Enhanced Enforcement of Health Coverage Act

Draft, Allowing Stand-Alone Supplemental Insurance Products to Be Sold on the ACA Individual Market (no bill number) - Sen. Wicker, Roger - supplement product insurance H.R. 4818 - Treat and Reduce Obesity Act - Rep. Wenstrup, Brad - weight loss coverage H.R. 6860 - Restore Protections for Dialysis Patients Act - Rep. Kelly, Mike - ESRD coverage H.R. 9572 - Enhanced Enforcement of Health Coverage Act - Rep. Murphy, Gregory F. - penalties for group health plans and health insurance issuers for practices that violate balance billing requirements H.R. 9643 - Right to IVF Act - Rep. Wild, Susan - protecting right to fertility treatment H.R. 9708 - Bridge to Medicaid Act of 2024 - Rep. Sewell, Teri - temporary private insurance option in non-Medicaid expansion states S. 655 - Chronic Disease Management Act of 2023 - Sen. Thune, John - increase the flexibility of HSA-HDHPs to cover chronic disease services on pre-deductible basis S. 1001 - Telehealth Expansion Act of 2023 - Sen. Daines, Steve - exemption of high deductible health plans from the requirement of a deductible for telehealth and other remote care services S. 2407 - Treat and Reduce Obesity Act - Sen. Carper, Tom - weight loss coverage S. 2771 - Increasing Access to Dental Insurance Act - Sen. Hassan, Maggie - permits individuals to enroll in a dental benefits plan on a health insurance exchange without also enrolling in a qualified health plan S. 4445 - Right to IVF Act- Sen. Duckworth, Tammy - protecting right to fertility treatment S. 4767 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - reduces fraudulent enrollments in qualified health plans S. 5018 - Restore Protections for Dialysis Patients Act - Sen. Cassidy, Bill - ESRD coverage S. 5218 - Health Infrastructure Security and Accountability Act of 2024 - Sen. Wyden, Ron - cyber security standards Issues related to implementation rule implementing the No Suprises Act prohibiting surprise medical bills; parity in mental health benefits; ERISA preemption; paperless delivery for health plan disclosures; Unauthorized Enrollments/Unauthorized Plan Switching; ACA Tax Credits (Inflation Reduction Act); pending rulemaking related to insurance requirements under the Mental Health Parity and Addiction Equity Act; final rule on Section 1557 of the ACA and its impact on Medigap plans; ACA Marketplace Enrollment and Agents and Brokers; Vaccine Coverage; Preventative Services Coverage; the Advanced Explanation of Benefits; and coverage of weight loss drugs.

Client expense: $2,610,000 · Firm income: Not reported

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

H.R. 485 - Protecting Health Care For All Patients Act of 2023 - Rep. McMorris Rodgers, Cathy - federal programs using prices based on quality-adjusted life years H.R. 824 - Telehealth Benefit Expansion for Workers Act of 2023 - Rep. Walberg, Tim - telehealth and ERISA amendments H.R. 830 - HELP Copays Act - Rep. Carter, Earl - health insurers responsibility for payments made by or on behalf of a plan enrollee toward a plans cost-sharing requirements H.R. 1488 - Affordable Insulin Now Act of 2023 - Rep. Craig, Angie - cost-sharing for insulin products H.R. 2666 - MVP Act - Rep. Guthrie, Brett - value-based purchasing arrangements under Medicaid program and reforms to price reporting H.R. 2691 - Transparent Price Act - Rep. McMorris Rodgers, Cathy - health insurer price transparency H.R. 2813 - Self-Insurance Protection Act - Rep. Good, Bob - ERISA amendments H.R. 2868 - Association Health Plans Act - Rep. Walberg, Tim - ERISA amendments H.R. 3305 - Black Maternal Health Momnibus Act - Rep. Underwood, Lauren - maternal health including in Medicaid and CHIP H.R. 3561 - PATIENT Act - Rep. McMorris Rodgers, Cathy - PBM transparency, PBM contract design, health insurance transparency, hospital transparency H.R. 3799 - Custom Health Option and Individual Care Expense Arrangement Act- Rep. Hern, Kevin - health reimbursement arrangements H.R. 7623 - Telehealth Modernization Act of 2024- Rep. Carter, Buddy - including requirements for Part D plan contracts with PBMs including transparency and delinking provisions H.R. 7858 - Telehealth Enhancement for Mental Health Act of 2024 - Rep. James, John - Medicare, behavioral health, telehealth H.R. 9572 - Enhanced Enforcement of Health Coverage Act - Rep. Murphy, Gregory - increased penalties of surprise billing violations H.R. 10445 - Further Continuing Appropriations and Disaster Relief Supplement Appropriations Act, 2025 - Rep. Cole, Tom - to fund the federal government through March 14, 2025 as well as extension of several health care policies S. 3393 - SUPPORT for Patients and Communities Reauthorization Act. - Sen. Sanders, Bernie - SUD treatment S. 3430 - Better Mental Health Care, Lower-Cost Drugs, and Extenders Act of 2023 - Sen. Wyden, Ron - mental health, telehealth, health workforce S. 3612 - Access to Family Building Act- Sen. Duckworth, Tammy- right to access reproductive technology (ex. IVF) S. 3805 - A bill to amend title XI of the Social Security Act to prohibit health plans from imposing fees on health care providers for electronic funds transfers and health care payment and remittance advice transactions, and for other purposes. - Sen. Cassidy, Bill - SSA, healthcare, electronic funds, payments, remittance S. 4357 - Comprehensive Dental Reform Act of 2024- Sen. Sanders, Bernie - promotes access to oral health care S. 4358 - Preventing and Treating Substance Use Disorders Among Older Adults Act- Sen. Casey, Robert - SAMHSA grant program for SUDs S. 4554 - Reproductive Freedom for Women Act- Sen. Murray, Patty - protecting abortion and reproductive rights Issues related to broadband and public health infrastructure; mental health and telehealth; behavioral health; rural health; substance use disorder treatments; Health Savings Accounts; provider directories; artificial intelligence and privacy; insurance industry response to and support for providers regarding the Change Healthcare cyberattack and broader cyber security issues; ACA Marketplace; and Mental Health Parity Proposed Rule.

