Health Equity and Accountability Act of 2024

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

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

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

Lobbying Report: July 1st - September 30th, 2024 (Action Fund) Federal (under tobacco issue code) Legislation: S.4690/H.R. 9027 - FY 25 Agriculture, Rural Development, and Food and Drug Administration, and Related Agencies Appropriations Bill S.4942/H.R. 9029 - FY 25 Labor, HHS, Education, and Related Agencies Appropriations Bill S.4795/H.R. 9026 - FY 25 Commerce, Justice, Science, and Related Agencies Appropriations Bill H.R. 8773 - FY 25 Financial Services and General Government Appropriations Bill H.R. 9367 - Preventing Vape Use Act H.R. 9161 - Health Equity and Accountability Act H.R. 9151 - Protecting American Industry & Labor from International Trade Crimes FY 26 Appropriations for CDCs Office on Smoking and Health H.R. 9161/S.4773 - Health Equity and Accountability Act H.R. 9425 - Tobacco User Fee Modernization Act of 2024 Promoting Responsible Enforcement of Vaping and Electronic Nicotine Technology Act Issues FDA proposed rule on menthol cigarettes FDA proposed rule on flavored cigars FDA regulation of e-cigarettes Nicotine Pouches Tobacco taxes Tobacco product user fees FDA nicotine standard Youth e-cigarette use Tobacco cessation CDC Office on Smoking and Health funding Ending the Youth Vaping Epidemic Caucus

Client expense: $440,000 · Firm income: Not reported

Maternal and Infant Syphilis Prevention Act (H.R. 8839) Health Equity and Accountability Act of 2024 (S. 4773/H.R. 9161) Stabilize Medicaid and CHIP Coverage Act (S. 3138/H.R. 5434) SUSTAIN 340B Act (not yet introduced)

Client expense: $112,543 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Maternal and Infant Syphilis Prevention Act (H.R. 8839) Health Equity and Accountability Act of 2024 (S. 4773/H.R. 9161) Stabilize Medicaid and CHIP Coverage Act (S. 3138/H.R. 5434) SUSTAIN 340B Act (not yet introduced)

Client expense: $112,543 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for H.R. 9161 / S. 4773 - Health Equity and Accountability Act (HEAA) Support for H.R.9774 - Health Care Affordability Act of 2024 Support for HHS/CMS authority to address the Medicaid unwinding Support for S. 4381 - Right to Contraception Act Support for S. 4445 - Right to IVF Act Support for S. 4554 - Reproductive Freedom for Women Act

