ABC Act

S.652 - Safe Step Act (Murkowski/Hassan), support passage H.R. 830 - HELP Copays Act, support passage S.935- Fair Accountability and Innovative Research Drug Pricing Act of 2023, support passage H.R. 485, Protecting Health Care For All Patients Act, oppose passage as currently written S.127, the Pharmacy Benefit Manager Transparency Act, support passage Urged HELP and House Energy and Commerce Committee to hold roundtables and advance proposals that address workforce issues within the healthcare community. S. 2333 - Pandemic and All-Hazards Preparedness and Response Act, support passage H.R. 824, Telehealth Benefit Expansion for Workers Act of 2023, oppose passage H.R. 4421, Preparing for All Hazards and Pathogens Reauthorization Act, monitor legislation H.R. 4420, Preparedness and Response Reauthorization Act, monitor legislation Committee Draft -The Primary Care and Health Workforce Expansion Act, support passage S. 1339, the Pharmacy Benefit Manager Reform Act, support passage S.127, the PBM Transparency Act of 2023, support passage S.113, The Prescription Pricing for the People Act of 2023, support passage S.2052, Protect Patient Access to Pharmacies Act H.R. 1692, Health Care Affordability Act of 2023 H.R. 3561, the PATIENT Act of 2023, support passage H.R. 3284, Providers and Payers Compete Act, support passage H.R. 4507, Transparency in Coverage Act, support passage H.R. 4508, Hidden Fee Disclosure Act, support passage H.R. 2816, PBM Sunshine and Accountability Act, support passage S.79- Interagency Patent Coordination and Improvement Act of 2023, support passage S. 142- Preserve Access to Affordable Generics and Biosimilars Act, support passage S.148- Stop STALLING Act, support passage S.150- Affordable Prescriptions for Patients Act of 2023, support passage S.775-Increasing Transparency in Generic Drug Applications Act, monitoring S.1067-Ensuring Timely Access to Generics Act of 2023, support passage S. 2780 Medication Affordability and Patent Integrity Ac H.R. 4189, the CONNECT for Health Act, support passage H.R. 1843, the Telehealth Expansion Act, support passage H.R. 8018, the Alleviating Barriers for Caregivers Act, support passage S. 3109, the Alleviating Barriers for Caregivers Act, support passage H.R.6302, the Health Share Transparency Act of 2023 H.R.7623, the Telehealth Modernization Act of 2024

Client expense: $51,247 · Firm income: Not reported

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

ALS Better Care Act (H.R 5663/S.3258) - Discussion around supplemental payment to designated ALS clinics that provide multidisciplinary services to people living with ALS. HELP Copays Act (H.R.830 / S.1375) -- Provisions related to health insurance plans requirement to apply payments made by or on behalf of plan enrollees toward a plan's cost-sharing requirements, i.e. a ban on copay-accumulator adjust programs. Access to Genetic Counselor Services Act of 2023 (H.R.3876) - Provisions related to modernization of Medicare to keep pace with generic and genomic medicine innovation. Improves the ability for practitioners to refer patients to genetic counselors, Provides 85% reimbursement of physicians fee schedule amount for service. Discussion around Telehealth permanence (no bill number) - provisions related to permanent telehealth services in Medicare and interstate telehealth services. Close the Medigap Act (HR 35) -Discussion around Medigap guarantee issue provisions for people living with ALS aged under 65. Alleviating Barriers for Caregivers (ABC) Act (S.3109/H.R.8018) - All provisions. Connecting Caregivers to Medicare Act of 2024 (H.R. 7274/S. 3766) - All provisions

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

RET [House, Senate, SSA, Administration on Aging, EOP, DOJ, DOL, DT] Older Americans Act Reauthorization. The Older Americans Act Reauthorization Act of 2024 (S. 4776): Proposals to reauthorize the Older Americans Act (OAA) of 1965 and to increase the authorization of appropriations for OAA programs, which is the major federal discretionary funding source for home and community-based services for older adults and their caregivers. Programs supported through the OAA include home-delivered and congregate nutrition services, in-home supportive services, transportation, caregiver support, community service employment, health and wellness programs, the long-term care ombudsman program, services to prevent the abuse, neglect, and exploitation of older adults, and other supportive services. Medicare, Medicaid and Social Security. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 8018 and S. 3109): Proposals would require HHS and SSA to review application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and Social Security programs in order to reduce administrative barriers facing family caregivers. The bill requires agencies to identify and report to Congress on actions that can be taken to streamline eligibility and assistance for family caregivers within existing programs. Social Security Cost of Living Adjustment (COLA). The Fair COLA for Seniors Act (H.R. 716) and the Social Security Cost of Living Increase Act (H.R. 1688): Proposals to adopt the Consumer Price Index for the Elderly (CPI-E) for the purpose of determining COLAs for Social Security beneficiaries; the Boosting Benefits and COLAs for Seniors Act (S. 3974): Proposal to calculate COLAs using the current Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) or the Consumer Price Index for the Elderly (CPI-E), whichever is greater. Social Security Expansion. The Social Security 2100 Act (H.R. 4583 and S. 2280): Proposals to improve benefits and to strengthen Social Security's financing by altering the payroll tax cap, among other changes. The Social Security Expansion Act (S. 393 and H.R. 1046): Proposals to enhance Social Security benefits and ensure the long-term solvency of the Social Security program. The Strengthening Social Security Act (H.R. 3261): Proposals to extend the solvency of the Social Security Trust Funds and improve benefits. The Safeguarding American Families & Expanding Social Security Act (S. 5017): Proposals to update and modernize Social Security benefits and to extend solvency of the Social Security Trust Funds. The Protecting and Preserving Social Security Act (H.R. 9300 and S. 4877): Proposals to adopt the Consumer Price Index for the Elderly (CPI-E) for the purpose of determining COLAs for Social Security beneficiaries and to ensure the long-term solvency of the Social Security program by altering the payroll tax cap. The Protecting Our Widows and Widowers in Retirement Act (H.R. 3926): Proposals to improve benefits for widows and widowers in two-income households. The Surviving Widow(er) Income Fair Treatment Act (SWIFT Act) (S. 2741): Proposal to increase survivors benefits for disabled widows, widowers, and surviving divorced spouses. Social Security Funding. The Medicare and Social Security Fair Share Act (H.R. 4535 and S. 1174): Proposals to close the loophole for wealthy individuals who bypass paying the net investment income tax (NIIT) and directing the revenue to the Social Security Trust Funds and to the Hospital Insurance Fund, which pays for Medicare Part A that covers inpatient care in hospitals. Social Security Privatization and Benefit Cuts. (No bill): Proposals to borrow funds to invest in the stock market, to raise the Social Security retirement age and to cut Social Security benefits for future retirees promoted by Senator Bill Cassidy and Senator Angus King. Caregiver Social Security Credits. The Social Security Caregiver Credits Act (S. 1211 and H.R. 3729): Proposal to provide Social Security wage credits for individuals who reduce their participation in the workforce or leave the workforce to provide care to specified family members and relatives. Social Security Government Pension Offset and Windfall Elimination Provision. The Social Security Fairness Act of 2023 (H.R. 82 and S. 597) and the Public Servants Protection and Fairness Act (H.R. 4260): Proposals to repeal or modify the Government Pension Offset and Windfall Elimination Provision. Opposition to amendments that would cut Social Security benefits, including raising the retirement age. Social Security Notch. (No bill): Proposals to ensure that Social Security benefits for individuals born in 1960 and 1961 are not reduced as a result of the coronavirus-related drop in the average wage index. Protecting Seniors from Garnishment. (No bill): Proposal to protect Social Security beneficiaries from having their Social Security benefits garnished to recover unpaid student loans. Social Security Disability Insurance Claim Adjudication. (No bill): Proposal to nullify the rule finalized by the Social Security Administration on November 16, 2020, that outlines when its administrative appeals judges may hold hearings and issue decisions on individual cases. Currently, these judges serve an appellate function where they review, at the request of Social Security claimants, the decisions of the administrative law judges who issue decisions in individual cases. Social Security Overpayments. (No bill): Proposals to protect retirees, survivors and people with disabilities from being forced to repay extra Social Security and Supplemental Security Income (SSI) benefits they received through no fault of their own. Strengthening Beneficiaries Rights. (No bill): Various proposals relating to the protection and rights available to Social Security and Supplemental Security Income beneficiaries. Social Security Benefit Statements. The Know Your Social Security Act (No bill): Proposal to implement section 1143 of the Social Security Act by clarifying the Social Security Administration is required to mail annual benefit statements to all workers over age 25. Supplemental Security Income (SSI) Program. The Supplemental Security Income Restoration Act (H.R. 7138 and S. 2767): Proposals to strengthen and restore the SSI program. Supplemental Security Income (SSI) Program. The SSI Savings Penalty Elimination Act (S. 2767 and H.R. 5408): Proposal to amend title XVI of the Social Security Act to update the resource limit for Supplemental Security Income eligibility. The Fairness in Social Security Act (H.R. 4348): Proposal to amend the Internal Revenue Code of 1986 to exclude the portion of a lump-sum Social Security benefit payment that relates to periods prior to the taxable year from the determination of household income as it relates to SSI eligibility. Retirement Plan Distribution: IRS Notice relating to Use of an Electronic Medium to Make Participant Elections and Spousal Consents (RIN 1545-Bq50). House Committee on Aging. (H. Res. 1029): A Resolution amending the Rules of the House to reestablish a Permanent Select Committee on Aging. Retirement Plan Fiduciary Rule: U.S. Department of Labor, Employee Benefits Security Administration, Office of Regulations and Interpretations - RIN 1210-AC02; Application No. D-12057; Application No. D-12060. Supporting the Department of Labor proposed regulation to modernize the fiduciary rule to strengthen protections for retirement investors who seek professional investment advice. (H.J. Res 142 and S.J. Res 79): Opposing resolutions providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Labor relating to "Retirement Security Rule: Definition of an Investment Advice Fiduciary". Social Security Administration. The Improving Social Securitys Service to Victims of Identity Theft Act (H.R. 3765 and H.R. 3784): Proposal to improve Social Security's service to victims of identity theft by requiring the Social Security Administration to provide a single point of contact for any individual whose Social Security account number has been misused. Social Security Administration. Comments in support of Omitting Food from In-Kind Support and Maintenance Calculations, Docket No. SSA-2021-0014; Comments in support of Expanding the Rental Subsidy, Docket No. SSA-2023-0010; Comments in support of Intermediate Improvement to the Disability Adjudication Process Including How We Consider Past Work, Docket No. SSA-2023-0024; Comments in support of Rulemaking Expanding the Definition of a Public Assistance Household, Docket No. SSA-2023-0015; Comments supporting and strengthening rule regarding the Use of Electronic Payroll Data to Improve Program Administration, Docket No. SSA-2016-0039. Social Security Administration: Comments submitted regarding Social Security Form SSA-827 proposal (Medical Record Collection Process) and the Disability Applicant Evidence Simplification Act (DAESA) draft. Womens Retirement Security. The Womens Retirement Protection Act (S. 2627 and H.R. 5060): Proposal to amend the Employee Retirement Income Security Act of 1974 to provide for greater spousal protection under defined contribution plans. Food Security for Seniors. Farm bill reauthorization (The Farm, Food, and National Security Act of 2024, H.R. 8467; No Senate bill): opposing any cuts to future Supplemental Nutrition Assistance Program (SNAP) benefits or other harmful policies that would worsen the problem of hunger for Americas older adults and other food insecure individuals.

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

Government targets: Administration on Aging, Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), Treasury, Dept of

