Rural Physician Workforce Production Act of 2025

Medicare Reimbursement: Medicare Coverage of Breakthrough Technologies (S. 1717/H.R. 5343); Transitional Coverage for Emerging Technologies (TCET)/Medicare Coverage for Innovative Technology (MCIT); supplies and services incident to a physician's services reimbursement. Medicare coverage of telehealth flexibilities CMS NPRM IPPS proposal to repeal New Technology Add on Payment (NTAP) and Transitional Pass-Through pathway for FDA Breakthrough Devices; proposal for adoption of unique device identifier (UDI) capture measure under the Medicare Promoting Interoperability Program. Medicare payment for FTE residents training in rural areas, "Rural Physician Workforce Production Act of 2025" (H.R. 1153) Medicare Program: Regulatory Alignment for Predictable and Immediate Device Coverage Pathway (RAPID) Proposed Coverage Pathway proposal by CMS

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1153, Rural Physician Workforce Production Act; funding for AHRQ and AHRQ Primary Care Center and HRSA Primary Care Teaching and Enhancement program; H.R. 8765, the Prioritizing Primary Care Act of 2026

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Teaching Health Center Funding (THCGME) Primary Care Research Funding AHRQ: Center for Primary Care Research HRSA: Title VII/ Title VIII GME Transparency H.R 1153 Rural Physician Workforce Production Act of 2025 Graduate Medical Education CMS Physician Payment Reform CMS Physician Fee Schedule Telehealth Expansion Vaccine safeguarding H-1B Visa Healthcare Exemption Primary Care Expansion

Client expense: $53,125 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

Dr. Lorna Breen Health Care Provider Protection Act (H.R 929, S. 266) Rural Physician Workforce Production Act (H.R. 1153) Physicians for Underserved Areas Act (H.R. 870, S. 1044) Fair Access In Residency Act (H.R. 2314, S.2715) Teaching Health Center Graduate Medical Education National Institutes of Health Research Expanding Medical Education Act (H.R. 2106, S. 975) Community TEAMS Act (H.R. 3885, S.3989) Post GRAD Act (H.R. 3711) Rural Health Transformation Program Healthcare Advisory Council Resident Physician Shortage Reduction Act (H.R.4731/S.2439) Medical Student Education Authorization Act (H.R.5248) Resident Education Deferred Interest (REDI Act) (H.R. 2028, S. 942) Rural Residency Planning and Development Act of 2025 (H.R. 6468) PSLF Payment Completion Fairness Act (H.R. 3267, S.3487) Foreign Medical School Accountability Fairness Act (S. 3757) Nutrition Education Community Academic Health Systems Nutrition Education and Chronic Disease Prevention in Community Health Centers Act of 2026 (H.R. 9389)

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

P.L.119-21 - One Big Beautiful Bill Act H.R.1 and Senate-Passed Amendment to H.R.1 Fiscal Year 2025 Budget Reconciliation H.Con.Res. 14 Fiscal Year 2026 Budget Reconciliation Issue: Educate Congress on potential financial implications of Medicare and Medicaid cuts and entitlement reform on academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. Support preservation of non-profit tax status of AAMC member institutions. Oppose reduction in Medicare hospital outpatient department reimbursement and site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital and provider cuts, including Medicare graduate medical education (GME) reforms, reduction or elimination of bad debt reimbursement, reforming Medicare disproportionate share hospital payments and uncompensated care, prevention of rural reclassification, and reductions in wage index. Oppose cuts to federal Medicaid funding, including reductions to the federal medical assistance percentage (FMAP), changes to provider taxes and state-directed payments, and the implementation of per-capita caps or block grants. Oppose policies that restrict access to coverage and care for the Medicaid population, such as work/community engagement requirements, more frequent eligibility redeterminations, and additional cost-sharing. Oppose limits on Affordable Care Act (ACA) premium tax credit eligibility and restrictions on eligibility for and enrollment in ACA Marketplace plans. Oppose reducing Medicare reimbursement for 340B-acquired drugs. Issue: Educate lawmakers on the need to delay, undo, or revise pending new restrictions on to provider taxes and state-directed payments, along with implement strategies to mitigate coverage losses due to the OBBBAs work requirements and more frequent eligibility redeterminations for the ACA expansion population. Issue: Educate lawmakers on the importance of academic health systems, teaching hospitals, and physician practice eligibility for Rural Health Transformation Program (RHTP), support increased funding for RHTP. Issue: Educate Congress and policymakers on the financial challenges facing academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. H.R.7409 - Defend Rural Health Act Issue: Oppose efforts to repeal or curtail the ability of urban hospitals to become rural referral centers or reclassify for the purposes of their wage index. Issue: Educate Congress and policymakers on the role academic health systems, teaching hospitals, medical schools, and faculty practices play in caring for rural patients and communities, training providers to practice in rural communities, and ensuring access to critical health care services not otherwise available. Issue: Educate Congress on impact of Statutory Pay-As-You-Go Act Medicare sequester H.R.1835 - Breaking the Gridlock Act S.3385 - Lower Health Care Costs Act S.3386 - Health Care Freedom for Patients Act of 2025 Issue: Support clean extension of Affordable Care Act enhanced premium tax credits (EPTCs) set to expire at the end of 2025 H.R.4371/S.2439 - Resident Physician Shortage Reduction Act of 2025 Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.2314/S.2715 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.1153 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare graduate medical education (GME) payment formulas that reduce current Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments to teaching hospitals. Issue: Educate Congress on teaching health system and hospital graduate medical education (GME) data collection practices and concerns related to duplicative reporting requirements. H.R.3178/S.2600 - Save Healthcare Workers Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. Issue: Oppose legislation that pays for workforce investments and mitigation of Medicaid Disproportionate Share Hospital (DSH) program cuts paid for by cuts to hospital outpatient departments. Issue: Support legislation that ensures the move to value-based care. Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported graduate medical education (GME) slots from the Consolidated Appropriations Act (CAA), 2021 and 2023. Issue: Educate Congress on status of Centers for Medicare and Medicaid Services (CMS) distribution of the 1,000 new graduate medical education (GME) slots authorized by the Consolidated Appropriations Act (CAA), 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: CAA, 2021 Sec. 131 extension and RTP thresholds Issue: Support Medicare graduate medical education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose the redesign of Medicare Indirect Medical Education (IME) financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient Indirect Medical Education (IME) payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support efforts to reform the Medicare physician fee schedule. H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issue: Support Medicare Physician Fee Schedule (PFS) reform. P.L.119-4 - Full-Year Continuing Appropriations and Extensions Act, 2025 P.L.118-158 - American Relief Act 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule (PFS) cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. H.R.5582/S.2355 - Patients Deserve Price Tags Act H.R.9393 - Lower Costs, More Transparency Act of 2026 H.R.9390 - Prices on the Wall Act of 2026 Issue: Oppose efforts to increase administrative burden on hospitals through expanded reporting measures. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. H.R.9504 - Tax Exempt Hospital Transparency Act Issue: Oppose efforts that increase duplicative and burdensome reporting requirements on tax exempt hospitals through expanded IRS reporting measures. H.R.3514/ S.1816 - Improving Seniors' Timely Access to Care Act of 2025 Issue: Support efforts to decrease the burden of prior authorization in Medicare Advantage plans Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support elimination of scheduled reductions to the Medicaid disproportionate share hospital (DSH) program. H.R.8163 - Provider Reimbursement Stability Act of 2026 Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. H.R.4313 - Hospital Inpatient Services Modernization Act Issue: Support extension of the Acute Hospital Care at Home program. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove the requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support legislation to eliminate the 190-day Lifetime Limit policy in the Medicare program. Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). S.2761/H.R.5269 - Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare. Issue: Oppose Department Homeland Security (DHS) proposed rule to expand public charge definition and educate Congress on potential impacts to health care providers.

