PEAKS Act

S. 2840, Bipartisan Primary Care and Health Workforce Act H.R. 3305 - Black Maternal Health Momnibus Act H.R. 4420, the Preparedness and Response Reauthorization Act H.R. 4531, the Support for Patients and Communities Reauthorization Act H.R. 2534, PROTECT 340B Act of 2023 H.R. 5013, the Value in Health Care Act of 2023 H.R. 3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. H.R. 7050 - Substance Use Disorder Workforce Act S.4101/ H.R.7931 - the Preserving Emergency Access in Key Sites Act Keeping Obstetrics Local Act S.4088, Welcome Back to the Health Care Workforce Act Issues related to essential hospital designation Issues related to health equity Issues related to the 340B Drug Pricing program Issues related to contact pharmacies Issues related to the health care workforce Issues related to Community Paramedicine Issues related to Artificial Intelligence and Health Care Issues related to hospital digital infrastructure Issues related to cybersecurity H.R. 9351 Save our Safety-Net Hospitals Act of 2024 Issues related to Opioid overdose reduction

Client expense: $870,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

Q4 Lobbying Report (Oct.1 -Dec. 31) HCR Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program Resident Physician Shortage Act of 2023 (H.R. 2389) No Surprises Act regulations Food and Drug Amendments No Surprise Bills for New Moms Act (H.R. 3387) Securing the U.S. Organ Procurement and Transplantation Network Act (H.R. 2544) Promoting Access to Treatments and Increasing Extremely Needed Transparency Act (H.R. 3561) Medicaid VBPs for Patients (MVP) Act (H.R. 2666) Providers and Payers COMPETE Act (H.R. 3284) To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290) Transparent PRICE Act (H.R. 3281/H.R. 2691)) Resident Physician Shortage Reduction (S. 1302) Medical Student Education Authorization Act (H.R. 3046) Save Americas Rural Hospitals Act (H.R. 833) Chronic Care Management Improvement Act (H.R. 2829) Safety From Violence for Healthcare Employees Act (H.R. 2584) Supporting Safety Net Hospitals Act (H.R. 2665) Patient Access to Higher Quality Health Care Act (H.R. 977/S.470) FEMA re: COVID-19 related reimbursement Public Health Guidance Transparency and Accountability Act of 2023 (H.R. 4529) Public Health Emergency Congressional Review Act (H.R. 4381) CDC Leadership Accountability Act of 2023 (H.R. 3813) Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) Preparedness and Response Reauthorization Act (H.R. 4420) Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887) Health Care Price Transparency Act of 2023 (H.R. 4822) Providers and Payers COMPETE Act (H.R. 3284) Lower Costs, More Transparency Act (H.R. 5378 Transparency in Coverage Act (H.R. 4507) GOLD Card Act of 2023 (H.R. 4968) No Fees for EFTs Act (H.R.6487) Rural Health Care Facilities Revitalization Act (H.R. 5989) Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (H.R. 7153) To amend title XVIII of the Social Security Act to establish a definition of essential health system in statute (H.R. 7397) Substance Use Disorder Workforce Act (H.R. 7050) 340B PATIENTS Act (H.R. 7635) The 340B Affording Care for Communities and Ensuring a Strong Safety-net (ACCESS) Act (H.R. 8574) Improving Seniors Access to Timely Care Act (H.R. 8702/S.4532) The Preserving Emergency Access in Key Sites (PEAKS) Act (H.R. 7931) Rural Health Care Facilities Revitalization Act (H.R. 5989) MMM Accelerated and Advance Payment Program repayment flexibility Graduate Medical Education (GME) funding Telehealth flexibilities and payment Annual Prospective Payment System Rules Organ acquisition payment policies Californias Medicaid Hospital Quality Assurance Fee Program Medicare Advantage BUD FY 2025 Appropriations bills Nursing and allied health workforce funding FY 2025 budget request Further Continuing Appropriations and Other Extensions Act (H.R. 6363) Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R. 5894) Tax Relief for American Families and Workers Act of 2024 (H.R. 7024) Extension of Continuing Appropriations and Other Matters Act, 2024 (H.R. 7463) Submitted Comments Regulatory Comment Letters SUBJECT: CMS-10913, Medicare Part C Utilization Management Annual Data Submission and Audit Protocol Data Request; Notice, Agency Information Collection Activities: Proposed Collection; Comment Request; Federal Register (Vol 89, No 145), September 10, 2024