MMM [House, Senate, HHS, CMS, FDA, Administration on Aging, EOP, DOC] Medicare Observation Stays. The Improving Access to Medicare Coverage Act of 2023 (H.R. 5138 and S. 4137): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Prices (No bill): Proposal to have the Biden Administration lower the price of the prostate cancer drug Xtandi through executive action by using so-called march-in rights under the Bayh-Dole Act; to amend the Federal Food, Drug, and Cosmetic Act to grant eligible researchers access to drugs or biologic products for research purposes at a price no higher than the cost to the manufacturer; to block so-called Dispense-As-Written campaigns where drug manufacturers incentivize health care providers to specify a brand drug on a prescription to block generic substitution at the pharmacy. Medicare Drug Costs. The Pharmaceutical Research Transparency Act of 2023 (S. 1476 and H.R. 3160): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Drug Savings. The Seniors Securing Access to Vital and Essential Prescription Drugs Act (H.R. 2893): Proposals to discount the treatment of eligible retirement plans in determining the eligibility of individuals for premium and cost sharing subsidies under Part D of the Medicare program. (No bills): Proposals to eliminate the Medicare Part D low-income subsidy programs asset test and raise the income eligibility levels to 200 percent of the federal poverty level. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. The Affordable Pricing for Taxpayer-Funded Prescription Drugs Act of 2023 (H.R. 3093): Proposals to require companies that receive federal funding for research (or a license of the rights to a patent or regulatory test data) for a biomedical product or service to agree to set reasonable prices for the resulting biomedical product or service and authorize to determine a reasonable price based on a formula that ensures the U.S. price for the product or service is not more than the median price for the product or service in Canada and six other reference countries. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act (Public Law No: 117-169). Medicare and Medicaid Prescription Drugs. (No bill): Joined comments with 19 other organizations urging HHS to use its existing authority to license competition in order to lower consumer and taxpayer costs for semaglutide drugs treating diabetes and weight management (e.g., Ozempic and Wegovy). Medicare Prescription Drugs. The PACE Part D Choice Act (H.R. 3549 and S. 1703): Proposal to increase the affordability of the Program of All-Inclusive Care for the Elderly (PACE) for Medicare beneficiaries by lowering the cost of Part D premiums substantially for Medicare-only enrollees, thus opening up the PACE program to this population. Medicare Low-Income Subsidy (LIS) Program. (No bill): Proposal to increase funding for LIS outreach and enrollment, so that low-income beneficiaries can more readily access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 34) and The Medicare and Social Security Fair Share Act (S. 1174 and H.R. 4535): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Trustees Report (No bill). Review of the findings on economic, legislative and other developments affecting the actuarial soundness of the Medicare Part A (Hospital Insurance) Trust Fund and the Trust Funds for Parts B and D coverage. Medicare Dental Coverage. The Medicare Dental Benefit Act (S. 2012 and H.R. 4146): Proposal to add a dental benefit to Medicare. Medicare Hearing Coverage. The Help Extend Auditory Relief Act of 2024 (H.R. 8064): Proposal to expand Medicare coverage to include hearing examinations and diagnoses, fittings and hearing aids. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Public Health Emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Privatization (No bill): Proposals to create reimbursement policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home and Community-Based Services. The HCBS Access Act (H.R. 1493 and S. 762): Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Caregiving. The Alleviating Barriers to Caregiving Act (H.R. 8018 and S. 3109): Proposal to require the Secretaries of HHS and SSA to review and streamline enrollment in coverage and benefits for family caregivers in Medicare, Medicaid, CHIP and Social Security. Medicare and Medicaid Nursing Homes. The Nursing Home Disclosure Act (H.R. 177): Proposal to direct HHS to establish a national registry of medical directors. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 7513 and S. 3410): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. (H.J. Res. 139 and S.J. Res. 91): Proposal to use the Congressional Review Act to disapprove the HHS Secretarys final rule promulgating national staffing standards in nursing homes Medicare, Medicaid Nursing Homes. The Building Americas Health Care Workforce Act (H.R. 9067): Proposal to allow time spent working in a nursing home (prior to any formal training, and permitted during the COVID-19 pandemic) to count toward a 75-hour minimum federal training standard that is required for certified nursing assistants. Medicare, Medicaid Nursing Homes. The Ensuring Seniors Access to Quality Care Act (H.R. 3227): Proposal to repeal regulations that prohibit certified nursing assistant training and competency evaluation programs in skilled nursing facilities that have a record of health and safety deficiencies and have incurred penalties (e.g., civil monetary penalties for substandard quality of care). Medicare, Medicaid Nursing Homes, Assisted Living and Other Long Term Care Services and Supports (LTSS) Settings. The Long-Term Care Workforce Support Act (H.R. 7994 and S. 4120): Proposals to increase the number of direct care professionals, including in rural communities; pathways to enter and be supported in the workforce for women, people of color, and people with disabilities; and to improve compensation for direct care professionals to reduce vacancies and turnover. Medicare and Medicaid Nursing Home Ownership. (No bill): A final HHS regulation for comprehensive ownership disclosure in the nursing home sector issued on November 17th, 2023. Rule calls for strengthened cost reporting requirements, together with ongoing national analyses and monitoring of the performance of the nursing home sector that uses ownership, staffing, cost report data and inspection data. Medicare and Medicaid Nursing Home Staffing. (No bill): Final regulations establishing national staffing standards in nursing homes that would safeguard the health and safety of all elderly and disabled residents. Medicaid Long-Term Services and Supports (LTSS). (No bill): Proposals to request that CMS collect standardized LTSS expenditure data annually from every state and across all LTSS programs and for disaggregation of expenditure data by the delivery system and demographic characteristics in order to identify disparities in access and use of LTSS and help states and CMS deploy targeted strategies to meet the needs of older adults and people with disabilities. Oversight of Health Care Industry Owned by Private Equity Firms. (No bill): Joined with other organizations in submitting comments (April 2024) to HHS, the Federal Trade Commission and the Department of Justice urging sustained, stepped up and rigorous oversight be extended to health care industry transactions that are financed by private equity company companies and other types of private investors. Medicaid Eligibility and Beneficiary Assets. Medicaid Estate Recovery Act (H.R. 7573): Proposals to provide financial protection to the families of Medicaid beneficiaries, including ending Medicaid estate claims and Medicaid liens, except in cases when benefits had been incorrectly paid, as determined by a court.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 547/S.100, the Better Care Better Jobs Act H.R. 670/ S. 4174, the Think Differently Database Act H.R. 1493/S. 762, the HCBS Access Act H.R. 4315, the Medicare Orthotics and Prosthetics Patient-Centered Care Act H.R. 6029/S. 3120, the Disaster Relief Medicaid Act H.R. 8018/S. 3109, the Alleviating Barriers for Caregivers (ABC) Act S. 3118, the HCBS Relief Act of 2023 Discussions: Interaction between Medicare Part B and Tricare for medically retired veterans Discussions: Definition of Medicare in the Home for DME purposes Discussions: Right to repair DME products - ensure providers of DME and prosthetics are reimbursed by Medicare when doing repairs and preventative maintenance

Client expense: $87,752 · Firm income: Not reported

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

Older Americans Act Reauthorization. The Older Americans Act Reauthorization Act of 2024 (S. 4776): Proposals to reauthorize the Older Americans Act (OAA) of 1965 and to increase the authorization of appropriations for OAA programs, which is the major federal discretionary funding source for home and community-based services for older adults and their caregivers. Programs supported through the OAA include home-delivered and congregate nutrition services, in-home supportive services, transportation, caregiver support, community service employment, health and wellness programs, the long-term care ombudsman program, services to prevent the abuse, neglect, and exploitation of older adults, and other supportive services. Medicare, Medicaid and Social Security. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 8018 and S. 3109): Proposals would require HHS and SSA to review application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and Social Security programs in order to reduce administrative barriers facing family caregivers. The bill requires agencies to identify and report to Congress on actions that can be taken to streamline eligibility and assistance for family caregivers within existing programs. Social Security Cost of Living Adjustment (COLA). The Fair COLA for Seniors Act (H.R. 716) and the Social Security Cost of Living Increase Act (H.R. 1688): Proposals to adopt the Consumer Price Index for the Elderly (CPI-E) for the purpose of determining COLAs for Social Security beneficiaries; the Boosting Benefits and COLAs for Seniors Act (S. 3974): Proposal to calculate COLAs using the current Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) or the Consumer Price Index for the Elderly (CPI-E), whichever is greater. Social Security Expansion. The Social Security 2100 Act (H.R. 4583 and S. 2280): Proposals to improve benefits and to strengthen Social Security's financing by altering the payroll tax cap, among other changes. The Social Security Expansion Act (S. 393 and H.R. 1046): Proposals to enhance Social Security benefits and ensure the long-term solvency of the Social Security program. The Strengthening Social Security Act (H.R. 3261): Proposals to extend the solvency of the Social Security Trust Funds and improve benefits. The Safeguarding American Families & Expanding Social Security Act (S. 5017): Proposals to update and modernize Social Security benefits and to extend solvency of the Social Security Trust Funds. The Protecting and Preserving Social Security Act (H.R. 9300 and S. 4877): Proposals to adopt the Consumer Price Index for the Elderly (CPI-E) for the purpose of determining COLAs for Social Security beneficiaries and to ensure the long-term solvency of the Social Security program by altering the payroll tax cap. The Protecting Our Widows and Widowers in Retirement Act (H.R. 3926): Proposals to improve benefits for widows and widowers in two-income households. The Surviving Widow(er) Income Fair Treatment Act (SWIFT Act) (S. 2741): Proposal to increase survivors benefits for disabled widows, widowers, and surviving divorced spouses. Social Security Funding. The Medicare and Social Security Fair Share Act (H.R. 4535 and S. 1174): Proposals to close the loophole for wealthy individuals who bypass paying the net investment income tax (NIIT) and directing the revenue to the Social Security Trust Funds and to the Hospital Insurance Fund, which pays for Medicare Part A that covers inpatient care in hospitals. Social Security Privatization and Benefit Cuts. (No bill): Proposals to borrow funds to invest in the stock market, to raise the Social Security retirement age and to cut Social Security benefits for future retirees promoted by Senator Bill Cassidy and Senator Angus King. Caregiver Social Security Credits. The Social Security Caregiver Credits Act (S. 1211 and H.R. 3729): Proposal to provide Social Security wage credits for individuals who reduce their participation in the workforce or leave the workforce to provide care to specified family members and relatives. Social Security Government Pension Offset and Windfall Elimination Provision. The Social Security Fairness Act of 2023 (H.R. 82 and S. 597) and the Public Servants Protection and Fairness Act (H.R. 4260): Proposals to repeal or modify the Government Pension Offset and Windfall Elimination Provision. Opposition to amendments that would cut Social Security benefits, including raising the retirement age. Social Security Notch. (No bill): Proposals to ensure that Social Security benefits for individuals born in 1960 and 1961 are not reduced as a result of the coronavirus-related drop in the average wage index. Protecting Seniors from Garnishment. (No bill): Proposal to protect Social Security beneficiaries from having their Social Security benefits garnished to recover unpaid student loans. Social Security Disability Insurance Claim Adjudication. (No bill): Proposal to nullify the rule finalized by the Social Security Administration on November 16, 2020, that outlines when its administrative appeals judges may hold hearings and issue decisions on individual cases. Currently, these judges serve an appellate function where they review, at the request of Social Security claimants, the decisions of the administrative law judges who issue decisions in individual cases. Social Security Overpayments. (No bill): Proposals to protect retirees, survivors and people with disabilities from being forced to repay extra Social Security and Supplemental Security Income (SSI) benefits they received through no fault of their own. Strengthening Beneficiaries Rights. (No bill): Various proposals relating to the protection and rights available to Social Security and Supplemental Security Income beneficiaries. Social Security Benefit Statements. The Know Your Social Security Act (No bill): Proposal to implement section 1143 of the Social Security Act by clarifying the Social Security Administration is required to mail annual benefit statements to all workers over age 25. Supplemental Security Income (SSI) Program. The Supplemental Security Income Restoration Act (H.R. 7138 and S. 2767): Proposals to strengthen and restore the SSI program. Supplemental Security Income (SSI) Program. The SSI Savings Penalty Elimination Act (S. 2767 and H.R. 5408): Proposal to amend title XVI of the Social Security Act to update the resource limit for Supplemental Security Income eligibility. The Fairness in Social Security Act (H.R. 4348): Proposal to amend the Internal Revenue Code of 1986 to exclude the portion of a lump-sum Social Security benefit payment that relates to periods prior to the taxable year from the determination of household income as it relates to SSI eligibility. Retirement Plan Distribution: IRS Notice relating to Use of an Electronic Medium to Make Participant Elections and Spousal Consents (RIN 1545-Bq50). House Committee on Aging. (H. Res. 1029): A Resolution amending the Rules of the House to reestablish a Permanent Select Committee on Aging. Retirement Plan Fiduciary Rule: U.S. Department of Labor, Employee Benefits Security Administration, Office of Regulations and Interpretations - RIN 1210-AC02; Application No. D-12057; Application No. D-12060. Supporting the Department of Labor proposed regulation to modernize the fiduciary rule to strengthen protections for retirement investors who seek professional investment advice. (H.J. Res 142 and S.J. Res 79): Opposing resolutions providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Labor relating to "Retirement Security Rule: Definition of an Investment Advice Fiduciary". Social Security Administration. The Improving Social Securitys Service to Victims of Identity Theft Act (H.R. 3765 and H.R. 3784): Proposal to improve Social Security's service to victims of identity theft by requiring the Social Security Administration to provide a single point of contact for any individual whose Social Security account number has been misused. Social Security Administration. Comments in support of Omitting Food from In-Kind Support and Maintenance Calculations, Docket No. SSA-2021-0014; Comments in support of Expanding the Rental Subsidy, Docket No. SSA-2023-0010; Comments in support of Intermediate Improvement to the Disability Adjudication Process Including How We Consider Past Work, Docket No. SSA-2023-0024; Comments in support of Rulemaking Expanding the Definition of a Public Assistance Household, Docket No. SSA-2023-0015; Comments supporting and strengthening rule regarding the Use of Electronic Payroll Data to Improve Program Administration, Docket No. SSA-2016-0039. Social Security Administration: Comments submitted regarding Social Security Form SSA-827 proposal (Medical Record Collection Process) and the Disability Applicant Evidence Simplification Act (DAESA) draft. Womens Retirement Security. The Womens Retirement Protection Act (S. 2627 and H.R. 5060): Proposal to amend the Employee Retirement Income Security Act of 1974 to provide for greater spousal protection under defined contribution plans. Food Security for Seniors. Farm bill reauthorization (The Farm, Food, and National Security Act of 2024, H.R. 8467; No Senate bill): opposing any cuts to future Supplemental Nutrition Assistance Program (SNAP) benefits or other harmful policies that would worsen the problem of hunger for Americas older adults and other food insecure individuals.

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

Government targets: Administration on Aging, Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), Treasury, Dept of

Lobbying to Increase Prescription Drug Affordability and Accessibility: Advocacy for Medicare Part D redesign and benefits for people living with Parkinson's, including expanding the low-income subsidy (LIS) program, capping out-of-pocket costs, implementing a smoothing mechanism, and streamlining utilization management processes. The Medicare Part D Six Protected Classes Policy: Requires Part D plans to cover all drugs in six classes: immunosuppressants, antidepressants, antipsychotics, anticonvulsants, antiretrovirals, and antineoplastics. For people living with Parkinson's, most of whom are Medicare beneficiaries, it is essential to have access to a wide range of treatment options for antidepressants and antipsychotics, which are crucial for managing non-motor symptoms like depression and psychosis. Signed Coalition Letters: - Medicare Access for Prescription Rx (MAPRx): Comment letter in response to Medicare Prescription Payment Plan Part One Guidance. - Patient and Provider Advocates for Telehealth: Comment letter in response to CMS CY 2024 Medicare Physician Fee Schedule (PFS) supporting expanded access to telehealth. - Alliance for Aging Research: Coalition letter in response to Medicare Prescription Payment Plan Part One Guidance supporting proposed beneficiary protections. H.R.4752/S.2379 - CHANGE Act of 2023: A bill to better utilize existing Medicare wellness visits for early screening, detection, and diagnosis of Alzheimer's and related dementias, including Parkinson's disease dementia. S.1544/H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023: A bill to establish separate payment requirements for diagnostic radiopharmaceuticals, including DaTscans used to confirm Parkinson's diagnoses, under the Medicare outpatient prospective payment system. CMS-1809-P (2025 Medicare OPPS Proposed Rule): Comment supporting CMS's proposal to separately reimburse certain diagnostic radiopharmaceuticals used in diagnosing Parkinson's disease and atypical parkinsonisms. H.R.8702/S.4532 - Improving Seniors' Timely Access to Care Act: Establishes requirements for the use of prior authorization under Medicare Advantage plans to ensure timely access to care for seniors, including those with Parkinson's. S.3109/H.R.8018 - Alleviating Barriers for Caregivers (ABC) Act: Requires the Centers for Medicare & Medicaid Services (CMS) and Social Security to simplify processes and communications for family caregivers to assist individuals in accessing and utilizing benefits. S.3766/H.R.7274 - Connecting Caregivers to Medicare Act: Amends the Social Security Act to provide outreach and education to Medicare beneficiaries and simplify access to information for family caregivers through 1-800-MEDICARE. Advocacy for Durable Medical Equipment (DME) Access: Lobbying CMS to direct Medicare contractors to clarify claims procedures for DME therapies requiring administration via external infusion pumps, ensuring quick access to new Parkinson's therapies after FDA approval. H.R.8331/S. 4280 - Essential Caregivers Act of 2024: To amend titles XVIII and XIX of the Social Security Act to require skilled nursing facilities, nursing facilities, intermediate care facilities for the intellectually disabled, and inpatient rehabilitation facilities to permit essential caregivers access during any period in which regular visitation is restricted.