Medicare Reimbursement: Medicare Coverage of Breakthrough Technologies (S. 1717/H.R. 5343); Transitional Coverage for Emerging Technologies (TCET)/Medicare Coverage for Innovative Technology (MCIT); supplies and services incident to a physician's services reimbursement. Medicare coverage of telehealth flexibilities CMS NPRM IPPS proposal to repeal New Technology Add on Payment (NTAP) and Transitional Pass-Through pathway for FDA Breakthrough Devices; proposal for adoption of unique device identifier (UDI) capture measure under the Medicare Promoting Interoperability Program. Medicare payment for FTE residents training in rural areas, "Rural Physician Workforce Production Act of 2025" (H.R. 1153)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1153, Rural Physician Workforce Production Act; funding for AHRQ and AHRQ Primary Care Center and HRSA Primary Care Teaching and Enhancement program

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Dr. Lorna Breen Health Care Provider Protection Act (H.R 929, S. 266) Rural Physician Workforce Production Act (H.R. 1153) Physicians for Underserved Areas Act (H.R. 870, S. 1044) Rural Health Innovation Act of 2025 (H.R.1480) Fair Access In Residency Act (H.R. 2314/S.2715) Teaching Health Center Graduate Medical Education National Institutes of Health Research Pathways to Health Professions Act (H.R. 593) Bipartisan Rural America Health Corps Act (H.R. 1127) Expanding Medical Education Act (H.R. 2106, S. 975) Community TEAMS Act (H.R. 3885, S.3989) Specialty Physicians Advancing Rural Care Act (S. 1380) Post GRAD Act (H.R. 3711) Physician and Patient Safety Act (H.R. 3413, S. 1767) IHS Workforce Production Act ( S.632) Rural Health Focus Act (S.403) Rural Health Transformation Program Healthcare Advisory Council Resident Physician Shortage Reduction Act (H.R.4731/S.2439) Medical Student Education Authorization Act (H.R.5248) Palliative Care and Hospice Education and Training Act (S.2287) Improving Care in Rural America Reauthorization Act (S.2301) Health Care Workforce Expansion Act (S.2954) Resident Education Deferred Interest (REDI Act) (H.R. 2028,S. 942) Save Americas Rural Hospitals Act (H.R. 3684) Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act (H.R. 4262) Train More Primary Care Doctors Act of 2025 (H.R. 958) Rural Hospital Flexibility Act (S. 3250) Rural Behavioral Health Improvement Act (H.R.5217) Community Health Workforce Development Act (H.R. 7289) Student Loan Tax Elimination Act (H.R. 3165 / S.3538) Healthcare is Human Act of 2026 (H.R. 7884) Rural Residency Planning and Development Act of 2025 (H.R. 6468) Healthcare Education in AI Literacy (HEAL A.I.) Act (H.R. 6077) PSLF Payment Completion Fairness Act (H.R. 3267 / S.3487) Foreign Medical School Accountability Fairness Act (S. 3757) Medically Tailored Home-Delivered Meals Program Pilot Act (H.R. 5439, S. 2834) Nutrition Education Community Academic Health Systems

Teaching Health Center Funding (THCGME) Primary Care Research Funding AHRQ: Center for Primary Care Research HRSA: Title VII/ Title VIII GME Transparency H.R 1153 Rural Physician Workforce Production Act of 2025 Graduate Medical Education CMS Physician Payment Reform CMS Physician Fee Schedule Telehealth Expansion Vaccine safeguarding H-1B Visa Healthcare Exemption