Client expense: $2,610,000 · 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

HR 5378 Lower Costs, More Transparency, S 3548 Health Care Prices Revealed and Information to Consumers Explained (PRICE) Transparency Act, and HR 9572 Enhanced Enforcement of Health Coverage Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 5378 Lower Costs, More Transparency, S 3548 Health Care Prices Revealed and Information to Consumers Explained (PRICE) Transparency Act, and HR 9572 Enhanced Enforcement of Health Coverage Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 618, Improving Access to Workers Compensation for Injured Federal Workers Act, all provisions S. 131, Improving Access to Workers Compensation for Injured Federal Workers Act, all provisions H.R. 2923, Living Donor Protection Act, all provisions of 2023, all provisions S. 1384, Living Donor Protection Act, all provisions of 2023, all provisions H.R. 1359, Modernizing Opioid Treatment Access Act, all provisions S. 644, Modernizing Opioid Treatment Access Act, all provisions H.R. 2630, Safe Step Act, all provisions S. 652, Safe Step Act, all provisions H.R. 2761, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions S. 705, Specialty Physicians Advancing Rural Care (SPARC) Act, all provisions S. 2840, Bipartisan Primary Care and Health Workforce Act, all provisions S. 113, Prescription Pricing for the People Act of 2023, all provisions H.R. 7153, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions S. 3679, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions H.R. 830, Help Ensure Lower Patient (HELP) Copays Act, all provisions S. 1375, Help Ensure Lower Patient (HELP) Copays Act, all provisions S. 127, Pharmacy Benefit Manager Transparency Act of 2023, all provisions H.R. 8325, Physician and Patient Safety Act, all provisions S. 4278, Physician and Patient Safety Act, all provisions H.R. 8383, Rural Obstetrics Readiness Act, all provisions S. 4079, Rural Obstetrics Readiness Act, all provisions S. 3447, Pregnant and Postpartum Women Treatment Reauthorization Act, all provisions H.R. 5012, SHINE for Autumn Act of 2023, all provisions S. 2647, SHINE for Autumn Act of 2023, all provisions S. 3370, Promoting Maternal and Child Health Through Substance Use Prevention Act, all provisions H.R. 1117, Advancing Safe Medications for Moms and Babies Act of 2023, all provisions H.R. 3417, Facilitating Accountability In Reimbursements (FAIR) Act, provisions relating to site neutral payments H.R. 6033, Supporting Patient Education And Knowledge (SPEAK) Act of 2024, provisions relating to telehealth/equity H.R. 2411, National Nursing Workforce Center Act of 2023, all provisions H.R. 6230, Doctor Knows Best Act of 2023, all provisions H.R. 9572, Enhanced Enforcement of Health Coverage Act, all provisions H.R. 6881, AI Foundation Model Transparency Act of 2023, all provisions H.R. 10282, Expanding Support for Living Donors Act of 2024, all provisions CURES 2.0/draft Dr. Paul Farmer Global Health Training Act/draft Artificial Intelligence for Care Utilization Research and Efficacy Act of 2024/draft Temporary Responders for Immediate Aid in Grave Emergencies (TRIAGE) Act/draft 21st Century Cures Act/implementation improvement No Surprises Act implementation Maternal Health Prior Authorization Public health/Infectious diseases/Chronic diseases Substance use disorder Cybersecurity Health IT and HIPAA/health data access privacy Augmented Intelligence Health Equity Reproductive health Health Information Technology/interoperability (HTI-2) Trusted Exchange Framework and Common Agreement (TEFCA) Health IT Certification Electronic Health Record (EHR) certification Physician burden reduction/Health IT Interoperability/data sharing/information blocking/provider disincentives Data segmentation Insights condition/maintenance of certification reporting CHANGE Healthcare Cyberattack Overdose epidemic Substance use disorder/barriers to care Rural and small hospitals/obstetrical services/conditions of participation Gender affirming care Nuclear power plants/decommissioning/health risks Nations drug supply/severe weather events