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

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

Family Caregiver issues (S.3766/H.R.7274 - Connecting Caregivers to Medicare Act, S.3109/H.R.8018 - Alleviating Barriers for Caregivers (ABC) Act, Physician Fee Schedule paid caregiver training in Medicare implementation, Older Americans Act Reauthorization)

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

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

Family Caregiver issues (Office of Caregiver Health, S.3766/H.R.7274 - Connecting Caregivers to Medicare Act, S.3109/H.R.8018 - Alleviating Barriers for Caregivers (ABC) Act, S.4325 - Lifespan Respite Reauthorization Act, Physician Fee Schedule paid caregiver training in Medicare implementation, Older Americans Act Reauthorization, caregiver mental health)

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA)

1. S. 762, The HCBS Access Act, entire bill 2. H.R. 1493, The HCBS Access Act, entire bill 3. S. 842, Medicare and Medicaid Dental, Vision and Hearing Benefit Act, entire bill 4. H.R. 33, Medicare and Medicaid Dental, Vision and Hearing Benefit Act, entire bill 5. Proposals regarding the treatment of eligible retirement plans in determining the eligibility of individuals for premium and cost-sharing subsidies under part D of the Medicare program 6. Medicare ACO Realizing Equity, Access, and Community Health (REACH) program 7. Proposals to reduce Medicaid funding 8. H.R. 3069, John Lewis Equality in Medicare and Medicaid Treatment (EMMT) Act, entire bill 9. S. 1296, John Lewis Equality in Medicare and Medicaid Treatment (EMMT) Act, entire bill 10. Implementation of provisions of the Inflation Reduction Act of 2022 regarding drug prices under the Medicare program 11. Proposals regarding revisions to Medicare rules regarding inpatient hospital stays 12. Proposed CMS rule: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting 13. H.R. 1638, Improving Access to Mental Health Act of 2023, entire bill 14. S. 838,Improving Access to Mental Health Act of 2023, entire bill 15. Proposals regarding the Medicare Low Income Subsidy program 16. H.R. 7513, Protecting Americas Seniors Access to Care Act, entire 17. S. 3410, Protecting Rural Seniors Access to Care Act, entire bill 18. H.R. 8106, To amend title XIX of the Social Security Act to increase transparency and expand coverage options with respect to home and community-based services under a Medicaid waiver, entire bill 19. H.R. 8107, Ensuring Access to Medicaid Buy-in Programs Act of 2024, entire bill 20. H.R. 8109, Money Follows the Person Permanency Act of 2024, entire bill 21. H.R. 8110, Protecting Married Seniors from Impoverishment Act of 2024, entire bill 22. H.R. 8018, Alleviating Barriers for Caregivers Act, entire bill 23. S. 3109, Alleviating Barriers for Caregivers Act, entire bill 24. H.R. 7573, Stop Unfair Medicaid Recoveries Act, entire bill 25. Proposals for $2 per month generic drug prescription co-pays under Medicare

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

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

1. S. 762, The HCBS Access Act, entire bill 2. H.R. 1493, The HCBS Access Act, entire bill 3. S. 842, Medicare and Medicaid Dental, Vision and Hearing Benefit Act, entire bill 4. H.R. 33, Medicare and Medicaid Dental, Vision and Hearing Benefit Act, entire bill 5. Proposals regarding the treatment of eligible retirement plans in determining the eligibility of individuals for premium and cost-sharing subsidies under part D of the Medicare program 6. Medicare ACO Realizing Equity, Access, and Community Health (REACH) program 7. Proposals to reduce Medicaid funding 8. H.R. 3069, John Lewis Equality in Medicare and Medicaid Treatment (EMMT) Act, entire bill 9. S. 1296, John Lewis Equality in Medicare and Medicaid Treatment (EMMT) Act, entire bill 10. Implementation of provisions of the Inflation Reduction Act of 2022 regarding drug prices under the Medicare program 11. Proposals regarding revisions to Medicare rules regarding inpatient hospital stays 12. Proposed CMS rule: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting 13. H.R. Improving Access to Mental Health Act of 2023, entire bill 14. S. 838,Improving Access to Mental Health Act of 2023, entire bill 15. Proposals regarding the Medicare Low Income Subsidy program 16. H.R. 7513, Protecting Americas Seniors Access to Care Act, entire 17. S. 3410, Protecting Rural Seniors Access to Care Act, entire bill 18. H.J.Res. 139, providing for Congressional disapproval of the CMS rule Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting," entire resolution 19. H.R. 8106, To amend title XIX of the Social Security Act to increase transparency and expand coverage options with respect to home and community-based services under a Medicaid waiver, entire bill 20. H.R. 8107, Ensuring Access to Medicaid Buy-in Programs Act of 2024, entire bill 21. H.R. 8109, Money Follows the Person Permanency Act of 2024, entire bill 22. H.R. 8110, Protecting Married Seniors from Impoverishment Act of 2024, entire bill 23. H.R. 8018, Alleviating Barriers for Caregivers Act, entire bill 24. S. 3109, Alleviating Barriers for Caregivers Act, entire bill

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

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

Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS Medicare compare website H.R. 35 - Close the Medigap Act of 2023 - Rep. Doggett, Lloyd - Medigap policies H.R. 3746 - Fiscal Responsibility Act of 2023 - Rep. McHenry, Patrick - work requirements for federal programs H.R. 3875 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 4411 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 4818 - Treat and Reduce Obesity Act of 2023 - Rep. Wenstrup, Brad -Medicare Coverage of weight loss treatment H.R. 5526 - Seniors' Access to Critical Medications Act of 2023 - Rep. Harshbarger, Diana - exception for physician self-referral H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - amends Medicaid Third Party liability requirements H.R. 5746 - Addressing Whole Health in Medicare Advantage Act - Rep. Bilirakis, Gus - Medicare Advantage supplemental benefits H.R. 5854 - Medicare Advantage Consumer Protection and Transparency Act - Rep. Porter, Katie - Medicare Advantage organization reporting H.R. 6364 - Medicare Telehealth Privacy Act of 2023 - Rep. Balderson, Troy - Provider privacy provisions for telehealth under Medicare H.R. 6400 - To amend title XVIII of the Social Security Act to extend eligibility for certain payment increases for biosimilar biological products under the Medicare program - Rep. Cardenas, Tony - Medicare payment increase for biosimilars H.R. 6445 - Medicare Audiology Access Improvement Act of 2023 - Rep. Bilirakis, Gus - Medicare Audiology Coverage H.R. 7147 - Medicare Transaction Fraud Prevention Act - Rep. Schweikert, David - oversight of payments for medical equipment & clinical DLTs under Medicare H.R. 7148 - Medicare Home Health Accessibility Act - Rep. Smucker, Lloyd - occupational therapy eligibility for home health coverage under Medicare H.R. 7254 - Hearing Device Coverage Clarification Act - Rep. Fischbach, Michelle - excludes fully implanted active middle ear hearing devices from the hearing aid coverage exclusion under Medicare H.R. 7274 - Connecting Caregivers to Medicare Act of 2024 - Rep. Carey, Mike - outreach, education, and simplify information for family caregivers on Medicare benefits H.R. 7432 - Sickle Cell Disease Comprehensive Care Act - Rep. Burgess, Michael - enables State Medicaid programs to provide coordinated care through health home to individuals with sickle cell disease H.R. 7512 - Real-Time Benefit Tool Implementation Act - Rep. Arrington, Jodey - implementation of real-time benefit tools under part D of under Medicare H.R. 7573 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - Medicaid Estate Recovery Program H.R. 7619 - Expand the Behavioral Health Workforce Now Act - Rep. Neguse, Joe - education, training, recruitment, and retention of mental health and substance use disorder providers under Medicaid and CHIP H.R. 7623 - Telehealth Modernization Act of 2024 - Rep. Carter, Earl L. Buddy - makes certain telehealth flexibilities permanent under Medicare and adds requirements for Part D plan contracts with PBMs including reporting and delinking provisions H.R. 7856 - Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies Act (PREVENT DIABETES Act)- Rep. DeGette, Diana - Medicare, coverage, preventive care, chronic care H.R. 7863 - To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program. - Rep. Steel, Michelle - Medicare, behavioral health, telehealth, accessibility H.R. 7939 - Patient Access to Innovative New Technologies Act of 2024 - Rep. Carey, Mike - Medicare, quality, medical devices, coverage H.R. 7996 - Improving CARE for Youth Act - Rep. Dunn, Neal - allows for same-day billing for mental health services for youth Medicaid beneficiaries who are being seen for a primary care service H.R. 8018 - Alleviating Barriers for Caregivers Act- Rep. Cammack, Kat - review and simplify caregiver paperwork, CHIP, Medicare, Medicaid H.R. 8064 - Help Extend Auditory Relief Act of 2024- Rep. Cartwright, Matt - Medicare coverage of hearing aids H.R. 8075 - Improving Access to Home Dialysis Act of 2024- Rep. Miller, Carol - Medicare coverage of home dialysis H.R. 8115 - To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid- Rep. Sarbanes, John - Medicaid managed care payment deferral H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act- Rep. Schweikert, David - extend flexibilities and payment for Medicare H.R. 8702 - Improving Seniors Timely Access to Care Act - Rep. Mike Kelly - prior authorization, transparency, MA S. 838 - Improving Access to Mental Health Act - Sen. Stabenow, Debbie - mental health services in Medicare S. 948 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - establishes programs and requirements to support maternal health services under Medicaid and CHIP S. 1002 - No UPCODE Act - Sen. Cassidy, Bill - modifies certain factors that are used to determine Medicare Advantage (MA) payments, particularly relating to health status and related data S. 2880 - Expanded Telehealth Access Act - Sen. Daines, Steve - Medicare payment for telehealth services S. 3573 - Medicare Advantage Supplemental Benefits Transparency Act- Sen. Warner, Mike - MA, data transparency, supplemental benefits S. 3578 - Protect Medicaid Act - Sen. Cassidy, Bill - prohibits federal payments under Medicaid for noncitizens, requires reporting to HHS of states that provide such health benefits S. 3630 - Medicare Transaction Fraud Prevention Act- Sen. Braun, Mike- pilot program for predictive risk-scoring algorithm, oversight, Medicare S. 3651 - Telemental Health Care Access Act of 2024- Sen. Cassidy, Bill - Medicare, mental health services, telehealth S. 3766 - Connecting Caregivers to Medicare Act of 2024- Sen. Tillis, Thomas - Medicare, outreach and education, caregivers S. 3882 - Helping States Integrate Medicare and Medicaid Act- Sen. Casey, Robert - dual eligibles, quality measures, access, enrollment S. 3934 - Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access S. 3950 - Delivering Unified Access to Lifesaving Services Act of 2024 - Sen. Cassidy, Bill - reforming Integrated Medicare/Medicaid Care Programs for Dually Eligible Individuals S. 4094 - PREVENT DIABETES Act - Sen. Scott, Tim - Medicare, coverage, preventive care, chronic care S. 4532 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - prior authorization, transparency, MA S. 4767 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - reduces fraudulent enrollments in qualified health plans Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicare Transparency in Coverage; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; Medicare Advantage Health Risk Assessment and chart reviews; Medicare Advantage supplemental benefits and Social Determinants of health; coverage of weight loss drugs; and Inflation Reduction Act implementation.

Client expense: $2,560,000 · Firm income: Not reported

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

Labor HHS Appropriations FY 25 PRC funding, NIDILRR& Spinal Cord Injury Model Systems SCIMS funding, Dear Colleague led by Fitzpatrick/Williams, HR8018/S3109 Alleviating Barriers to Care Act

Client expense: $25,090 · Firm income: Not reported

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

CMS Coverage of Seat Elevation and standing feature at CMS for power wheelchairs Coding changes to intermittent catheters at CMS Alleviating Barriers to Care Act HR8018/s3109

Client expense: $25,090 · Firm income: Not reported

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

Family Caregiver issues (Office of Caregiver Health, S.3766/H.R.7274 - Connecting Caregivers to Medicare Act, S.3109/H.R.8018 - Alleviating Barriers for Caregivers (ABC) Act, S.4325 - Lifespan Respite Reauthorization Act, Physician Fee Schedule paid caregiver training in Medicare implementation, Older Americans Act Reauthorization, caregiver mental health)

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA)

Family Caregiver issues (S.3766/H.R.7274 - Connecting Caregivers to Medicare Act, S.3109/H.R.8018 - Alleviating Barriers for Caregivers (ABC) Act, Physician Fee Schedule paid caregiver training in Medicare implementation, Older Americans Act Reauthorization)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 4556/H.R. 9179, the SAFE STEPS for Veterans Act. H.R. 542, the Elizabeth Dole Home and Community-Based Services for Veterans and Caregivers Act. S. 495/H.R. 1815, the Expanding Veterans Options for Long Term Care Act. H.R. 3581, the Caregiver Outreach and Program Enhancement (COPE) Act. H.R. 2818, the Autonomy for Disabled Veterans Act. H.R. 3956, the Veterans Protection from Fraud Act. S. 3109/H.R. 8018, the Alleviating Barriers for Caregivers Act. S. 3702/H.R. 7165, the Credit for Caring Act. S. 3254/H.R. 7222, the Lowering Costs for Caregivers Act. S. 3766/H.R. 7274, the Connecting Caregivers to Medicare Act. No bill number. Discussed veterans and military veteran caregivers. H.R. 8108, the Care for Military Kids Act. No bill number. Discussed VA Caregiver Support Programs.