Client expense: $69,391 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

Medicare Reimbursement: Medicare Coverage of Breakthrough Technologies (S. 1717/H.R. 5343); Transitional Coverage for Emerging Technologies (TCET)/Medicare Coverage for Innovative Technology (MCIT); supplies and services incident to a physician's services reimbursement. Medicare coverage of telehealth flexibilities Medicare payment for FTE residents training in rural areas, "Rural Physician Workforce Production Act of 2025" (H.R. 1153)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L.119-21 - One Big Beautiful Bill Act H.R.1 and Senate-Passed Amendment to H.R.1 Fiscal Year 2025 Budget Reconciliation H.Con.Res. 14 Fiscal Year 2026 Budget Reconciliation Issue: Educate Congress on potential financial implications of Medicare and Medicaid cuts and entitlement reform on academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. Support preservation of non-profit tax status of AAMC member institutions. Oppose reduction in Medicare hospital outpatient department reimbursement and site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital and provider cuts, including Medicare graduate medical education (GME) reforms, reduction or elimination of bad debt reimbursement, reforming Medicare disproportionate share hospital payments and uncompensated care, prevention of rural reclassification, and reductions in wage index. Oppose cuts to federal Medicaid funding, including reductions to the federal medical assistance percentage (FMAP), changes to provider taxes and state-directed payments, and the implementation of per-capita caps or block grants. Oppose policies that restrict access to coverage and care for the Medicaid population, such as work/community engagement requirements, more frequent eligibility redeterminations, and additional cost-sharing. Oppose limits on Affordable Care Act (ACA) premium tax credit eligibility and restrictions on eligibility for and enrollment in ACA Marketplace plans. Oppose reducing Medicare reimbursement for 340B-acquired drugs. Issue: Educate lawmakers on the need to delay, undo, or revise pending new restrictions on to provider taxes and state-directed payments, along with strategies to mitigate coverage losses in light of the implementation of work requirements and more frequent eligibility redeterminations for the ACA expansion population. Issue: Educate lawmakers on the importance of academic health systems, teaching hospitals, and physician practice eligibility for Rural Health Transformation Program (RHTP), support increased funding for RHTP. Issue: Educate Congress and policymakers on the financial challenges facing academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. H.R.7409 - Defend Rural Health Act Issue: Oppose efforts to repeal or curtail the ability of urban hospitals to become rural referral centers or reclassify for the purposes of their wage index. Issue: Educate Congress and policymakers on the role academic health systems, teaching hospitals, medical schools, and faculty practices play in caring for rural patients and communities, training providers to practice in rural communities, and ensuring access to critical health care services not otherwise available. Issue: Educate Congress on impact of Statutory Pay-As-You-Go Act Medicare sequester H.R.1835 - Breaking the Gridlock Act S.3385 - Lower Health Care Costs Act S.3386 - Health Care Freedom for Patients Act of 2025 Issue: Support clean extension of Affordable Care Act enhanced premium tax credits (EPTCs) set to expire at the end of 2025 H.R.4371/S.2439 - Resident Physician Shortage Reduction Act of 2025 Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.2314/S.2715 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.1153 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare graduate medical education (GME) payment formulas that reduce current Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments to teaching hospitals. Issue: Educate Congress on teaching health system and hospital graduate medical education (GME) data collection practices and concerns related to duplicative reporting requirements. H.R.3178/S.2600 - Save Healthcare Workers Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. Issue: Oppose legislation that pays for workforce investments and mitigation of Medicaid Disproportionate Share Hospital (DSH) program cuts paid for by cuts to hospital outpatient departments. Issue: Support legislation that ensures the move to value-based care. Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported graduate medical education (GME) slots from the Consolidated Appropriations Act (CAA), 2021 and 2023. Issue: Educate Congress on status of Centers for Medicare and Medicaid Services (CMS) distribution of the 1,000 new graduate medical education (GME) slots authorized by the Consolidated Appropriations Act (CAA), 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: CAA, 2021 Sec. 131 extension and RTP thresholds Issue: Support Medicare graduate medical education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose the redesign of Medicare Indirect Medical Education (IME) financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient Indirect Medical Education (IME) payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support efforts to reform the Medicare physician fee schedule. H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issue: Support Medicare Physician Fee Schedule (PFS) reform. P.L.119-4 - Full-Year Continuing Appropriations and Extensions Act, 2025 P.L.118-158 - American Relief Act 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule (PFS) cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. S.2355 - Patients Deserve Price Tags Act Issue: Oppose efforts to increase administrative burden on hospitals through expanded reporting measures. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support elimination of scheduled reductions to the Medicaid disproportionate share hospital (DSH) program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. H.R.4313 - Hospital Inpatient Services Modernization Act Issue: Support extension of the Acute Hospital Care at Home program. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove the requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support legislation to eliminate the 190-day Lifetime Limit policy in the Medicare program. Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). S.2761/H.R.5269 - Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare. Issue: Oppose Department Homeland Security (DHS) proposed rule to expand public charge definition and educate Congress on potential impacts to health care providers.

H.R. 1153, Rural Physician Workforce Production Act; funding for AHRQ and AHRQ Primary Care Center and HRSA Primary Care Teaching and Enhancement program

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General health care issues and Medicare graduate medical education. H.R.1153, Rural Physician Workforce Production Act of 2025. Vaccine policy issues.

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

Teaching Health Center Funding (THCGME) Primary Care Research Funding AHRQ: Center for Primary Care Research HRSA: Title VII/ Title VIII GME Transparency H.R 1153 Rural Physician Workforce Production Act of 2025 Graduate Medical Education CMS Physician Payment Reform CMS Physician Fee Schedule Telehealth Expansion Vaccine safeguarding

