatal screening (general);Prenatal supplements (general); Crisis pregnancy centers (general); Care for pregnant and postpartum incarcerated individuals (general); Congenital syphilis (general); Gun violence as a public health issue (general); Obstetric hemorrhage managements at the Indian Health Service (general); H.Res. 1180, Recognizing the importance of diversity, equity, and inclusion efforts in medical education.

Client expense: $350,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

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 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: $225,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for proposals to provide direct financial support to safety net hospitals with Congressional staff. Discuss support for the 340B Drug Pricing Program with Congressional staff and oppose certain changes. Respond to Senate request for information on 340B Drug Pricing Program - SUSTAIN 340B Act discussion draft. Oppose 340B ACCESS Act (H.R. 7635). Discuss legislative proposals with Congressional staff to stabilize long-term care and post-acute care providers: establish a temporary per diem Medicare payment to ease capacity issues and address financial challenges from slow discharges (support); make permanent three-day hospital stay waiver (support) and other COVID-19 PHE regulatory flexibilities. Discuss Medicare Graduate Medical Education (GME) provisions in the Consolidated Appropriations Act (CAA), 2021 and CAA, 2023 with HHS staff. Discuss with Congressional staff support for Medicare GME expansion: the Resident Physician Shortage Reduction Act, the Pathway to Practice Act of 2021, the Substance Use Disorder Workforce Act; additional GME slots in CAA, 2021 and CAA, 2023. Support the Rural Residency Planning and Development Act (H.R. 7855) to provide grant funding for rural hospitals seeking to develop GME programs. Oppose Rural Physician Workforce Preservation Act (H.R. 8235) and modifications to ongoing distribution of CAA, 2021 Section 126 GME slots. Discuss with Congressional staff legislative recommendations to address workforce shortages for nursing and ancillary health care workforce with Congressional staff: faculty recruitment and retention, additional financial support for supervision and precepting students, Medicare payment for nursing and allied health, testing new workforce models, establishing incentives and early recruitment strategies, providing funding for clinical training site, and immigration reforms that expedite entry for foreign health care workers. Support passage of the Safety from Violence for Healthcare Employees (SAVE) Act to create legal penalties for individuals who assault or intimidate hospital employees. Support revisions to Conrad 30 waiver program to increase the number of foreign physicians that may remain in the US after completing GME: S.665/H.R.4942, S.2719/H.R.6980, H.R. 4875. Meet with Congressional staff to discuss technical amendment to CAA, 2021 Section 131. Respond to Senate Finance Committee request for information on Medicare GME and offer recommendations. Discuss federal support for nursing and allied health workforce with HHS staff. Discuss opposition to site-neutral payment policies with Congressional staff. Educate Congressional staff on hospital price transparency federal rule (84 FR 65602). Meet with Congressional staff to discuss H.R. 5378, the Lower Costs, More Transparency Act of 2023, and comment on following proposals in bill: support for delay of Medicaid DSH cut, codification and expansion of Federal price transparency rule, oppose National Provider Identifier requirements for hospital outpatient departments, oppose changes to 340B drug pricing program, support reauthorization of Community Health Centers, support reauthorization of National Health Service Corps, support reauthorization of Teaching Health Center Graduate Medical Education funding. Oppose Medicare site-neutral cuts, sequester cuts, and national provider identifier proposals in H.R. 4822, the Health Care Price Transparency Act of 2023. Oppose H.R. 4509 to require a separate unique health identifier for hospital outpatient departments. Oppose changes to national provider identifier requirements in H.R. 7623. Comment on legislative proposals in S.2840, the Primary Care and Health Workforce Expansion Act: oppose eliminating facility fees, oppose requiring a separate identification number for off-campus hospital outpatient departments. Discuss S.3430, the Better Mental Health Care, Lower-Cost Drugs, and Extenders Act, with Congressional staff. Discuss hospital and health provisions in CAA, 2024 (H.R. 4366) with HHS staff. Discuss telehealth issues with Congressional staff and support legislative proposals to extend PHE telehealth flexibilities. Support legislative proposals for additional extension of the Acute Hospital Care at Home waiver. Support public health extenders and elimination of Medicaid DSH cut in CAA, 2024 (H.R. 4366) and discuss with Congressional staff. Meet with Congressional staff to discuss proposals for financial relief for hospitals affected by the Change Healthcare cyberattack. Oppose legislative proposals to impose financial penalties on hospitals relating to minimum cybersecurity standards. Discuss legislative proposals to regulate the use of artificial intelligence in health care delivery with Congressional staff. Discuss federal legislative proposals for sepsis reporting with Congressional staff. Discuss Earned Income Tax Credit and opposition to ERTC proposal in the Tax Relief for American Families and Workers Act of 2024 with Congressional staff. Discuss FEMA COVID-19 Public Assistance payouts with Congressional staff. Discuss FDA final rule to regulate laboratory developed tests (89 FR 37286) with Congressional staff. Support passage of Improving Seniors Timely Access to Care Act (S. 4532/H.R. 8702).