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Nuclear Regulatory Commission (NRC), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), SENATE

H.R. 6445, Medicare Audiology Access Improvement Act, all provisions S. 2377, Medicare Audiology Access Improvement Act, all provisions H.R. 1610, Chiropractic Medicare Coverage Modernization Act, all provisions S. 799, Chiropractic Medicare Coverage Modernization Act, all provisions H.R. 4189, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions S. 2016, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act, all provisions H.R. 1770, Equitable Community Access to Pharmacist Services Act, all provisions S. 2477, Equitable Community Access to Pharmacist Services Act, all provisions H.R. 751, Fair Access In Residency (FAIR) Act, all provisions H.R. 4968, GOLD CARD Act, all provisions H.R. 2713, Improving Care and Access to Nurses (I CAN) Act, all provisions S. 2418, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 2583, Increasing Access to Quality Cardiac Rehabilitation Care Act, all provisions H.R. 6487, No Fees for EFTs Act, all provisions S. 3805, No Fees for EFTs Act, all provisions H.R. 977, Patient Access to Higher Quality Health Care Act of 2023, all provisions S. 470, Patient Access to Higher Quality Health Care Act of 2023, all provisions H.R. 2389, Resident Physician Shortage Reduction Act of 2023, all provisions S. 1302, Resident Physician Shortage Reduction Act of 2023, all provisions H.R. 2630, Safe Step Act, all provisions S. 652, Safe Step Act, all provisions H.R. 7050, Substance Use Disorder Workforce Act, all provisions H.R. 7623, Telehealth Modernization Act of 2024, all provisions H.R. 2474, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 6371, Provider Reimbursement Stability Act of 2023, all provisions H.R. 6545, Physician Fee Schedule Update and Improvements Act, all provisions H.R. 5378, Lower Costs, More Transparency Act, all provisions H.R. 6683, Preserving Seniors Access to Physicians Act of 2023, all provisions H.R. 5013, Value in Health Care Act of 2023, all provisions S. 3503, Value in Health Care Act of 2023, all provisions H.R. 8702, Improving Seniors Timely Access to Care Act of 2024, all provisions S. 4532, Improving Seniors Timely Access to Care Act of 2024, all provisions S. 4935, Physician Fee Stabilization Act, all provisions H.R. 10073, Medicare Patient Access and Practice Stabilization Act of 2024, all provisions H.R. 7856, PREVENT DIABETES Act, all provisions H.R. 3838, Preventing Maternal Deaths Reauthorization Act of 2023, all provisions S. 2415, Preventing Maternal Deaths Reauthorization Act of 2023, all provisions H.R. 8532, Connected MOM Act, all provisions S. 712, Connected MOM Act, all provisions H.R. 6369, To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models, all provisions H.R. 8404, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions S. 4330, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2024, all provisions H.R. 8235, Rural Physician Workforce Preservation Act, all provisions H.R. 1745, Medicare Fraud Detection and Deterrence Act of 2023, all provisions H.R. 1746, Preventing Medicare Telefraud Act, all provisions H.R. 8261, Preserving Telehealth, Hospital, and Ambulance Access Act, all provisions S. 1491, Pharmacy and Medically Underserved Areas Enhancement Act, all provisions S. 669, Increasing Mental Health Options Act of 2023, all provisions H.R. 7618, Stopping Addiction and Falls for the Elderly (SAFE) Act, all provisions H.R. 3730, Rural Health Clinic Burden Reduction Act, all provisions H.R. 7279, Remove Duplicative Unnecessary Clerical Exchanges (REDUCE) Act, all provisions H.R. 6230, Doctor Knows Best Act of 2023, all provisions H.R. 9572, Enhanced Enforcement of Health Coverage Act, all provisions H.R. 9001, Physician Led and Rural Access to Quality Care Act, all provisions S. 5218, Health Infrastructure Security and Accountability Act of 2024, all provisions S. 4054, Health Care Cybersecurity Improvement Act of 2024, all provisions H.R. 9572, Enhanced Enforcement of Health Coverage Act, all provisions Supporting Health Moms and Babies Act/draft Fewer Burdens for Better Healthcare Act/draft Medicaid Primary Care Improvement Act/Senate draft Opioid Workforce Act of 2021/Senate draft Electronic clinical quality measures (eCQM) reporting/draft Medicare program: Medicare physician payment/2.83% cut for FY2025 Medicare program: Payment reform/Medicare Part B cuts Medicare program: Medicare Economic Index (MEI) inflation update Medicare program: Budget neutrality reforms Medicare program: Merit-based Incentive Payment System (MIPS) reforms and penalties Medicare program: G2211 inherent complexity codes Medicare program: Protecting Access to Medicare Act (PAMA 2014)/clinical lab cut reforms Medicare Program: Medicare Access and CHIP Reauthorization Act (MACRA) physician burdens Medicare program: Alternative Payment Models (APMs) Medicare program: Advanced APMs reporting requirements Medicare program: APMs for rural physicians Medicare program: Graduate Medical Education (GME) cap flexibility Medicare program: Physician-owned hospitals Medicare program: Telehealth Medicare program: Prior Authorization Medicare program: Site neutral payment Medicare program: Physician-Focused Payment Model Technical Advisory Committee (PTAC) reform Medicare program: Sunsetting of web interface Medicare program: Access to claims data Medicare program: Coding Medicare program: Accountable Care Organization (ACO)/APM/Medicare Shared Savings Program Medicare program: Medicare Diabetes Prevention Program Medicare program: Physician burden Medicare program: Promoting Interoperability (PI) program Medicare program: Quality Payment Program Medicare program: Certified electronic health record technology and PI Medicare program: Shared Savings program Medicare program: Public Health Reporting and Data Exchange Medicare program: Patient engagement Medicare program: Medicare Advantage plans/Prior Authorization Medicare program: Physician-owned hospitals Medicare program: Medigap/modified community rating Medicare and Medicaid programs: Artificial intelligence Medicare and Medicaid programs: Substance use disorder Medicare and Medicaid programs: Cybersecurity/health care clearinghouses Medicare and Medicaid programs: Health IT Medicare and Medicaid programs: Interoperability Medicare and Medicaid programs: Mandatory models Medicaid and Medicare programs: Quality programs/physician choice Medicaid program: Maternal health Medicaid program: Maternal mortality