Client expense: $62,290 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

H.R. 21/S. 6 - Born-Alive Abortion Survivors Protection Act H.R.1096 - HOPE and Mental Wellbeing Act of 2025 H.R. 929/S. 266 - Lorna Breen Health Care Provider Protection Reauthorization H.R. 593 - Strengthening Pathways to Health Professions Act H.R. 879/S. 1640 - Medicare Patient Access and Practice Stabilization Act H.R. 1153 - Rural America Health Corps Act H.R. 1227/S. 475 - Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 1735/S. 779 - EARLY Minds Act H.R. 1448 - PEER for Mental Health Act H.R. 1585/S. 709 - Conrad State 30 and Physician Access Reauthorization Act H.R. 1909/S. 2621 - Preventing Maternal Deaths Reauthorization Act of 2025 H.R. 957 - Parity Enforcement Act H.R. 2509/S. 931 - COMPLETE Care Act H.R. 4206/S. 1261 - CONNECT for Health Act H.R. 1305 - Improving Measurements for Loneliness and Isolation Act H.R. 1902 - Helping Emergency Responders Overcome (HERO) Act H.R. 2223 - Building Capacity for Care Act H.R. 2586 - Reentry Act of 2025 H.R. 3884/S.2011 - Telemental Health Care Access Act of 2025 H.R. 3266/S.1673 - Mental Health Infrastructure Improvement Act of 2025 Mental Health Matters Act H.R. 4619 - Medicare Mental Health Inpatient Equity Act Letter to Congress in support of the Prevention and Public Health Fund Letter to Congress to extend telehealth flexibilities Letter to Congress for funding for public health research into firearm morbidity and mortality prevention at CDC, NIH and NIJ. Letter to Congress on Agency for Healthcare Research and Quality (AHRQ) funding Letter to Congress on funding for FDAs Neurology Drug Program in FY26 Letter to Congress on funding for the BRAIN Initiative in FY26 Letter to Congress regarding school-based Medicaid programs Letters to Congress in support of Medicaid Letter to NIH regarding indirect cost caps for NIH grants Letter to HHS in response to the draft Make American Healthy Again Commission Assessment. S. 1062 - Suicide Prevention Act H.R. 912 - 9-8-8 Lifeline Cybersecurity Act H.R. 2587 - Youth Mental Health Research Act H.R. 2483/S. 2121 - SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 539/S. 106 - Chiropractic Medicare Coverage Modernization Act of 2025 H.R. 2630 - Youth Suicide Prevention Research Act H.R. 3655 - STAR Plus Scholarship Act Letter to Congress in support of NIH neuroscience research Letter to Congress to protect federal funding of maternal health programs Letter to Congress supporting the Pediatric Mental Health Care Access (PMHCA) program Letter to Congress in support of funding for the Children's Hospital Graduate Medical Education (CHGME) program Letter to Congress in support of school mental health workforce grants Communication with Congressional offices on CCBHC funding Letter to Congress to include report language in FY26 appropriations for the 988 Suicide and Crisis Lifeline and Garrett Lee Smith Youth Suicide Prevention Campus Grants Letter to Congress concerning funding for 988 lifeline LGBTQ+ youth specialized services H.R. 3890/S. 2439 - Resident Physician Shortage Reduction Act of 2025 H.R. 3885 - Community TEAMS Act H.R. 3658 - 911 Community Crisis Responders Act H.R. 4745/S. 2410 - Medicaid Bump Act H.R. 3758 - Workers' Disability Benefits Parity Act H.R. 4744/S. 2445 - Community Mental Wellness and Resilience Act H.R. 1867 - To amend title XVIII of the Social Security Act to remove in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology H.R 4641 - Keep Kids Covered Act Letter opposing H.R. 3164 - Ensuring Community Access to Pharmacist Services (ECAPS) Act Letter to Congress to support the integrity of the United States Preventive Services Task Force (USPSTF) Letter in response to FDA panel review of SSRIs and pregnancy Letter to HHS in response to proposed change to its interpretation of federal public benefit to include 13 additional programs as restricted Federal public benefits Letter to SAMHSA regarding reports on the redirection of FY25 funds H.R. 4681/S. 1379 - Specialty Physicians Advancing Rural Care (SPARC) Act H.R. 4723/S. 2446 - Mental Health for Latinos Act Conversations with Congressional offices on Teaching Health Center Graduate Medical Education (THCGME) H.R.3505 - Barriers to Suicide Act H.R. 5454/S.2879 - Medicare Advantage Prompt Pay Act Letters to Congress to extend the enhanced premium tax credits H.R.6249 - Addressing Addiction After Disasters Act Mental Health Emergency Needs in Disasters (MEND) Act Mental Health Career Promotion Act H.R. 5074 - Protecting Young Minds Online Act H.R. 5434/S. 2826 - 988 LGBTQ+ Youth Access Act H.R.5509 /S.2903 - Safe Step Act H.R.5553 - CTE Student Mental Health and Wellness Act H.R. 5557 - Mental Health Services for Students Act H.R.1197 - PREEMIE Reauthorization Act of 2025 H.R. 3514/S.1816 - Improving Seniors Timely Access to Care Act Draft legislation on expedited FDA approval pathways for addiction therapeutics Mental Health Emergency Package: Youth Mental Health Day and Suicide Prevention Day Resolution, Mental Health Crisis Response Act, and Mental Health Emergency Responder Act S. 3064 - Relief of Chronic Pain Act H.R. 6226 - Latino Youth Mental Health Empowerment Act H.R. 5482 - Prevent Youth Suicide Act H.R.6672 - Mental Health Professionals Workforce Shortage Loan Repayment Act Letter to Letter to Department of Labor, Department of Health and Human Services, and Department of Treasury regarding mental health parity enforcement. H.R. 3492 - Protect Children's Innocence Act H.R. 498 - Do No Harm in Medicaid Act H.R. 6817/ S. 1056 - Home-Based Telemental Health Care Act Letters and a presentation to the FDA digital health advisory panel regarding generative AI enabled mental health medical devices

P.L.119-21 - One Big Beautiful Bill Act H.R.1 and Senate-Passed Amendment to H.R.1 Fiscal Year 2025 Budget Reconciliation H.Con.Res. 14 Issue: Educate Congress on potential financial implications of Medicare and Medicaid cuts and entitlement reform on academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. Support preservation of non-profit tax status of AAMC member institutions. Oppose reduction in Medicare hospital outpatient department reimbursement and site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital and provider cuts, including Medicare graduate medical education (GME) reforms, reduction or elimination of bad debt reimbursement, reforming Medicare disproportionate share hospital payments and uncompensated care, prevention of rural reclassification, and reductions in wage index. Oppose cuts to federal Medicaid funding, including reductions to the federal medical assistance percentage (FMAP), changes to provider taxes and state-directed payments, and the implementation of per-capita caps or block grants. Oppose policies that restrict access to coverage and care for the Medicaid population, such as work/community engagement requirements, more frequent eligibility redeterminations, and additional cost-sharing. Oppose limits on Affordable Care Act (ACA) premium tax credit eligibility and restrictions on eligibility for and enrollment in ACA Marketplace plans. Oppose reducing Medicare reimbursement for 340B-acquired drugs. Issue: Educate lawmakers on the importance of academic health systems, teaching hospitals, and physician practice eligibility for Rural Health Transformation Program (RHTP), support increased funding for RHTP. Issue: Educate Congress and policymakers on the financial challenges facing academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on impact of Statutory Pay-As-You-Go Act Medicare sequester H.R.1835 - Breaking the Gridlock Act S.3385 - Lower Health Care Costs Act S.3386 - Health Care Freedom for Patients Act of 2025 Issue: Support clean extension of Affordable Care Act enhanced premium tax credits (EPTCs) set to expire at the end of 2025 H.R.4371/S.2439 - Resident Physician Shortage Reduction Act of 2025 Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.2314/S.2715 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.1153 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare graduate medical education (GME) payment formulas that reduce current Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments to teaching hospitals. Issue: Educate Congress on teaching health system and hospital graduate medical education (GME) data collection practices and concerns related to duplicative reporting requirements. H.R.3178/S.2600 - Save Healthcare Workers Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. Issue: Oppose legislation that pays for workforce investments and mitigation of Medicaid Disproportionate Share Hospital (DSH) program cuts paid for by cuts to hospital outpatient departments. Issue: Support legislation that ensures the move to value-based care. Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported graduate medical education (GME) slots from the Consolidated Appropriations Act (CAA), 2021 and 2023. Issue: Educate Congress on status of Centers for Medicare and Medicaid Services (CMS) distribution of the 1,000 new graduate medical education (GME) slots authorized by the Consolidated Appropriations Act (CAA), 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare graduate medical education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose the redesign of Medicare Indirect Medical Education (IME) financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient Indirect Medical Education (IME) payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support efforts to reform the Medicare physician fee schedule. H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issue: Support Medicare Physician Fee Schedule (PFS) reform. P.L.119-4 - Full-Year Continuing Appropriations and Extensions Act, 2025 P.L.118-158 - American Relief Act 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule (PFS) cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support elimination of scheduled reductions to the Medicaid disproportionate share hospital (DSH) program. Issue: Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their disproportionate share hospital (DSH) cap. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. H.R. 4313 - Hospital Inpatient Services Modernization Act Issue: Support extension of the Acute Hospital Care at Home program. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove the requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support legislation to eliminate the 190-day Lifetime Limit policy in the Medicare program. Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). S.2761 / H.R.5269 - Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare. Issue: Oppose Department Homeland Security (DHS) proposed rule to expand public charge definition and educate Congress on potential impacts to health care providers.