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE, White House Office

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

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), 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

H.R. 1202/S.704, the Resident Education Deferred Interest Act or the REDI Act. H.R. 2389, the Resident Physician Shortage Reduction Act of 2023. Medical training concerns relating to H.R. 7725, the Embracing Anti-Discrimination, Unbiased Curriculum, and Advancing Truth in Education (EDUCATE) Act. Support for H.R. 7855, the Rural Residency Planning and Development Act of 2024.

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

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

Issues relating to long-term reform of the Medicare Physician payment system. Support for expansion of funding for Graduate Medical Education. Issues relating to physician practice consolidation and access to care. H.R. 2389, the Resident Physician Shortage Reduction Act. H.R. 2474, the Strengthening Medicare for Patients and Providers Act. H.R. 3674, the Providing Relief and Stability for Medicare Patients Act. H.R. 4261, the Amputation Reduction and Compassion (ARC) Act. Issues relating to site-neutral payments in the Medicare system. Issues relating to rural access to health care and health disparities. Support for easing administrative burdens on physicians. Support for H.R. 6683, the "Preserving Seniors Access to Physicians Act." Medical training concerns relating to H.R. 7725, the Embracing Anti-Discrimination, Unbiased Curriculum, and Advancing Truth in Education (EDUCATE) Act. Issues relating to MACRA reform; in general. Support for S. 4532/H.R. 8702, The Improving Seniors Timely Access to Care (Seniors) Act. Support for H.R. 7855, the Rural Residency Planning and Development Act of 2024.

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

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

S. 2333 - Pandemic and All-Hazards Preparedness and Response Act (PAHPA) H.R. 4420 - The Preparedness and Response Reauthorization Act H.R. 4421 - The Preparing for All Hazards and Pathogens Reauthorization Act H.R. 715/S. 494 - The Bipartisan Background Checks Act/Background Check Expansion Act S. 1140/H.R. 1781 - Ensuring Access to General Surgery Act H.R. 2416 - MISSION Zero Reauthorization S. 220/H.R. 731 - Workforce Mobility Act (Non-compete Legislation) S. 705/H.R. 2761 - The Specialty Physicians Advancing Rural Care (SPARC) Act S. 704/H.R. 1202 - The Resident Education Deferred Interest (REDI) Act S. 1653 - Prevent BLEEDing Act H.R. 2427 - Strengthening Medicare for Patients and Providers Act S. 2644 - Law Enforcement Sustaining Aid and Vital Emergency Resources (SAVER) Act H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 5213 - Reducing Medically Unnecessary Delays in Care H.R. 6487/S. 3805 - No Fees for EFTS H.R. 6960/S. 3765 - Emergency Medical Services for Children Act Reauthorization S. 3679/H.R.7153 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. RES. 567 - Resolution for Health Workforce Well-Being Day of Awareness S. 1447 - The Bipartisan Solution to Cyclical Violence Act H.R. 2819 - Good Samaritan Health Professionals Act H.R. 4366 - Consolidated Appropriations Act, 2024 S. 1894/H.R. 3382 - Colorectal Cancer Payment Fairness Act H.R. 3086 - Find it Early Act H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act H.R. 7855 - Rural Residency Planning and Development Act S. 2768/H.R. 2584 - Safety from Violence for Healthcare Employees (SAVE) Act Physician-Focused Payment Model Technical Advisory Committee (PTAC) reform Telehealth issues MACRA reforms through MIPS e-prescribing Medicare Physician Fee Schedule CMS Quality Payment Program (QPP) Proposed Rule Safe opioid disposal policy Bilateral Exchange Visa Issues/Visas for physician educational and cultural exchange (Conrad-30 Waiver Program) Medicare Price Transparency Labor HHS Appropriations Medicare Physician Payment Cuts AI Taskforce Neglected Surgical Conditions Age Friendly Hospital Measure in IQR program Stop the Bleed program Cancer Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda National Trauma and Emergency Preparedness System (NTEPs) Administrative Burden/Prior Authorization Legislation Physician Burnout and Wellbeing Organ Transplant National Cancer Database (NCDB) updates Merit-based Incentive Payment System (MIPS) and MIPS Value Pathways (MVPs) Health Equity Firearm injury prevention research Global Code data collection Surgeon compensation studies Council on Graduate Medical Education (COGME) rural surgery studies Surgical Hospital Measures