Client expense: $4,820,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

S.J.Res.79 - A joint resolution providing for congressional disapproval of the rule submitted by the Department of Labor relating to "Retirement Security Rule: Definition of an Investment Advice Fiduciary. H.J.Res.140 - Providing for congressional disapproval of the rule submitted by the Department of Labor relating to "Amendment to Prohibited Transaction Exemption 2020-02. H.J.Res.141 - Providing for congressional disapproval of the rule submitted by the Department of Labor relating to "Amendment to Prohibited Transaction Exemption 84-24". H.J.Res.142 - Providing for congressional disapproval of the rule submitted by the Department of Labor relating to "Retirement Security Rule: Definition of an Investment Advice Fiduciary". H.J.Res.143 - Providing for congressional disapproval of the rule submitted by the Department of Labor relating to "Amendment to Prohibited Transaction Exemptions 75-1, 77-4, 80-83, 83-1, and 86-128". No bill number. Discussed retirement issues. H.R. 665, the Stronger Workforce for America Act. S. 1979, the Protecting Older Americans Act. S. 1030/ H.R. 6581, the Protecting Older Workers Against Discrimination Act. H.R. 3491, the Protect Older Job Applicants Act. No bill number. Discussed the Senior Community Service Employment Program. No bill number. Discussed the Workforce Innovation and Opportunity Act. S. 3109/H.R. 8018, the Alleviating Barriers for Caregivers Act. H.R. 4289, the WISH Act of 2023. No bill number. Discussed long-term care. S.1190, the Direct Support Worker Training Reimbursement Act. S.1196, the Mollie Baldwin Upskilling of Personal and Home Care Aides Act of 2023. S.1192, the CADSAW Act of 2023.

Client expense: $4,820,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, White House Office

S. 3109/H.R. 8018, the Alleviating Barriers for Caregivers Act. S. 3766/H.R. 7274, the Connecting Caregivers to Medicare Act. No bill number. Discussed funding for SHIP low-income outreach and enrollment programs. No bill number. Discussed Medicare Advantage and health savings accounts. H.R.7623/S.3697, the Telehealth Modernization Act. S. 5070/H.R. 8107, the Ensuring Access to Medicaid Buy-In Programs Act. No bill number. Discussed Medicare Physician Fee Schedule for calendar year 2025. No bill number. Discussed Medicare Hospital Outpatient Prospective Payment System for calendar year 2025. No bill number. Discussed Fiscal Year 2025 Home Health Prospective Payment System Rate Update. No bill number. Discussed Medicare open enrollment. H.R. 8702/S.4532, the Improving Seniors Timely Access to Care Act of 2024. H.R. 8331/S. 4280, the Essential Caregivers Act. H.J.Res.139, Providing for Congressional disapproval of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting. S.J.Res.91, A joint resolution providing for Congressional disapproval of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting" H.R. 8244, the Ensuring Seniors Access to Quality Care Act. S.1749/H.R. 3227, the Ensuring Seniors Access to Quality Care Act. S.3410/H.R. 7513, the Protecting Americas Seniors Access to Care Act. H.R. 468, the Building Americas Health Care Workforce Act. H.R. 9067, the Building Americas Health Care Workforce Act. S. 5023, the Stand Strong Falls Prevention Act. S.1190, the Direct Support Worker Training Reimbursement Act of 2023. S.1196, the Mollie Baldwin Upskilling of Personal and Home Care Aides Act of 2023. S.1192, the CADSAW Act of 2023. No bill number. Discussed Medicaid home and community-based services and presumptive eligibility and self-directed services. No bill number. Discussed Caregiver Training Services. No bill number. Discussed GUIDE Model. No bill number. Discussed Medicare, Medicaid, and family caregivers. No bill number. Discussed Medicaid access final rule. H.R. 8108, the Care for Military Kids Act. H. R. 8106, to increase transparency and expand coverage options for home and community-based services under a Medicaid waiver. No bill number. Discussed long-term care. H.R. 9803, the Hospice Care Act.

Client expense: $4,820,000 · Firm income: Not reported

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

S. 3109/H.R. 8018, the Alleviating Barriers for Caregivers Act. S. 3766/H.R. 7274, Connecting Caregivers to Medicare Act. S. 3254/H.R 7222, the Lowering Costs for Caregivers Act. H.R. 7165/S. 3702, the Credit for Caring Act. S.3680/ H.R. 8860, the Paid Family and Medical Leave Tax Credit Extension and Enhancement Act. No bill number. Discussed paid leave for family caregivers. S.4776, the Older Americans Act Reauthorization Act. S. 5023, the Stand Strong Falls Prevention Act. S. 4556/H.R. 9179, the SAFE STEPS for Veterans Act. H.Con.Res.129 - Supporting the designation of "National Fall Prevention Awareness Week". No bill number. Discussed Strategic Framework for a National Plan on Aging. No bill number. Discussed Proposed Fiscal Year 2025 Home Health Prospective Payment System Rate Update. S.1190, the Direct Support Worker Training Reimbursement Act of 2023. S.1196, the Mollie Baldwin Upskilling of Personal and Home Care Aides Act of 2023. S.1192, the CADSAW Act of 2023. No bill number. Discussed Older Americans Act programs. No bill number. Discussed family caregiving priorities and Older Americans Act reauthorization. S. 4765, the Respect Parents Childcare Choices Act. H.R. 9803, the Hospice Care Act. No bill number. Discussed GUIDE Model. No bill number. Discussed National Strategy to Support Family Caregivers. No bill number. Discussed Medicare and Medicaid and family caregivers. H.R. 542, the Elizabeth Dole Home and Community-Based Services for Veterans and Caregivers Act. H.R. 3581, Caregiver Outreach and Program Enhancement (COPE) Act. H.R. 6160, To reauthorize a lifespan respite care program. S. 4325, the Lifespan Respite Care Reauthorization Act. No bill number. Discussed Medicare Physician Fee Schedule for calendar year 2025. No bill number. Discussed Medicare Hospital Outpatient Prospective Payment System for calendar year 2025. S.3697/H.R.7623, the Telehealth Modernization Act. No bill number. Discussed military and veteran caregivers and VA Caregiver Support Programs.

Client expense: $4,820,000 · Firm income: Not reported

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

H.R. 2941/S.1332, Recognizing the Role of Direct Support Professionals Act, all provisions H.R. 2965/S.1333, Autism Family Caregivers Act of 2023, all provisions H.R. 3380, HEADs UP Act of 2023, all provisions H.R. 5408/S.2767, SSI Savings Penalty Elimination Act, all provisions H.R. 5893, Commerce, Justice, Science, and Related Agencies Appropriations Act, 2024, provisions related to funding for Kevin and Avontes Law H.R. 5894, Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2024, and for other purposes, provisions related to funding autism research and services at the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration; assistive technology programs and special education at the Department of Education H.R. 6468, Ban Water Beads Act, all provisions H.R. 7213/S.4762, Autism CARES Act of 2024, all provisions H.R. 7300, Family-to-Family Reauthorization Act of 2024, all provisions H.R. 8018/S.3109, Alleviating Barriers for Caregivers Act, all provisions H.R. 8774, Department of Defense Appropriations Act, 2025, provisions related to the congressionally directed medical research autism research program H.R. 9026, Making appropriations for the Departments of Commerce and Justice, Science, and Related Agencies for the fiscal year ending September 30, 2025, and for other purposes, provisions related to funding for Kevin and Avontes Law H.R. 9027, Making appropriations for Agriculture, Rural Development, Food and Drug Administration, and Related Agencies programs for the fiscal year ending September 30, 2025, and for other purposes, a proposal to limit the Food and Drug Administration's ability to restrict certain uses of a device under certain circumstances H.R. 9028, Making appropriations for the Departments of Transportation, and Housing and Urban Development, and related agencies for the fiscal year ending September 30, 2025, and for other purposes, a proposal for research at the Department of Housing and Urban Development on autism and housing H.R. 9029, Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2025, and for other purposes, provisions related to funding autism research and services at the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration; assistive technology programs, vocational rehabilitation, and special education programs at the Department of Education S. 4298, Esthers Law, all provisions S. 4539/H.R. 9614, ENABLE Act, all provisions H.R.9436 - SPECTRUM Act, all provisions S.4921 - Department of Defense Appropriations Act, 2025, provisions related to the congressionally directed medical research autism research program S.4942 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025, provisions related to funding autism research and services at the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration; assistive technology programs, vocational rehabilitation and special education programs at the Department of Education S.4796 - Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2025 a proposal for research at the Department of Housing and Urban Development on autism and housing S. 3076, Disability Employment Incentive Act, all provisions S. 2522/H.R. 5102, ABLE Match Act, all provisions S. 4910, ABLE Awareness Act, all provisions S. 4911, ABLE Employment Flexibility Act, all provisions S. 3528, Supporting Disabled Entrepreneurs Act, all provisions H.R. 2706/S. 1183, Charlotte Woodward Organ Transplant Discrimination Prevention Act, all provisions H.R. 670/S. 4741, Think Differently Database Act, all provisions A proposal for the creation of an Office of Caregiver Health at the Department of Health and Human Services A bill not yet introduced to enhance incentives to create accessible and inclusive workplaces

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

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE

Older Americans Act Reauthorization. The Older Americans Act Reauthorization Act of 2024 (S. 4776): Proposals to reauthorize the Older Americans Act (OAA) of 1965 and to increase the authorization of appropriations for OAA programs, which is the major federal discretionary funding source for home and community-based services for older adults and their caregivers. Programs supported through the OAA include home-delivered and congregate nutrition services, in-home supportive services, transportation, caregiver support, community service employment, health and wellness programs, the long-term care ombudsman program, services to prevent the abuse, neglect, and exploitation of older adults, and other supportive services. Medicare, Medicaid and Social Security. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 8018 and S. 3109): Proposals would require HHS and SSA to review application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and Social Security programs in order to reduce administrative barriers facing family caregivers. The bill requires agencies to identify and report to Congress on actions that can be taken to streamline eligibility and assistance for family caregivers within existing programs. Social Security Cost of Living Adjustment (COLA). The Fair COLA for Seniors Act (H.R. 716) and the Social Security Cost of Living Increase Act (H.R. 1688): Proposals to adopt the Consumer Price Index for the Elderly (CPI-E) for the purpose of determining COLAs for Social Security beneficiaries; the Boosting Benefits and COLAs for Seniors Act (S. 3974): Proposal to calculate COLAs using the current Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) or the Consumer Price Index for the Elderly (CPI-E), whichever is greater. Social Security Expansion. The Social Security 2100 Act (H.R. 4583 and S. 2280): Proposals to improve benefits and to strengthen Social Security's financing by altering the payroll tax cap, among other changes. The Social Security Expansion Act (S. 393 and H.R. 1046): Proposals to enhance Social Security benefits and ensure the long-term solvency of the Social Security program. The Strengthening Social Security Act (H.R. 3261): Proposals to extend the solvency of the Social Security Trust Funds and improve benefits. The Safeguarding American Families & Expanding Social Security Act (S. 5017): Proposals to update and modernize Social Security benefits and to extend solvency of the Social Security Trust Funds. The Protecting and Preserving Social Security Act (H.R. 9300 and S. 4877): Proposals to adopt the Consumer Price Index for the Elderly (CPI-E) for the purpose of determining COLAs for Social Security beneficiaries and to ensure the long-term solvency of the Social Security program by altering the payroll tax cap. The Protecting Our Widows and Widowers in Retirement Act (H.R. 3926): Proposals to improve benefits for widows and widowers in two-income households. The Surviving Widow(er) Income Fair Treatment Act (SWIFT Act) (S. 2741): Proposal to increase survivors benefits for disabled widows, widowers, and surviving divorced spouses. Social Security Funding. The Medicare and Social Security Fair Share Act (H.R. 4535 and S. 1174): Proposals to close the loophole for wealthy individuals who bypass paying the net investment income tax (NIIT) and directing the revenue to the Social Security Trust Funds and to the Hospital Insurance Fund, which pays for Medicare Part A that covers inpatient care in hospitals. Social Security Privatization and Benefit Cuts. (No bill): Proposals to borrow funds to invest in the stock market, to raise the Social Security retirement age and to cut Social Security benefits for future retirees promoted by Senator Bill Cassidy and Senator Angus King. Caregiver Social Security Credits. The Social Security Caregiver Credits Act (S. 1211 and H.R. 3729): Proposal to provide Social Security wage credits for individuals who reduce their participation in the workforce or leave the workforce to provide care to specified family members and relatives. Social Security Government Pension Offset and Windfall Elimination Provision. The Social Security Fairness Act of 2023 (H.R. 82 and S. 597) and the Public Servants Protection and Fairness Act (H.R. 4260): Proposals to repeal or modify the Government Pension Offset and Windfall Elimination Provision. Social Security Notch. (No bill): Proposals to ensure that Social Security benefits for individuals born in 1960 and 1961 are not reduced as a result of the coronavirus-related drop in the average wage index. Protecting Seniors from Garnishment. (No bill): Proposal to protect Social Security beneficiaries from having their Social Security benefits garnished to recover unpaid student loans. Social Security Disability Insurance Claim Adjudication. (No bill): Proposal to nullify the rule finalized by the Social Security Administration on November 16, 2020, that outlines when its administrative appeals judges may hold hearings and issue decisions on individual cases. Currently, these judges serve an appellate function where they review, at the request of Social Security claimants, the decisions of the administrative law judges who issue decisions in individual cases. Social Security Overpayments. (No bill): Proposals to protect retirees, survivors and people with disabilities from being forced to repay extra Social Security and Supplemental Security Income (SSI) benefits they received through no fault of their own. Strengthening Beneficiaries Rights. (No bill): Various proposals relating to the protection and rights available to Social Security and Supplemental Security Income beneficiaries. Social Security Benefit Statements. The Know Your Social Security Act (No bill): Proposal to implement section 1143 of the Social Security Act by clarifying the Social Security Administration is required to mail annual benefit statements to all workers over age 25. Supplemental Security Income (SSI) Program. The Supplemental Security Income Restoration Act (H.R. 7138 and S. 2767): Proposals to strengthen and restore the SSI program. Supplemental Security Income (SSI) Program. The SSI Savings Penalty Elimination Act (S. 2767 and H.R. 5408): Proposal to amend title XVI of the Social Security Act to update the resource limit for Supplemental Security Income eligibility. The Fairness in Social Security Act (H.R. 4348): Proposal to amend the Internal Revenue Code of 1986 to exclude the portion of a lump-sum Social Security benefit payment that relates to periods prior to the taxable year from the determination of household income as it relates to SSI eligibility. Retirement Plan Distribution: IRS Notice relating to Use of an Electronic Medium to Make Participant Elections and Spousal Consents (RIN 1545-Bq50). House Committee on Aging. (H. Res. 1029): A Resolution amending the Rules of the House to reestablish a Permanent Select Committee on Aging. Retirement Plan Fiduciary Rule: U.S. Department of Labor, Employee Benefits Security Administration, Office of Regulations and Interpretations - RIN 1210-AC02; Application No. D-12057; Application No. D-12060. Supporting the Department of Labor proposed regulation to modernize the fiduciary rule to strengthen protections for retirement investors who seek professional investment advice. (H.J. Res 142 and S.J. Res 79): Opposing resolutions providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Labor relating to "Retirement Security Rule: Definition of an Investment Advice Fiduciary". Social Security Administration. The Improving Social Securitys Service to Victims of Identity Theft Act (H.R. 3765 and H.R. 3784): Proposal to improve Social Security's service to victims of identity theft by requiring the Social Security Administration to provide a single point of contact for any individual whose Social Security account number has been misused. Social Security Administration. Comments in support of Omitting Food from In-Kind Support and Maintenance Calculations, Docket No. SSA-2021-0014; Comments in support of Expanding the Rental Subsidy, Docket No. SSA-2023-0010; Comments in support of Intermediate Improvement to the Disability Adjudication Process Including How We Consider Past Work, Docket No. SSA-2023-0024; Comments in support of Rulemaking Expanding the Definition of a Public Assistance Household, Docket No. SSA-2023-0015; Comments supporting and strengthening rule regarding the Use of Electronic Payroll Data to Improve Program Administration, Docket No. SSA-2016-0039. Social Security Administration: Comments submitted regarding Social Security Form SSA-827 proposal (Medical Record Collection Process) and the Disability Applicant Evidence Simplification Act (DAESA) draft. Womens Retirement Security. The Womens Retirement Protection Act (S. 2627 and H.R. 5060): Proposal to amend the Employee Retirement Income Security Act of 1974 to provide for greater spousal protection under defined contribution plans. Food Security for Seniors. Farm bill reauthorization (The Farm, Food, and National Security Act of 2024, H.R. 8467; No Senate bill): opposing any cuts to future Supplemental Nutrition Assistance Program (SNAP) benefits or other harmful policies that would worsen the problem of hunger for Americas older adults and other food insecure individuals.