General health care issues and Medicare graduate medical education. H.R.1153, Rural Physician Workforce Production Act of 2025. Vaccine policy issues.

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

Dr. Lorna Breen Health Care Provider Protection Act (H.R 929, S. 266) Rural Physician Workforce Production Act (H.R. 1153) Physicians for Underserved Areas Act (H.R. 870, S. 1044) Rural Health Innovation Act of 2025 (H.R.1480) Fair Access In Residency Act (H.R. 2314/S.2715) Teaching Health Center Graduate Medical Education National Institutes of Health Research Pathways to Health Professions Act (H.R. 593) Bipartisan Rural America Health Corps Act (H.R. 1127) Expanding Medical Education Act (H.R. 2106, S. 975) Community TEAMS Act (H.R. 3885) Specialty Physicians Advancing Rural Care Act (S. 1380) Post GRAD Act (H.R. 3711) Physician and Patient Safety Act (H.R. 3413, S. 1767) IHS Workforce Production Act ( S.632) Rural Health Focus Act (S.403) Rural Health Transformation Program Healthcare Advisory Council Resident Physician Shortage Reduction Act (H.R.4731/S.2439) Medical Student Education Authorization Act (H.R.5248) Palliative Care and Hospice Education and Training Act (S.2287) Improving Care in Rural America Reauthorization Act (S.2301) Health Care Workforce Expansion Act (S.2954) Resident Education Deferred Interest (REDI Act) (H.R. 2028,S. 942) Save Americas Rural Hospitals Act (H.R. 3684) Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act (H.R. 4262) Train More Primary Care Doctors Act of 2025 (H.R. 958) Rural Hospital Flexibility Act (S. 3250) Rural Behavioral Health Improvement Act (H.R.5217)

Client expense: $100,000 · Firm income: Not reported

H.R. 1153, Rural Physician Workforce Production Act; funding for AHRQ and AHRQ Primary Care Center and HRSA Primary Care Teaching and Enhancement program

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 21/S. 6 - Born-Alive Abortion Survivors Protection Act H.R.1096 - HOPE and Mental Wellbeing Act of 2025 H.R. 929/S. 266 - Lorna Breen Health Care Provider Protection Reauthorization H.R. 593 - Strengthening Pathways to Health Professions Act H.R. 879/S. 1640 - Medicare Patient Access and Practice Stabilization Act H.R. 1153 - Rural America Health Corps Act H.R. 1227/S. 475 - Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 1735/S. 779 - EARLY Minds Act H.R. 1448 - PEER for Mental Health Act H.R. 1585/S. 709 - Conrad State 30 and Physician Access Reauthorization Act H.R. 1909/S. 2621 - Preventing Maternal Deaths Reauthorization Act of 2025 H.R. 957 - Parity Enforcement Act H.R. 2509/S. 931 - COMPLETE Care Act H.R. 4206/S. 1261 - CONNECT for Health Act H.R. 1305 - Improving Measurements for Loneliness and Isolation Act H.R. 1902 - Helping Emergency Responders Overcome (HERO) Act H.R. 2223 - Building Capacity for Care Act H.R. 2586 - Reentry Act of 2025 H.R. 3884/S.2011 - Telemental Health Care Access Act of 2025 H.R. 3266/S.1673 - Mental Health Infrastructure Improvement Act of 2025 Mental Health Matters Act H.R. 4619 - Medicare Mental Health Inpatient Equity Act Letter to Congress in support of the Prevention and Public Health Fund Letter to Congress to extend telehealth flexibilities Letter to Congress for funding for public health research into firearm morbidity and mortality prevention at CDC, NIH and NIJ. Letter to Congress on Agency for Healthcare Research and Quality (AHRQ) funding Letter to Congress on funding for FDAs Neurology Drug Program in FY26 Letter to Congress on funding for the BRAIN Initiative in FY26 Letter to Congress regarding school-based Medicaid programs Letters to Congress in support of Medicaid Letter to NIH regarding indirect cost caps for NIH grants Letter to HHS in response to the draft Make American Healthy Again Commission Assessment. S. 1062 - Suicide Prevention Act H.R. 912 - 9-8-8 Lifeline Cybersecurity Act H.R. 2587 - Youth Mental Health Research Act H.R. 2483/S. 2121 - SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 539/S. 106 - Chiropractic Medicare Coverage Modernization Act of 2025 H.R. 2630 - Youth Suicide Prevention Research Act H.R. 3655 - STAR Plus Scholarship Act Letter to Congress in support of NIH neuroscience research Letter to Congress to protect federal funding of maternal health programs Letter to Congress supporting the Pediatric Mental Health Care Access (PMHCA) program Letter to Congress in support of funding for the Children's Hospital Graduate Medical Education (CHGME) program Letter to Congress in support of school mental health workforce grants Communication with Congressional offices on CCBHC funding Letter to Congress to include report language in FY26 appropriations for the 988 Suicide and Crisis Lifeline and Garrett Lee Smith Youth Suicide Prevention Campus Grants Letter to Congress concerning funding for 988 lifeline LGBTQ+ youth specialized services H.R. 3890/S. 2439 - Resident Physician Shortage Reduction Act of 2025 H.R. 3885 - Community TEAMS Act H.R. 3658 - 911 Community Crisis Responders Act H.R. 4745/S. 2410 - Medicaid Bump Act H.R. 3758 - Workers' Disability Benefits Parity Act H.R. 4744/S. 2445 - Community Mental Wellness and Resilience Act H.R. 1867 - To amend title XVIII of the Social Security Act to remove in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology H.R 4641 - Keep Kids Covered Act Letter opposing H.R. 3164 - Ensuring Community Access to Pharmacist Services (ECAPS) Act Letter to Congress to support the integrity of the United States Preventive Services Task Force (USPSTF) Letter in response to FDA panel review of SSRIs and pregnancy Letter to HHS in response to proposed change to its interpretation of federal public benefit to include 13 additional programs as restricted Federal public benefits Letter to SAMHSA regarding reports on the redirection of FY25 funds H.R. 4681/S. 1379 - Specialty Physicians Advancing Rural Care (SPARC) Act H.R. 4723/S. 2446 - Mental Health for Latinos Act Conversations with Congressional offices on Teaching Health Center Graduate Medical Education (THCGME) H.R.3505 - Barriers to Suicide Act H.R. 5454/S.2879 - Medicare Advantage Prompt Pay Act Letters to Congress to extend the enhanced premium tax credits Addressing Addiction After Disasters Act Mental Health Emergency Needs in Disasters (MEND) Act Mental Health Career Promotion Act H.R. 5074 - Protecting Young Minds Online Act H.R. 5434/S. 2826 - 988 LGBTQ+ Youth Access Act H.R.5509 /S.2903 - Safe Step Act H.R.5553 - CTE Student Mental Health and Wellness Act H.R. 5557 - Mental Health Services for Students Act H.R.1197 - PREEMIE Reauthorization Act of 2025

General health care issues and Medicare graduate medical education. H.R.1153, Rural Physician Workforce Production Act of 2025. Vaccine policy issues.