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

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

S. 2333 - Pandemic and All-Hazards Preparedness and Response Act (PAHPA) H.R. 4420 - The Preparedness and Response Reauthorization Act H.R. 4421 - The Preparing for All Hazards and Pathogens Reauthorization Act H.R. 715/S. 494 - The Bipartisan Background Checks Act/Background Check Expansion Act S. 1140/H.R. 1781 - Ensuring Access to General Surgery Act H.R. 2416 - MISSION Zero Reauthorization S. 220/H.R. 731 - Workforce Mobility Act (Non-compete Legislation) S. 705/H.R. 2761 - The Specialty Physicians Advancing Rural Care (SPARC) Act S. 704/H.R. 1202 - The Resident Education Deferred Interest (REDI) Act S. 1653 - Prevent BLEEDing Act H.R. 2427 - Strengthening Medicare for Patients and Providers Act S. 2644 - Law Enforcement Sustaining Aid and Vital Emergency Resources (SAVER) Act H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 5213 - Reducing Medically Unnecessary Delays in Care H.R. 6487/S. 3805 - No Fees for EFTS H.R. 6960/S. 3765 - Emergency Medical Services for Children Act Reauthorization S. 3679/H.R.7153 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. RES. 567 - Resolution for Health Workforce Well-Being Day of Awareness S. 1447 - The Bipartisan Solution to Cyclical Violence Act H.R. 2819 - Good Samaritan Health Professionals Act H.R. 4366 - Consolidated Appropriations Act, 2024 S. 1894/H.R. 3382 - Colorectal Cancer Payment Fairness Act H.R. 3086 - Find it Early Act H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act H.R. 7855 - Rural Residency Planning and Development Act S. 2768/H.R. 2584 - Safety from Violence for Healthcare Employees (SAVE) Act Physician-Focused Payment Model Technical Advisory Committee (PTAC) reform Telehealth issues MACRA reforms through MIPS e-prescribing Medicare Physician Fee Schedule CMS Quality Payment Program (QPP) Proposed Rule Safe opioid disposal policy Bilateral Exchange Visa Issues/Visas for physician educational and cultural exchange (Conrad-30 Waiver Program) Medicare Price Transparency Labor HHS Appropriations Medicare Physician Payment Cuts AI Taskforce Neglected Surgical Conditions Age Friendly Hospital Measure in IQR program Stop the Bleed program Cancer Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda National Trauma and Emergency Preparedness System (NTEPs) Administrative Burden/Prior Authorization Legislation Physician Burnout and Wellbeing Organ Transplant National Cancer Database (NCDB) updates Merit-based Incentive Payment System (MIPS) and MIPS Value Pathways (MVPs) Health Equity Firearm injury prevention research Global Code data collection Surgeon compensation studies Council on Graduate Medical Education (COGME) rural surgery studies Surgical Hospital Measures