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

Government targets: Administration on Aging, Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), Treasury, Dept of

Medicare Observation Stays. The Improving Access to Medicare Coverage Act of 2023 (H.R. 5138 and S. 4137): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Prices (No bill): Proposal to have the Biden Administration lower the price of the prostate cancer drug Xtandi through executive action by using so-called march-in rights under the Bayh-Dole Act; to amend the Federal Food, Drug, and Cosmetic Act to grant eligible researchers access to drugs or biologic products for research purposes at a price no higher than the cost to the manufacturer; to block so-called Dispense-As-Written campaigns where drug manufacturers incentivize health care providers to specify a brand drug on a prescription to block generic substitution at the pharmacy. Medicare Drug Costs. The Pharmaceutical Research Transparency Act of 2023 (S. 1476 and H.R. 3160): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Drug Savings. The Seniors Securing Access to Vital and Essential Prescription Drugs Act (H.R. 2893): Proposals to discount the treatment of eligible retirement plans in determining the eligibility of individuals for premium and cost sharing subsidies under Part D of the Medicare program. (No bills): Proposals to eliminate the Medicare Part D low-income subsidy programs asset test and raise the income eligibility levels to 200 percent of the federal poverty level. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. The Affordable Pricing for Taxpayer-Funded Prescription Drugs Act of 2023 (H.R. 3093): Proposals to require companies that receive federal funding for research (or a license of the rights to a patent or regulatory test data) for a biomedical product or service to agree to set reasonable prices for the resulting biomedical product or service and authorize to determine a reasonable price based on a formula that ensures the U.S. price for the product or service is not more than the median price for the product or service in Canada and six other reference countries. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act (Public Law No: 117-169). Medicare and Medicaid Prescription Drugs. (No bill): Joined comments with 19 other organizations urging HHS to use its existing authority to license competition in order to lower consumer and taxpayer costs for semaglutide drugs treating diabetes and weight management (e.g., Ozempic and Wegovy). Medicare Prescription Drugs. The PACE Part D Choice Act (H.R. 3549 and S. 1703): Proposal to increase the affordability of the Program of All-Inclusive Care for the Elderly (PACE) for Medicare beneficiaries by lowering the cost of Part D premiums substantially for Medicare-only enrollees, thus opening up the PACE program to this population. Medicare Low-Income Subsidy (LIS) Program. (No bill): Proposal to increase funding for LIS outreach and enrollment, so that low-income beneficiaries can more readily access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 34) and The Medicare and Social Security Fair Share Act (S. 1174 and H.R. 4535): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Trustees Report (No bill). Review of the findings on economic, legislative and other developments affecting the actuarial soundness of the Medicare Part A (Hospital Insurance) Trust Fund and the Trust Funds for Parts B and D coverage. Medicare Dental Coverage. The Medicare Dental Benefit Act (S. 2012 and H.R. 4146): Proposal to add a dental benefit to Medicare. Medicare Hearing Coverage. The Help Extend Auditory Relief Act of 2024 (H.R. 8064): Proposal to expand Medicare coverage to include hearing examinations and diagnoses, fittings and hearing aids. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Public Health Emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Privatization (No bill): Proposals to create reimbursement policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home and Community-Based Services. The HCBS Access Act (H.R. 1493 and S. 762): Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Caregiving. The Alleviating Barriers to Caregiving Act (H.R. 8018 and S. 3109): Proposal to require the Secretaries of HHS and SSA to review and streamline enrollment in coverage and benefits for family caregivers in Medicare, Medicaid, CHIP and Social Security. Medicare and Medicaid Nursing Homes. The Nursing Home Disclosure Act (H.R. 177): Proposal to direct HHS to establish a national registry of medical directors. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 7513 and S. 3410): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. (H.J. Res. 139 and S.J. Res. 91): Proposal to use the Congressional Review Act to disapprove the HHS Secretarys final rule promulgating national staffing standards in nursing homes Medicare, Medicaid Nursing Homes. The Building Americas Health Care Workforce Act (H.R. 9067): Proposal to allow time spent working in a nursing home (prior to any formal training, and permitted during the COVID-19 pandemic) to count toward a 75-hour minimum federal training standard that is required for certified nursing assistants. Medicare, Medicaid Nursing Homes. The Ensuring Seniors Access to Quality Care Act (H.R. 3227): Proposal to repeal regulations that prohibit certified nursing assistant training and competency evaluation programs in skilled nursing facilities that have a record of health and safety deficiencies and have incurred penalties (e.g., civil monetary penalties for substandard quality of care). Medicare, Medicaid Nursing Homes, Assisted Living and Other Long Term Care Services and Supports (LTSS) Settings. The Long-Term Care Workforce Support Act (H.R. 7994 and S. 4120): Proposals to increase the number of direct care professionals, including in rural communities; pathways to enter and be supported in the workforce for women, people of color, and people with disabilities; and to improve compensation for direct care professionals to reduce vacancies and turnover. Medicare and Medicaid Nursing Home Ownership. (No bill): A final HHS regulation for comprehensive ownership disclosure in the nursing home sector issued on November 17th, 2023. Rule calls for strengthened cost reporting requirements, together with ongoing national analyses and monitoring of the performance of the nursing home sector that uses ownership, staffing, cost report data and inspection data. Medicare and Medicaid Nursing Home Staffing. (No bill): Final regulations establishing national staffing standards in nursing homes that would safeguard the health and safety of all elderly and disabled residents. Medicaid Long-Term Services and Supports (LTSS). (No bill): Proposals to request that CMS collect standardized LTSS expenditure data annually from every state and across all LTSS programs and for disaggregation of expenditure data by the delivery system and demographic characteristics in order to identify disparities in access and use of LTSS and help states and CMS deploy targeted strategies to meet the needs of older adults and people with disabilities. Oversight of Health Care Industry Owned by Private Equity Firms. (No bill): Joined with other organizations in submitting comments (April 2024) to HHS, the Federal Trade Commission and the Department of Justice urging sustained, stepped up and rigorous oversight be extended to health care industry transactions that are financed by private equity company companies and other types of private investors.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Lobbying to Increase Prescription Drug Affordability and Accessibility: Advocacy for Medicare Part D redesign and benefits for people living with Parkinson's, including expanding the low-income subsidy (LIS) program, capping out-of-pocket costs, implementing a smoothing mechanism, and streamlining utilization management processes. The Medicare Part D Six Protected Classes Policy: Requires Part D plans to cover all drugs in six classes: immunosuppressants, antidepressants, antipsychotics, anticonvulsants, antiretrovirals, and antineoplastics. For people living with Parkinson's, most of whom are Medicare beneficiaries, it is essential to have access to a wide range of treatment options for antidepressants and antipsychotics, which are crucial for managing non-motor symptoms like depression and psychosis. Signed Coalition Letters: - Medicare Access for Prescription Rx (MAPRx): Comment letter in response to Medicare Prescription Payment Plan Part One Guidance. - Patient and Provider Advocates for Telehealth: Comment letter in response to CMS CY 2024 Medicare Physician Fee Schedule (PFS) supporting expanded access to telehealth. - Alliance for Aging Research: Coalition letter in response to Medicare Prescription Payment Plan Part One Guidance supporting proposed beneficiary protections. H.R.4752/S.2379 - CHANGE Act of 2023: A bill to better utilize existing Medicare wellness visits for early screening, detection, and diagnosis of Alzheimer's and related dementias, including Parkinson's disease dementia. S.1544/H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023: A bill to establish separate payment requirements for diagnostic radiopharmaceuticals, including DaTscans used to confirm Parkinson's diagnoses, under the Medicare outpatient prospective payment system. CMS-1809-P (2025 Medicare OPPS Proposed Rule): Comment supporting CMS's proposal to separately reimburse certain diagnostic radiopharmaceuticals used in diagnosing Parkinson's disease and atypical parkinsonisms. H.R.8702/S.4532 - Improving Seniors' Timely Access to Care Act: Establishes requirements for the use of prior authorization under Medicare Advantage plans to ensure timely access to care for seniors, including those with Parkinson's. S.3109/H.R.8018 - Alleviating Barriers for Caregivers (ABC) Act: Requires the Centers for Medicare & Medicaid Services (CMS) and Social Security to simplify processes and communications for family caregivers to assist individuals in accessing and utilizing benefits. S.3766/H.R.7274 - Connecting Caregivers to Medicare Act: Amends the Social Security Act to provide outreach and education to Medicare beneficiaries and simplify access to information for family caregivers through 1-800-MEDICARE. Advocacy for Durable Medical Equipment (DME) Access: Lobbying CMS to direct Medicare contractors to clarify claims procedures for DME therapies requiring administration via external infusion pumps, ensuring quick access to new Parkinson's therapies after FDA approval.

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

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

H.R. 2941/S.1332, Recognizing the Role of Direct Support Professionals Act, all provisions H.R. 2965/S.1333, Autism Family Caregivers Act of 2023, all provisions H.R. 3380, HEADs UP Act of 2023, all provisions H.R. 5408/S.2767, SSI Savings Penalty Elimination Act, all provisions H.R. 5893, Commerce, Justice, Science, and Related Agencies Appropriations Act, 2024, provisions related to funding for Kevin and Avontes Law H.R. 5894, Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2024, and for other purposes, provisions related to funding autism research and services at the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration; assistive technology programs and special education at the Department of Education H.R. 6468, Ban Water Beads Act, all provisions H.R. 7213/S.4762, Autism CARES Act of 2024, all provisions H.R. 7300, Family-to-Family Reauthorization Act of 2024, all provisions H.R. 8018/S.3109, Alleviating Barriers for Caregivers Act, all provisions H.R. 8774, Department of Defense Appropriations Act, 2025, provisions related to the congressionally directed medical research autism research program H.R. 9026, Making appropriations for the Departments of Commerce and Justice, Science, and Related Agencies for the fiscal year ending September 30, 2025, and for other purposes, provisions related to funding for Kevin and Avontes Law H.R. 9027, Making appropriations for Agriculture, Rural Development, Food and Drug Administration, and Related Agencies programs for the fiscal year ending September 30, 2025, and for other purposes, a proposal to limit the Food and Drug Administration's ability to restrict certain uses of a device under certain circumstances H.R. 9028, Making appropriations for the Departments of Transportation, and Housing and Urban Development, and related agencies for the fiscal year ending September 30, 2025, and for other purposes, a proposal for research at the Department of Housing and Urban Development on autism and housing H.R. 9029, Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2025, and for other purposes, provisions related to funding autism research and services at the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration; assistive technology programs, vocational rehabilitation, and special education programs at the Department of Education S. 4298, Esthers Law, all provisions S. 4539/H.R. 9614, ENABLE Act, all provisions H.R.9436 - SPECTRUM Act, all provisions S.4921 - Department of Defense Appropriations Act, 2025, provisions related to the congressionally directed medical research autism research program S.4942 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2025, provisions related to funding autism research and services at the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration; assistive technology programs, vocational rehabilitation and special education programs at the Department of Education S.4796 - Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2025 a proposal for research at the Department of Housing and Urban Development on autism and housing S. 3076, Disability Employment Incentive Act, all provisions S. 2522/H.R. 5102, ABLE Match Act, all provisions S. 4910, ABLE Awareness Act, all provisions S. 4911, ABLE Employment Flexibility Act, all provisions S. 3528, Supporting Disabled Entrepreneurs Act, all provisions H.R. 2706/S. 1183, Charlotte Woodward Organ Transplant Discrimination Prevention Act, all provisions H.R. 670/S. 4741, Think Differently Database Act, all provisions A proposal for the creation of an Office of Caregiver Health at the Department of Health and Human Services A bill not yet introduced to enhance incentives to create accessible and inclusive workplaces

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

Government targets: HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE

ALS Better Care Act (H.R 5663/S.3258) - Discussion around supplemental payment to designated ALS clinics that provide multidisciplinary services to people living with ALS. HELP Copays Act (H.R.830 / S.1375) -- Provisions related to health insurance plans requirement to apply payments made by or on behalf of plan enrollees toward a plan's cost-sharing requirements, i.e. a ban on copay-accumulator adjust programs. Access to Genetic Counselor Services Act of 2023 (H.R.3876) - Provisions related to modernization of Medicare to keep pace with generic and genomic medicine innovation. Improves the ability for practitioners to refer patients to genetic counselors, Provides 85% reimbursement of physicians fee schedule amount for service. Discussion around Telehealth permanence (no bill number) - provisions related to permanent telehealth services in Medicare and interstate telehealth services. Close the Medigap Act (HR 35) -Discussion around Medigap guarantee issue provisions for people living with ALS aged under 65. Alleviating Barriers for Caregivers (ABC) Act (S.3109/H.R.8018) - All provisions. Connecting Caregivers to Medicare Act of 2024 (H.R. 7274/S. 3766) - All provisions