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), SENATE

Oversight of No Surprises Act implementation, support enhanced penalties for insurer non-compliance with the No Surprises Act through H.R. 9572 and S.5535, the No Surprises Act Enforcement Act; support clinician behavioral health and well-being, including funding of grant programs authorized by the Dr. Lorna Breen Provider Protection Act; S.3679/H.R.7153 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Issues related to health data cybersecurity; Fiduciary issues related to ERISA coverage; clinical reimbursement through government/non-government insurance programs

Client expense: $215,000 · Firm income: Not reported

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

No Surprises Act implementation Eliminating prior authorization requirements in Medicare Advantage H.R. 4968-GOLD CARD Act of 2023, to improve prior authorization processes under Medicare Advantage for physicians with high approval rates H.R. 9572-the Enhanced Enforcement of Health Coverage Act, to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements under the No Surprises Act

Client expense: $407,855 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to surprise emergency medical bills, including implementation of provisions in P.L. 116-260, the Consolidated Appropriations Act, 2021, included in Requirements Related to Surprise Billing; Part I Interim Final Rule (86 FR 36872), Requirements Related to Surprise Billing; Part II Interim Final Rule (86 FR 55980), and Requirements Related to Surprise Billing Final Rule (87 FR 52618); Federal Independent Dispute Resolution (IDR) Process Administrative Fee and Certified IDR Entity Fee Ranges Proposed Rule (88 FR 65888) and Final Rule (88 FR 88494); Federal Independent Dispute Resolution Operations Proposed Rule (88 FR 75744); Federal Independent Dispute Resolution (IDR) Process Partial Reopening of Dispute Initiation Guidance (October 2023); and FAQs About Consolidated Appropriations Act, 2021 Implementation Part 62. H.R. 9572, the Enhanced Enforcement of Health Coverage Act. S. 5535, the No Surprises Act Enforcement Act. Issues related to health plan policies.