Client expense: Not reported · Firm income: Not reported

Teaching Health Center Funding (THCGME) Primary Care Research Funding AHRQ: Center for Pirmary Care Research HRSA: Title VII/ Title VIII GME Transparency H.R 1153 Rural Physician Workforce Production Act of 2025 Graduate Medical Education

Client expense: $61,993 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

P.L.119-21 - One Big Beautiful Bill Act H.R.1 and Senate-Passed Amendment to H.R.1 Fiscal Year 2025 Budget Reconciliation H. Con. Res. 14 Issue: Educate Congress on potential financial implications of Medicare and Medicaid cuts and entitlement reform on teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Support preservation of non-profit tax status of AAMC member institutions. Oppose reduction in Medicare hospital outpatient department reimbursement and site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts including Medicare graduate medical education (GME) reforms, reduction or elimination of bad debt reimbursement, reforming Medicare disproportionate share hospital payments and uncompensated care, prevention of rural reclassification, reductions in wage index. Oppose cuts to federal Medicaid funding, including through reductions to the federal medical assistance percentage (FMAP), changes to provider taxes and state-directed payments, and the implementation of per-capita caps or block grants. Oppose policies that restrict access to coverage and care for the Medicaid population, such as work/community engagement requirements, more frequent eligibility redeterminations, and additional cost-sharing. Oppose limits on Affordable Care Act (ACA) premium tax credit eligibility and restrictions on eligibility for and enrollment in ACA Marketplace plans. Oppose reducing Medicare reimbursement for 340B-acquired drugs. Issue: Educate lawmakers on the importance of academic health systems, teaching hospitals, and physician practice eligibility for Rural Health Transformation Program (RHTP), support increased funding for RHTP. Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on impact of Statutory Pay-As-You-Go Act Medicare sequester H.R.4371/S.2439 - Resident Physician Shortage Reduction Act of 2025 Issue: Support increased Medicare funding for graduate medical education (GME). Issue: Support codification of Rural Residency Planning and Development grants. Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.2314/ S.2715 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.1153 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare graduate medical education (GME) payment formulas that reduce current Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments to teaching hospitals. Issue: Educate Congress on teaching health system and hospital graduate medical education (GME) data collection practices and concerns related to duplicative reporting requirements. H.R.3178/ S.2600 Save Healthcare Workers Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. Issue: Oppose legislation that pays for workforce investments and mitigation of Medicaid Disproportionate Share Hospital (DSH) program cuts paid for by cuts to hospital outpatient departments. Issue: Support legislation that ensures the continued move to value-based care. Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported graduate medical education (GME) slots from the Consolidated Appropriations Act (CAA), 2021 and 2023. Issue: Educate Congress on status of Centers for Medicare and Medicaid Services (CMS) distribution of the 1,000 new graduate medical education (GME) slots authorized by the Consolidated Appropriations Act (CAA), 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare graduate medical education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose the redesign of Medicare Indirect Medical Education (IME) financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient Indirect Medical Education (IME) payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support efforts to reform the Medicare physician fee schedule. H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issue: Support Medicare Physician Fee Schedule (PFS) reform. P.L.119-4 - Full-Year Continuing Appropriations and Extensions Act, 2025 P.L.118-158 - American Relief Act 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule (PFS) cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support elimination of scheduled reductions to the Medicaid disproportionate share hospital (DSH) program. Issue: Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their disproportionate share hospital (DSH) cap. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support extension of the Acute Hospital Care at Home program. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support legislation to eliminate the 190-day Lifetime Limit policy in the Medicare program. Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare.

Dr. Lorna Breen Health Care Provider Protection Act (H.R 929, S. 266) Rural Physician Workforce Production Act (H.R. 1153) Physicians for Underserved Areas Act (H.R. 870, S. 1044) Rural Health Innovation Act of 2025 (H.R.1480) Fair Access In Residency Act (H.R. 2314/S.2715) Teaching Health Center Graduate Medical Education National Institutes of Health Research Pathways to Health Professions Act (H.R. 593) Bipartisan Rural America Health Corps Act (H.R. 1127) Expanding Medical Education Act (H.R. 2106, S. 975) Community TEAMS Act (H.R. 3885) Specialty Physicians Advancing Rural Care Act (S. 1380) Post GRAD Act (H.R. 3711) Physician and Patient Safety Act (H.R. 3413, S. 1767) IHS Workforce Production Act ( S.632) Rural Health Focus Act (S.403) Rural Health Transformation Program Healthcare Advisory Council Resident Physician Shortage Reduction Act (H.R.4731/S.2439) Medical Student Education Authorization Act (H.R.5248) Palliative Care and Hospice Education and Training Act (S.2287) Improving Care in Rural America Reauthorization Act (S.2301) Health Care Workforce Expansion Act (S.2954) Resident Education Deferred Interest (REDI Act) (H.R. 2028,S. 942) Save Americas Rural Hospitals Act (H.R. 3684) Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act (H.R. 4262) Train More Primary Care Doctors Act of 2025 (H.R. 958)

Client expense: $160,000 · Firm income: Not reported

H.R. 1153, Rural Physician Workforce Production Act; funding for AHRQ and AHRQ Primary Care Center and HRSA Primary Care Teaching and Enhancement program

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Teaching Health Center Funding (THCGME) Primary Care Research Funding AHRQ: Center for Pirmary Care Research HRSA: Title VII/ Title VIII GME Transparency H.R 1153 Rural Physician Workforce Production Act of 2025 Graduate Medical Education