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Older Americans Act Reauthorization. The Older Americans Act Reauthorization Act of 2024 (S. 4776): Proposals to reauthorize the Older Americans Act (OAA) of 1965 and to increase the authorization of appropriations for OAA programs, which is the major federal discretionary funding source for home and community-based services for older adults and their caregivers. Programs supported through the OAA include home-delivered and congregate nutrition services, in-home supportive services, transportation, caregiver support, community service employment, health and wellness programs, the long-term care ombudsman program, services to prevent the abuse, neglect, and exploitation of older adults, and other supportive services. Medicare, Medicaid and Social Security. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 8018 and S. 3109): Proposals would require HHS and SSA to review application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and Social Security programs in order to reduce administrative barriers facing family caregivers. The bill requires agencies to identify and report to Congress on actions that can be taken to streamline eligibility and assistance for family caregivers within existing programs. Social Security Cost of Living Adjustment (COLA). The Fair COLA for Seniors Act (H.R. 716) and the Social Security Cost of Living Increase Act (H.R. 1688): Proposals to adopt the Consumer Price Index for the Elderly (CPI-E) for the purpose of determining COLAs for Social Security beneficiaries; the Boosting Benefits and COLAs for Seniors Act (S. 3974): Proposal to calculate COLAs using the current Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) or the Consumer Price Index for the Elderly (CPI-E), whichever is greater. Social Security Expansion. The Social Security 2100 Act (H.R. 4583 and S. 2280): Proposals to improve benefits and to strengthen Social Security's financing by altering the payroll tax cap, among other changes. The Social Security Expansion Act (S. 393 and H.R. 1046): Proposals to enhance Social Security benefits and ensure the long-term solvency of the Social Security program. The Strengthening Social Security Act (H.R. 3261): Proposals to extend the solvency of the Social Security Trust Funds and improve benefits. The Safeguarding American Families & Expanding Social Security Act (S. 5017): Proposals to update and modernize Social Security benefits and to extend solvency of the Social Security Trust Funds. The Protecting and Preserving Social Security Act (H.R. 9300 and S. 4877): Proposals to adopt the Consumer Price Index for the Elderly (CPI-E) for the purpose of determining COLAs for Social Security beneficiaries and to ensure the long-term solvency of the Social Security program by altering the payroll tax cap. The Protecting Our Widows and Widowers in Retirement Act (H.R. 3926): Proposals to improve benefits for widows and widowers in two-income households. The Surviving Widow(er) Income Fair Treatment Act (SWIFT Act) (S. 2741): Proposal to increase survivors benefits for disabled widows, widowers, and surviving divorced spouses. Social Security Funding. The Medicare and Social Security Fair Share Act (H.R. 4535 and S. 1174): Proposals to close the loophole for wealthy individuals who bypass paying the net investment income tax (NIIT) and directing the revenue to the Social Security Trust Funds and to the Hospital Insurance Fund, which pays for Medicare Part A that covers inpatient care in hospitals. Social Security Privatization and Benefit Cuts. (No bill): Proposals to borrow funds to invest in the stock market, to raise the Social Security retirement age and to cut Social Security benefits for future retirees promoted by Senator Bill Cassidy and Senator Angus King. Caregiver Social Security Credits. The Social Security Caregiver Credits Act (S. 1211 and H.R. 3729): Proposal to provide Social Security wage credits for individuals who reduce their participation in the workforce or leave the workforce to provide care to specified family members and relatives. Social Security Government Pension Offset and Windfall Elimination Provision. The Social Security Fairness Act of 2023 (H.R. 82 and S. 597) and the Public Servants Protection and Fairness Act (H.R. 4260): Proposals to repeal or modify the Government Pension Offset and Windfall Elimination Provision. Social Security Notch. (No bill): Proposals to ensure that Social Security benefits for individuals born in 1960 and 1961 are not reduced as a result of the coronavirus-related drop in the average wage index. Protecting Seniors from Garnishment. (No bill): Proposal to protect Social Security beneficiaries from having their Social Security benefits garnished to recover unpaid student loans. Social Security Disability Insurance Claim Adjudication. (No bill): Proposal to nullify the rule finalized by the Social Security Administration on November 16, 2020, that outlines when its administrative appeals judges may hold hearings and issue decisions on individual cases. Currently, these judges serve an appellate function where they review, at the request of Social Security claimants, the decisions of the administrative law judges who issue decisions in individual cases. Social Security Overpayments. (No bill): Proposals to protect retirees, survivors and people with disabilities from being forced to repay extra Social Security and Supplemental Security Income (SSI) benefits they received through no fault of their own. Strengthening Beneficiaries Rights. (No bill): Various proposals relating to the protection and rights available to Social Security and Supplemental Security Income beneficiaries. Social Security Benefit Statements. The Know Your Social Security Act (No bill): Proposal to implement section 1143 of the Social Security Act by clarifying the Social Security Administration is required to mail annual benefit statements to all workers over age 25. Supplemental Security Income (SSI) Program. The Supplemental Security Income Restoration Act (H.R. 7138 and S. 2767): Proposals to strengthen and restore the SSI program. Supplemental Security Income (SSI) Program. The SSI Savings Penalty Elimination Act (S. 2767 and H.R. 5408): Proposal to amend title XVI of the Social Security Act to update the resource limit for Supplemental Security Income eligibility. The Fairness in Social Security Act (H.R. 4348): Proposal to amend the Internal Revenue Code of 1986 to exclude the portion of a lump-sum Social Security benefit payment that relates to periods prior to the taxable year from the determination of household income as it relates to SSI eligibility. Retirement Plan Distribution: IRS Notice relating to Use of an Electronic Medium to Make Participant Elections and Spousal Consents (RIN 1545-Bq50). House Committee on Aging. (H. Res. 1029): A Resolution amending the Rules of the House to reestablish a Permanent Select Committee on Aging. Retirement Plan Fiduciary Rule: U.S. Department of Labor, Employee Benefits Security Administration, Office of Regulations and Interpretations - RIN 1210-AC02; Application No. D-12057; Application No. D-12060. Supporting the Department of Labor proposed regulation to modernize the fiduciary rule to strengthen protections for retirement investors who seek professional investment advice. (H.J. Res 142 and S.J. Res 79): Opposing resolutions providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Labor relating to "Retirement Security Rule: Definition of an Investment Advice Fiduciary". Social Security Administration. The Improving Social Securitys Service to Victims of Identity Theft Act (H.R. 3765 and H.R. 3784): Proposal to improve Social Security's service to victims of identity theft by requiring the Social Security Administration to provide a single point of contact for any individual whose Social Security account number has been misused. Social Security Administration. Comments in support of Omitting Food from In-Kind Support and Maintenance Calculations, Docket No. SSA-2021-0014; Comments in support of Expanding the Rental Subsidy, Docket No. SSA-2023-0010; Comments in support of Intermediate Improvement to the Disability Adjudication Process Including How We Consider Past Work, Docket No. SSA-2023-0024; Comments in support of Rulemaking Expanding the Definition of a Public Assistance Household, Docket No. SSA-2023-0015; Comments supporting and strengthening rule regarding the Use of Electronic Payroll Data to Improve Program Administration, Docket No. SSA-2016-0039. Social Security Administration: Comments submitted regarding Social Security Form SSA-827 proposal (Medical Record Collection Process) and the Disability Applicant Evidence Simplification Act (DAESA) draft. Womens Retirement Security. The Womens Retirement Protection Act (S. 2627 and H.R. 5060): Proposal to amend the Employee Retirement Income Security Act of 1974 to provide for greater spousal protection under defined contribution plans. Food Security for Seniors. Farm bill reauthorization (The Farm, Food, and National Security Act of 2024, H.R. 8467; No Senate bill): opposing any cuts to future Supplemental Nutrition Assistance Program (SNAP) benefits or other harmful policies that would worsen the problem of hunger for Americas older adults and other food insecure individuals

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

Government targets: Administration on Aging, Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), Treasury, Dept of

H.R. 547/S.100, the Better Care Better Jobs Act H.R. 1493/S. 762, the HCBS Access Act H.R. 4315, the Medicare Orthotics and Prosthetics Patient-Centered Care Act H.R. 6029/S. 3120, the Disaster Relief Medicaid Act H.R. 8018/S. 3109, the Alleviating Barriers for Caregivers (ABC) Act S. 3118, the HCBS Relief Act of 2023 Discussions: Interaction between Medicare Part B and Tricare for medically retired veterans Discussions: Definition of Medicare in the Home for DME purposes Discussions: Right to repair DME products - ensure providers of DME and prosthetics are reimbursed by Medicare when doing repairs and preventative maintenance

Client expense: $86,378 · Firm income: Not reported

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

S.652 - Safe Step Act (Murkowski/Hassan), support passage H.R. 830 - HELP Copays Act, support passage S.935- Fair Accountability and Innovative Research Drug Pricing Act of 2023, support passage H.R. 485, Protecting Health Care For All Patients Act, oppose passage as currently written S.127, the Pharmacy Benefit Manager Transparency Act, support passage Urged HELP and House Energy and Commerce Committee to hold roundtables and advance proposals that address workforce issues within the healthcare community. S. 2333 - Pandemic and All-Hazards Preparedness and Response Act, support passage H.R. 824, Telehealth Benefit Expansion for Workers Act of 2023, oppose passage H.R. 4421, Preparing for All Hazards and Pathogens Reauthorization Act, monitor legislation H.R. 4420, Preparedness and Response Reauthorization Act, monitor legislation Committee Draft -The Primary Care and Health Workforce Expansion Act, support passage S. 1339, the Pharmacy Benefit Manager Reform Act, support passage S.127, the PBM Transparency Act of 2023, support passage S.113, The Prescription Pricing for the People Act of 2023, support passage S.2052, Protect Patient Access to Pharmacies Act H.R. 1692, Health Care Affordability Act of 2023 H.R. 3561, the PATIENT Act of 2023, support passage H.R. 3284, Providers and Payers Compete Act, support passage H.R. 4507, Transparency in Coverage Act, support passage H.R. 4508, Hidden Fee Disclosure Act, support passage H.R. 2816, PBM Sunshine and Accountability Act, support passage S.79- Interagency Patent Coordination and Improvement Act of 2023, support passage S. 142- Preserve Access to Affordable Generics and Biosimilars Act, support passage S.148- Stop STALLING Act, support passage S.150- Affordable Prescriptions for Patients Act of 2023, support passage S.775-Increasing Transparency in Generic Drug Applications Act, monitoring S.1067-Ensuring Timely Access to Generics Act of 2023, support passage S. 2780 Medication Affordability and Patent Integrity Ac H.R. 4189, the CONNECT for Health Act, support passage H.R. 1843, the Telehealth Expansion Act, support passage H.R. 8018, the Alleviating Barriers for Caregivers Act, support passage S. 3109, the Alleviating Barriers for Caregivers Act, support passage H.R.6302, the Health Share Transparency Act of 2023 H.R.7623, the Telehealth Modernization Act of 2024

Client expense: $60,810 · Firm income: Not reported

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

- Support the May 22, 2024 Statement for the Record submitted by the Consortium of Constituents with Disabilities to the Congressional Hearing on The Family First Prevention Services Act: Successes, Roadblocks, and Opportunities for Improvement. The statement opposed the Ensuring Medicaid Continuity for Children in Foster Care Act (S. 3196) because of it would potentially create new financial incentives to expand institutional care and undermine efforts to keep youth with families - Support the Alleviating Barriers for Caregivers (ABC) Act (S. 3109/H.R. 8018), which would require the Centers for Medicare & Medicaid Services (CMS) and Social Security Administration (SSA) to review eligibility determinations and application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and the Social Security programs to reduce administrative barriers to attaining and maintaining program eligibility