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

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

HR 10545 American Relief Act HR 9572 Enhanced Enforcement of Health Care Coverage Act. Surprise billing reform. S 4532/HR 8702 Seniors Timely Access to Care Act - prior authorization reform HR 6371 Provider Reimbursement Stability Act of 2023 (Bucshon, Kelly) budget neutrality reform S 4935 Physician Fee Stabilization Act of 2024 (Welch, Boozman) Medicare budget neutrality reform S 3503/HR 5013 The Value in Health Care Act of 2023 (Lahood, Wenstrup) Extends the ACO Bonus + HR 8261 Preserving Telehealth, Hospital, and Ambulance Access to Care Act (Ways and Means Committee adopted) HR 7623 Telehealth Modernization Act of 2024 (Energy and Commerce Health Subcommittee adopted) S 2016/HR 4189 CONNECT for Health Act of 2023 (Telehealth) (Menendez, Boozman, Schumer, Collins/Thompson, Matsui) HR 4941 (Schiff) Providing Access to Treatment and Housing Act of 2023 (PATH Act) HR 4974 (Cardenas) Local 988 Response Act of 2023 Mental Health Hotline S 1339 (Sanders, Cassidy) PBM Reform Act HR 3784 Providers and Payers Compete Act

Client expense: $55,000 · Firm income: Not reported

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

ERISA preemption Health care cost transparency, prescription drugs and PBM cost transparency and hospital cost transparency; Lower Costs More Transparency Act (H.R. 5378); telehealth extension and transparency (H.R. 9457); medical management; PBM Reform Act (S. 1339) medical management Tax treatment of employer-sponsored health benefit plans End-stage renal disease and Medicare secondary payer standards; Restore Protections for Dialysis Patients Act (H.R. 6860, S. 5018) Hospital consolidation and billing practices, site neutral payment reform; SITE Act (H.R. 1869) Healthy Competition for Better Care Act (H.R. 3120, S. 1451), Transparent Telehealth Act (H.R. 9457) Health Savings Accounts and High-Deductible Health Plans Paid leave; draft interstate Paid Leave Action Network Act, draft Family Leave Public-Private Partnership Act Mental health parity final regulations Voluntary Employee Beneficiary Associations (VEBAs) Guidance related to the definition of essential health benefits under the Affordable Care Act Guidance related to coverage of preventive services and the definition of cost-sharing under the Affordable Care Act Guidance related to the definition of cost-sharing under the Affordable Care Act 340B Prescription Drug Program proposed legislation Chronic Disease Flexible Coverage Act (H.R. 3800) Surprise Medical Billing, Enhanced Enforcement of Health Coverage Act (H.R. 9572)

Client expense: $377,907 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of

Practice Support/Grants to Practice H.R. 10331, Anesthesia for All Act: prohibit time caps on reimbursement for anesthesia services H.R.1173, Patients Right to Know Their Medication Act of 2023: prescription drug labeling H.R. 9572, No Surprises Enforcement Act: strengthen compliance with the No Surprises Act S.3548, Health Care Prices Revealed and Information to Consumers Explained Transparency Act: Ambulatory Surgical Centers H.R.6205, Healthcare Workforce Resilience Act: physician workforce H.R.7591, National Patient Safety Board Act of 2024: patient safety S.1302, Resident Physician Shortage Reduction Act of 2023: residency positions S.665, Conrad State 30 and Physician Access Reauthorization Act: Foreign physician immigration status Medical liability H.Res. 734: Expressing support for the designation of October 1 as "National Latino and Latina Physician Day" S. 705, Specialty Physicians Advancing Rural Care (SPARC) Act: physician shortages in rural areas Public Law No. 113-5, Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPRA): preparedness for public health Lorna Breen Reauthorization H.R. 3259, NOPAIN Act: Opioids S. 586, NOPAIN Act: Opioids S. 1292, Non-Opioid Directive Act: Opioids H.R. 7961, SAVE Act: To protect hospital personnel from violence, and for other purposes. H.R.833, Save America's Rural Hospitals: rural pass through H.R. 7725, Embracing anti-Discrimination, Unbiased Curricula, and Advancing Truth in Education (EDUCATE) Act: medical school funding H.R. 2671, Specialty Physicians Advancing Rural Care Act (the SPARC Act): student loan repayment programs to support specialty medical care in rural areas Pre-authorization; prior authorization Affordable Care Act reform efforts 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care Resident Education Deferred Interest Act (REDI Act): Student loan relief Student Loan Forgiveness for Frontline Health Workers Act: Student loan relief 21st Century Cures Initiative H.R. 4369, National Centers of Excellence in Continuous Pharmaceutical Manufacturing Act: Drug shortages DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Ketamine use by law enforcement Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Brain health Certified Anesthesiologist Assistants Blood management Long COVID research Anesthesia workforce shortages CDC Opioid Prescribing Guideline 2024 Labor/HHS/Education appropriations bill Defense Health Agency anesthesia policy Maternal Mortality/Maternal Care Deserts Change Healthcare, Change Healthcare data breach Insurance reform, shared savings, insurer accountability