Client expense: $54,379 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

H.R. 21/S. 6 - Born-Alive Abortion Survivors Protection Act H.R.1096 - HOPE and Mental Wellbeing Act of 2025 H.R. 929/S. 266 - Lorna Breen Health Care Provider Protection Reauthorization H.R. 593 - Strengthening Pathways to Health Professions Act H.R. 879/S. 1640 - Medicare Patient Access and Practice Stabilization Act H.R. 1153 - Rural America Health Corps Act H.R. 1227/S. 475 - Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 1735/S. 779 - EARLY Minds Act H.R. 1448 - PEER for Mental Health Act H.R. 1585/S. 709 - Conrad State 30 and Physician Access Reauthorization Act H.R. 1909 - Preventing Maternal Deaths Reauthorization Act of 2025 H.R. 957 - Parity Enforcement Act H.R. 2509/S. 931 - COMPLETE Care Act H.R. 4206/S. 1264 - CONNECT for Health Act H.R. 1305 - Improving Measurements for Loneliness and Isolation Act H.R. 1902 - Helping Emergency Responders Overcome (HERO) Act H.R. 2223 - Building Capacity for Care Act H.R. 2586 - Reentry Act of 2025 H.R. 3884/S.2011 - Telemental Health Care Access Act of 2025 H.R. 3266/S.1673 - Mental Health Infrastructure Improvement Act of 2025 Mental Health Matters Act GME draft legislation Medicare Mental Health Inpatient Equity Act Letter to Congress in support of the Prevention and Public Health Fund Letter to Congress to extend telehealth flexibilities Letter to Congress for funding for public health research into firearm morbidity and mortality prevention at CDC, NIH and NIJ. Letter to Congress on Agency for Healthcare Research and Quality (AHRQ) funding Letter to Congress on funding for FDAs Neurology Drug Program in FY26 Letter to Congress on funding for the BRAIN Initiative in FY26 Letter to Congress regarding school-based Medicaid programs Letters to Congress in support of Medicaid Letter to ONDCP on 2026 National Drug Control Strategy Conversation with GAO regarding TRICARE network adequacy and TRICARE T5 contract transition. Meeting with SAMHSA on Teleprescribing flexibilities expiring in December 2025 S. 1062 - Suicide Prevention Act H.R. 912 - 9-8-8 Lifeline Cybersecurity Act H.R. 2587 - Youth Mental Health Research Act H.R. 2483 - SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 539/S. 106 - Chiropractic Medicare Coverage Modernization Act of 2025 H.R. 2630 - Youth Suicide Prevention Research Act H.R. 3655 - STAR Plus Scholarship Act Letter to Congress in support of NIH neuroscience research Letter to Congress to protect federal funding of maternal health programs Letter to Congress supporting the Pediatric Mental Health Care Access (PMHCA) program Letter to Congress in support of funding for the Children's Hospital Graduate Medical Education (CHGME) program Letter to Congress in support of school mental health workforce grants Communication with Congressional offices on CCBHC funding Letter to Congress to include report language in FY26 appropriations for the 988 Suicide and Crisis Lifeline and Garrett Lee Smith Youth Suicide Prevention Campus Grants Letter to Congress concerning funding for 988 lifeline LGBTQ+ youth specialized services H.R. 3890 - Resident Physician Shortage Reduction Act of 2025 H.R. 3885 - Community TEAMS Act H.R. 3658 - 911 Community Crisis Responders Act Medicaid Bump Act H.R. 3758 - Workers' Disability Benefits Parity Act Community Mental Wellness and Resilience Act Letter to HHS regarding funding SAMHSA programs

General health care issues and Medicare graduate medical education. H.R.1153, Rural Physician Workforce Production Act of 2025. Vaccine policy issues.

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

Government targets: HOUSE OF REPRESENTATIVES

Dr. Lorna Breen Health Care Provider Protection Act (H.R 929, S. 266) Rural Physician Workforce Production Act (H.R. 1153) Physicians for Underserved Areas Act (H.R. 870, S. 1044) Rural Health Innovation Act of 2025 (H.R. 1480) FAIR Access in Residency Act (H.R. 2314) National Osteopathic Medicine Week (S.Res.181) Teaching Health Center Graduate Medical Education National Institutes of Health Research Pathways to Health Professions Act (H.R. 593) Bipartisan Rural America Health Corps Act (H.R. 1127) Expanding Medical Education Act (H.R. 2106, S. 975) Clinical rotations for medical students Community TEAMS Act (H.R. 3885) Specialty Physicians Advancing Rural Care Act (S. 1380) Post GRAD Act (H.R. 3711) Physician and Patient Safety Act (H.R. 3413, S. 1767) Resident Physician Shortage Reduction Act of 2025 (H.R. 3890) IHS Workforce Production Act (S. 632) Rural Health Focus Act (S. 403)

Client expense: $130,000 · Firm income: Not reported

P.L.119-21 - One Big Beautiful Bill Act H.R.1 and Senate-Passed Amendment to H.R.1 Fiscal Year 2025 Budget Reconciliation H. Con. Res. 14 Issue: Educate Congress on potential financial implications of Medicare and Medicaid cuts and entitlement reform on teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Support preservation of non-profit tax status of AAMC member institutions. Oppose reduction in Medicare hospital outpatient department reimbursement and site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts including Medicare graduate medical education (GME) reforms, reduction or elimination of bad debt reimbursement, reforming Medicare disproportionate share hospital payments and uncompensated care, prevention of rural reclassification, reductions in wage index. Oppose cuts to federal Medicaid funding, including through reductions to the federal medical assistance percentage (FMAP), changes to provider taxes and state-directed payments, and the implementation of per-capita caps or block grants. Oppose policies that restrict access to coverage and care for the Medicaid population, such as work/community engagement requirements, more frequent eligibility redeterminations, and additional cost-sharing. Oppose limits on Affordable Care Act (ACA) premium tax credit eligibility and restrictions on eligibility for and enrollment in ACA Marketplace plans. Oppose reducing Medicare reimbursement for 340B-acquired drugs. Issue: Educate lawmakers on the importance of academic health systems, teaching hospitals, and physician practice eligibility for Rural Health Transformation Program (RHTP), support increased funding for RHTP. Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. H.R.3890 - Resident Physician Shortage Reduction Act of 2025 Issue: Support increased Medicare funding for graduate medical education (GME). Support inclusion of Rural Residency Planning and Development grant codification in the bill. Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.2314 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.1153 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare graduate medical education (GME) payment formulas that reduce current Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments to teaching hospitals. Issue: Educate Congress on teaching health system and hospital graduate medical education (GME) data collection practices and concerns related to duplicative reporting requirements. Safety From Violence for Healthcare Employees (SAVE) Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. Issue: Oppose legislation that pays for workforce investments and mitigation of Medicaid Disproportionate Share Hospital (DSH) program cuts paid for by cuts to hospital outpatient departments. Issue: Support legislation that ensures the continued move to value-based care. Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported graduate medical education (GME) slots from the Consolidated Appropriations Act (CAA), 2021 and 2023. Issue: Educate Congress on status of Centers for Medicare and Medicaid Services (CMS) distribution of the 1,000 new graduate medical education (GME) slots authorized by the Consolidated Appropriations Act (CAA), 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare graduate medical education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose the redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient Indirect Medical Education (IME) payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support efforts to reform the Medicare physician fee schedule. H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issue: Support Medicare Physician Fee Schedule (PFS) reform. P.L.119-4 - Full-Year Continuing Appropriations and Extensions Act, 2025 P.L.118-158 - American Relief Act 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule (PFS) cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support elimination of scheduled reductions to the Medicaid disproportionate share hospital (DSH) program. Issue: Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their disproportionate share hospital (DSH) cap. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support extension of Acute Hospital at Home program. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support legislation to eliminate the 190-day Lifetime Limit policy in the Medicare program. Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare.