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

Draft, Broker Accountability Act (no bill number) - ACA Agent/Broker accountability H.R. 35 - Close the Medigap Act of 2023 - Rep. Doggett, Lloyd - Medigap policies H.R. 3746 - Fiscal Responsibility Act of 2023 - Rep. McHenry, Patrick - work requirements for federal programs H.R. 3875 - Expanded Telehealth Access Act - Rep. Sherrill, Mikie - Medicare payment for telehealth services H.R. 4411 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer - disparity in MA benchmark rates H.R. 4818 - Treat and Reduce Obesity Act of 2023 - Rep. Wenstrup, Brad -Medicare Coverage of weight loss treatment H.R. 5526 - Seniors' Access to Critical Medications Act of 2023 - Rep. Harshbarger, Diana - exception for physician self-referral H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - amends Medicaid Third Party liability requirements H.R. 5746 - Addressing Whole Health in Medicare Advantage Act - Rep. Bilirakis, Gus - Medicare Advantage supplemental benefits H.R. 5854 - Medicare Advantage Consumer Protection and Transparency Act - Rep. Porter, Katie - Medicare Advantage organization reporting H.R. 6364 - Medicare Telehealth Privacy Act of 2023 - Rep. Balderson, Troy - Provider privacy provisions for telehealth under Medicare H.R. 6400 - To amend title XVIII of the Social Security Act to extend eligibility for certain payment increases for biosimilar biological products under the Medicare program - Rep. Cardenas, Tony - Medicare payment increase for biosimilars H.R. 6445 - Medicare Audiology Access Improvement Act of 2023 - Rep. Bilirakis, Gus - Medicare Audiology Coverage H.R. 7147 - Medicare Transaction Fraud Prevention Act - Rep. Schweikert, David - oversight of payments for medical equipment & clinical DLTs under Medicare H.R. 7148 - Medicare Home Health Accessibility Act - Rep. Smucker, Lloyd - occupational therapy eligibility for home health coverage under Medicare H.R. 7254 - Hearing Device Coverage Clarification Act - Rep. Fischbach, Michelle - excludes fully implanted active middle ear hearing devices from the hearing aid coverage exclusion under Medicare H.R. 7274 - Connecting Caregivers to Medicare Act of 2024 - Rep. Carey, Mike - outreach, education, and simplify information for family caregivers on Medicare benefits H.R. 7432 - Sickle Cell Disease Comprehensive Care Act - Rep. Burgess, Michael - enables State Medicaid programs to provide coordinated care through health home to individuals with sickle cell disease H.R. 7512 - Real-Time Benefit Tool Implementation Act - Rep. Arrington, Jodey - implementation of real-time benefit tools under part D of under Medicare H.R. 7573 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - Medicaid Estate Recovery Program H.R. 7619 - Expand the Behavioral Health Workforce Now Act - Rep. Neguse, Joe - education, training, recruitment, and retention of mental health and substance use disorder providers under Medicaid and CHIP H.R. 7623 - Telehealth Modernization Act of 2024 - Rep. Carter, Earl L. Buddy - makes certain telehealth flexibilities permanent under Medicare H.R. 7856 - Promoting Responsible and Effective Virtual Experiences through Novel Technology to Deliver Improved Access and Better Engagement with Tested and Evidence-based Strategies Act (PREVENT DIABETES Act)- Rep. DeGette, Diana - Medicare, coverage, preventive care, chronic care H.R. 7863 - To require the Secretary of Health and Human Services to issue guidance on furnishing behavioral health services via telehealth to individuals with limited English proficiency under Medicare program. - Rep. Steel, Michelle - Medicare, behavioral health, telehealth, accessibility H.R. 7939 - Patient Access to Innovative New Technologies Act of 2024 - Rep. Carey, Mike - Medicare, quality, medical devices, coverage H.R. 8018 - Alleviating Barriers for Caregivers Act- Rep. Cammack, Kat - review and simplify caregiver paperwork, CHIP, Medicare, Medicaid H.R. 8064 - Help Extend Auditory Relief Act of 2024- Rep. Cartwright, Matt - Medicare coverage of hearing aids H.R. 8075 - Improving Access to Home Dialysis Act of 2024- Rep. Miller, Carol - Medicare coverage of home dialysis H.R. 8115 - To amend title XIX of the Social Security Act to allow for the deferral or disallowance of portions of payments for certain managed care violations under Medicaid- Rep. Sarbanes, John - Medicaid managed care payment deferral H.R. 8261 - Preserving Telehealth, Hospital, and Ambulance Access Act- Rep. Schweikert, David - extend flexibilities and payment for Medicare H.R. 8702 - Improving Seniors Timely Access to Care Act - Rep. Mike Kelly - prior authorization, transparency, MA S. 838 - Improving Access to Mental Health Act - Sen. Stabenow, Debbie - mental health services in Medicare S. 2880 - Expanded Telehealth Access Act - Sen. Daines, Steve - Medicare payment for telehealth services S. 3573 - Medicare Advantage Supplemental Benefits Transparency Act- Sen. Warner, Mike - MA, data transparency, supplemental benefits S. 3578 - Protect Medicaid Act - Sen. Cassidy, Bill - prohibits federal payments under Medicaid for noncitizens, requires reporting to HHS of states that provide such health benefits S. 3630 - Medicare Transaction Fraud Prevention Act- Sen. Braun, Mike- pilot program for predictive risk-scoring algorithm, oversight, Medicare S. 3651 - Telemental Health Care Access Act of 2024- Sen. Cassidy, Bill - Medicare, mental health services, telehealth S. 3766 - Connecting Caregivers to Medicare Act of 2024- Sen. Tillis, Thomas - Medicare, outreach and education, caregivers S. 3882 - Helping States Integrate Medicare and Medicaid Act- Sen. Casey, Robert - dual eligibles, quality measures, access, enrollment S. 3934 - Increasing Access to Biosimilars Act of 2023- Sen. Cornyn, John - Medicare drug access S. 3950 - Delivering Unified Access to Lifesaving Services Act of 2024 - Sen. Cassidy, Bill - reforming Integrated Medicare/Medicaid Care Programs for Dually Eligible Individuals S. 4094 - PREVENT DIABETES Act - Sen. Scott, Tim - Medicare, coverage, preventive care, chronic care S. 4532 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - prior authorization, transparency, MA Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicaid Access Final Rule; Medicaid Redeterminations; value of Medicaid Managed Care; Medicare Advantage Health Risk Assessment; coverage of weight loss drugs; and Inflation Reduction Act implementation.

Client expense: $2,390,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, SENATE

Medicare Observation Stays. The Improving Access to Medicare Coverage Act of 2023 (H.R. 5138 and S. 4137): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Prices (No bill): Proposal to have the Biden Administration lower the price of the prostate cancer drug Xtandi through executive action by using so-called march-in rights under the Bayh-Dole Act; to amend the Federal Food, Drug, and Cosmetic Act to grant eligible researchers access to drugs or biologic products for research purposes at a price no higher than the cost to the manufacturer; to block so-called Dispense-As-Written campaigns where drug manufacturers incentivize health care providers to specify a brand drug on a prescription to block generic substitution at the pharmacy. Medicare Drug Costs. The Pharmaceutical Research Transparency Act of 2023 (S. 1476 and H.R. 3160): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Drug Savings. The Seniors Securing Access to Vital and Essential Prescription Drugs Act (H.R. 2893): Proposals to discount the treatment of eligible retirement plans in determining the eligibility of individuals for premium and cost sharing subsidies under Part D of the Medicare program. (No bills): Proposals to eliminate the Medicare Part D low-income subsidy programs asset test and raise the income eligibility levels to 200 percent of the federal poverty level. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. The Affordable Pricing for Taxpayer-Funded Prescription Drugs Act of 2023 (H.R. 3093): Proposals to require companies that receive federal funding for research (or a license of the rights to a patent or regulatory test data) for a biomedical product or service to agree to set reasonable prices for the resulting biomedical product or service and authorize to determine a reasonable price based on a formula that ensures the U.S. price for the product or service is not more than the median price for the product or service in Canada and six other reference countries. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act. Medicare Low-Income Subsidy (LIS) Program. (No bill): Proposal to increase funding for LIS outreach and enrollment, so that low-income beneficiaries can more readily access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 34) and The Medicare and Social Security Fair Share Act (S. 1174 and H.R. 4535): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental Coverage. The Medicare Dental Benefit Act (S. 2012 and H.R. 4146): Proposal to add a dental benefit to Medicare. Medicare Hearing Coverage. The Medicare Hearing Aid Coverage Act of 2021 (H.R. 244): Proposal to expand Medicare coverage to include hearing aids and services for seniors under Medicare Part B. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Public Health Emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Privatization (No bill): Proposals to create reimbursement policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home And Community-Based Services. The HCBS Access Act (H.R. 1493 and S. 762): Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Caregiving. The Alleviating Barriers to Caregiving Act (H.R. 8018 and S. 3109): Proposal to require the Secretaries of HHS and SSA to review and streamline enrollment in coverage and benefits for family caregivers in Medicare, Medicaid, CHIP and Social Security. Medicare and Medicaid Nursing Homes. The Nursing Home Disclosure Act (H.R. 177): Proposal to direct HHS to establish a national registry of medical directors. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 7513 and S. 3410): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. (H.J. Res. 139 and S.J. Res. 91): Proposal to use the Congressional Review Act to disapprove the HHS Secretarys final rule promulgating national staffing standards in nursing homes Medicare, Medicaid Nursing Homes, Assisted Living and Other Long Term Care Services and Supports (LTSS) Settings. The Long-Term Care Workforce Support Act (H.R. 7994 and S. 4120): Proposal to increase the number of direct care professionals, including in rural communities; pathways to enter and be supported in the workforce for women, people of color, and people with disabilities; and to improve compensation for direct care professionals to reduce vacancies and turnover. Medicare and Medicaid Nursing Home Ownership. (No bill): A proposed final HHS regulation for comprehensive ownership disclosure in the nursing home sector issued on November 17th, 2023. Rule calls for strengthened cost reporting requirements, together with ongoing national analyses and monitoring of the performance of the nursing home sector that uses ownership, staffing, cost report data and inspection data. Medicare and Medicaid Nursing Home Staffing. (No bill): Final regulations establishing national staffing standards in nursing homes that would safeguard the health and safety of all elderly and disabled residents. Medicaid Long-Term Services and Supports (LTSS). (No bill): Proposal to request that CMS collect standardized LTSS expenditure data annually from every state and across all LTSS programs and for disaggregation of expenditure data by the delivery system and demographic characteristics in order to identify disparities in access and use of LTSS and help states and CMS deploy targeted strategies to meet the needs of older adults and people with disabilities.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Family Caregiver issues (S.3766/H.R.7274 - Connecting Caregivers to Medicare Act, S.3109/H.R.8018 - Alleviating Barriers for Caregivers (ABC) Act, Physician Fee Schedule paid caregiver training in Medicare implementation, Older Americans Act Reauthorization)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Family Caregiver issues (Office of Caregiver Health, S.3766/H.R.7274 - Connecting Caregivers to Medicare Act, S.3109/H.R.8018 - Alleviating Barriers for Caregivers (ABC) Act, Physician Fee Schedule paid caregiver training in Medicare implementation, Older Americans Act Reauthorization, caregiver mental health)

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA)

1. S. 762, The HCBS Access Act, entire bill 2. H.R. 1493, The HCBS Access Act, entire bill 3. S. 842, Medicare and Medicaid Dental, Vision and Hearing Benefit Act, entire bill 4. H.R. 33, Medicare and Medicaid Dental, Vision and Hearing Benefit Act, entire bill 5. Proposals regarding the treatment of eligible retirement plans in determining the eligibility of individuals for premium and cost-sharing subsidies under part D of the Medicare program 6. Medicare ACO Realizing Equity, Access, and Community Health (REACH) program 7. Proposals to reduce Medicaid funding 8. H.R. 3069, John Lewis Equality in Medicare and Medicaid Treatment (EMMT) Act, entire bill 9. S. 1296, John Lewis Equality in Medicare and Medicaid Treatment (EMMT) Act, entire bill 10. Implementation of provisions of the Inflation Reduction Act of 2022 regarding drug prices under the Medicare program 11. Proposals regarding revisions to Medicare rules regarding inpatient hospital stays 12. Proposed CMS rule: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting 13. H.R. Improving Access to Mental Health Act of 2023, entire bill 14. S. 838,Improving Access to Mental Health Act of 2023, entire bill 15. Proposals regarding the Medicare Low Income Subsidy program 16. H.R. 7513, Protecting Americas Seniors Access to Care Act, entire 17. S. 3410, Protecting Rural Seniors Access to Care Act, entire bill 18. H.J.Res. 139, providing for Congressional disapproval of the CMS rule Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting," entire resolution 19. H.R. 8106, To amend title XIX of the Social Security Act to increase transparency and expand coverage options with respect to home and community-based services under a Medicaid waiver, entire bill 20. H.R. 8107, Ensuring Access to Medicaid Buy-in Programs Act of 2024, entire bill 21. H.R. 8109, Money Follows the Person Permanency Act of 2024, entire bill 22. H.R. 8110, Protecting Married Seniors from Impoverishment Act of 2024, entire bill 23. H.R. 8018, Alleviating Barriers for Caregivers Act, entire bill 24. S. 3109, Alleviating Barriers for Caregivers Act, entire bill 25. Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program rule, entire rule

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

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

H.R. 2941/S.1332, Recognizing the Role of Direct Support Professionals Act, all provisions H.R. 2965/S.1333, Autism Family Caregivers Act of 2023, all provisions H.R. 3380, HEADs UP Act of 2023, all provisions H.R. 5408/S.2767, SSI Savings Penalty Elimination Act, all provisions H.R. 5893, Commerce, Justice, Science, and Related Agencies Appropriations Act, 2024, provisions related to funding for Kevin and Avontes Law H.R. 5894, Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2024, and for other purposes, provisions related to funding autism research and services at the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration; assistive technology programs and special education at the Department of Education H.R. 6468, Ban Water Beads Act, all provisions H.R. 7213, Autism CARES Act of 2024, all provisions H.R. 7300, Family-to-Family Reauthorization Act of 2024, all provisions H.R. 8018/S.3109, Alleviating Barriers for Caregivers Act H.R. 8108, a bill to amend title XIX of the Social Security Act to add a Medicaid State plan requirement with respect to the determination of residency of certain individuals serving in the Armed Forces, all provisions H.R. 8774, Department of Defense Appropriations Act, 2025, provisions related to the congressionally directed medical research autism research program H.R. 9026, Making appropriations for the Departments of Commerce and Justice, Science, and Related Agencies for the fiscal year ending September 30, 2025, and for other purposes, provisions related to funding for Kevin and Avontes Law H.R. 9027, Making appropriations for Agriculture, Rural Development, Food and Drug Administration, and Related Agencies programs for the fiscal year ending September 30, 2025, and for other purposes, a proposal to limit the Food and Drug Administration's ability to restrict certain uses of a device under certain circumstances H.R. 9028, Making appropriations for the Departments of Transportation, and Housing and Urban Development, and related agencies for the fiscal year ending September 30, 2025, and for other purposes, a proposal for research at the Department of Housing and Urban Development on autism and housing H.R. 9029, Making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2025, and for other purposes, provisions related to funding autism research and services at the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration; assistive technology programs and special education at the Department of Education S. 4298, Esthers Law, all provisions S. 4549, A bill to amend the Internal Revenue Code of 1986 to make certain provisions with respect to qualified ABLE programs permanent, all provisions A House bill not yet introduced to increase funding for autism research focused on women and girls A Senate bill not yet introduced to provide Fiscal Year 2025 appropriations for the Department of Defense, provisions related to the congressionally directed medical research autism research program A Senate bill not yet introduced to provide Fiscal Year 2025 appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies provisions related to funding autism research and services at the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration; assistive technology programs and special education at the Department of Education A Senate bill not yet introduced to provide Fiscal Year 2025 appropriations for the Departments of Transportation, and Housing and Urban Development, and related agencies, a proposal for research at the Department of Housing and Urban Development on autism and housing A Senate bill not yet introduced to amend the Public Health Service Act to enhance activities of the National Institutes of Health with respect to research on autism spectrum disorder and enhance programs relating to autism, and for other purpose A proposal for the creation of an Office of Caregiver Health at the Department of Health and Human Services

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

Government targets: HOUSE OF REPRESENTATIVES, Natl Institute of Mental Health (NIMH), President of the U.S., SENATE

H.R. 547/S.100, the Better Care Better Jobs Act H.R. 1493/S. 762, the HCBS Access Act H.R. 4315, the Medicare Orthotics and Prosthetics Patient-Centered Care Act H.R. 6029/S. 3120, the Disaster Relief Medicaid Act H.R. 8018/S. 3109, the Alleviating Barriers for Caregivers (ABC) Act S. 3118, the HCBS Relief Act of 2023 Discussions: Interaction between Medicare Part B and Tricare for medically retired veterans Discussions: Definition of Medicare in the Home for DME purposes Discussions: Right to repair DME products - ensure providers of DME and prosthetics are reimbursed by Medicare when doing repairs and preventative maintenance