Client expense: $110,000 · 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), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

HR2389/S1302 - Resident Physician Shortage Reduction Act S2333 - Public Health Workforce Loan Repayment Act Health Workforce Resilience Act S665/HR 4942 Conrad 30 and Physician Access Reauthorization Act CLIA Waiver CURES 2.0 To prevent across-the-board direct spending cuts Cytotechnologist labor rates Remote digital telepathology S 1000/HR 2377 SALSA HR 977 - legislation that would repeal provisions prohibiting self-referrals to new or expanded POHs. HR 1202/S 704 - REDI Act HR2761/S 705 - SPARC Act HR 2764/S1229 - Green New Deal for Health HR 3248 - Diagnostic Lab Testing Transparency Act H.R. 3561, the Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 Student loan repayment for FPs HR 4527 - HEALTH DATA Act Primary Care and Health Workforce Expansion Act S 1994 Counting Veterans Cancer Act HR 4875 Doctors in our Borders Act HR 2474 - Strengthening Medicare for Patients and Providers Act Continuing Appropriations Act, 2024 and Other Extensions Act Further Continuing Appropriations and Other Extensions Act, 2024 HR 6683 - Preserving Seniors Access to Physicians Act of 2023 Gene Therapy Precision Medicine Answers for Kids Today Act S.3018/H.R.3173 the Improving Seniors Timely Access to Care Act of 2021 Dr. Lorna Breen Health Care Provider Protection Act PREVAIL HR 6371 - budget neutrality bill EDUCATE Act - Murphy DEI Bill HR 2369 - VALID Act FDA final rule on LDTs Pandemic All-Hazards Preparedness Act H.R.9747, the Continuing Appropriations and Extensions Act, 2025 S.2140/H.R. 9474, the Patent Eligibility Restoration Act of 2023 S.1451 / H.R. 3120 - Healthy Competition for Better Care Act H.R. 9572 - Enhanced Enforcement of Health Coverage Act H.R. 6025/S. 3211 - Healthcare Workforce Resilience Act Cures 2.1 H.R. 10073, Medicare patient Access and Practice Stabilization Act of 2024 S. 4935, Physician Fee Stabilization Act H.R. 5392, The Timely Access to Coverage Decisions Act of 2023 Medical Lab Personnel Shortage Relief Act H.R. 9572 Enhanced Enforcement of Health Coverage Act Sickle Cell Disease Comprehensive Care Act

Client expense: $126,566 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

10/17/2024 Meeting with Rep. Foxx staff re surprise billing 10/17/2024 Meeting with Rep. McMorris Rodgers staff re surprise billing 10/17/2024 Meeting with Rep. Smith staff re surprise billing 10/28/2024 Meeting with Rep. Moore staff re dialysis 10/31/2024 Meeting w Rep. Murphy staff on HR 9572/surprise billing

Client expense: Not reported · Firm income: $240,000

Government targets: HOUSE OF REPRESENTATIVES

Legislative and regulatory issues related to preventing surprise medical bills and lowering health care costs, including implementation of H.R.133, Consolidated Appropriations Act, 2021 (P.L.116-260); H.R. 9572, Enhanced Enforcement of Health Coverage Act; S. 5535, A bill to amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of