Client expense: $600,000 · 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

Access to Care Inflation Reduction Act (IRA). ACS CAN actively monitors implementation of the Inflation Reduction Acts Medicare Drug Price negotiation provisions to ensure cancer patients have access to costly prescription drugs. ACS CAN also supports the Medicare Prescription Payment Plan, which allows Part D enrollees to spread their out-of-pocket costs over the plan year. Enhanced Advanced Premium Tax Credits, H.R. 9774, Improving Health Insurance Affordability Act of 2023, S.5194. House and Senate bills would permanently extend the enhanced advanced premium tax credits. Retaining Access and Restoring Exclusivity (RARE) Act H.R.7383. This bill specifies that the seven-year market exclusivity period for drugs for rare diseases or conditions (i.e., orphan drug exclusivity period) prohibits the approval of the same drug for the same approved use or indication with respect to the disease or condition. Help CoPays Act S.1375; Help Ensure Lower Patient Copays Act, H.R.830. This bill requires health insurance plans to apply certain payments made by, or on behalf of, a plan enrollee toward a plan's cost-sharing requirements. Specifically, plans must apply third-party payments, financial assistance, discounts, product vouchers, and other reductions in out-of-pocket expenses toward the requirements. Safe Step Act, S.652, H.R. 2630. This bill requires a group health plan to establish an exception to medication step-therapy protocol in specified cases. A medication step-therapy protocol establishes a specific sequence in which prescription drugs are covered by a group health plan or a health insurance issuer. Creating Opportunities Now for Necessary and Effective Technologies (CONNECT) for Health Act of 2023 H.R.4189, S.2016. This bill expands coverage of telehealth services under Medicare. Telehealth Modernization Act of 2924, H.R. 7623. Modifies requirements relating to coverage of telehealth services under Medicare. Permanently expands telehealth flexibilities first authorized during the public health emergency. The Preserving Telehealth, Hospital, and Ambulance Access Act, H.R. 8261. This bill allows employers to offer stand-alone telehealth benefits to all employees. This includes employees who are eligible for enrollment in their employer's group health plan. Equitable Community Access to Pharmacist Services Act, H.R.1770, S.2477. This bill expands Medicare coverage to permanently include services provided by a pharmacist, including incidental services and supplies, related to testing, vaccines, and treatment for COVID-19, influenza, and certain other illnesses. This bill also requires drug manufacturers to report on the suppliers of ingredients used in their products. Drug Shortage Prevention Act, H.R. 3008. This bill requires drug manufacturers to notify the Food and Drug Administration (FDA) if there is an increased demand for certain critical essential medicines that may result in a shortage. Protecting Americans from Unsafe Drugs Act of 2023, H.R. 2500. This bill expands the authority of the Secretary of the Department of Health and Human Services (HHS) to order the recall of controlled substances to cover all drugs. Ensuring Access to Lifesaving Drugs Act of 2023, H.R. 3793. This bill allows the Food and Drug Administration (FDA) to obtain additional information from manufacturers of life-saving drugs in order to assess and potentially modify the drug's expiration date. (The bill defines life-saving drug as a medical countermeasure or a drug that is in short supply and that is life-supporting, life-sustaining, or intended to be used to prevent or treat a debilitating disease or condition in humans or animals.) Specifically, the FDA may order a manufacturer of a life-saving drug to submit data and other information from any stage of the drug's development in order to assess the drug's stability and the longest supported expiration date. If such information is not readily available, the FDA may order the manufacturer to conduct additional studies. The FDA may require changes to the drug's label accordingly. Manufacturers that fail to comply are subject to civil penalties. Medical Device Shortage Reduction Act of 2023, H.R. 3807. This bill expands the scope of required notifications about medical device shortages beyond public health emergencies. Protecting PAHPA Action of 2023, H.R. 4697. ACS CAN is lobbying on all provisions related to drug shortages. This bill extends through FY2028 and modifies various programs and activities that support public health preparedness and response. The bill also addresses matters concerning shortages of drugs and medical devices and recalls of drugs. Essential Medicines Strategic Stockpile Act of 2023, H.R. 405. This bill requires the Department of Health and Human Services (HHS) to create a pilot program to test the effectiveness of acquiring, maintaining, managing, and distributing a stockpile of generic drugs at risk of shortage. Alan Reinstein Ban Asbestos Now Act of 2023, H.R. 2402, S. 1069. This bill prohibits the manufacture, process, use, and distribution in commerce of commercial asbestos or any mixture or article containing commercial asbestos. RAPID Reserve Act, S. 2510. This bill improves supply