Lobbied on the Protecting Access to Ground Ambulance Medical Services Act (H.R. 1666, S.1673), Preserving Telehealth, Hospital, and Ambulance Access Act (H.R. 8261) and American Relief Act (H.R. 10545) to extend temporary increases in Medicare payments to ground ambulance services. Educated congressional offices and committees on scheduled changes in geographical designation of zip codes under the Medicare ambulance fee schedule following the 2020 Census. Lobbied on legislation, Improving Access to Emergency Medical Services Act of 2024 (H.R. 8977, S. 5400), to create a CMMI demonstration project on the reimbursement of treatment in place as well as on alternative destination and mobile integrated health policies. Lobbied on the Emergency Medical Services Reimbursement for On-Scene Care and Support Act (S. 3236, H.R. 6257) and Community Paramedicine Act (H.R. 8042). Engaged with congressional offices on the Preserving Emergency Access in Key Sites Act (H.R. 7931, S. 4101).

Client expense: $290,000 · Firm income: Not reported

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

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

Q3 Lobbying Report (July 1-Sept. 10) HCR Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program Resident Physician Shortage Act of 2023 (H.R. 2389) No Surprises Act regulations Food and Drug Amendments No Surprise Bills for New Moms Act (H.R. 3387) Securing the U.S. Organ Procurement and Transplantation Network Act (H.R. 2544) Promoting Access to Treatments and Increasing Extremely Needed Transparency Act (H.R. 3561) Medicaid VBPs for Patients (MVP) Act (H.R. 2666) Providers and Payers COMPETE Act (H.R. 3284) To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290) Transparent PRICE Act (H.R. 3281/H.R. 2691)) Resident Physician Shortage Reduction (S. 1302) Medical Student Education Authorization Act (H.R. 3046) Save Americas Rural Hospitals Act (H.R. 833) Chronic Care Management Improvement Act (H.R. 2829) Safety From Violence for Healthcare Employees Act (H.R. 2584) Supporting Safety Net Hospitals Act (H.R. 2665) Patient Access to Higher Quality Health Care Act (H.R. 977/S.470) FEMA re: COVID-19 related reimbursement Public Health Guidance Transparency and Accountability Act of 2023 (H.R. 4529) Public Health Emergency Congressional Review Act (H.R. 4381) CDC Leadership Accountability Act of 2023 (H.R. 3813) Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) Preparedness and Response Reauthorization Act (H.R. 4420) Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887) Health Care Price Transparency Act of 2023 (H.R. 4822) Providers and Payers COMPETE Act (H.R. 3284) Lower Costs, More Transparency Act (H.R. 5378 Transparency in Coverage Act (H.R. 4507) GOLD Card Act of 2023 (H.R. 4968) No Fees for EFTs Act (H.R.6487) Rural Health Care Facilities Revitalization Act (H.R. 5989) Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (H.R. 7153) To amend title XVIII of the Social Security Act to establish a definition of essential health system in statute (H.R. 7397) Substance Use Disorder Workforce Act (H.R. 7050) 340B PATIENTS Act (H.R. 7635) The 340B Affording Care for Communities and Ensuring a Strong Safety-net (ACCESS) Act (H.R. 8574) Improving Seniors Access to Timely Care Act (H.R. 8702/S.4532) The Preserving Emergency Access in Key Sites (PEAKS) Act (H.R. 7931) Rural Health Care Facilities Revitalization Act (H.R. 5989) MMM Accelerated and Advance Payment Program repayment flexibility Graduate Medical Education (GME) funding Telehealth flexibilities and payment Annual Prospective Payment System Rules Organ acquisition payment policies Californias Medicaid Hospital Quality Assurance Fee Program Medicare Advantage BUD FY 2024 Appropriations bills Nursing and allied health workforce funding FY 2024 budget request Further Continuing Appropriations and Other Extensions Act (H.R. 6363) Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R. 5894) Tax Relief for American Families and Workers Act of 2024 (H.R. 7024) Extension of Continuing Appropriations and Other Matters Act, 2024 (H.R. 7463) Submitted Comments Regulatory Comment Letters SUBJECT: CMS-1809-P, Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs, including the Hospital Inpatient Quality Reporting Program; Health and Safety Standards for Obstetrical Services in Hospitals and Critical Access Hospitals; Prior Authorization; Requests for Information; Medicaid and CHIP Continuous Eligibility; Medicaid Clinic Services Four Walls Exceptions; Individuals Currently or Formerly in Custody of Penal Authorities; Revision to Medicare Special Enrollment Period for Formerly Incarcerated Individuals; and All-Inclusive Rate Add-On Payment for High-Cost Drugs Provided by Indian Health Service and Tribal Facilities, (Vol 89, No 140), July 22, 2024 SUBJECT: CMS-1803-P, Medicare Program; Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update; HH Quality Reporting Program Requirements; HH Value-Based Purchasing Expanded Model Requirements; Home Intravenous Immune Globulin (IVIG) Items and Services Rate Update; and Other Medicare Policies, Federal Register (Vol. 89, No. 128), July 3, 2024 SUBJECT: CMS-5535-P, Medicare Program; Alternative Payment Model Updates and the Increasing Organ Transplant Access (IOTA) Model, Federal Register (Vol. 89, No. 97), May 17, 2024 Legislative Comment Letters Letter to HHS on Johnson & Johnson's Proposed Changes to 340B Drug Discount Program, Sept. 19, 2024