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

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

S. 2333 - Pandemic and All-Hazards Preparedness and Response Act (PAHPA) H.R. 4420 - The Preparedness and Response Reauthorization Act H.R. 4421 - The Preparing for All Hazards and Pathogens Reauthorization Act H.R. 715/S. 494 - The Bipartisan Background Checks Act/Background Check Expansion Act S. 1140/H.R. 1781 - Ensuring Access to General Surgery Act H.R. 2416 - MISSION Zero Reauthorization S. 220/H.R. 731 - Workforce Mobility Act (Non-compete Legislation) S. 705/H.R. 2761 - The Specialty Physicians Advancing Rural Care (SPARC) Act S. 704/H.R. 1202 - The Resident Education Deferred Interest (REDI) Act S. 1653 - Prevent BLEEDing Act H.R. 2427 - Strengthening Medicare for Patients and Providers Act S. 2644 - Law Enforcement Sustaining Aid and Vital Emergency Resources (SAVER) Act H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 5213 - Reducing Medically Unnecessary Delays in Care H.R. 6487/S. 3805 - No Fees for EFTS H.R. 6960/S. 3765 - Emergency Medical Services for Children Act Reauthorization S. 3679/H.R.7153 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. RES. 567 - Resolution for Health Workforce Well-Being Day of Awareness S. 1447 - The Bipartisan Solution to Cyclical Violence Act H.R. 2819 - Good Samaritan Health Professionals Act H.R. 4366 - Consolidated Appropriations Act, 2024 S. 1894/H.R. 3382 - Colorectal Cancer Payment Fairness Act H.R. 3086 - Find it Early Act H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act H.R. 7855 - Rural Residency Planning and Development Act S. 2768/H.R. 2584 - Safety from Violence for Healthcare Employees (SAVE) Act Physician-Focused Payment Model Technical Advisory Committee (PTAC) reform Telehealth issues MACRA reforms through MIPS e-prescribing Medicare Physician Fee Schedule CMS Quality Payment Program (QPP) Proposed Rule Safe opioid disposal policy Bilateral Exchange Visa Issues/Visas for physician educational and cultural exchange (Conrad-30 Waiver Program) Medicare Price Transparency Labor HHS Appropriations Medicare Physician Payment Cuts AI Taskforce Neglected Surgical Conditions Age Friendly Hospital Measure in IQR program Stop the Bleed program Cancer Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda National Trauma and Emergency Preparedness System (NTEPs) Administrative Burden/Prior Authorization Legislation Physician Burnout and Wellbeing Organ Transplant National Cancer Database (NCDB) updates Merit-based Incentive Payment System (MIPS) and MIPS Value Pathways (MVPs) Health Equity Firearm injury prevention research Global Code data collection Surgeon compensation studies Council on Graduate Medical Education (COGME) rural surgery studies Surgical Hospital Measures

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

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

S. 2333 - Pandemic and All-Hazards Preparedness and Response Act (PAHPA) H.R. 4420 - The Preparedness and Response Reauthorization Act H.R. 4421 - The Preparing for All Hazards and Pathogens Reauthorization Act H.R. 715/S. 494 - The Bipartisan Background Checks Act/Background Check Expansion Act S. 1140/H.R. 1781 - Ensuring Access to General Surgery Act H.R. 2416 - MISSION Zero Reauthorization S. 220/H.R. 731 - Workforce Mobility Act (Non-compete Legislation) S. 705/H.R. 2761 - The Specialty Physicians Advancing Rural Care (SPARC) Act S. 704/H.R. 1202 - The Resident Education Deferred Interest (REDI) Act S. 1653 - Prevent BLEEDing Act H.R. 2427 - Strengthening Medicare for Patients and Providers Act S. 2644 - Law Enforcement Sustaining Aid and Vital Emergency Resources (SAVER) Act H.R. 2474 - Strengthening Medicare for Patients and Providers Act H.R. 5213 - Reducing Medically Unnecessary Delays in Care H.R. 6487/S. 3805 - No Fees for EFTS H.R. 6960/S. 3765 - Emergency Medical Services for Children Act Reauthorization S. 3679/H.R.7153 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act S. RES. 567 - Resolution for Health Workforce Well-Being Day of Awareness S. 1447 - The Bipartisan Solution to Cyclical Violence Act H.R. 2819 - Good Samaritan Health Professionals Act H.R. 4366 - Consolidated Appropriations Act, 2024 S. 1894/H.R. 3382 - Colorectal Cancer Payment Fairness Act H.R. 3086 - Find it Early Act H.R. 8702/S. 4532 - Improving Seniors Timely Access to Care Act H.R. 7855 - Rural Residency Planning and Development Act S. 2768/H.R. 2584 - Safety from Violence for Healthcare Employees (SAVE) Act Physician-Focused Payment Model Technical Advisory Committee (PTAC) reform Telehealth issues MACRA reforms through MIPS e-prescribing Medicare Physician Fee Schedule CMS Quality Payment Program (QPP) Proposed Rule Safe opioid disposal policy Bilateral Exchange Visa Issues/Visas for physician educational and cultural exchange (Conrad-30 Waiver Program) Medicare Price Transparency Labor HHS Appropriations Medicare Physician Payment Cuts AI Taskforce Neglected Surgical Conditions Age Friendly Hospital Measure in IQR program Stop the Bleed program Cancer Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda National Trauma and Emergency Preparedness System (NTEPs) Administrative Burden/Prior Authorization Legislation Physician Burnout and Wellbeing Organ Transplant National Cancer Database (NCDB) updates Merit-based Incentive Payment System (MIPS) and MIPS Value Pathways (MVPs) Health Equity Firearm injury prevention research Global Code data collection Surgeon compensation studies Council on Graduate Medical Education (COGME) rural surgery studies Surgical Hospital Measures