chain resiliency for critical drug products with vulnerable supply chains and ensure that reserves of critical drugs and active pharmaceutical ingredients are maintained to prevent supply disruptions in the event of drug shortages or public health emergencies. Rolling Active Pharmaceutical Ingredient and Drug Reserve Act, H.R.6802. A bill to improve supply chain resiliency for critical drug products with vulnerable supply chains and ensure that reserves of critical drugs and active pharmaceutical ingredients are maintained to prevent supply disruptions in the event of drug shortages or public health emergencies Senate Finance Committee Drug Shortage Proposal. This draft legislation would address the ongoing drug shortage crisis. Access to Breast Cancer Diagnosis Act of 2023, H.R.3851, S.2464. To amend title XXVII of the Public Health Service Act to prohibit group health plans and health insurance issuers offering group or individual health insurance coverage from imposing cost-sharing requirements with respect to diagnostic and supplemental breast examinations. Health Disparities Nancy Gardner Sewell Multi-Cancer Early Detection Act, H.R. 2407. This bill allows for Medicare coverage and payment for multi-cancer early detection screening tests that are approved by the Food and Drug Administration and that are used to screen for cancer across many cancer types, if the Centers for Medicare & Medicaid Services determines such coverage is appropriate. Medicare Multi-Cancer Early Detection Screening Coverage (MCED) Act, S.2085. Legislation to improve access to new and innovative cancer screenings for Medicare beneficiaries by creating a pathway to allow Medicare to initiate coverage of multi-cancer tests following FDA approval if a clinical benefit is shown. Screening for Communities to Receive Early and Equitable Needed Services (SCREENS for Cancer) Act, S.1840, H.R.3916. Reauthorization of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) for fiscal years 2024 through 2028 to provide the program greater flexibility in providing access to lifesaving screening, diagnostic, and treatment services and continue its innovative work aimed to reduce disparities and advance health equity in breast and cervical cancer. Prostate-Specific Antigen Screening for High-Risk Insured Men (PSA Screening for HIM) Act, S.2821, H.R.1826. Legislation to remove cost sharing of PSA testing for those at the highest risk of being diagnosed with prostate cancer. Lung Cancer Screening and Prevention Act, H.R.6693. To amend title XVIII of the Social Security Act to authorize the coverage of additional lung cancer screening tests under the Medicare program. Health Equity and Accountability Act (HEAA), H.R. 9161, S. 4773. Legislation to eliminate racial and ethnic health disparities. We actively advocate for provisions (HEAA), which focuses on health inequalities, societal injustices, and their intersection with immigration status, age, disability, sex, gender, sexual orientation, and socioeconomic status. Increased Funding for the National Institute for Minority Health and Health Disparities. Reducing disparities in the use of recommended preventive services targeting three leading causes of death in the United States - cancer, heart disease, and diabetes. Cancer Drug Parity Act of 2023, S.2039, H.R.6301. Level the playing field for cancer patients by ensuring that the cost-sharing for oral anticancer drugs is on par with intravenous chemotherapy, thereby removing a significant financial obstacle to effective treatment. Henrietta Lacks Enhancing Cancer Research Act of 2019 Report. Request for Congress to urge the Government Accountability Office (GAO) to revisit the Henrietta Lacks Enhancing Cancer Research Act of 2019 report, with respect to promoting diverse participation in cancer clinical trials and addressing fully the request for insight into either implementation challenges for current federal activities or recommendations for additional activities and policy changes related to clinical trial diversity. Data Equity. Legislative and regulatory funding to support the collection of detailed demographic data toward reducing disparities in cancer prevention, detection, and treatment. Childhood Cancer Childhood Cancer Survivorship, Treatment, Access, and Research Reauthorization Act of 2022 (STAR) Act. Continued implementation and funding of the Childhood Cancer STAR Act to promote the development of new, safer therapies for children with cancer. Our appropriations request includes $30 million for the Childhood Cancer STAR Act and $50 million for the Childhood Cancer Data Initiative. Gabriella Miller Kids First Research Act 2.0, H.R. 623, S. 1523. This bill reauthorizes through FY2028 a pediatric disease research initiative within the National Institutes of Health (NIH) and requires the NIH to coordinate pediatric research activities to avoid duplicative efforts. Additionally, the Department of Health and Human Services must report to Congress about research funded through the initiative. Promoting Resources to Expand Vaccination, Education and New Treatments for HPV Cancers (PREVENT) Act, H.R.3633. Legislation that would help prevent cancer and save lives by raising awareness about HPV and HPV-related cancers through a national campaign to educate