S. 2840, Bipartisan Primary Care and Health Workforce Act H.R. 3305 - Black Maternal Health Momnibus Act H.R. 4420, the Preparedness and Response Reauthorization Act H.R. 4531, the Support for Patients and Communities Reauthorization Act H.R. 2534, PROTECT 340B Act of 2023 H.R. 5013, the Value in Health Care Act of 2023 H.R. 3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. H.R. 7050 - Substance Use Disorder Workforce Act S.4101/ H.R.7931 - the Preserving Emergency Access in Key Sites Act Keeping Obstetrics Local Act S.4088, Welcome Back to the Health Care Workforce Act Issues related to essential hospital designation Issues related to health equity Issues related to the 340B Drug Pricing program Issues related to contact pharmacies Issues related to the health care workforce Issues related to Community Paramedicine Issues related to Artificial Intelligence and Health Care Issues related to hospital digital infrastructure Issues related to cybersecurity H.R. 9351 Save our Safety-Net Hospitals Act of 2024 Issues related to Opioid overdose reduction

Client expense: $460,000 · Firm income: Not reported

H.R. 9101/S. 4274, 9/11 Responder and Survivor Health Funding Correction Act of 2024 H.R. 8977, Improving Access to Emergency Medical Services Act of 2024 H.R. 7931/S. 4101, PEAKS Act H.R. 7788/S. 4013, Firefighter PFAS Injury Compensation Act of 2024 H.R. 4306, Michael Lecik Military Firefighters Protection Act H.R. 3671/S. 1925, HERO Act H.R. 2407/S. 2085, Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act H.R. 1666/S. 1673, Protecting Access to Ground Ambulance Medical Services Act of 2021 H.R. 1294/S. 569, 9/11 Responder and Survivor Health Funding Correction Act Issues related to health insurance for retired public safety officers Issues related to supplemental Medicaid reimbursements for ground ambulance service Issues pertaining to the provision of mental health services for fire fighters Issues pertaining to ground ambulance billing/reimbursement Issues pertaining to implementation of the No Surprises Act Supporting the National Firefighter Cancer Registry Issues related to cancer screenings for fire fighters

Client expense: $163,011 · Firm income: Not reported

H.R. 8977, Improving Access to Emergency Medical Services Act of 2024 H.R. 7931/S. 4101, PEAKS Act Issues pertaining to CMS reimbursement for ground ambulance services Issues pertaining to implementation of the No Surprises Act Issues pertaining to supplemental Medicaid reimbursement opportunities for ambulance service Issues pertaining to CMS' Ground Ambulance and Patient Billing Advisory Committee Issues pertaining to the ET3 Model Policy