Client expense: $75,053 · Firm income: Not reported

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

Lobbying to increase prescription drug affordability and accessibility for people living with Parkinson's via Medicare Part D redesign and benefits, including expanding the low-income subsidy (LIS) program, capping out-of-pocket costs, implementing a smoothing mechanism, and streamlining utilization management processes. The Medicare Part D Six Protected Classes Policy: requires Part D plan to cover all drugs in six classes: immunosuppressants, antidepressants, antipsychotics, anticonvulsants, antiretrovirals, and antineoplastics. For people living with Parkinson's, most of whom are Medicare beneficiaries, it is essential to have access to wide range of treatment options for antidepressants and antipsychotics. Parkinson's causes non-motor symptoms, including depression and psychosis, and individuals often experience different side effects, reactions, and efficacy based on which medications they take. Partnership for Part D Access coalition congressional meetings and signed coalition letter to CMS in response to Medicare Prescription Payment Plan Part One Guidance in support of continued protection for the six protected classes policy. Signed Medicare Access for Prescription Rx (MAPRx) coalition comment letter in response to Medicare Prescription Payment Plan Part One Guidance. Signed Patient and Provider Advocates for Telehealth coalition comment letter in response to CMS CY 2024 Medicare Physician Fee Schedule (PFS) in support prioritizing the needs of patients by expanding policies that improved access to safe and timely health care via telehealth. Signed Alliance for Aging Research coalition letter in response to Medicare Prescription Payment Plan Part One Guidance in support of proposed beneficiary protections and to provide feedback on implementation considerations for the Medicare Prescription Payment Plan program. H.R.4752/S.2379 - the Concentrating High-value Alzheimer's Needs to Get to an End (CHANGE) Act of 2023: a bill to better utilize the existing Welcome to Medicare initial exam and Medicare annual wellness visits to screen, detect, and diagnose Alzheimers and related dementias, including Parkinson's disease dementia, in their earliest stages. Signed Leaders Engaged on Alzheimer's Disease (LEAD) Coalition letter to members of Congress in support of this legislation. S. 3109- Alleviating Barriers for Caregivers (ABC) Act- bill to require the Administrator of the Centers for Medicare & Medicaid Services and the Commissioner of Social Security to review and simplify the processes, procedures, forms, and communications for family caregivers to assist individuals in establishing eligibility for, enrolling in, and maintaining and utilizing coverage and benefits under the Medicare, Medicaid, CHIP, and Social Security programs respectively, and for other purposes. Lobbying the Centers for Medicare and Medicaid Services to direct Durable Medical Equipment Medicare Administrative Contractors to provide additional clarification regarding the use of claim modifiers for DME therapies that require administration via an external infusion pump to expedite patient access once new Parkinson's therapies receive approvals from the Food and Drug Administration. S.1544/H.R.1199 - Facilitating Innovative Nuclear Diagnostics Act of 2023: a bill to establish separate payment requirements for diagnostic radiopharmaceuticals, including DaTscans, which can aid in confirming a Parkinson's diagnosis, under the Medicare prospective payment system for hospital outpatient department services. S. 3766/H.R. 7274- Connecting Caregivers to Medicare Act -To amend title XVIII of the Social Security Act to provide for outreach and education to Medicare beneficiaries to simplify access to information for family caregivers through 1-800-MEDICARE, and for other purposes. H.R. 8018/S. 3109- Alleviating Barriers for Caregivers (ABC) Act- bill to require the Administrator of the Centers for Medicare & Medicaid Services and the Commissioner of Social Security to review and simplify the processes, procedures, forms, and communications for family caregivers to assist individuals in establishing eligibility for, enrolling in, and maintaining and utilizing coverage and benefits under the Medicare, Medicaid, CHIP, and Social Security programs respectively, and for other purposes. H.R.8702/S.4532 - Improving Seniors Timely Access to Care Act: a bill to establish requirements with respect to the use of prior authorization under Medicare Advantage plans.

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

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

S.652 - Safe Step Act (Murkowski/Hassan), support passage H.R. 830 - HELP Copays Act, support passage S.935- Fair Accountability and Innovative Research Drug Pricing Act of 2023, support passage H.R. 485, Protecting Health Care For All Patients Act, oppose passage as currently written S.127, the Pharmacy Benefit Manager Transparency Act, support passage Urged HELP and House Energy and Commerce Committee to hold roundtables and advance proposals that address workforce issues within the healthcare community. S. 2333 - Pandemic and All-Hazards Preparedness and Response Act, support passage H.R. 824, Telehealth Benefit Expansion for Workers Act of 2023, oppose passage H.R. 4421, Preparing for All Hazards and Pathogens Reauthorization Act, monitor legislation H.R. 4420, Preparedness and Response Reauthorization Act, monitor legislation Committee Draft -The Primary Care and Health Workforce Expansion Act, support passage S. 1339, the Pharmacy Benefit Manager Reform Act, support passage S.127, the PBM Transparency Act of 2023, support passage S.113, The Prescription Pricing for the People Act of 2023, support passage S.2052, Protect Patient Access to Pharmacies Act H.R. 3561, the PATIENT Act of 2023, support passage H.R. 3284, Providers and Payers Compete Act, support passage H.R. 4507, Transparency in Coverage Act, support passage H.R. 4508, Hidden Fee Disclosure Act, support passage H.R. 2816, PBM Sunshine and Accountability Act, support passage S.79- Interagency Patent Coordination and Improvement Act of 2023, support passage S. 142- Preserve Access to Affordable Generics and Biosimilars Act, support passage S.148- Stop STALLING Act, support passage S.150- Affordable Prescriptions for Patients Act of 2023, support passage S.775-Increasing Transparency in Generic Drug Applications Act, monitoring S.1067-Ensuring Timely Access to Generics Act of 2023, support passage S. 2780 Medication Affordability and Patent Integrity Ac H.R. 4189, the CONNECT for Health Act, support passage H.R. 1843, the Telehealth Expansion Act, support passage H.R. 8018, the Alleviating Barriers for Caregivers Act, support passage S. 3109, the Alleviating Barriers for Caregivers Act, support passage H.R.6302, the Health Share Transparency Act of 2023 Joined together with coalition allies to offer recommendations for the 2026 Notice of Benefit and Payment Parameters (NBPP), as well as future rulemaking, to advance the goals of making healthcare accessible, adequate, and affordable. Joined together with coalition allies to advocate to the federal government, including HHS and CMS, to ensure that any revision of the cost-sharing rule related to copay accumulator adjustment policies includes clear, commonsense protections guaranteeing that copayments made by or on behalf of an enrollee are counted as payments toward their annual cost-sharing contributions.

Client expense: $41,572 · Firm income: Not reported

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

FY 2025 Funding- Report Language on Medicare Prescription Payment Program H.R.2630/S. 652SafeStepAct - Continued call for passage S.1375/H.R. 839 HELP Copays Act - Continued call for passage Advocacy to extend enhanced ACA premium tax credits Bills endorsed in 2nd Quarter: S.4120 Long-term Care Workforce Support Act S. 3109/H.R. 8018 Alleviating Barriers for Caregivers (ABC) Act S. 4532/ H.R. 8702 Improving Seniors Timely Access to Care Act Increasing Medication Access for Seniors Act of 2024 S. 3109/H.R. 8018 Alleviating Barriers for Caregivers Act H.R. 1691 - Ensuring Patient Access to Critical Breakthrough Products Act of 2023 Broker Accountability Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

No bill number. Discussed customer service at the Social Security Administration and funding. H.R. 8806, to direct the Comptroller General of the United States to carry out a study relating to the resiliency of Social Security and Medicare. H.R. 5779, the Fiscal Commission Act of 2023. No bill number. Discussed Social Security and the financial security of families. No bill number. Discussed Social Security overpayments. S. 597/H.R. 82, the Social Security Fairness Act of 2023. No bill number. Discussed garnishment of Social Security benefits for defaulted student loan debt. No bill number. Discussed Department of Labor Retirement Security Rule. S.J.Res.79 - A joint resolution providing for congressional disapproval of the rule submitted by the Department of Labor relating to "Retirement Security Rule: Definition of an Investment Advice Fiduciary" H.J.Res.140 - Providing for congressional disapproval of the rule submitted by the Department of Labor relating to "Amendment to Prohibited Transaction Exemption 2020-02" H.J.Res.141 - Providing for congressional disapproval of the rule submitted by the Department of Labor relating to "Amendment to Prohibited Transaction Exemption 84-24" H.J.Res.142 - Providing for congressional disapproval of the rule submitted by the Department of Labor relating to "Retirement Security Rule: Definition of an Investment Advice Fiduciary" H.J.Res.143 - Providing for congressional disapproval of the rule submitted by the Department of Labor relating to "Amendment to Prohibited Transaction Exemptions 75-1, 77-4, 80-83, 83-1, and 86-128" H.R.6007, the Retirement Investment in Small Employers Act. H.R. 6065/S.3102, the Retirement Savings for Americans Act of 2023. H.R. 7293, the Automatic IRA Act of 2024. H.R. 4924/S.2517, the Auto Reenroll Act of 2023. S. 3109/H.R. 8018, the Alleviating Barriers for Caregivers Act. No bill number. Discussed family caregiving and retirement. No bill number. Discussed Electronic Payroll Data to Improve Program Administration. H.R. 3206, the Senior Citizens Tax Elimination Act. H.R. 5342, the Equal Treatment of Public Servants Act. H.R. 4260, the Public Servants Protection and Fairness Act of 2023. H.R. 7697, the Dignity and Autonomy for Our Supplemental Security Income PNA Beneficiaries Act. S. 2767/H.R. 5408, the SSI Savings Penalty Elimination Act. H.R. 6858, the Social Security Overpayment Relief Act. No bill number. Discussed the long-term solvency of the Social Security trust funds. H.R. 6853, the SOS Act.

Client expense: $5,170,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), White House Office

No bill number. Discussed paid leave. No bill number. Discussed CMS Office of Caregiver Health. No bill number. Discussed Respect Parents' Childcare Choices Act. No bill number. Discussed National Plan on Aging. No bill number. Discussed Older Americans Act. No bill number. Discussed National Strategy to Support Family Caregivers. No bill number. Discussed family caregivers and Medicare and Medicaid policy. No bill number. Discussed Medicare FY25 Skilled Nursing Facility Payment Proposed Rule. No bill number. Discussed Medicare FY25 Hospital Inpatient Payment Proposed Rule. S. 4399, the Help Grandfamilies Prevent Child Abuse Act. No bill number. Discussed peer support programs for family caregivers. No bill number. Discussed family caregiving and retirement. No bill number. Discussed family caregiving and overtime. No bill number. Discussed Care Executive Order. No bill number. Discussed family caregivers, direct care workers, care at home, and in other settings. H.R. 8588, the Linking Seniors to Needed Legal Services Act. H.R. 6160, to amend the Public Health Service Act to reauthorize a lifespan respite care program. S. 4325, the Lifespan Respite Care Reauthorization Act of 2024. S. 3109/H.R. 8018, the Alleviating Barriers for Caregivers Act. S. 3766/H.R. 7274, the Connecting Caregivers to Medicare Act. S. 3254/H.R 7222, the Lowering Costs for Caregivers Act. S. 3702/H.R. 7165, the Credit for Caring Act. No bill number. Discussed Domestic Worker Bill of Rights. No bill number. Discussed family caregivers and Acute Hospital Care at Home waiver. H.R. 8371, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act. S. 495/H.R. 1815, the Expanding Veterans Options for Long Term Care Act. H.R. 542, the Elizabeth Dole Home Care Act. H.R. 3581, the Caregiver Outreach and Program Enhancement (COPE) Act. No bill number. Discussed family caregiving and Older Americans Act reauthorization. No bill number. Discussed Farm Bill and nutrition programs, including SNAP. H.R. 8467, the Farm, Food, and National Security Act of 2024.

Client expense: $5,170,000 · Firm income: Not reported

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

No bill number. Discussed medically necessary dental coverage and oral health care in Medicare. No bill number. Discussed Medicare coverage for telehealth services. No bill number. Discussed workforce training, physician reimbursement, and Medicare provider access. No bill number. Discussed Improving Seniors Timely Access to Care Act of 2024. H.R. 2407, the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act. No bill number. Discussed Medicaid estate recovery. No bill number. Discussed Medicare Advantage data. H.R. 3549/ S. 1703, the PACE Part D Choice Act of 2023. No bill number. Discussed family caregivers and Medicare and Medicaid policy. No bill number. Discussed Medicare FY25 Skilled Nursing Facility Payment Proposed Rule. No bill number. Discussed Medicare FY25 Hospital Inpatient Payment Proposed Rule. No bill number. Discussed hospitals and a buffer of essential medicines. No bill number. Discussed Medicaid unwinding. H.R. 8114, To prohibit the Secretary of Health and Human Services from finalizing a rule proposed by the Centers for Medicare & Medicaid Services to place certain limitations on Medicaid payments for home or community-based services. No bill number. Discussed Care Executive Order. H.R. 8018, the Alleviating Barriers for Caregivers Act. S. 3109, Alleviating Barriers for Caregivers Act. S. 3766/H.R. 7274, Connecting Caregivers to Medicare Act. No bill number. Discussed Acute Hospital Care at Home waiver and family caregivers. No bill number. Discussed family caregivers, direct care workers, care at home, and in other settings. S. 4120/H.R. 7994, the Long-Term Care Workforce Support Act. H.R. 8094, to amend Title XIX of the Social Security Act to modify certain asset recovery rules. H.R. 7573, the Stop Unfair Medicaid Recoveries Act. No bill number. Discussed the Coordinating Care for Veterans and Wounded Warriors Act. No bill number. Discussed nursing home staffing standards. No bill number. Discussed Medicare home health and hospice benefits. No bill number. Discussed health care coverage expansion. H.R. 8331/S. 4280, the Essential Caregivers Act. H.R. 7442, Philippine Medicare Portability Study Act. H.R. 3227, the Ensuring Seniors Access to Quality Care Act. H.R. 8244, Ensuring Seniors Access to Quality Care Act. H.R.468, the Building Americas Health Care Workforce Act. HR 7513/S.3410, the Protecting Americas Seniors Access to Care Act. H.J.Res.139, Providing for Congressional disapproval of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs: Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting. S.J.Res.91, A joint resolution providing for congressional disapproval of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Medicare and Medicaid Programs; Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting" S.4137, the Improving Access to Medicare Coverage Act of 2024.

Client expense: $5,170,000 · Firm income: Not reported

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