providers, parents, and the public about the life-saving HPV vaccine. It would also boost resources for a federal initiative to provide access to timely cervical cancer screening and diagnostic services for uninsured and underserved individuals. Accelerating Kids Access to Care Act, S.2372, H.R.4758. Legislation that alleviates these burdens for families and providers by facilitating coordination across state lines and clarifying the process by which state Medicaid programs can cover specialized treatment regardless of where the child lives and where their care is received. Creating Hope Reauthorization Act of 2024, H.R. 7384. This bill extends until FY2029 a Food and Drug Administration program that awards priority review vouchers to manufacturers of drugs that treat rare pediatric diseases. (A priority review voucher entitles the voucher holder to priority review of a single human drug application.) Quality of Life Palliative Care Palliative Care and Hospice Education and Training Act (PCHETA), S.2243. Legislation to facilitate access to palliative care and coordinated care management. Palliative Care Research Funding. Funding to focus and expand national research programs in palliative care at the National Institutes of Health. Specifically, ACS CAN is working to ensure the U.S. Congress, for the first time, appropriates specific money for palliative care research, upon enactment of the FY2024 LHHS Appropriations bill. Patient Navigation for People with Cancer. Legislation and policies to increase access to patient navigation for people with cancer, prioritizing policies that create sustainable funding to ensure access to patient navigation services across the cancer continuum. Patient Navigation Assistance Act, H.R. 9446. This bill would require state Medicaid programs to provide patient navigation services for enrollees. Cancer Survivorship Comprehensive Cancer Survivorship Act (CCSA), S.2213, H.R.4363. ACS CAN supports legislation that sets new standards for survivorship from diagnosis to end of life, ensuring the best and most seamless experience for survivors, and their families and caregivers throughout the journey. CCSA will address gaps in survivorship care and develop needed standards to improve the overall patient-centered quality of care and navigation needs that cancer survivors and their families experience. Federal Health Care Programs Increased Funding Levels for Cancer Research and Prevention. Ensure continued progress in the fight against cancer at the National Institutes of Health (NIH), the National Cancer Institute (NCI), the Advanced Research Projects Agency for Health (ARPA-H), and the Centers for Disease Control and Preventions (CDC) cancer programs. CDC Cancer Programs, the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Regulatory issues related to healthy food and dietary guidelines PC CARE Act, H.R.1315. This bill establishes a committee to develop, implement, and periodically revise a plan to coordinate federal activities and programs concerning prostate cancer, including those related to research, screening, diagnosis, and treatment. Women and Lung Cancer Research and Preventive Services Act of 2023, H.R.4534, S.2245. This bill requires the Department of Health and Human Services to conduct an interagency review of the status of women and lung cancer. Department of Defense Appropriations Act, 2024 H.R.4365, S.2587. DOD Congressionally Directed Medical Research Program. Cancer Alan Reinstein Ban Asbestos Act, H.R.2402, S.1069. This bill generally prohibits the manufacture, process, use, and distribution in commerce of commercial asbestos or any mixture or article containing commercial asbestos. The President may, on application, grant exemptions from the prohibition in situations where it is necessary to protect national security interests. Nutrition Medical Nutrition Act H.R.6407, S.3297. A bill to amend title XVIII of the Social Security Act to expand the availability of medical nutrition therapy services under the Medicare program Farm, Food, and National Security Act of 2024, H.R.8467. To provide for the reform and continuation of agricultural and other programs of the Department of Agriculture through fiscal year 2029, and for other purposes. Rural Prosperity and Food Security Act. To provide for the reform and continuation of agricultural and other programs of the Department of Agriculture through fiscal year 2029, and for other purposes. Clinical Trials Clinical Trial Modernization Act, H.R. 8412. Increase diversity in clinical trials and make it easier for all persons with cancer to participate by reducing barriers to enrollment. Barriers may include ancillary (non-medical) costs, such as transportation and lodging, and remote access to trials, particularly for people who are underrepresented, including certain racial and ethnic groups, older adults, rural residents, and those with limited incomes. NIH Clinical Trial Diversity Act, S.1701, H.R.3503. Legislation to increase the diversity of participants in all National Institutes of Health (NIH)-funded trials. Harley Jacobsen Clinical Trial Participant Income Exemption Act, H.R.7090, H.R. 7418. Legislation to amend the Internal Revenue Code of 1986 to exclude from gross income certain compensation to clinical trial participants.