Client expense: $163,011 · Firm income: Not reported

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

Lobbied on the Protecting Access to Ground Ambulance Medical Services Act (H.R. 1666, S.1673) and Preserving Telehealth, Hospital, and Ambulance Access Act (H.R. 8261) to extend temporary increases in Medicare payments to ground ambulance services. Educated congressional offices and committees on scheduled changes in geographical designation of zip codes under the Medicare ambulance fee schedule following the 2020 Census. Lobbied on legislation, Improving Access to Emergency Medical Services Act of 2024 (H.R. 8977), to create a CMMI demonstration project on the reimbursement of treatment in place as well as on alternative destination and mobile integrated health policies. Lobbied on the Emergency Medical Services Reimbursement for On-Scene Care and Support Act (S. 3236, H.R. 6257) and Community Paramedicine Act (H.R. 8042). Engaged with congressional offices on the Preserving Emergency Access in Key Sites Act (H.R. 7931, S. 4101).

Client expense: $275,000 · Firm income: Not reported

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

S. 3565, Affordable Connectivity Program Extension Act of 2024, all provisions; Draft Bill, Sustain 340B Program Discussion Draft, Issues pertaining to 340B Program access; S. 1302/H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions; S. 3679/H.R. 7153, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions; S.2415, Preventing Maternal Deaths Reauthorization Act, all provisions; H.R. 7931, Preserving Emergency Access in Key Sites Act (PEAKS) , all provisions; H.R. 8245, Rural Hospital Stabilization Act , all provisions; H.R. 8246, Second Chances for Rural Hospitals Act, all provisions; S.940/ H.R. 1711, Rural America Health Corps Act, all provisions; S.665 / H.R. 4942, Conrad State 30 and Physician Access Reauthorization Act, all provisions; S. 3211/ H.R. 6205, Healthcare Workforce Resilience Act, all provisions; S. 3765 / H.R. 6960, Emergency Medical Services for Children Reauthorization Act of 2024, all provisions; H.R. 7635, The 340B PATIENTS Act, all provisions; H.R.8574, the 340B Affording Care for Communities and Ensuring a Strong Safety-net (340B ACCESS) Act, Issues pertaining to 340B Program access; S. 2364, Mapping Americas Pharmaceutical Supply Act, all provisions; S. 1961, Pharmaceutical Supply Chain Risk Assessment Act of 2023, all provisions; S. 2510, RAPID Reserve Act, all provisions; S. 2362, Drug Shortage Prevention Act, all provisions; Draft Bill, the Drug Shortage Prevention and Mitigation Act, Issues pertaining to proposed solutions to address generic drug shortages; S. 862, Restoring America's Health Care Workforce and Readiness Act, all provisions; HR 2584/ S.2768, Safety From Violence for Healthcare Employees (SAVE) Act, all provisions; S.4079/H.R. 8383, Rural Obstetrics Readiness Act , all provisions; H.R. 8186, Healthy Affordable Housing Act, all provisions; S. 4289, Medical Debt Cancellation Act, all provisions; S. 4054, Health Care Cybersecurity Improvement Act of 2024, all provisions; S. 3770/ H.R. 7266, "The Future Advancement of Academic Nursing (FAAN Act)", all provisions; S. 1176 / H.R. 2663, Workplace Violence Prevention for Health Care and Social Service Workers Act, all provisions; H.R. 977/S. 470, Patient Access to Higher Quality Care Act, all provisions; Draft Bill, Family Health Affordability Act, all provisions; Draft Bill, HEALTH for MOM Act, all provisions; U.S. Department of Labor, Health Plan Accountability, health plan accountability; Office of the U.S. Trade Representative, Section 301 Tariffs, Issues related to tariffs on health care products manufactured in China; Federal Emergency Management Agency (FEMA), Public Assistance for COVID expenses, Issues related to distribution of public assistance funds to hospitals; Administration for Strategic Preparation & Response (ASPR / HHS), Pediatric Emergencies, Issues related to Pediatric Disaster Care Centers of Excellence; U.S. Department of State Immigration, Issues related to visas for foreign-trained health care workers; Immediate Office of the Secretary (IOS - HHS), Medical Debt, Issues related to how hospitals address medical debt; Cyber Security, Issues pertaining to Change Health Care cyber attack, breach notifications and ongoing cyber risks to the health care field; Lab Developed Tests (LDTs), Issues related to proposed regulatory oversight of Lab Developed Tests (LDTs); Employment Retirement Income Security Act (ERISA), ERISA improvements; Artificial Intelligence (AI), AI use in health care; Rural Health Care Access, Issues to protect access to rural health care; Prescription drug shortages, Issues pertaining to Drug shortages, supply chains; Hospital mergers and acquisitions, Issues pertaining to hospital consolidation, mergers an acquisition, community benefit, physician practice acquisition; Workforce nurse staffing mandate, workforce development programs; Maternal Health and Child Health, Access to maternal and child health care and addressing related workforce shortages; Behavioral Health, Related to expanding access to care and reducing regulatory barriers; Price Transparency, Issues related to hospital price transparency; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay and cost-based reimbursement for critical access hospitals under Medicare Advantage; Medical Debt, Issues specific to medical debt incurred by patients and hospital billing and collection practices; Physician Owned Hospitals, Physician-owned hospitals; Tax-exempt status, not-for-profit hospitals' tax exempt status; Health Professions Diversity, Increasing health professionals of color, National health service corps; centers of excellence; health careers opportunity programs.