Client expense: $220,000 · 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.3046/S.1403 - Medical Student Education Authorization Act of 2023 Issue: Support grants for primary care training in medically under-resourced communities. Draft Social Determinants Accelerator Act Issue: Support grants to address social determinants of health. Draft Health Equity and Accountability Act Issue: Support programs to improve health equity and address social determinants of health. S.2333 - Pandemic and All-Hazards Preparedness and Response Act H.R.4420 - Preparedness and Response Reauthorization Act H.R.4421 - Preparing for All Hazards and Pathogens Reauthorization Act H.R.4697 - Protecting PAHPA Act of 2023 Issues: Support the reauthorization of the Pandemic and All-Hazards Preparedness Act with increased funding authorization levels. Issue: Support authorities to strengthen CDCs and ASPRs ability to prevent and respond to existing and emerging threats. S.1995 - Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Educate Congress on how the 340B Drug Pricing Program helps safety-net providers to fulfill their missions and care for patients and communities. Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, restrict the use of contract pharmacies, define patient in the context of the program, and impose additional reporting requirements on 340B hospitals. H.R.2534 - Preserving Rules Ordered for the Entities Covered Through 340B Act of 2023 (PROTECT 340B Act) Issue: Support measures to prevent pharmacy benefit managers and commercial insurers from imposing discriminatory reimbursement policies on 340B covered entities. H.R.3290 - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. Issue: Oppose efforts to impose additional reporting requirements on 340B hospitals. Draft Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future of 340B (SUSTAIN 340B) Act Issue: Support efforts to prohibit pharmaceutical and pharmacy benefit manager (PBM) discrimination against covered entities. Oppose efforts to define patient in the context of the program. Oppose efforts to impose additional administrative and reporting requirements on 340B hospitals. Issue: Educate Congress about the impacts of drug shortages on academic medical centers and the patients they serve. Support measures to address drug shortages and strengthen the pharmaceutical supply chain. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Support policies to improve maternal health outcomes through expanded Medicaid coverage, enhanced data collection, and improved access to behavioral health care during the perinatal period. H.R.3838/S.2415 - Preventing Maternal Deaths Reauthorization Act Issue: Support continued federal funding for state-based maternal mortality review committees. H.R.2369 - Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2023 Issue: Educate Congress on development of laboratory developed tests (LDTs) at academic medical centers and oppose policies that would increase burdensome regulations and negatively impact patients access to care by allowing FDA regulation of the development of LDTs at academic medical centers. Issue: Educate Congress on the medical education and training continuum, the annual residency Match, and the role of the National Resident Matching Program (NRMP) in medical education and residency. Issue: Provide guidance on the implementation of the No Surprises Act (P.L.116-260). Issue: Educate Congress and the administration on the role of academic medicine in the provision of mental and behavioral health care, including initiatives to respond to the opioid epidemic. Support policies to strengthen the behavioral health workforce, promote the uptake of integrated behavioral health models, advance mental health research, and ensure access to coverage and care. Issue: Educate Congress about the financial challenges facing academic medical centers, including reimbursement challenges, workforce challenges, inflation, and others. Issue: Educate Congress and the administration about the impact of the unwinding of the COVID-19 public health emergency on the academic medicine community and the patients they serve. H.R.3887 - Childrens Hospital GME Support Reauthorization Act of 2023 H.R.3841 - To amend title III of the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs Issue: Support clean reauthorization of the Childrens Hospital GME program. Issue: Express concern regarding actions to inappropriately undermine FDA regulatory authority. Issue: Educate Congress and the administration about medical education on nutrition, hunger, and health; reproductive health; substance use disorders; medication assisted treatment for opioid use disorders; trans health; preventing fraud and abuse; diversity, equity, and inclusion; menopause management; health care for people with disabilities; and maternal health. Issue: Educate Congress on resident expectations related to clinical practice and oppose so-called physician service mandates. H.R.7855 - Rural Residency Planning and Development Act of 2024 Issue: Support codification of HRSAs rural residency planning and development program. Issue: Educate Congress on vaccine safety.

Client expense: $660,005 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Vice President of the U.S., White House Office