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

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

Lobbying Report: July 1st - September 30th, 2024 (Campaign) Federal (under tobacco issue code) Legislation: S.4690/H.R. 9027 - FY 25 Agriculture, Rural Development, and Food and Drug Administration, and Related Agencies Appropriations Bill S.4942/H.R. 9029 - FY 25 Labor, HHS, Education, and Related Agencies Appropriations Bill S.4795/H.R. 9026 - FY 25 Commerce, Justice, Science, and Related Agencies Appropriations Bill H.R. 8773 - FY 25 Financial Services and General Government Appropriations Bill H.R. 9367 - Preventing Vape Use Act H.R. 9161 - Health Equity and Accountability Act H.R. 9151 - Protecting American Industry & Labor from International Trade Crimes FY 26 Appropriations for CDCs Office on Smoking and Health H.R. 9161/S.4773 - Health Equity and Accountability Act H.R. 9425 - Tobacco User Fee Modernization Act of 2024 Promoting Responsible Enforcement of Vaping and Electronic Nicotine Technology Act Issues FDA proposed rule on menthol cigarettes FDA proposed rule on flavored cigars FDA regulation of e-cigarettes Nicotine Pouches Tobacco taxes Tobacco product user fees FDA nicotine standard Youth e-cigarette use Tobacco cessation CDC Office on Smoking and Health funding Ending the Youth Vaping Epidemic Caucus Agencies Visited: Centers for Disease Control and Prevention US House of Representatives US Senate Food and Drug Administration OMB