S. 3565, Affordable Connectivity Program Extension Act of 2024, all provisions; Draft Bill, Sustain 340B Program Discussion Draft, Issues pertaining to 340B Program access; S. 1302/H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions; S. 3679/H.R. 7153, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions; S.2415, Preventing Maternal Deaths Reauthorization Act, all provisions; H.R. 7931, Preserving Emergency Access in Key Sites Act (PEAKS) , all provisions; H.R. 8245, Rural Hospital Stabilization Act , all provisions; H.R. 8246, Second Chances for Rural Hospitals Act, all provisions; S.940/ H.R. 1711, Rural America Health Corps Act, all provisions; S.665 / H.R. 4942, Conrad State 30 and Physician Access Reauthorization Act, all provisions; S. 3211/ H.R. 6205, Healthcare Workforce Resilience Act, all provisions; S. 3765 / H.R. 6960, Emergency Medical Services for Children Reauthorization Act of 2024, all provisions; H.R. 7635, The 340B PATIENTS Act, all provisions; H.R.8574, the 340B Affording Care for Communities and Ensuring a Strong Safety-net (340B ACCESS) Act, Issues pertaining to 340B Program access; S. 2364, Mapping Americas Pharmaceutical Supply Act, all provisions; S. 1961, Pharmaceutical Supply Chain Risk Assessment Act of 2023, all provisions; S. 2510, RAPID Reserve Act, all provisions; S. 2362, Drug Shortage Prevention Act, all provisions; Draft Bill, the Drug Shortage Prevention and Mitigation Act, Issues pertaining to proposed solutions to address generic drug shortages; S. 862, Restoring America's Health Care Workforce and Readiness Act, all provisions; HR 2584/ S.2768, Safety From Violence for Healthcare Employees (SAVE) Act, all provisions; S.4079/H.R. 8383, Rural Obstetrics Readiness Act , all provisions; H.R. 8186, Healthy Affordable Housing Act, all provisions; S. 4289, Medical Debt Cancellation Act, all provisions; S. 4054, Health Care Cybersecurity Improvement Act of 2024, all provisions; S. 3770/ H.R. 7266, "The Future Advancement of Academic Nursing (FAAN Act)", all provisions; S. 1176 / H.R. 2663, Workplace Violence Prevention for Health Care and Social Service Workers Act, all provisions; H.R. 977/S. 470, Patient Access to Higher Quality Care Act, all provisions; Draft Bill, Family Health Affordability Act, all provisions; Draft Bill, HEALTH for MOM Act, all provisions; U.S. Department of Labor, Health Plan Accountability, health plan accountability; Office of the U.S. Trade Representative, Section 301 Tariffs, Issues related to tariffs on health care products manufactured in China; Federal Emergency Management Agency (FEMA), Public Assistance for COVID expenses, Issues related to distribution of public assistance funds to hospitals; Administration for Strategic Preparation & Response (ASPR / HHS), Pediatric Emergencies, Issues related to Pediatric Disaster Care Centers of Excellence; U.S. Department of State Immigration, Issues related to visas for foreign-trained health care workers; Immediate Office of the Secretary (IOS - HHS), Medical Debt, Issues related to how hospitals address medical debt; Cyber Security, Issues pertaining to Change Health Care cyber attack, breach notifications and ongoing cyber risks to the health care field; Lab Developed Tests (LDTs), Issues related to proposed regulatory oversight of Lab Developed Tests (LDTs); Employment Retirement Income Security Act (ERISA), ERISA improvements; Artificial Intelligence (AI), AI use in health care; Rural Health Care Access, Issues to protect access to rural health care; Prescription drug shortages, Issues pertaining to Drug shortages, supply chains; Hospital mergers and acquisitions, Issues pertaining to hospital consolidation, mergers an acquisition, community benefit, physician practice acquisition; Workforce nurse staffing mandate, workforce development programs; Maternal Health and Child Health, Access to maternal and child health care and addressing related workforce shortages; Behavioral Health, Related to expanding access to care and reducing regulatory barriers; Price Transparency, Issues related to hospital price transparency; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay and cost-based reimbursement for critical access hospitals under Medicare Advantage; Medical Debt, Issues specific to medical debt incurred by patients and hospital billing and collection practices; Physician Owned Hospitals, Physician-owned hospitals; Tax-exempt status, not-for-profit hospitals' tax exempt status; Health Professions Diversity, Increasing health professionals of color, National health service corps; centers of excellence; health careers opportunity programs.