H.R. 1153, Rural Physician Workforce Production Act; funding for AHRQ and AHRQ Primary Care Center and HRSA Primary Care Teaching and Enhancement program

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1153, Rural Physician Workforce Production Act; funding for AHRQ and AHRQ Primary Care Center and HRSA Primary Care Teaching and Enhancement program

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Teaching Health Center Funding (THCGME) Primary Care Research Funding AHRQ: Center for Pirmary Care Research HRSA: Title VII/ Title VIII GME Transparency H.R 1153 Rural Physician Workforce Production Act of 2025

Client expense: $67,087 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

General health care issues and Medicare graduate medical education; H.R.1153, Rural Physician Workforce Production Act of 2025.

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

Government targets: HOUSE OF REPRESENTATIVES

Fiscal Year 2025 Budget Reconciliation H. Con. Res. 14 Issue: Educate Congress on potential financial implications of Medicare and Medicaid cuts and entitlement reform on teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Support preservation of nonprofit tax status for Association of American Medical Colleges (AAMC) member teaching health systems and hospitals with federal non-profit status. Oppose reduction in Medicare hospital outpatient department reimbursement and site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts including Medicare graduate medical education (GME) reforms, reduction or elimination of bad debt reimbursement, reforming Medicare disproportionate share hospital payments and uncompensated care, prevention of rural reclassification, reductions in wage index. Oppose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage, restrictions on provider taxes, limits on state directed payments, reductions in the Federal Medical Assistance Percentage (FMAP), and the implementation of per-capita caps and/or block grants. Oppose reducing Medicare reimbursement for 340B-acquired drugs. Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.2314 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.1153 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare graduate medical education (GME) payment formulas that reduce current Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments to teaching hospitals. Issue: Educate Congress on teaching health system and hospital graduate medical education (GME) data collection practices and concerns related to duplicative reporting requirements. Safety From Violence for Healthcare Employees (SAVE) Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. Issue: Oppose legislation that pays for workforce investments and mitigation of Medicaid Disproportionate Share Hospital (DSH) program cuts paid for by cuts to hospital outpatient departments. Issue: Support legislation that ensures the continued move to value-based care. Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported graduate medical education (GME) slots from the Consolidated Appropriations Act (CAA), 2021 and 2023. Issue: Educate Congress on status of Centers For Medicare and Medicaid Services (CMS) distribution of the 1,000 new graduate medical education (GME) slots authorized by the Consolidated Appropriations Act (CAA), 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare graduate medical education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose the redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient Indirect Medical Education (IME) payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support efforts to reform the Medicare physician fee schedule. H.R. 879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issue: Support Medicare Physician Fee Schedule (PFS) reform. P.L. 119-4 - Full-Year Continuing Appropriations and Extensions Act, 2025 P.L. 118-158 - American Relief Act 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule (PFS) cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support elimination of scheduled reductions to the Medicaid disproportionate share hospital (DSH) program. Issue: Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their disproportionate share hospital (DSH) cap. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support legislation to eliminate the 190-day Lifetime Limit policy in the Medicare program. Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare.

H.R. 21/S. 6 - Born-Alive Abortion Survivors Protection Act H.R.1096 - HOPE and Mental Wellbeing Act of 2025 H.R. 929/S. 266 - Lorna Breen Health Care Provider Protection Reauthorization H.R. 593 - Strengthening Pathways to Health Professions Act H.R. 879 - Medicare Patient Access and Practice Stabilization Act H.R. 1153 - Rural America Health Corps Act S. 475 - Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 1735/S. 779 - EARLY Minds Act H.R. 1448 - PEER for Mental Health Act H.R. 1585/S. 709 - Conrad State 30 and Physician Access Reauthorization Act H.R. 1909 - Preventing Maternal Deaths Reauthorization Act of 2025 H.R. 2028/ S. 942 - Resident Education Deferred Interest Act (REDI Act) H.R. 957 - Parity Enforcement Act H.R. 2509/S. 931 - COMPLETE Care Act S. 1264 - CONNECT for Health Act H.R. 1305 - Improving Measurements for Loneliness and Isolation Act H.R. 1902 - Helping Emergency Responders Overcome (HERO) Act H.R. 2223 - Building Capacity for Care Act H.R. 2586 - Reentry Act of 2025 Mental Health Matters Act GME draft legislation Medicare Mental Health Inpatient Equity Act Telemental Health Care Access Act Mental Health Infrastructure Improvement Act of 2025 Letter to Congress in support of the Prevention and Public Health Fund Letter to Congress to extend telehealth flexibilities Letter to Congress for funding for public health research into firearm morbidity and mortality prevention at CDC, NIH and NIJ. Letter to Congress on Agency for Healthcare Research and Quality (AHRQ) funding Letter to Congress on funding for FDAs Neurology Drug Program in FY26 Letter to Congress on funding for the BRAIN Initiative in FY26 Letter to Congress regarding school-based Medicaid programs Letters to Congress in support of Medicaid Letter to NIH regarding indirect cost caps for NIH grants Letter to HHS/OCR in response to the HIPAA Security Rule to Strengthen the cybersecurity of electronic protected health information Letter to HHS regarding the use of psychiatric medications for the treatment of pediatric mental illness and substance use disorder. Response to AHRQ RFI regarding the Impact of Ageism in Healthcare. Conversation with GAO regarding CMS distribution of medical residency slots as authorized by Section 126 of the Consolidated Appropriations Act, 2021 Communication with EBSA regarding their meeting with APA members and Councils at APAs annual meeting.

Dr. Lorna Breen Health Care Provider Protection Act (H.R 929, S. 266) Rural Physician Workforce Production Act (H.R. 1153) Physicians for Underserved Areas Act (H.R. 870, S. 1044) Rural Health Innovation Act of 2025 (H.R.1480) Fair Access in Residency Act (H.R. 2314) National Osteopathic Medicine Week Teaching Health Center Graduate Medical Education National Institutes of Health Research Pathways to Health Professions Act (H.R. 593) Bipartisan Rural America Health Corps Act (H.R. 1127) Expanding Medical Education Act (H.R. 2106, S. 975) Clinical rotations for medical students

Client expense: $130,000 · Firm income: Not reported