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

Department of Veterans Affairs appropriations and its delivery of benefits and services to veterans, their dependents and survivors: HR 1001, HR 1003, HR 104, HR 1078, HR 1083, HR 1089, HR 1139, HR 1144, HR 1166, HR 1169, HR 1179, HR 1182, HR 1191, HR 1226, HR 1278, HR 1282, HR 1311, HR 1315, HR 1329, HR 1378, HR 1402, HR 1529, HR 1530, HR 1554, HR 1606, HR 1609, HR 1616, HR 1639, HR 1659, HR 1669, HR 1753, HR 1767, HR 1774, HR 1786, HR 1799, HR 1815, HR 196, HR 228, HR 232, HR 234, HR 236, HR 2410, HR 2413, HR 2414, HR 2441, HR 2447, HR 2469, HR 2472, HR 2499, HR 251, HR 2518, HR 2525, HR 2526, HR 2530, HR 2543, HR 2733, HR 2768, HR 2809, HR 2818, HR 2830, HR 2846, HR 2896, HR 2911, HR 2932, HR 2971, HR 3023, HR 303, HR 3040, HR 3075, HR 3084, HR 3110, HR 3128, HR 3157, HR 3186, HR 3192, HR 3214, HR 3225, HR 3303, HR 3326, HR 333, HR 3363, HR 3368, HR 3450, HR 3489, HR 3499, HR 3504, HR 3511, HR 3581, HR 3584, HR 3600, HR 3601, HR 3603, HR 3644, HR 3648, HR 3649, HR 3651, HR 3676, HR 3677, HR 3698, HR 3718, HR 3720, HR 3722, HR 3738, HR 3790, HR 3811, HR 3816, HR 3848, HR 3870, HR 3874, HR 3895, HR 3898, HR 3933, HR 394, HR 395, HR 3956, HR 3981, HR 4016, HR 4047, HR 4060, HR 4061, HR 41, HR 411, HR 4150, HR 4155, HR 4157, HR 4171, HR 4190, HR 4225, HR 4249, HR 4262, HR 4264, HR 4278, HR 4325, HR 4400, HR 4401, HR 4424, HR 4461, HR 4518, HR 4566, HR 4569, HR 4670, HR 4886, HR 4906, HR 491, HR 492, HR 4921, HR 5002, HR 5014, HR 5147, HR 5153, HR 516, HR 522, HR 523, HR 5247, HR 5259, HR 5365, HR 5377, HR 5416, HR 542, HR 543, HR 544, HR 5470, HR 5492, HR 5530, HR 5559, HR 5610, HR 5633, HR 5697, HR 5702, HR 5785, HR 5794, HR 5870, HR 5890, HR 5891, HR 5904, HR 5914, HR 592, HR 5938, HR 5956, HR 6023, HR 6179, HR 6197, HR 6225, HR 6294, HR 6300, HR 6315, HR 6324, HR 6330, HR 6331, HR 6333, HR 6338, HR 6340, HR 6345, HR 6360, HR 6361, HR 6362, HR 6373, HR 6374, HR 6380, HR 645, HR 6452, HR 6492, HR 6507, HR 6524, HR 6531, HR 6538, HR 6551, HR 6656, HR 6800, HR 6833, HR 6873, HR 6874, HR 6916, HR 693, HR 6949, HR 6995, HR 7097, HR 7136, HR 7150, HR 728, HR 7323, HR 733, HR 7347, HR 7365, HR 7401, HR 7434, HR 746, HR 7480, HR 7490, HR 7504, HR 7514, HR 7543, HR 7596, HR 7613, HR 7643, HR 7653, HR 7654, HR 7657, HR 7703, HR 7732, HR 7773, HR 7777, HR 7793, HR 7816, HR 7860, HR 7884, HR 7895, HR 7896, HR 7917, HR 7919, HR 7920, HR 7971, HR 8009, HR 8009, HR 8017, HR 8025, HR 8048, HR 808, HR 8136, HR 8165, HR 8167, HR 8168, HR 8223, HR 8312, HR 8340, HR 8347, HR 8371, HR 8381, HR 8418, HR 8442, HR 8454, HR 8481, HR 8511, HR 8514, HR 854, HR 8560, HR 8562, HR 8567, HR 8580, HR 8592, HR 8627, HR 8646, HR 8661, HR 885, HR 8851, HR 8874, HR 8879, HR 8880, HR 8881, HR 8896, HR 894, HR 9029, HR 903, HR 9050, HR 9057, HR 9094, HR 9146, HR 9161, HR 9179, HR 9276, HR 9324, HR 9328, HR 9404, HR 9415, HR 9449, HR 9468, HR 9478, HR 9484, HR 9510, HR 9525, HR 9575, HR 9819, HR 984, HR 9924, S 10, S 1028, S 1037, S 106, S 1090, S 1113, S 1119, S 1125, S 1172, S 1266, S 1267, S 1299, S 1309, S 1314, S 132, S 1330, S 1360, S 141, S 1436, S 1469, S 1515, S 1590, S 1612, S 1635, S 1678, S 1739, S 1792, S 1828, S 185, S 1877, S 1910, S 1954, S 1972, S 1975, S 1994, S 2014, S 2026, S 2083, S 2084, S 2146, S 216, S 2174, S 2181, S 2183, S 2212, S 2256, S 2259, S 2263, S 2276, S 2294, S 2315, S 24, S 2422, S 2431, S 2465, S 2503, S 2513, S 2516, S 263, S 2679, S 2745, S 2757, S 2778, S 2795, S 280, S 2801, S 2803, S 2863, S 2888, S 291, S 296, S 2975, S 30, S 302, S 3126, S 3243, S 3256, S 326, S 3274, S 3282, S 3284, S 3288, S 3290, S 3295, S 3341, S 3352, S 344, S 3452, S 3466, S 350, S 3524, S 3526, S 3546, S 3560, S 3598, S 3614, S 3636, S 3728, S 3746, S 3751, S 3768, S 38, S 3834, S 3841, S 3873, S 3885, S 3886, S 3911, S 3958, S 3970, S 3979, S 4009, S 4047, S 4061, S 4074, S 4109, S 4111, S 414, S 42, S 4226, S 4246, S 4284, S 4357, S 4372, S 4396, S 4423, S 4445, S 449, S 4556, S 4748, S 4879, S 4922, S 4929, S 495, S 498, S 4997, S 5035, S 5141, S 5210, S 528, S 531, S 592, S 622, S 656, S 665, S 680, S 740, S 748, S 774, S 777, S 853, S 897, S 928