Legislative and regulatory issues, including: Health care reform; Legislative and regulatory policy proposals to protect employer-sponsored health care coverage; S. 655, Chronic Disease Management Act; S. 1001 / H.R. 1843, Telehealth Expansion Act of 2023; S. 731, TELEHEALTH HSA Act of 2023; H.R. 3800 / S. 3224, the Chronic Disease Flexible Coverage Act; H.R. 824, the Telehealth Benefit Expansion for Workers Act of 2023; H.R. 3237, to amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department; H.R. 3417, the FAIR Act; H.R. 3561, the Promoting Access to Treatments and Increasing; Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023; S. 1869, the Site-based Invoicing and Transparency Enhancement Act; S. 1451 / H.R. 3120, the Healthy Competition for Better Care Act; S. 1339, the Pharmacy Benefit Manager Reform Act; Legislative and regulatory issues related to preventing surprise medical bills and lowering health care costs, including implementation of H.R.133, Consolidated Appropriations Act, 2021 (P.L.116-260); H.R. 5688, Bipartisan HSA Improvements Act of 2023; H.R. 5687, HSA Modernization Act of 2023; H.R. 5378, the Lower Costs, More Transparency Act; S. 2840, the Bipartisan Primary Care and Health Workforce Act; H.R. 9572, Enhanced Enforcement of Health Coverage Act; H.R. 10445, Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025; H.R. 10545, American Relief Act, 2025; S. 5535, A bill to amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of

Legislative and regulatory issues, including: Health care reform; Legislative and regulatory policy proposals to protect employer-sponsored health care coverage; S. 655, Chronic Disease Management Act; S. 1001 / H.R. 1843, Telehealth Expansion Act of 2023; S. 731, TELEHEALTH HSA Act of 2023; H.R. 3800 / S. 3224, the Chronic Disease Flexible Coverage Act; H.R. 824, the Telehealth Benefit Expansion for Workers Act of 2023; H.R. 3237, to amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department; H.R. 3417, the FAIR Act; H.R. 3561, the Promoting Access to Treatments and Increasing; Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023; S. 1869, the Site-based Invoicing and Transparency Enhancement Act; S. 1451 / H.R. 3120, the Healthy Competition for Better Care Act; S. 1339, the Pharmacy Benefit Manager Reform Act; Legislative and regulatory issues related to preventing surprise medical bills and lowering health care costs, including implementation of H.R.133, Consolidated Appropriations Act, 2021 (P.L.116-260); H.R. 5688, Bipartisan HSA Improvements Act of 2023; H.R. 5687, HSA Modernization Act of 2023; H.R. 5378, the Lower Costs, More Transparency Act; S. 2840, the Bipartisan Primary Care and Health Workforce Act; H.R. 9572, Enhanced Enforcement of Health Coverage Act; H.R. 10445, Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025; H.R. 10545, American Relief Act, 2025; S. 5535, A bill to amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of

Legislative and regulatory issues, including: Health care reform; Legislative and regulatory policy proposals to protect employer-sponsored health care coverage; S. 655, Chronic Disease Management Act; S. 1001 / H.R. 1843, Telehealth Expansion Act of 2023; S. 731, TELEHEALTH HSA Act of 2023; H.R. 3800 / S. 3224, the Chronic Disease Flexible Coverage Act; H.R. 824, the Telehealth Benefit Expansion for Workers Act of 2023; H.R. 3237, to amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department; H.R. 3417, the FAIR Act; H.R. 3561, the Promoting Access to Treatments and Increasing; Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023; S. 1869, the Site-based Invoicing and Transparency Enhancement Act; S. 1451 / H.R. 3120, the Healthy Competition for Better Care Act; S. 1339, the Pharmacy Benefit Manager Reform Act; Legislative and regulatory issues related to preventing surprise medical bills and lowering health care costs, including implementation of H.R.133, Consolidated Appropriations Act, 2021 (P.L.116-260); H.R. 5688, Bipartisan HSA Improvements Act of 2023; H.R. 5687, HSA Modernization Act of 2023; H.R. 5378, the Lower Costs, More Transparency Act; S. 2840, the Bipartisan Primary Care and Health Workforce Act; H.R. 9572, Enhanced Enforcement of Health Coverage Act

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of

Legislative and regulatory issues, including: Health care reform; Legislative and regulatory policy proposals to protect employer-sponsored health care coverage; S. 655, Chronic Disease Management Act; S. 1001 / H.R. 1843, Telehealth Expansion Act of 2023; S. 731, TELEHEALTH HSA Act of 2023; H.R. 3800 / S. 3224, the Chronic Disease Flexible Coverage Act; H.R. 824, the Telehealth Benefit Expansion for Workers Act of 2023; H.R. 3237, to amend title XVIII of the Social Security Act to require each off-campus outpatient department of a provider to include a unique identifier on claims for items and services, and to require providers with a department of a provider to submit to the Centers for Medicare & Medicaid Services an attestation with respect to each such department; H.R. 3417, the FAIR Act; H.R. 3561, the Promoting Access to Treatments and Increasing; Extremely Needed Transparency Act of 2023 or the PATIENT Act of 2023; S. 1869, the Site-based Invoicing and Transparency Enhancement Act; S. 1451 / H.R. 3120, the Healthy Competition for Better Care Act; S. 1339, the Pharmacy Benefit Manager Reform Act; Legislative and regulatory issues related to preventing surprise medical bills and lowering health care costs, including implementation of H.R.133, Consolidated Appropriations Act, 2021 (P.L.116-260); H.R. 5688, Bipartisan HSA Improvements Act of 2023; H.R. 5687, HSA Modernization Act of 2023; H.R. 5378, the Lower Costs, More Transparency Act; S. 2840, the Bipartisan Primary Care and Health Workforce Act; H.R. 9572, Enhanced Enforcement of Health Coverage Act