H.R. 618, Improving Access to Workers Compensation for Injured Federal Workers Act, all provisions S. 131, Improving Access to Workers Compensation for Injured Federal Workers Act of 2023, all provisions H.R. 2923, Living Donor Protection Act of 2023, all provisions S. 1384, Living Donor Protection Act of 2023, all provisions H.R. 1359, Modernizing Opioid Treatment Access Act, all provisions S. 644, Modernizing Opioid Treatment Access Act, all provisions H.R. 6487, No Fees for EFTs Act, all provisions S. 3805, No Fees for EFTs Act, all provisions H.R. 766, Dr. Michael C. Burgess Preventive Health Savings Act, all provisions S. 114, Dr. Michael C. Burgess Preventive Health Savings Act, all provisions H.R. 2630, Safe Step Act, all provisions S. 652, Safe Step Act, all provisions S. 2840, Bipartisan Primary Care and Health Workforce Act, all provisions S. 113, Prescription Pricing for the People Act of 2023, all provisions H.R. 7153, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, al provisions S. 3679, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions H.R. 830, Help Ensure Lower Patient (HELP) Copays Act, all provisions S. 1375, Help Ensure Lower Patient (HELP) Copays Act, all provisions S. 127, Pharmacy Benefit Manager Transparency Act of 2023, all provisions H.R. 8325, Physician and Patient Safety Act, all provisions S. 4278, Physician and Patient Safety Act, all provisions H.R. 6475, Health Disparity Zones Act of 2023, all provisions H.R. 3417, Facilitating Accountability In Reimbursements (FAIR) Act, all provisions H.R. 7931, Preserving Emergency Access in Key Sites (PEAKS) Act, all provisions H.R. 8245, Rural Hospital Stabilization Act, all provisions H.R. 8246, Second Chances for Rural Hospitals Act, all provisions H.R. 6230, Doctor Knows Best Act of 2023, all provisions S. 4349, A bill to require private health plans to provide for secure electronic transmission of prior authorization requests for prescription drugs, all provisions H.R. 6881, AI Foundation Model Transparency Act of 2023, all provisions H. Res. 217, Supporting the designation of March 2023 as Endometriosis Awareness Month, all provisions S. Res. 90, A resolution recognizing the significance of endometriosis as an unmet chronic disease for women and designating March 2023 as "Endometriosis Awareness Month, all provisions H.R. 1310, States Handling Access to Reciprocity for Employment (SHARE) Act, all provisions H.R. 8818, American Privacy Rights Act of 2024, all provisions H.R. 2584, Safety From Violence for Healthcare Employees Act, all provisions S. 2768, Safety From Violence for Healthcare Employees Act, all provisions H.R. 6766, Transparency, Readability, Understandability, Truth, and Helpfulness (TRUTH) in Labeling Act, all provisions S. 3512, Transparency, Readability, Understandability, Truth, and Helpfulness (TRUTH) in Labeling Act, all provisions H.R. 7002, Nurse Faculty Shortage Reduction Act of 2024, all provisions H.R. 6033, Supporting Patient Education And Knowledge (SPEAK) Act of 2023, provisions relating to telehealth/equity H.R. 134, To amend title XVIII of the Social Security Act to remove geographic requirements and expand originating sites for telehealth services, all provisions H.R. 206, Healthy Technology Act of 2023, all provisions Dr. Paul Farmer Global Health Training Act/draft Health Over Wealth Act/draft Mental Health Parity and Addiction Equity Act implementation Physician-practice ownership Maternal health Food is medicine Coding AI in health care/principles Digital health/regulation Diet-related disease Prescription drug shortages Rural health care Telehealth Sexual orientation policies CHANGE Healthcare cyberattack/HIPAA Data privacy Buprenorphine/barriers to access Drug overdose epidemic Infectious diseases Health equity Reproductive health Augmented intelligence Cybersecurity Substance Use Disorder Prior authorization Put Water on MyPlate/better beverage choices Pharmacy Benefit Managers Biologics/biosimilars Farm policy/food security/clean air and water

Q2 Lobbying Report (April 1-June 30) HCR Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program Resident Physician Shortage Act of 2023 (H.R. 2389) No Surprises Act regulations Food and Drug Amendments No Surprise Bills for New Moms Act (H.R. 3387) Securing the U.S. Organ Procurement and Transplantation Network Act (H.R. 2544) Promoting Access to Treatments and Increasing Extremely Needed Transparency Act (H.R. 3561) Medicaid VBPs for Patients (MVP) Act (H.R. 2666) Providers and Payers COMPETE Act (H.R. 3284) To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program (H.R. 3290) Transparent PRICE Act (H.R. 3281/H.R. 2691)) Resident Physician Shortage Reduction (S. 1302) Medical Student Education Authorization Act (H.R. 3046) Save Americas Rural Hospitals Act (H.R. 833) Chronic Care Management Improvement Act (H.R. 2829) Safety From Violence for Healthcare Employees Act (H.R. 2584) Supporting Safety Net Hospitals Act (H.R. 2665) Patient Access to Higher Quality Health Care Act (H.R. 977/S.470) FEMA re: COVID-19 related reimbursement Public Health Guidance Transparency and Accountability Act of 2023 (H.R. 4529) Public Health Emergency Congressional Review Act (H.R. 4381) CDC Leadership Accountability Act of 2023 (H.R. 3813) Preparing for All Hazards and Pathogens Reauthorization Act (H.R. 4421) Preparedness and Response Reauthorization Act (H.R. 4420) Childrens Hospital GME Support Reauthorization Act of 2023 (H.R. 3887) Health Care Price Transparency Act of 2023 (H.R. 4822) Providers and Payers COMPETE Act (H.R. 3284) Lower Costs, More Transparency Act (H.R. 5378 Transparency in Coverage Act (H.R. 4507) GOLD Card Act of 2023 (H.R. 4968) No Fees for EFTs Act (H.R.6487) Rural Health Care Facilities Revitalization Act (H.R. 5989) Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (H.R. 7153) To amend title XVIII of the Social Security Act to establish a definition of essential health system in statute (H.R. 7397) Substance Use Disorder Workforce Act (H.R. 7050) 340B PATIENTS Act (H.R. 7635) The 340B Affording Care for Communities and Ensuring a Strong Safety-net (ACCESS) Act (H.R. 8574) Improving Seniors Access to Timely Care Act (H.R. 8702/S.4532) The Preserving Emergency Access in Key Sites (PEAKS) Act (H.R. 7931) Rural Health Care Facilities Revitalization Act (H.R. 5989) MMM Accelerated and Advance Payment Program repayment flexibility Graduate Medical Education (GME) funding Telehealth flexibilities and payment Annual Prospective Payment System Rules Organ acquisition payment policies Californias Medicaid Hospital Quality Assurance Fee Program BUD FY 2024 Appropriations bills Nursing and allied health workforce funding FY 2024 budget request Further Continuing Appropriations and Other Extensions Act (H.R. 6363) Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act (H.R. 5894) Tax Relief for American Families and Workers Act of 2024 (H.R. 7024) Extension of Continuing Appropriations and Other Matters Act, 2024 (H.R. 7463) Submitted Comments Regulatory Comment Letters SUBJECT: CMS-1808-P, Medicare and Medicaid Programs and the Childrens Health Insurance Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2025 Rates; Quality Programs Requirements; and Other Policy Changes; Proposed Rule, Federal Register (Vol. 89, No. 86), May 2, 2024 SUBJECT: CMS-4207-NC, Medicare Program; Request for Information on Medicare Advantage Data, Federal Register (Vol. 89, No. 20), January 30, 2024 SUBJECT: CMS-1806-P, Medicare Program; FFY 2025 Inpatient Psychiatric Facilities Prospective Payment System - Rate Update, Proposed Rule, Federal Register (Vol. 89, No. 65), April 3, 2024 SUBJECT: CMS-1804-P, Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for FFY 2025 and Updates to the IRF Quality Reporting Program; Proposed Rule, Federal Register (Vol. 89, No. 62), March 29, 2024 SUBJECT: Docket No. ATR 102 - Request for Information on Consolidation in Health Care Markets SUBJECT: CMS-3367-P, Medicare Program; Strengthening Oversight of Accrediting Organizations (AOs) and Preventing AO Conflict of Interest, and Related Provisions, Proposed Rule, Federal Register (Vol 89, No 32), February 15, 2024 Legislative Comment Letters Rep. Ami Bera Request for Information Regarding the Current State of Artificial Intelligence (AI) in the Health Care Industry, April 30, 2024 Senate Request for Information Regarding Draft SUSTAIN 340B Act, April 1, 2024

S. 2840, Bipartisan Primary Care and Health Workforce Act H.R. 3305 - Black Maternal Health Momnibus Act H.R. 4420, the Preparedness and Response Reauthorization Act H.R. 4531, the Support for Patients and Communities Reauthorization Act H.R. 2534, PROTECT 340B Act of 2023 H.R. 5013, the Value in Health Care Act of 2023 H.R. 3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. H.R. 7050 - Substance Use Disorder Workforce Act S.4101/ H.R.7931 - the Preserving Emergency Access in Key Sites Act Keeping Obstetrics Local Act S.4088, Welcome Back to the Health Care Workforce Act Issues related to essential hospital designation Issues related to health equity Issues related to the 340B Drug Pricing program Issues related to contact pharmacies Issues related to the health care workforce Issues related to Community Paramedicine Issues related to Artificial Intelligence and Health Care Issues related to hospital digital infrastructure Issues related to cybersecurity

Client expense: $450,000 · Firm income: Not reported

Lobbied on the Protecting Access to Ground Ambulance Medical Services Act (H.R. 1666, S.1673) and Preserving Telehealth, Hospital, and Ambulance Access Act (H.R. 8261) to extend temporary increases in Medicare payments to ground ambulance services. Educated congressional offices and committees on scheduled changes in geographical designation of zip codes under the Medicare ambulance fee schedule following the 2020 Census. Lobbied on draft legislation to create a CMMI demonstration project on the reimbursement of treatment in place as well as on alternative destination and mobile integrated health policies. Lobbied on the Emergency Medical Services Reimbursement for On-Scene Care and Support Act (S. 3236, H.R. 6257) and Community Paramedicine Act (H.R. 8042). Engaged with congressional offices on the Preserving Emergency Access in Key Sites Act (H.R. 7931, S. 4101).

Client expense: $275,000 · Firm income: Not reported

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

S. 2840, Bipartisan Primary Care and Health Workforce Act H.R. 3305 - Black Maternal Health Momnibus Act H.R. 4420, the Preparedness and Response Reauthorization Act H.R. 4531, the Support for Patients and Communities Reauthorization Act H.R. 2534, PROTECT 340B Act of 2023 H.R. 5013, the Value in Health Care Act of 2023 H.R. 3290, To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. H.R. 7050 - Substance Use Disorder Workforce Act S.4101/ H.R.7931 - the Preserving Emergency Access in Key Sites Act Welcome Back to the Health Care Workforce Act Issues related to essential hospital designation Issues related to health equity Issues related to the 340B Drug Pricing program Issues related to contact pharmacies Issues related to the health care workforce Issues related to Community Paramedicine Issues related to Artificial Intelligence and Health Care Issues related to hospital digital infrastructure Issues related to cybersecurity

Client expense: $420,000 · Firm income: Not reported