Lobbying Issues Description: Budget and appropriations for public health, disease and injury prevention, including obesity and related diseases; pandemics and emerging infectious diseases; physical activity; public health preparedness; nutrition programs; environmental health; health equity; community-based public health interventions; public health infrastructure and workforce; and substance misuse/behavioral health issues. Specific Legislation: 1.Preventing Adverse Childhood Experiences Act (S. 3085) 2.Mental Health Services for Students Act (S. 1884/H.R. 3713) 3.Helping Kids Cope Act (H.R. 2412) 4.Advancing Student Services in Schools Today Act (S. 1774/H.R. 3761) 5.Student Mental Health Rights Act (H.R. 3726) 6.Pursuing Equity in Mental Health Act (S. 1700/H.R. 3548) 7.RISE from Trauma Act (S. 1426) 8.Better Mental Health Care for Americans Act (S. 923) 9.Reentry Act (S. 1165/H.R. 2400) 10.FY 2024 Labor, HHS, Education and Related Agencies Appropriations 11.FY 2025 Labor, HHS, Education and Related Agencies Appropriations 12.Farm Bill 13.Improving Social Determinants of Health Act (H.R. 4781/S. 3847) 14.Health Equity and Accountability Act of 2024 (H.R. 9161/S.4773) 15.Social Determinants Accelerator Act (Not yet introduced) 16.The UNDERSTAND Act (S. 5182) 17.SNAP Nutrition Security Act of 2023 (S.2326/ H.R.4909) 18.SWEET Act (Not yet introduced) 19.OH SNAP, Close the Fruit and Vegetable Gap Act of 2023 (S. 2015/ H.R. 4149) 20.FY 2026 Labor, HHS, Education and Related Agencies Appropriations 21.The TRUTH in Labeling Act (H.R.6766/ S.3512) 22.Personal Health Investment Today (PHIT) Act (Not yet introduced) 23.Child Nutrition Reauthorization 24.Whole Milk for Healthy Kids Act of 2023 (H.R. 1147/ S. 1957) 25.Promoting Physical Activity for Americans Act (S.397) 26.CDC Oral Health Reauthorization Act (Not yet introduced) 27.GusNIP Expansion Act of 2023 (H.R. 4856) 28.Senior Hunger Prevention Act of 2023 (S. 1036/ H.R. 3474) 29.Black Maternal Health Momnibus Act (H.R. 3305/S. 1606) 30.Older Americans Act (Not yet introduced) 31.Protecting the Health of Americas Older Adults Act (Not yet introduced) 32.REAADI Act (S. 1049) 33.Improving Data in Public Health Act (H.R. 3791) 34.Pandemic and All-Hazards Preparedness Act Reauthorization (H.R. 4420, H.R. 4421) 35.Public Health Infrastructure Saves Lives Act (S. 1995) 36.BIO Early Warning Act (Not yet introduced) 37.The Support for Patients and Communities Reauthorization Act (H.R. 4531) 38.The PEER Support Act (S. 2733/H.R. 7212) 39.The Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act (S. 1378) 40.The Barriers to Suicide Act (H.R. 3759) 41.The 9-8-8 Implementation Act (H.R. 4851) 42.Influenza Act (H.R. 5846) 43.Bipartisan Primary Care and Health Workforce Act (S. 2840) 44.National Defense Authorization Act (S. 2226) 45.A resolution declaring racism a public health crisis (S. Res 319) 46.Preventing Maternal Deaths Reauthorization Act of 2023 (S. 2415) 47.Continuity in Necessary Evaluative Crisis Treatment (CONNECT) Act (H.R. 6928) 48.Local 988 Response Act (S. 3444) 49.Better Mental Health Care, Lower Drug Cost, and Extenders Act (S. 3430) 50.Lead-Safe Housing for Kids Act (Not yet introduced) 51.The Medicaid Bump Act (S. 3921/H.R. 4892) 52.The Kid PROOF Act (S. 3364/H.R. 6663) 53.EARLY Minds Act (H.R. 7808) 54.Campus Prevention and Recovery Services for Students Act (H.R. 9214) 55.Stabilization to Prevent (STOP) Suicide Act (H.R. 9577) 56.FY 2025 Interior, Environment and Related Agencies Appropriations 57.American Family Act (H.R. 3899) 58.H.Res.1375 - Recognizing the threat of extreme weather to children's health and well-being, and expressing the sense of Congress that solutions must be rapidly and equitably developed and deployed to address the unique vulnerabilities and needs of children. House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, White House Domestic Policy Council, HHS, CDC, FDA, CMS, OMB, NIH, USDA, HRSA, SAMHSA, and Federal Communications Commission (FCC).