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of

No Surprises Act implementation Eliminating prior authorization requirements in Medicare Advantage H.R. 4968-GOLD CARD Act of 2023, to improve prior authorization processes under Medicare Advantage for physicians with high approval rates H.R. 9572-the Enhanced Enforcement of Health Coverage Act, to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements under the No Surprises Act

Client expense: $428,634 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Oversight of No Surprises Act implementation, support enhanced penalties for insurer non-compliance with the No Surprises Act through H.R. 9572, the No Surprises Act Enforcement Act; support clinician behavioral health and well-being, including funding of grant programs authorized by the Dr. Lorna Breen Provider Protection Act; S.3679/H.R.7153 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Issues related to health data cybersecurity; Fiduciary issues related to ERISA coverage; clinical reimbursement through government/non-government insurance programs

Client expense: $195,000 · Firm income: Not reported

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

Issues related to surprise emergency medical bills, including implementation of provisions in P.L. 116-260, the Consolidated Appropriations Act, 2021, included in Requirements Related to Surprise Billing; Part I Interim Final Rule (86 FR 36872), Requirements Related to Surprise Billing; Part II Interim Final Rule (86 FR 55980), and Requirements Related to Surprise Billing Final Rule (87 FR 52618); Federal Independent Dispute Resolution (IDR) Process Administrative Fee and Certified IDR Entity Fee Ranges Proposed Rule (88 FR 65888) and Final Rule (88 FR 88494); Federal Independent Dispute Resolution Operations Proposed Rule (88 FR 75744); Federal Independent Dispute Resolution (IDR) Process Partial Reopening of Dispute Initiation Guidance (October 2023); and FAQs About Consolidated Appropriations Act, 2021 Implementation Part 62. H.R. 9572, the Enhanced Enforcement of Health Coverage Act.

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

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

HR2389/S1302 - Resident Physician Shortage Reduction Act S2333 - Public Health Workforce Loan Repayment Act Health Workforce Resilience Act S665/HR 4942 Conrad 30 and Physician Access Reauthorization Act CLIA Waiver CURES 2.0 To prevent across-the-board direct spending cuts Cytotechnologist labor rates Remote digital telepathology S 1000/HR 2377 SALSA HR 977 - legislation that would repeal provisions prohibiting self-referrals to new or expanded POHs. HR 1202/S 704 - REDI Act HR2761/S 705 - SPARC Act HR 2764/S1229 - Green New Deal for Health HR 3248 - Diagnostic Lab Testing Transparency Act H.R. 3561, the Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act of 2023 Student loan repayment for FPs HR 4527 - HEALTH DATA Act Primary Care and Health Workforce Expansion Act S 1994 Counting Veterans Cancer Act HR 4875 Doctors in our Borders Act HR 2474 - Strengthening Medicare for Patients and Providers Act Continuing Appropriations Act, 2024 and Other Extensions Act Further Continuing Appropriations and Other Extensions Act, 2024 HR 6683 - Preserving Seniors Access to Physicians Act of 2023 Gene Therapy Precision Medicine Answers for Kids Today Act S.3018/H.R.3173 the Improving Seniors Timely Access to Care Act of 2021 Dr. Lorna Breen Health Care Provider Protection Act PREVAIL HR 6371 - budget neutrality bill EDUCATE Act - Murphy DEI Bill HR 2369 - VALID Act FDA final rule on LDTs Pandemic All-Hazards Preparedness Act H.R.9747, the Continuing Appropriations and Extensions Act, 2025 S.2140/H.R. 9474, the Patent Eligibility Restoration Act of 2023 S.1451 / H.R. 3120 - Healthy Competition for Better Care Act H.R. 9572 - Enhanced Enforcement of Health Coverage Act H.R. 6025/S. 3211 - Healthcare Workforce Resilience Act

Client expense: $193,594 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE