ABC Act

H.R. 7336/S.3763 - ALS Better Care Act - All provisions. H.R. 6423/S. 864 - HELP Copays Act -- Provisions related to health insurance plans requirement to apply payments made by or on behalf of plan enrollees toward a plan's cost-sharing requirements, i.e. a ban on copay-accumulator adjust programs. H.R. 4206 / S. 1261 - CONNECT for Health Act - Provisions related to permanent telehealth services in Medicare and interstate telehealth services. H.R. 2491 / S. 1227 - Alleviating Barriers for Caregivers (ABC) Act - All provisions. H.R. 2560 / S.830 - Lifespan Respite Care Reauthorization Act - All provisions H.R. 3514 / S. 1816 - Improving Seniors Timely Access to Care Act of 2025 All provisions relating to prior authorization usage under Medicare Advantage Plans. H.R. 6280/S. 3607- Genetic Counselor Services Act - All provisions H.R.2172/S.1058 - Preserving Patient Access to Home Infusion Act - All Provisions H.R.8375/S.4284 - Medicare Advantage Improvement Act of 2026 - Provisions related to expedited care authorizations, increased transparency and oversight, align coverage criteria with traditional Medicare, and strengthen beneficiary protections, in Medicare Advantage plans. H.R.8500 - Timely Access to Coverage Decisions Act of 2026 - All Provisions

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Observation Stays. The Improving Access to Medicare Coverage Act (H.R. 3954): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Costs. The Pharmaceutical Research Transparency Act (No bill): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Law to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act (Public Law No: 117-169). Medicare and Medicaid Prescription Drugs. (No bill): Joined comments with 19 other organizations urging HHS to use its existing authority to license competition in order to lower consumer and taxpayer costs for semaglutide drugs treating diabetes and weight management (e.g., Ozempic and Wegovy). Medicare Savings Program and Low-Income Subsidy (LIS) Programs. (No bill): Proposals to make enrollment of dually eligible individuals in the Medicare Savings Programs (MSP) and the LIS program easier, so that low-income beneficiaries can more readily access financial assistance for Medicare copayments, premiums and deductibles, and to be able to access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 609): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental, Hearing and Vision Coverage. Medicare Dental, Vision, and Hearing Benefit Act of 2025 (H.R. 2045): Proposal to add dental, vision and hearing benefits to Medicare. Medicare Hearing Coverage: The Medicare Hearing Aid Coverage Act of 2025 (H.R. 500): Proposals to add hearing benefits to Medicare. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Advantage. (H.R. 3467) Proposal to make Medicare Advantage plans the default choice during initial enrollment periods. Medicare Privatization (No bill): Proposals to create policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid. The HCBS Access Act (H.R. 8540): Proposals to expand Medicaid home and community-based services (HCBS) by elevating them to a mandatory entitlement. H.R. 8540 would reduce waitlists and guarantee seniors and individuals with disabilities a choice between home care and institutional care. Would also establish new grant programs and a technical assistance center to improve the wages, benefits, and training pathways for the direct care workforce. Medicare, Medicaid and Social Security. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 2491 and S. 1227): Proposals would require HHS and SSA to review application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and Social Security programs in order to reduce administrative barriers facing family caregivers. The bill requires agencies to identify and report to Congress on actions that can be taken to streamline eligibility and assistance for family caregivers within existing programs. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 1303): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. The Safe Staffing Saves Lives Act (H.R. 8100): Proposal to establish mandatory, statutory, minimum nurse staffing standards in nursing homes to ensure at least 4.1 hours of total nursing care per resident per day. Medicare, Medicaid Nursing Homes. The Nurses Belong in Nursing Homes Act (S. 3886): Proposal aims to establish federal minimum staffing standards, specifically requiring 3.48 hours per resident per day (HPRD) of total nursing care and 24/7 on-site Registered Nurse (RN) coverage. Medicare, Medicaid Nursing homes. The Safe Staffing Saves Lives Act (H.R. 8100): Proposals to establish a minimum of 4.1 hours of direct nursing home care per resident per day, and a Registered Nurse on duty on-site 24/7. Adds penalties for facilities failing to meet required minimums. Medicare, Medicaid Nursing Homes. The Building Americas Health Care Workforce Act (No bill): Proposal to allow time spent working in a nursing home (prior to any formal training, and permitted during the COVID-19 pandemic) to count toward a 75-hour minimum federal training standard that is required for certified nursing assistants. Medicare, Medicaid Nursing Homes. The Ensuring Seniors Access to Quality Care Act (H.R. 7096): Proposal to repeal regulations that prohibit certified nursing assistant training and competency evaluation programs in skilled nursing facilities that have a record of health and safety deficiencies and have incurred penalties (e.g., civil monetary penalties for substandard quality of care). Medicare Treatment for Osteoporosis (No bill): Support for making payment revisions to the 2026 Physician Fee Schedule that would accelerate treatment improvements for beneficiaries with osteoporosis and help prevent repeat fractures. Medicare and Medicaid Waste, Fraud and Abuse (No bill): Submitted comments with other organizations to a CMS Request for Information (RFI) Related to Comprehensive Regulations To Uncover Suspicious Healthcare (CRUSH), 91 Fed. Reg. 9803 (February 27, 2026) CMS-6098-NC. Medicaid Work Requirements Affecting Eligibility (No bill): Submitted comments with other organizations to request CMS to clarify in regulations that people with disabilities, older adults, and caregivers are exempt from the Medicaid working requirements in P.L. 119-21. Health Insurance. Health Insurance Premium Fairness Act (H.R. 6455). Proposal to close loophole that penalizes couples with one spouse in Medicare and one receiving health care through Affordable Care Act (ACA) exchanges, by allowing for subtraction of Medicare premiums from the maximum premium paid for a marketplace plan. Health Insurance. (H.R. 1834). Proposals to extend the Enhanced Premium Tax Credits for ACA marketplace health insurance plans. Health Insurance. The Lower Health Care Premiums for All Americans Act (H.R. 6703) Proposals to weakening consumer protections and destabilizing markets by allowing skimpier, less‑regulated plans that can cherry‑pick healthier groups and leave higher‑cost enrollees in the ACA‑regulated small‑group and individual markets with higher premiums. Medicaid and Health Insurance. Protecting Health Care and Lowering Costs Act (S. 2556, H.R. 4849): Proposals to restore massive funding cuts to Medicaid that were included in the 2025 budget reconciliation law, and to make permanent ACA enhanced premium tax credits. Medicare. The Medicare Cost Cap Act (S. 4886): Proposals to add a $5,000 annual cap on out-of-pocket costs for traditional Medicare (Part A and Part B) beneficiaries. Would require Medicare to pay 100 percent of covered health care costs once the $5,000 cap is reached.

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

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

Labor-HHS Appropriations Billing and Coding classifications CAR-T Therapy Clarifications H.R. 2491/S. 1227, Alleviating Barriers to Care Act H.R. 5160/S.4109, the Stem Cell Therapeutic and Research Reauthorization Act of 2025 H.R.1262/S.932, the Give Kids a Chance Act S. 4440/H.R. 3521 - The Clinical Trial Modernization Act

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

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

- CMS coding and billing clarity for CAR-T therapies - CMS engagement on MS-DRG 018 for CAR-T therapies - H.R. 2491/S. 1227, the Alleviating Barriers to Care Act

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

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

H.R. 2491/S. 1227, the Alleviating Barriers for Caregivers Act H.R. 5039, the Wheelchair Right to Repair Act H.R. 9364, the FAST Repairs for Wheelchairs Act Senate Draft, Timely Wheelchair Repair Act of 2025 Discussions: Interaction between Medicare Part B and Tricare for medically retired veterans Discussions: Definition of Medicare in the Home for DME purposes Discussions: Efforts to dismantle the Administration on Community Living Discussions: Efforts to include ostomy and urological products in Medicare competitive bidding Discussions: Efforts to deny coverage for seat elevation in certain wheelchairs

Client expense: $112,137 · Firm income: Not reported

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

Medicare and Medicaid coverage, access, and affordability of treatments for Parkinsons disease and other chronic conditions, including beneficiary access to care, prescription drug coverage, and utilization management policies. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 2491 / S. 1227), including advocacy related to simplifying Medicare and Social Security processes and improving access to benefits for caregivers and individuals with chronic conditions. The Essential Caregivers Act of 2025 (H.R. 6766 / S. 3492), including advocacy related to ensuring access for designated essential caregivers in health care facilities during periods of restricted visitation under Medicare and Medicaid. The Alzheimers Screening and Prevention (ASAP) Act (H.R. 6130 / S. 3267), including advocacy related to Medicare coverage of blood-based biomarker tests for early detection of Alzheimers disease and related dementias. Centers for Medicare & Medicaid Services (CMS) policies, including advocacy related to Medicare Part D and Medicare Advantage, prescription drug affordability, formulary design, utilization management, and beneficiary protections.

Client expense: $150,000 · Firm income: Not reported

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

Alleviating Barriers for Caregivers (House and Senate), S. 1227/H.R. 2491. Reauthorization of C.W. Bill Young Cell Transplantation Program (House and Senate), H.R. 5160/S. 4109. Accelerating Kids Access to Care Act (House and Senate), S. 752/H.R. 1509. Credit for Caring Act (House and Senate), S. 925/H.R. 2036. Sickle Cell Disease Comprehensive Care Act (House and Senate), H.R. 5178/S. 721. Lowering Costs for Caregives Act (House and Senate), S. 1565/H.R. 138.

Client expense: $320,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Labor-HHS Appropriations Billing and Coding classifications CAR-T Therapy Clarifications Revaccination of Immunosuppressed Patients H.R. 1509/S. 752, The Accelerating Kids Access to Care Act H.R. 2491/S. 1227, Alleviating Barriers to Care Act H.R. 5160/S.4109, the Stem Cell Therapeutic and Research Reauthorization Act of 2025 H.R.1262/S.932, the Give Kids a Chance Act

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

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

- CMS coding and billing clarity for CAR-T therapies - CMS engagement on MS-DRG 018 for CAR-T therapies - H.R. 1509/S. 752, the Accelerating Kids Access to Care Act - H.R. 2491/S. 1227, the Alleviating Barriers to Care Act

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

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

S. 3439/H.R. 6735, Connecting Caregivers to Medicare Act. S. 1227/H.R. 2491, Alleviating Barriers for Caregivers Act. P.L. 119-21, the One Big Beautiful Bill Act. H.R. 6766/S. 3492, the Essential Caregivers Act. H.R. 7966/S. 4118, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act. H.R. 7618, Stopping Addiction and Falls for the Elderly (SAFE) Act. S. 2237/H.R. 4313, Hospital Inpatient Services Modernization Act. H.R. 8100, Safe Staffing Saves Lives Act. S. 3886, Nurses Belong in Nursing Homes Act. H.R. 7966/S. 4118, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act. S. 3886, Nurses Belong in Nursing Homes Act. No bill number. Discussed Medicare payment models. No bill number. Discussed Medicare waste, fraud, and abuse. No bill number. Discussed health technology, data security, enrollee accounts, and access. No bill number. Discussed Medicaid and waste, fraud, and abuse. No bill number. Discussed Medicaid community engagement requirements and Data Strategy for Family Caregiver Verification. No bill number. Discussed nursing home staffing standards, safety, and quality. No bill number. Discussed nursing home transparency and ownership requirements. No bill number. Discussed home health, hospice, and long-term care. No bill number. Discussed Medicare Advantage. No bill number. Discussed the Medicare Prescription Drug Benefit Program. No bill number. Discussed the Medicare Cost Plan Program. No bill number. Discussed Medicare Advantage Capitation Rates. No bill number. Discussed Medicare Part C and Part D payment policies. No bill number. Discussed Medicare Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH). No bill number. Discussed AI tools for Medicare Experience modernization. No bill number. Discussed Medicare Advantage provider networks. No bill number. Discussed fraud in Medicare and Medicaid. No bill number. Discussed long-term services and supports. No bill number. Discussed home and community-based services. No bill number. Discussed the Money Follows the Person Rebalancing Demonstration Program. No bill number. Discussed Medicaid home and community-based services (HCBS) spousal impoverishment protections. No bill number. Discussed the direct care workforce. No bill number. Discussed family caregiver exemption from Medicaid community engagement requirements. No bill number. Discussed falls prevention. No bill number. Discussed age-friendly communities. No bill number. Discussed health at home. No bill number. Discussed the National Strategy to Support Family Caregivers. No bill number. Discussed the Older Americans Act reauthorization. No bill number. Discussed Medicaid HCBS waivers. No bill number. Discussed the health care workforce.

Client expense: $3,830,000 · Firm income: Not reported

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

S. 925/H.R. 2036, Credit for Caring Act. S. 1565/H.R. 138, Lowering Costs for Caregivers Act. S. 3439/H.R. 6735, Connecting Caregivers to Medicare Act. S. 1227/H.R. 2491, Alleviating Barriers for Caregivers Act. P.L. 119-21, One Big Beautiful Bill Act. S. 830/H.R. 2560, the Lifespan Respite Care Reauthorization Act. H.R. 3089, the More Paid Leave for More Americans Act. H.R. 8100, the Safe Staffing Saves Lives Act. S. 3886, the Nurses Belong in Nursing Homes Act. H.R. 6766/S. 3492, the Essential Caregivers Act of 2025. H.R. 7966/S. 4118, the Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act S.2120, the Older Americans Act Reauthorization Act of 2025. H.R. 5575, the Firefighters Assisting Seniors to Emergency Response (FASTER) Act of 2025. H.R. 7567, the Farm, Food, and National Security Act of 2026. HR 1538, the Delivering for Rural Seniors Act of 2025. H.R. 1782, the Supporting all Healthy Options when Purchasing Produce (SHOPP) Act of 2025. S. 2237/H.R. 4313, the Hospital Inpatient Services Modernization Act. No bill number. Discussed paid leave for family caregivers. No bill number. Discussed support for family caregivers. No bill number. Discussed minimum staffing standards for long-term care facilities. No bill number. Discussed the Senior Hunger Prevention Act. No bill number. Discussed Nursing Home staffing standards, safety, and quality. No bill number. Discussed Nursing home transparency and ownership requirements. No bill number. Discussed SNAP, TEFAP, OAA nutrition programs, senior nutrition and food security. No bill number. Discussed home health, hospice, and long-term care. No bill number. Discussed falls prevention. No bill number. Discussed social isolation. No bill number. Discussed family caregiver exemption from Medicaid community engagement requirements and Data Strategy for Family Caregiver Verification. No bill number. Discussed fraud in Medicare and Medicaid, long-term services and supports, and home and community-based services. No bill number. Discussed research and data on family caregivers. No bill number. Discussed Medicare Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH). No bill number Discussed the direct care workforce. No bill number. Discussed family caregiver exemption from Medicaid community engagement requirements. No bill number. Discussed falls prevention. No bill number. Discussed health at home. No bill number. Discussed the National Strategy to Support Family Caregivers. No bill number. Discussed the Older Americans Act reauthorization. No bill number. Discussed Medicaid HCBS waivers. No bill number. Discussed the health care workforce. No bill number. Discussed end-of-life. No bill number. Discussed Assisting Caregivers Today (ACT) Caucus. No bill number. Discussed long-term care affordability. No bill number. Discussed long-term care.

Client expense: $3,830,000 · Firm income: Not reported

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

S. 3439/H.R. 6735, Connecting Caregivers to Medicare Act. S. 1227/H.R. 2491, Alleviating Barriers for Caregivers Act. S. 2237/H.R. 4313, Hospital Inpatient Services Modernization Act. H.R. 8100, Safe Staffing Saves Lives Act. S. 3886, Nurses Belong in Nursing Homes Act. H.R. 6766/S. 3492, the Essential Caregivers Act. H.R. 7966/S. 4118, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act. S.2120, the Older Americans Act Reauthorization Act. H.R. 5575, the Firefighters Assisting Seniors to Emergency Response (FASTER) Act. S. 668/H.R. 3183, Supporting Access to Falls Education and Prevention and Strengthening Training Efforts and Promoting Safety Initiatives (SAFE STEPS) for Veterans Act. H.R. 7618, Stopping Addiction and Falls for the Elderly (SAFE) Act. No bill number. Discussed minimum staffing standards. No bill number. Discussed Nursing Home staffing standards, safety, and quality. No bill number. Discussed Nursing home transparency and ownership requirements. No bill number. Discussed health technology, data security, and access. No bill number. Discussed senior nutrition and food security programs. No bill number. Discussed home health, hospice, and long-term care. No bill number. Discussed falls prevention. No bill number. Discussed social isolation. No bill number. Discussed enhanced premium tax credits for health insurance. No bill number. Discussed artificial intelligence in clinical care. No bill number. Discussed Health Data, Technology, and Interoperability (HTI-5) Proposed Rule. No bill number. Discussed Affordable Care Act Benefit and Payment Parameters. No bill number. Discussed electronic notification by health insurance plans. No bill number. Discussed fraud in Medicare and Medicaid. No bill number. Discussed long-term services and supports. No bill number. Discussed home and community-based services. No bill number. Discussed Medicaid HCBS. No bill number. Discussed Medicare Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH). No bill number Discussed direct care workforce. No bill number. Discussed family caregiver exemption from Medicaid community engagement requirements. No bill number. Discussed falls prevention. No bill number. Discussed health at home. No bill number. Discussed the National Strategy to Support Family Caregivers. No bill number. Discussed the Older Americans Act reauthorization. No bill number. Discussed Medicaid HCBS waivers. No bill number. Discussed the health care workforce. No bill number. Discussed end-of-life. No bill number. Discussed health savings accounts. No bill number. Discussed prescription drugs. No bill number. Discussed health care workforce issues.

Client expense: $3,830,000 · Firm income: Not reported

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

S. 1227/H.R. 2491, Alleviating Barriers for Caregivers Act. Public Law 119-21, the One, Big, Beautiful Bill Act. S.1831 Auto Reenroll Act. H.R.6722 Automatic IRA Act. S. 1526/H.R. 2696, the Retirement Savings for Americans Act. S.1840, the RISE Act. S.3924, the We Cant Wait Act. S.4255, the Expedited Disability Insurance Payments for Terminally Ill Individuals Act. H.R.3517, the Social Security Enhancement and Protection Act. S.4092, the No Crypto in Social Security Act. H.R.6644, the ROAD to Housing Act. S.988 /H.R. 2023, the Women's Retirement Protection Act. H.R.6084, the ERISA Litigation Reform Act. S.1234/HR 2540, the SSI Savings Penalty Elimination Act. S.1504/HR 5284, the Claiming Age Clarity Act. S. 1666/HR 5345, the Improving Social Securitys Service to Victims of Identity Theft Act. H.R. 5348, the Social Security Child Protection Act. H.R. 3695, the Social Security Access Act. H.R. 3271/S 1690, the Medicare & Social Security Fair Share Act. S. 4184, the Senior Citizens Freedom to Work Act. H.R. 1877, the Protecting Americans Social Security Data Act. S. 4001/HR 7828, the Supplemental Security Income Restoration Act. H.Res.1059 - Of inquiry requesting the President of the United States to furnish certain information to the House of Representatives relating to the Department of Government Efficiency's access to and usage of NUMIDENT and other personally identifiable information in the possession of the Social Security Administration. H.R. 7573, the Modernize SSI Stipends Act. No bill number. Discussed retirement access and coverage issues. No bill number. Discussed fiduciary obligations. No bill number. Discussed alternative assets in retirement plans. No bill number. Discussed Lifetime income. No bill number. Discussed retirement plan rollovers. No bill number. Discussed litigation reform and ERISA. No bill number. Discussed federal retirement savings program. No bill number. Discussed funding for the Social Security Administration (SSA). No bill number. Discussed SSAs customer service and agency operations. No bill number. Discussed SSAs in-person service options. No bill number. Discussed SSAs National Scheduling Calendar initiative. No bill number. Discussed SSAs engagement with advocacy groups. No bill number. Discussed Social Securitys Retirement Earnings Test. No bill number. Discussed Social Security solvency. No bill number. Discussed a balanced budget amendment. No bill number. Discussed SSA data privacy. No bill number. Discussed the Senior Independence Act. No bill number. Discussed the Final Month Fairness Act. No bill number. Discussed the Social Security Caregiver Credit Act. No bill number. Discussed Social Security and crypto investments. No bill number. Discussed a sovereign wealth fund for Social Security. No bill number. Discussed ways to improve SSI take-up.

Client expense: $3,830,000 · Firm income: Not reported

Government targets: General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, Social Security Administration (SSA), White House Office

Medicare Observation Stays. The Improving Access to Medicare Coverage Act (H.R. 3954): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Costs. The Pharmaceutical Research Transparency Act (No bill): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Law to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act (Public Law No: 117-169). Medicare and Medicaid Prescription Drugs. (No bill): Joined comments with 19 other organizations urging HHS to use its existing authority to license competition in order to lower consumer and taxpayer costs for semaglutide drugs treating diabetes and weight management (e.g., Ozempic and Wegovy). Medicare Savings Program and Low-Income Subsidy (LIS) Programs. (No bill): Proposals to make enrollment of dually eligible individuals in the Medicare Savings Programs (MSP) and the LIS program easier, so that low-income beneficiaries can more readily access financial assistance for Medicare copayments, premiums and deductibles, and to be able to access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 609): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental, Hearing and Vision Coverage. Medicare Dental, Vision, and Hearing Benefit Act of 2025 (H.R. 2045): Proposal to add dental, vision and hearing benefits to Medicare. Medicare Hearing Coverage: The Medicare Hearing Aid Coverage Act of 2025 (H.R. 500): Proposals to add hearing benefits to Medicare. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Advantage. (H.R. 3467) Proposal to make Medicare Advantage plans the default choice during initial enrollment periods. Medicare Privatization (No bill): Proposals to create policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home and Community-Based Services. The HCBS Access Act (No bill): Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Medicare, Medicaid and Social Security. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 2491 and S. 1227): Proposals would require HHS and SSA to review application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and Social Security programs in order to reduce administrative barriers facing family caregivers. The bill requires agencies to identify and report to Congress on actions that can be taken to streamline eligibility and assistance for family caregivers within existing programs. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 1303): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. The Safe Staffing Saves Lives Act (H.R. 8100): Proposal to establish mandatory, statutory, minimum nurse staffing standards in nursing homes to ensure at least 4.1 hours of total nursing care per resident per day. Medicare, Medicaid Nursing Homes. The Nurses Belong in Nursing Homes Act (S. 3886): Proposal aims to establish federal minimum staffing standards, specifically requiring 3.48 hours per resident per day (HPRD) of total nursing care and 24/7 on-site Registered Nurse (RN) coverage. Medicare, Medicaid Nursing Homes. The Building Americas Health Care Workforce Act (No bill): Proposal to allow time spent working in a nursing home (prior to any formal training, and permitted during the COVID-19 pandemic) to count toward a 75-hour minimum federal training standard that is required for certified nursing assistants. Medicare, Medicaid Nursing Homes. The Ensuring Seniors Access to Quality Care Act (H.R. 7096): Proposal to repeal regulations that prohibit certified nursing assistant training and competency evaluation programs in skilled nursing facilities that have a record of health and safety deficiencies and have incurred penalties (e.g., civil monetary penalties for substandard quality of care). Medicare Treatment for Osteoporosis (No bill): Support for making payment revisions to the 2026 Physician Fee Schedule that would accelerate treatment improvements for beneficiaries with osteoporosis and help prevent repeat fractures. Medicare and Medicaid Waste, Fraud and Abuse (No bill): Submitted comments with other organizations to a CMS Request for Information (RFI) Related to Comprehensive Regulations To Uncover Suspicious Healthcare (CRUSH), 91 Fed. Reg. 9803 (February 27, 2026) CMS-6098-NC. Medicaid Work Requirements Affecting Eligibility (No bill): Submitted comments with other organizations to request CMS to clarify in regulations that people with disabilities, older adults, and caregivers are exempt from the Medicaid working requirements in P.L. 119-21. Health Insurance. Health Insurance Premium Fairness Act (H.R. 6455). Proposal to close loophole that penalizes couples with one spouse in Medicare and one receiving health care through Affordable Care Act (ACA) exchanges, by allowing for subtraction of Medicare premiums from the maximum premium paid for a marketplace plan. Health Insurance. (H.R. 1834). Proposals to extend the Enhanced Premium Tax Credits for ACA marketplace health insurance plans. Health Insurance. The Lower Health Care Premiums for All Americans Act (H.R. 6703) Proposals to weakening consumer protections and destabilizing markets by allowing skimpier, less‑regulated plans that can cherry‑pick healthier groups and leave higher‑cost enrollees in the ACA‑regulated small‑group and individual markets with higher premiums. Medicaid and Health Insurance. Protecting Health Care and Lowering Costs Act (S. 2556, H.R. 4849): Proposals to restore massive funding cuts to Medicaid that were included in the 2025 budget reconciliation law, and to make permanent ACA enhanced premium tax credits.

Client expense: $190,000 · Firm income: Not reported

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

Medicare and Medicaid coverage, access, and affordability of treatments for Parkinsons disease and other chronic conditions, including beneficiary access to care, prescription drug coverage, and utilization management policies. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 2491 / S. 1227), including advocacy related to simplifying Medicare and Social Security processes and improving access to benefits for caregivers and individuals with chronic conditions. The Essential Caregivers Act of 2025 (H.R. 6766 / S. 3492), including advocacy related to ensuring access for designated essential caregivers in health care facilities during periods of restricted visitation under Medicare and Medicaid. The Alzheimers Screening and Prevention (ASAP) Act (H.R. 6130 / S. 3267), including advocacy related to Medicare coverage of blood-based biomarker tests for early detection of Alzheimers disease and related dementias. Centers for Medicare & Medicaid Services (CMS) policies, including advocacy related to Medicare Part D and Medicare Advantage, prescription drug affordability, formulary design, utilization management, beneficiary protections, and the CY 2027 Advance Notice.

Client expense: $190,000 · 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. 2491/S. 1227, the Alleviating Barriers for Caregivers Act H.R. 5039, the Wheelchair Right to Repair Act Senate Draft, Timely Wheelchair Repair Act of 2025 Discussions: Interaction between Medicare Part B and Tricare for medically retired veterans Discussions: Definition of Medicare in the Home for DME purposes Discussions: Efforts to dismantle the Administration on Community Living Discussions: Efforts to include ostomy and urological products in Medicare competitive bidding Discussions: Efforts to deny coverage for seat elevation in certain wheelchairs

Client expense: $108,181 · Firm income: Not reported

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

H.R. 7336/S.3763 - ALS Better Care Act - All provisions. H.R. 6423/S. 864 - HELP Copays Act -- Provisions related to health insurance plans requirement to apply payments made by or on behalf of plan enrollees toward a plan's cost-sharing requirements, i.e. a ban on copay-accumulator adjust programs. H.R. 4206 / S. 1261 - CONNECT for Health Act - Provisions related to permanent telehealth services in Medicare and interstate telehealth services. H.R. 2491 / S. 1227 - Alleviating Barriers for Caregivers (ABC) Act - All provisions. H.R. 2560 / S.830 - Lifespan Respite Care Reauthorization Act - All provisions H.R. 3514 / S. 1816 - Improving Seniors Timely Access to Care Act of 2025 All provisions relating to prior authorization usage under Medicare Advantage Plans. H.R. 6280/S. 3607- Genetic Counselor Services Act - All provisions

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

ALS Better Care Act (Draft legislation) - Discussion around re introduction and provisions related to supplemental payment to designated ALS clinics that provide multidisciplinary services to people living with ALS. HELP Copays Act (S.864) -- Provisions related to health insurance plans requirement to apply payments made by or on behalf of plan enrollees toward a plan's cost-sharing requirements, i.e. a ban on copay-accumulator adjust programs. CONNECT for Health Act (S.1261) - provisions related to permanent telehealth services in Medicare and interstate telehealth services. Alleviating Barriers for Caregivers (ABC) Act (H.R.2491) - All provisions. Lifespan Respite Care Reauthorization Act (H.R. 2560/S.830) - all provisions

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

ALS Better Care Act (No Bill Number)- Discussion around re introduction and provisions related to supplemental payment to designated ALS clinics that provide multidisciplinary services to people living with ALS. H.R. 6423/S. 864 - HELP Copays Act -- Provisions related to health insurance plans requirement to apply payments made by or on behalf of plan enrollees toward a plan's cost-sharing requirements, i.e. a ban on copay-accumulator adjust programs. H.R. 4206 / S. 1261 - CONNECT for Health Act - provisions related to permanent telehealth services in Medicare and interstate telehealth services. H.R. 2491 / S. 1227 - Alleviating Barriers for Caregivers (ABC) Act - All provisions. H.R. 2560 / S.830 - Lifespan Respite Care Reauthorization Act - all provisions H.R. 3514 / S. 1816 - Improving Seniors Timely Access to Care Act of 2025 All provisions relating to prior authorization usage under Medicare Advantage Plans. H.R. 6280/S. 3607 - Genetic Counselor Services Act - All provisions

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Observation Stays. The Improving Access to Medicare Coverage Act (H.R. 3954): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Costs. The Pharmaceutical Research Transparency Act (No bill): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act (Public Law No: 117-169). Medicare and Medicaid Prescription Drugs. (No bill): Joined comments with 19 other organizations urging HHS to use its existing authority to license competition in order to lower consumer and taxpayer costs for semaglutide drugs treating diabetes and weight management (e.g., Ozempic and Wegovy). Medicare Savings Program and Low-Income Subsidy (LIS) Programs. (No bill): Proposals to make enrollment of dually eligible individuals in the Medicare Savings Programs (MSP) and the LIS program easier, so that low-income beneficiaries can more readily access financial assistance for Medicare copayments, premiums and deductibles, and to be able to access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 609): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental, Hearing and Vision Coverage. Medicare Dental, Vision, and Hearing Benefit Act of 2025 (H.R. 2045): Proposal to add dental, vision and hearing benefits to Medicare. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Public Health Emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Advantage. (H.R. 3467) Proposal to make Medicare Advantage plans the default choice during initial enrollment periods. Medicare Privatization (No bill): Proposals to create policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home and Community-Based Services. The HCBS Access Act (No bill): Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Medicare, Medicaid and Social Security. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 2491 and S. 1227): Proposals would require HHS and SSA to review application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and Social Security programs in order to reduce administrative barriers facing family caregivers. The bill requires agencies to identify and report to Congress on actions that can be taken to streamline eligibility and assistance for family caregivers within existing programs. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 1303): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. The Building Americas Health Care Workforce Act (No bill): Proposal to allow time spent working in a nursing home (prior to any formal training, and permitted during the COVID-19 pandemic) to count toward a 75-hour minimum federal training standard that is required for certified nursing assistants. Medicare, Medicaid Nursing Homes. The Ensuring Seniors Access to Quality Care Act (No bill): Proposal to repeal regulations that prohibit certified nursing assistant training and competency evaluation programs in skilled nursing facilities that have a record of health and safety deficiencies and have incurred penalties (e.g., civil monetary penalties for substandard quality of care). Medicare Treatment for Osteoporosis (No bill): Support for making payment revisions to the 2026 Physician Fee Schedule that would accelerate treatment improvements for beneficiaries with osteoporosis and help prevent repeat fractures. Health Insurance. Health Insurance Premium Fairness Act (H.R. 6455). Proposal to close loophole that penalizes couples with one spouse in Medicare and one receiving health care through Affordable Care Act (ACA) exchanges, by allowing for subtraction of Medicare premiums from the maximum premium paid for a marketplace plan. Health Insurance. (H.R. 1834). Proposals to extend the Enhanced Premium Tax Credits for ACA marketplace health insurance plans. Health Insurance. (H.R. 6703). Proposals to allow associated health plans. Places new transparency and reporting requirements on pharmacy benefit managers to disclose drug spending, rebates, and pricing information to group health plans, with penalties for noncompliance. Medicaid and Health Insurance. Protecting Health Care and Lowering Costs Act (S. 2556, H.R. 4849): Proposals to restore massive funding cuts to Medicaid that were included in the 2025 budget reconciliation law, and to make permanent ACA enhanced premium tax credits.

Client expense: $190,000 · Firm income: Not reported

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

Labor-HHS Appropriations Billing and Coding CAR-T Therapy Clarifications Revaccination of Immunosuppressed Patients Patient-Care Episode Financial Toxicity NIH Funding Cancer Moonshot H.R. 1509/S. 752, The Accelerating Kids Access to Care Act H.R. 2491/S. 1227, Alleviating Barriers to Care Act H.R. 5160, the Stem Cell Therapeutic and Research Reauthorization Act of 2025 H.R.1262/S.932, the Give Kids a Chance Act

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

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

- CMS coding and billing clarity for CAR-T therapies - CMS engagement on MS-DRG 018 for CAR-T therapies - H.R. 1509/S. 752, the Accelerating Kids Access to Care Act - H.R. 2491/S. 1227, the Alleviating Barriers to Care Act

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

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

Alleviating Barriers for Caregivers (House and Senate), S. 1227/H.R. 2491. Reauthorization of C.W. Bill Young Cell Transplantation Program (House and Senate), H.R. 5160. Accelerating Kids Access to Care Act (House and Senate), S. 752/H.R. 1509. Credit for Caring Act (House and Senate), S. 925/H.R. 2036. Sickle Cell Disease Comprehensive Care Act (House and Senate), H.R. 5178/S. 721.

Client expense: $280,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1227/H.R. 2491, Alleviating Barriers for Caregivers of 2025. S 1234/HR 2540, SSI Savings Penalty Elimination Act of 2025. H.R. 34, the Land And Social Security Optimization Act of 2025. HR 6237, the Repairing Social Security After Trump and DOGE Act of 2025. HR 5893, the Guaranteed Uninterrupted Access to Retiree Disbursements (GUARD) Act of 2025. S. 1504/HR 5284, Claiming Age Clarity Act of 2025. S. 1666/HR 5345, Improving Social Securitys Service to Victims of Identity Theft Act of 2025. HR 5348, Social Security Child Protection Act of 2025. S. 3078/HR 6193, the Social Security Emergency Inflation Relief Act of 2025. S. 639/HR 227, Clergy Act of 2026. H.R.6724, Protecting Supplemental Security Income for Disaster Victims Act of 2025. H.R. 2716, Ending Improper Payments to Deceased People Act of 2025. S. 1831Auto Reenroll Act of 2025. H.R. 6722 Automatic IRA Act of 2025. H.R. 2696 Retirement Savings for Americans Act of 2025. S. 1526Retirement Savings for Americans Act of 2025. S. 1840RISE Act of 2025. S. 988 /H.R. 2023 Women's Retirement Protection Act of 2025. No bill number. Discussed retirement access and coverage issues. No bill number. Discussed fiduciary obligations. No bill number. Discussed alternative assets in retirement plans. No bill number. Discussed Lifetime income. No bill number. Discussed paper checks at the Social Security Administration. No bill number. Discussed Social Security COLAs. No bill number. Discussed Social Security disability regulations. No bill number. Discussed Social Security solvency. No bill number. Discussed SSAs engagement with advocacy groups. No bill number. Discussed customer service at the Social Security Administration. No bill number. Discussed funding for the Social Security Administration. No bill number. Discussed phone service and Security Authentication PIN (SAP) process at the Social Security Administration. No bill number. Discussed Social Security Administration operations during a government shutdown. No bill number. Discussed ABLE accounts. No bill number. Discussed the SSI personal needs allowance.

Client expense: $5,300,000 · Firm income: Not reported

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

S. 3439/H.R. 6735, Connecting Caregivers to Medicare Act of 2025. S. 1227/H.R. 2491, Alleviating Barriers for Caregivers Act of 2025. P.L. 119-21, One Big Beautiful Bill Act of 2025. S. 2466/H.R. 6210, the Senior Savings Protection Act of 2025. S. 1261/H.R. 4206, the CONNECT for Health Act of 2025. S. 639/HR 227, the Clergy Act of 2026. S.1105, the No UPCODE Act of 2025. S. 1816, the Improving Seniors Timely Access to Care Act of 2025. H.R. 6766/S. 3492. Essential Caregivers Act of 2025. H.R.3954. Improving Access to Medicare Coverage Act of 2025. No bill number. Discussed family caregiver exemption from Medicaid community engagement requirements. S. 2237/H.R. 4313, the Hospital Inpatient Services Modernization Act. No bill number. Discussed prior authorization and artificial intelligence in Medicare. No bill number. Discussed Medicare fraud. No bill number. Discussed Money Follows the person Rebalancing Demonstration Program and Medicaid home and community-based services (HCBS) spousal impoverishment protections. No bill number. Discussed Medicare Part B premiums. No bill number. Discussed support for family caregivers. No bill number. Discussed respite care. No bill number. Discussed Medicaid home and community-based services (HCBS), No bill number. Discussed Medicares support for family caregivers. No bill number. Discussed Medicare open enrollment. No bill number. Discussed timing for provider claims filings. No bill number. Discussed access to digital tools. No bill number. Nursing Home staffing standards, safety, and quality. No bill number. Home Health, Hospice and Long-term care.

Client expense: $5,300,000 · Firm income: Not reported

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

S.925/H.R. 2036 Credit for Caring Act of 2025. S. 1565/H.R. 138, the Lowering Costs for Caregivers Act of 2025. S. 3439/H.R. 6735, the Connecting Caregivers to Medicare Act of 2025. S. 1227/H.R. 2491, the Alleviating Barriers for Caregivers Act of 2025. H.R.395, the Improving Access to Medicare Coverage Act of 2025. P.L. 119-21, One Big Beautiful Bill Act. S. 2237/H.R. 4313, the Hospital Inpatient Services Modernization Act of 2025. S. 3271, the In-Home Caregiver Assessment Resources and Education Act of 2025. H. Res. 898/S. Res. 502, Recognizing November 2025 as National Family Caregivers Month H.R. 6766/S. 3492, the Essential Caregivers Act of 2025. S. 830, Lifespan Respite Care Reauthorization Act of 2025. S.2120. Older Americans Act Reauthorization Act of 2025 H.R. 5575. Firefighters Assisting Seniors to Emergency Response (FASTER) Act of 2025. H.R. 6678, the Senior Legal Hotline Act of 2025. H.R. 6900, the American Affordability Act of 2025. No bill number. Discussed family caregivers. No bill number - Discussed paid leave for working family caregivers. No bill number. Discussed family caregiver exemption from Medicaid community engagement requirements. No bill number. Discussed financial challenges facing family caregivers. No bill number. Discussed tax policy to support family caregivers. No bill number. Discussed employers supporting family caregivers. No bill number. Discussed family caregivers and technology. No bill number. Discussed support for family caregivers (including Medicare and CMMI care models). No bill number. Discussed Medicare Caregiver Training Services. No bill number. Discussed the Guiding an Improved Dementia Experience (GUIDE) Model. No bill number Discussed respite care. No bill number. Discussed Medicaid home and community-based services (HCBS), No bill number. Discussed Medicares support for family caregivers. No bill number. Discussed Older Americans Act reauthorization. No bill number. Discussed the health, long-term care, and caregiving needs of older adults and end of life. No bill number. Discussed nursing Home staffing standards, safety, and quality. No bill number. Discussed home health, hospice and long-term care. No bill number. Discussed falls prevention. No bill number. Discussed social isolation. No bill number. Discussed Farm Bill Reauthorization. No bill number. Discussed SNAP and nutrition assistance programs.

Client expense: $5,300,000 · Firm income: Not reported

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

H.R. 2491/S. 1227, the Alleviating Barriers for Caregivers Act H.R. 5039, the Wheelchair Right to Repair Act Senate Draft, Timely Wheelchair Repair Act of 2025 Discussions: Interaction between Medicare Part B and Tricare for medically retired veterans Discussions: Definition of Medicare in the Home for DME purposes Discussions: Efforts to dismantle the Administration on Community Living Discussions: Efforts to include ostomy and urological products in Medicare competitive bidding

Client expense: $87,212 · Firm income: Not reported

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

Lobbying to increase the affordability and accessibility of treatments for Parkinsons disease. S.1227/H.R.2491- Alleviating Barriers for Caregivers (ABC) Act: requires the Centers for Medicare & Medicaid Services (CMS) and Social Security to simplify processes and communications for family caregivers to assist individuals in accessing and utilizing benefits. Wasteful and Inappropriate Service Reduction (WISeR) Model: Advocacy related to the WISeR Model, a Center for Medicare and Medicaid Innovation demonstration project that tests a new prior authorization and review framework for select services in Original Medicare.

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

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

Alleviating Barriers for Caregivers (House and Senate), S. 1227/H.R. 2491. Reauthorization of C.W. Bill Young Cell Transplantation Program (House and Senate), H.R. 5160. Accelerating Kids Access to Care Act (House and Senate), S. 752/H.R. 1509. Credit for Caring Act (House and Senate), S. 925/H.R. 2036. Clinical Trial Modernization Act (House), H.R. 3521. Reauthorization of the Enhanced Advance Premium Tax Credit (House and Senate).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Observation Stays. The Improving Access to Medicare Coverage Act (H.R. 3954): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Costs. The Pharmaceutical Research Transparency Act (No bill): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Proposal to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act (Public Law No: 117-169). Medicare and Medicaid Prescription Drugs. (No bill): Joined comments with 19 other organizations urging HHS to use its existing authority to license competition in order to lower consumer and taxpayer costs for semaglutide drugs treating diabetes and weight management (e.g., Ozempic and Wegovy). Medicare Savings Program and Low-Income Subsidy (LIS) Programs. (No bill): Proposals to make enrollment of dually eligible individuals in the Medicare Savings Programs (MSP) and the LIS program easier, so that low-income beneficiaries can more readily access financial assistance for Medicare copayments, premiums and deductibles, and to be able to access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 609): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental, Hearing and Vision Coverage. Medicare Dental, Vision, and Hearing Benefit Act of 2025 (H.R. 2045): Proposal to add dental, vision and hearing benefits to Medicare. Medicare call center (No bill): Proposal to address the poor working conditions of the call center workers employed by Maximus, a federal contractor with the Department of Health and Humans Services/Center for Medicare and Medicaid Services) HHS/CMS. Public Health Emergency (No bill): Proposals to ensure the transition out of the public health emergency doesnt create enrollment or coverage gaps for Medicare eligible individuals. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Advantage. (H.R. 3467) Proposal to make Medicare Advantage plans the default choice during initial enrollment periods. Medicare Privatization (No bill): Proposals to create policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid Home and Community-Based Services. The HCBS Access Act (No bill): Proposals to make home and community-based services (HCBS) a mandatory benefit within Medicaid, and to ensure eligible older adults and people with disabilities have the option to choose between home care and institutional care. Medicare, Medicaid and Social Security. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 2491): Proposals would require HHS and SSA to review application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and Social Security programs in order to reduce administrative barriers facing family caregivers. The bill requires agencies to identify and report to Congress on actions that can be taken to streamline eligibility and assistance for family caregivers within existing programs. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 1303): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. The Building Americas Health Care Workforce Act (No bill): Proposal to allow time spent working in a nursing home (prior to any formal training, and permitted during the COVID-19 pandemic) to count toward a 75-hour minimum federal training standard that is required for certified nursing assistants. Medicare, Medicaid Nursing Homes. The Ensuring Seniors Access to Quality Care Act (No bill): Proposal to repeal regulations that prohibit certified nursing assistant training and competency evaluation programs in skilled nursing facilities that have a record of health and safety deficiencies and have incurred penalties (e.g., civil monetary penalties for substandard quality of care). Medicare Treatment for Osteoporosis (No bill): Support for making payment revisions to the 2026 Physician Fee Schedule that would accelerate treatment improvements for beneficiaries with osteoporosis and help prevent repeat fractures. Health Insurance. Health Insurance Premium Fairness Act (No bill). Proposal to close loophole that penalizes couples with one spouse in Medicare and one receiving health care through Affordable Care Act (ACA) exchanges, by allowing for subtraction of Medicare premiums from the maximum premium paid for a marketplace plan. Health Insurance. (No bill). Proposals to extend the Enhanced Premium Tax Credits for ACA marketplace health insurance plans. Medicaid and Health Insurance. Protecting Health Care and Lowering Costs Act (S. 2556, H.R. 4849): Proposals to restore massive funding cuts to Medicaid that were included in the 2025 budget reconciliation law, and to make permanent ACA enhanced premium tax credits.

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

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

Older Americans Act Reauthorization. The Older Americans Act Reauthorization Act (S. 2120): Proposals to reauthorize the Older Americans Act (OAA) of 1965 and to increase the authorization of appropriations for OAA programs, which is the major federal discretionary funding source for home and community-based services for older adults and their caregivers. Programs supported through the OAA include home-delivered and congregate nutrition services, in-home supportive services, transportation, caregiver support, community service employment, health and wellness programs, the long-term care ombudsman program, services to prevent the abuse, neglect, and exploitation of older adults, and other supportive services. Medicare, Medicaid and Social Security. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 2491): Proposals would require HHS and SSA to review application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and Social Security programs in order to reduce administrative barriers facing family caregivers. The bill requires agencies to identify and report to Congress on actions that can be taken to streamline eligibility and assistance for family caregivers within existing programs. Social Security Cost of Living Adjustment (COLA). The Fair COLA for Seniors Act (No bill) and the Social Security Cost of Living Increase Act (No bill): Proposals to adopt the Consumer Price Index for the Elderly (CPI-E) for the purpose of determining COLAs for Social Security beneficiaries; the Boosting Benefits and COLAs for Seniors Act (No bill): Proposal to calculate COLAs using the current Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) or the Consumer Price Index for the Elderly (CPI-E), whichever is greater. Social Security Expansion. The Social Security 2100 Act (No bill): Proposals to improve benefits and to strengthen Social Security's financing by altering the payroll tax cap, among other changes. The Social Security Expansion Act (S. 770 and H.R. 1700): Proposals to enhance Social Security benefits and ensure the long-term solvency of the Social Security program. The Strengthening Social Security Act (No bill): Proposals to extend the solvency of the Social Security Trust Funds and improve benefits. The Safeguarding American Families & Expanding Social Security Act (No bill): Proposals to update and modernize Social Security benefits and to extend solvency of the Social Security Trust Funds. The Protecting and Preserving Social Security Act (S. 2614 and H.R. 4968): Proposals to adopt the Consumer Price Index for the Elderly (CPI-E) for the purpose of determining COLAs for Social Security beneficiaries and to ensure the long-term solvency of the Social Security program by altering the payroll tax cap. The Protecting Our Widows and Widowers in Retirement Act (No bill): Proposals to improve benefits for widows and widowers in two-income households. The Surviving Widow(er) Income Fair Treatment Act (SWIFT Act) (No bill): Proposal to increase survivors benefits for disabled widows, widowers, and surviving divorced spouses; Social Security Enhancement and Protection Act (H.R. 3517): Proposal would improve Social Security benefits by increasing the Special Minimum Benefit, boosting benefits for seniors who have on the Social Security rolls for a long period of time, restore student benefits to age 26 and extend the life of the Trust Funds by eliminating the cap on Social Security benefits and phasing-in an increase in the payroll tax rate. The Social Security Survivor Benefits Equity Act (No bill): Proposal to increase the lump-sum benefit amount payable upon the death of a beneficiary to take into account inflation. Social Security Funding. The Medicare and Social Security Fair Share Act (H.R. 3271 and S. 1690): Proposals to close the loophole for wealthy individuals who bypass paying the net investment income tax (NIIT) and directing the revenue to the Social Security Trust Funds and to the Hospital Insurance Fund, which pays for Medicare Part A that covers inpatient care in hospitals. Social Security Privatization and Benefit Cuts. Proposals to borrow funds to invest in the stock market, to raise the Social Security retirement age and to cut Social Security benefits for future retirees promoted by Senator Bill Cassidy and Senator Angus King. Cutting Social Security by raising the retirement age. Affirming the Presidents Promise Not to Raise the Social Security and Medicare Retirement Age (H. Res. 657): House Resolution opposing raising Social Security or Medicare eligibility age. Caregiver Social Security Credits. The Social Security Caregiver Credits Act (No bill): Proposal to provide Social Security wage credits for individuals who reduce their participation in the workforce or leave the workforce to provide care to specified family members and relatives. Social Security Notch. (No bill): Proposals to ensure that Social Security benefits for individuals born in 1960 and 1961 are not reduced as a result of the coronavirus-related drop in the average wage index. Protecting Seniors from Garnishment. (No bill): Proposal to protect Social Security beneficiaries from having their Social Security benefits garnished to recover unpaid student loans. Social Security Disability Insurance Claim Adjudication. (No bill): Proposal to nullify the rule finalized by the Social Security Administration on November 16, 2020, that outlines when its administrative appeals judges may hold hearings and issue decisions on individual cases. Currently, these judges serve an appellate function where they review, at the request of Social Security claimants, the decisions of the administrative law judges who issue decisions in individual cases. Social Security Overpayments. (H.R. 2999, H.R. 2142 and S. 1023): Proposals to protect retirees, survivors and people with disabilities from being forced to repay extra Social Security and Supplemental Security Income (SSI) benefits they received through no fault of their own. Strengthening Beneficiaries Rights. (No bill): Various proposals relating to the protection and rights available to Social Security and Supplemental Security Income beneficiaries. Social Security Benefit Statements. The Know Your Social Security Act (No bill): Proposal to implement section 1143 of the Social Security Act by clarifying the Social Security Administration is required to mail annual benefit statements to all workers over age 25. Supplemental Security Income (SSI) Program. The Supplemental Security Income Restoration Act (No bill): Proposals to strengthen and restore the SSI program. Supplemental Security Income (SSI) Program. The SSI Savings Penalty Elimination Act (H.R. 2540 and S. 1234): Proposal to amend title XVI of the Social Security Act to update the resource limit for Supplemental Security Income eligibility. The Fairness in Social Security Act (No bill): Proposal to amend the Internal Revenue Code of 1986 to exclude the portion of a lump-sum Social Security benefit payment that relates to periods prior to the taxable year from the determination of household income as it relates to SSI eligibility. Retirement Plan Distribution: IRS Notice relating to Use of an Electronic Medium to Make Participant Elections and Spousal Consents (RIN 1545-Bq50). House Committee on Aging. (No bill): A Resolution amending the Rules of the House to reestablish a Permanent Select Committee on Aging. Retirement Plan Fiduciary Rule: U.S. Department of Labor, Employee Benefits Security Administration, Office of Regulations and Interpretations - RIN 1210-AC02; Application No. D-12057; Application No. D-12060. The Department of Labor proposed regulation to modernize the fiduciary rule to strengthen protections for retirement investors who seek professional investment advice. (No bill): Congressional reversal of the rule submitted by the Department of Labor relating to "Retirement Security Rule: Definition of an Investment Advice Fiduciary". Social Security Administration. Keep Billionaires Out of Our Social Security Act (S. 2763), Hands Off Our Social Security Act (H.R. 4734), Repairing Social Security after DOGE (No bill). Proposals to reverses cuts the Trump administration has made to the Social Security Administration (SSA), prevents Social Security field offices from shutting down, makes it easier for seniors and people with disabilities to apply for the benefits they have earned over the phone, provides the resources the SSA needs to approve earned benefits quickly, protects benefits from unauthorized tampering, delays or changes, blocks privatization of SSA, enforces privacy protections for beneficiary data, and requires annual Government Accountability Office audits on staffing, operations and compliance. Social Security Administration. Letter to Social Security Commissioner Frank Bisignano opposing enhanced identity verification procedures for beneficiary transactions with SSA that will make it difficult, if not impossible, for many older Americans and members of the disability community to access their earned benefits. Social Security Administration. Resolution of Inquiry by Representative John Larson (H. Res. 195): Requesting information be provided to Congress regarding the Department of Government Efficiencys (DOGE) access to the Social Security Administrations computer data, which compromises beneficiary privacy by allowing access to Americans personal information such as Social Security numbers, banking information, earnings history and medical information. Social Security Administration. Keep Our Field Offices Open Act (H.R. 1876): Proposals to suspend Social Security field office closures until January 21, 2029, after which date the Commissioner of Social Security would be required to submit a detailed report to Congress, laying out and justifying a process for closing, consolidating, or reducing access to field offices; bill also requires the Commissioner to maintain the total number of field offices and hearing offices that were in operation on January 20, 2025, after the moratorium ends and requires that, in considering future office closures, the Commissioner must consider potential transportation and communication barriers for individuals served by the office, provide significant advance notice to the public and members of Congress, and ensure opportunities for public input and appeals. Social Security Administration. Protecting Americans Social Security Data Act (H.R. 1877): Proposals to protect Americans from having their sensitive personal information politicized or bought and sold to the highest bidder by preventing Elon Musk, his associates, and political appointees from accessing sensitive data systems at SSA, codifying SSA data privacy requirements into law and strengthening oversight and civil penalties for any privacy and disclosure violations of Social Security beneficiaries personal information. Social Security Administration. The Improving Social Securitys Service to Victims of Identity Theft Act (S. 1666): Proposal to improve Social Security's service to victims of identity theft by requiring the Social Security Administration to provide a single point of contact for any individual whose Social Security account number has been misused. Social Security Administration. Comments on Omitting Food from In-Kind Support and Maintenance Calculations, Docket No. SSA-2021-0014; Comments on Expanding the Rental Subsidy, Docket No. SSA-2023-0010; Comments on Intermediate Improvement to the Disability Adjudication Process Including How We Consider Past Work, Docket No. SSA-2023-0024; Comments on Rulemaking Expanding the Definition of a Public Assistance Household, Docket No. SSA-2023-0015; Comments on strengthening rule regarding the Use of Electronic Payroll Data to Improve Program Administration, Docket No. SSA-2016-0039. Social Security Administration. Comments submitted regarding Social Security Form SSA-827 proposal (Medical Record Collection Process) and the Disability Applicant Evidence Simplification Act (DAESA) draft. Social Security Administration. The creation of an online application for all SSI applicants, streamlining data collection to more effectively obtain treating source evidence, eliminating the reconsideration level of review, updating outdated occupational information, adding a robust online scheduling tool and ensuring comprehensive customer service for all individuals. Womens Retirement Security. The Womens Retirement Protection Act (S. 988 and H.R. 2023): Proposal to amend the Employee Retirement Income Security Act of 1974 to provide for greater spousal protection under defined contribution plans. Food Security for Seniors. Farm bill reauthorization (American Relief Act, P.L. 118-158, Division D): Provisions to cut future Supplemental Nutrition Assistance Program (SNAP) benefits or other harmful policies that would worsen the problem of hunger for Americas older adults and other food insecure individuals.

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

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

Lobbying to increase the affordability and accessibility of treatments for Parkinsons disease. S.1227/H.R.2491- Alleviating Barriers for Caregivers (ABC) Act: requires the Centers for Medicare & Medicaid Services (CMS) and Social Security to simplify processes and communications for family caregivers to assist individuals in accessing and utilizing benefits.

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

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

Labor-HHS Appropriations Billing and Coding CAR-T Therapy Clarifications Revaccination of Immunosuppressed Patients Patient-Care Episode Financial Toxicity NIH Funding Cancer Moonshot H.R. 1509/S. 752, The Accelerating Kids Access to Care Act H.R. 2491/S. 1227, Alleviating Barriers to Care Act H.R. 5160, the Stem Cell Therapeutic and Research Reauthorization Act of 2025

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

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

- CMS coding and billing clarity for CAR-T therapies - CMS engagement on MS-DRG 018 for CAR-T therapies - Patient Care Episode - Financial Toxicity - Cancer Moonshot - H.R. 1509/S. 752, the Accelerating Kids Access to Care Act - H.R. 2491/S. 1227, the Alleviating Barriers to Care Act

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

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

H.R. 1 - One Big Beautiful Bill Act, provisions related to Medicaid H.R. 869/S.343, Keep Our PACT Act, all provisions H.R. 1436/S.627, ENABLE Act, all provisions H.R. 1520, CharlotteWoodwardOrgan Transplant Discrimination Prevention Act, all provisions H.R. 1570/S.745, EmpoweringFamiliesin Special Education Act, all provisions H.R. 1621, Entrepreneurs with Disabilities Reporting Act of 2025, all provisions H.R. 1634, ThinkDIFFERENTLY About Disability Employment Act, all provisions H.R. 1757/S.73, EMPSA Act, all provisions H.R. 2036/S. 925, CreditforCaring Act of 2025, all provisions H.R. 2491/S.1227, ABC Act, all provisions H.R. 2540/S.1234, SSI Savings Penalty Elimination Act, all provisions H.R. 2560/S.830, Lifespan Respite Care Reauthorization Act of 2025, all provisions H.R. 2598/S.1277, IDEA Full Funding Act, all provisions H.R. 3049, HEADs UP Act of 2025, all provisions H.R. 3939, RISE Act, all provisions H.R. 4086, Autism Family Caregivers Act, all provisions H.R. 4644/S.2459, ABLE Employment Flexibility Act, all provisions H.R.4016, Department of Defense Appropriations Act, 2026, provisions related to funding for the congressionally directed medical research autism research program H.R. 5304, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026, provisions related to funding autism research and services at the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration; assistive technology programs and special education at the Department of Education H.R. 5342, Commerce, Justice, Science, and Related Agencies Appropriations Act, 2026, provisions related to funding for the Kevin and Avonte's Law Program H.R. 5476/S. 2330, Preparing and Retaining All (PARA) Educators Act, all provisions S. 2354, Commerce, Justice, Science, and Related Agencies Appropriations Act, 2026, provisions related to funding for the Kevin and Avonte's Law Program S. 2572, Department of Defense Appropriations Act, 2026, provisions related to funding for the congressionally directed medical research autism research program S. 2587, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026, provisions related to funding autism research and services at the National Institutes of Health, Centers for Disease Control and Prevention, Health Resources and Services Administration; assistive technology programs and special education at the Department of Education Implementation of Public Law 118-80, Autism CARES Act of 2024, all provisions Implementation of Public Law 119-21, One Big Beautiful Bill Act, provisions related to Medicaid A bill not yet introduced to enhance incentives to create accessible and inclusive workplaces A bill not yet introduced to increase housing opportunities for people with disabilities A bill not yet introduced in the Senate to enhance skills related to family caregivers and developmental disabilities A bill not yet introduced related to public safety for people with autism and other developmental disabilities

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Natl Institutes of Health (NIH), SENATE

H.R. 2491/S. 1227, the Alleviating Barriers for Caregivers Act Senate Draft, Timely Wheelchair Repair Act of 2025 Discussions: Interaction between Medicare Part B and Tricare for medically retired veterans Discussions: Definition of Medicare in the Home for DME purposes Discussions: Efforts to dismantle the Administration on Community Living Discussions: Efforts to include ostomy and urological products in Medicare competitive bidding

Client expense: $87,212 · Firm income: Not reported

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

H.R. 1, the One Big Beautiful Bill Act of 2025. S. 1227/H.R. 2491, the Alleviating Barriers for Caregivers Act of 2025. S. 3766, the Connecting Caregivers to Medicare Act of 2025. H.R. 3665, the Medicare Economic Security Solutions Act of 2025. H.R. 4619, the Medicare Mental Health Inpatient Equity Act of 2025. S. 1996/H.R. 2757, the Medicare Audiology Access Improvement Act of 2025. S. 1105, the No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act (No UPCODE Act of 2025). S. 1816, the Improving Seniors Timely Access to Care Act of 2025. S. 1261/H.R.4206, the CONNECT for Health Act of 2025. S. 2237/H.R. 4313, the Hospital Inpatient Services Modernization Act of 2025. H.R. 5228, the HCBS Worker Protection Act of 2025. H.R. 3954, the Improving Access to Medicare Coverage Act of 2025. No bill number. Discussed prior authorization in Medicare. No bill number. Discussed consumer protections and deceptive marketing in Medicare Advantage. No bill number. Discussed digital health technology and telehealth. No bill number. Discussed network adequacy and provider access issues in Medicare Advantage. No bill number. Discussed the proposed Medicare Physician Fee Schedule for calendar year 2026. No bill number. Discussed Long-term care ombudsman program. No bill number. Discussed the proposed Medicare Hospital Outpatient Prospective Payment System for calendar year 2026. No bill number. Discussed Medicaid work requirements. No bill number. Discussed Medicaid retroactive coverage. No bill number. Discussed Medicaid cost-sharing. No bill number. Discussed Medicaid redeterminations. No bill number. Discussed nursing home staffing and quality. No bill number. Discussed long-term care, home health, hospice, and post-acute care. No bill number. Discussed Essential Caregivers Act. No bill number. Discussed 2026 Medicare Home Health Prospective Payment System (HH PPS). No bill number. Discussed family caregivers and Medicaid. No bill number. Discussed Acute Hospital Care at Home waiver.

Client expense: $3,810,000 · 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

H.R. 1, the One Big Beautiful Bill Act of 2025. S. 925/H.R. 2036, the Credit for Caring Act of 2025. S. 1565/H.R. 138, the Lowering Costs for Caregivers Act of 2025. S. 1227/H.R. 2491, the Alleviating Barriers for Caregivers Act of 2025. No bill number. Discussed the Connecting Caregivers to Medicare Act. S. 400/H.R. 996, the Paid Family and Medical Leave Tax Credit Extension and Enhancement Act of 2025. S. 2120, the Older Americans Act (OAA) Reauthorization of 2025. S. 2237/H.R. 4313, the Hospital Inpatient Services Modernization Act of 2025. No bill number. Discussed the Long-term Care Ombudsman program. No bill number. Discussed home delivered and congregate meal programs. No bill number. Discussed National Family Caregiver Support Program. No bill number. Discussed family caregiving. No bill number. Discussed multi-sector plans on aging. No bill number. Discussed Farm Bill Reauthorization & Food Security. No bill number. Discussed Commodity Supplemental Food Program. No bill number. Discussed nursing home staffing and quality. No bill number. Discussed the 2026 Medicare Home Health Prospective Payment System. No bill number. Discussed long-term care, home health, hospice, and post-acute care. No bill number. Discussed elder abuse and neglect. No bill number. Discussed elder abuse & neglect, exploitation, and guardianship, guardianship alternatives, legal assistance programs, and fraud. No bill number. Discussed social isolation. No bill number. Discussed the Essential Caregivers Act. H.Con.Res.52, Resolution supporting the designation of National Falls Prevention Awareness Week. No bill number. Discussed falls prevention. No bill number. Discussed Guardianship Accountability Act. No bill number. Discussed the Guardianship Grant Flexibility Act. S. 830, the Lifespan Respite Care Reauthorization Act of 2025. No bill number. Discussed Elder Justice Act. No bill number. Discussed multigenerational housing tax credit. No bill number. Discussed the Senior Legal Hotline Act. No bill number. Discussed family caregivers and Medicaid. No bill number. Discussed the In-Home Caregiver Assessment Resources & Education (CARE) Act. No bill number. Discussed Supplemental Nutrition Assistance Program (SNAP).

Client expense: $3,810,000 · Firm income: Not reported

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

ALS Better Care Act (No Bill Number)- Discussion around re introduction and provisions related to supplemental payment to designated ALS clinics that provide multidisciplinary services to people living with ALS. S. 864 - HELP Copays Act -- Provisions related to health insurance plans requirement to apply payments made by or on behalf of plan enrollees toward a plan's cost-sharing requirements, i.e. a ban on copay-accumulator adjust programs. H.R. 4206 / S. 1261 - CONNECT for Health Act - provisions related to permanent telehealth services in Medicare and interstate telehealth services. H.R. 2491 / S. 1227 - Alleviating Barriers for Caregivers (ABC) Act - All provisions. H.R. 2560 / S.830 - Lifespan Respite Care Reauthorization Act - all provisions H.R. 3514 / S. 1816 - Improving Seniors Timely Access to Care Act of 2025 All provisions relating to prior authorization usage under Medicare Advantage Plans. Genetic Counselor Services Act (no bill number) - All provisions

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H. Con. Res. 14/S. Con. Res. 7, the Budget Reconciliation Resolution. S. 925/H.R. 2036, the Credit for Caring Act. H.R. 138, the Lowering Costs for Caregivers Act. H.R. 2491, the Alleviating Barriers for Caregivers Act. No bill number. Discussed the Connecting Caregivers to Medicare Act. H.R. 1305, Improving Measurements for Loneliness and Isolation Act. H.R. 1317/S. 575, the Improving Care and Access to Nurses (I CAN) Act of 2025. H.R. 1171, the Stopping Addiction and Falls for the Elderly (SAFE) Act. No bill number. Discussed health and wellness. No bill number. Discussed the National Nursing Workforce Center Act. No bill number. Discussed ensuring access to quality post-acute care. No bill number. Discussed ageism in health care. No bill number. Discussed access to home and community-based services, long-term services and supports, and post-acute care. No bill number. Discussed the Affordable Care Act. No bill number. Discussed nursing home staffing and quality. No bill number. Discussed programs within the Older Americans Act. No bill number. Discussed falls prevention. No bill number. Discussed the Essential Caregivers Act. No bill number. Discussed the Americans Giving Care to Elders Act. No bill number. Discussed Medicaid long-term care, and family caregivers. No bill number. Discussed hospice and advance directives No bill number. Discussed scope of practice and bed rails in nursing homes No bill number. Discussed the Home Accessibility Tax Credit Act.

Client expense: $6,630,000 · Firm income: Not reported

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

H. Con. Res. 14/S. Con. Res. 7, the Budget Reconciliation Resolution. H.R. 2491, the Alleviating Barriers for Caregivers Act. No bill number. Discussed the Connecting Caregivers to Medicare Act. H.R. 1171, the Stopping Addiction and Falls for the Elderly (SAFE) Act. H.R. 1317/S. 575, the Improving Care and Access to Nurses (I CAN) Act of 2025. H.R. 10445, Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act, 2025 No bill number. Discussed Medicare physician reimbursement reform. No bill number. Discussed Medicare telehealth access. No bill number. Discussed Medicare Advantage. No bill number. Discussed access to home and community-based services, long-term services and supports, and post-acute care. No bill number. Discussed nursing home staffing and quality. No bill number. Discussed falls prevention. No bill number. Discussed Essential Caregivers Act No bill number, discussed Medicaid self-direction programs and related data No bill number. Discussed the Care for Military Kids Act No bill number. Discussed the Ensuring Access to Medicaid Buy-in Programs Act. No bill number. Discussed hospice and advance directives. No bill number. Discussed scope of practice and bed rails in nursing homes. No bill number. Discussed Medicaid, long-term care, and family caregivers.

Client expense: $6,630,000 · 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

H.R. 2036/S.925 - Credit for Caring Act of 2025 H.R. 138, the Lowering Costs for Caregivers Act. H.R. 2491, the Alleviating Barriers for Caregivers Act. No bill number. Discussed the Connecting Caregivers to Medicare Act. H.R. 1305 - Improving Measurements for Loneliness and Isolation Act. H. Con. Res. 14/S. Con. Res. 7, the Budget Reconciliation Resolution. H.R. 1171 - Stopping Addiction and Falls for the Elderly (SAFE) Act. H.R. 996/ S. 400, the Paid Family and Medical Leave Tax Credit Extension and Enhancement Act of 2025. H.R. 2560/ S. 830, the Lifespan Respite Care Reauthorization Act of 2025. No bill number. Discussed legislation to amend the Public Health Service Act to reauthorize a lifespan respite care program. No bill number. Discussed access to home and community-based services, long-term services and supports, and post-acute care. No bill number. Discussed nursing home staffing and quality. No bill number. Discussed programs within Older Americans Act. No bill number. Discussed falls prevention. No bill number. Discussed the Essential Caregivers Act. No bill number. Discussed nutrition and SNAP changes. No bill number. Discussed Older Americans Act Reauthorization Act of 2024 No bill number. Discussed Americans Giving Care to Elders Act. H.R. 10445, the Further Continuing Appropriations and Disaster Relief Supplemental Appropriations Act of 2025 No bill number. Discussed Medicaid and family caregivers. No bill number. Discussed respite care. No bill number. Discussed Family Caregiver Awareness, Resources, and Education (CARE) Partnerships Act. P.L. 118-210, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act. No bill number. Discussed the Expanding Veterans Options for Long Term Care Act. No bill number. Discussed the Caregiver Outreach and Program Enhancement (COPE) Act. No bill number. Discussed the Home Accessibility Tax Credit Act.

Client expense: $6,630,000 · Firm income: Not reported

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

H.R. 2491, the Alleviating Barriers for Caregivers Act. H.R. 2082, the Well-Being Insurance for Seniors to be at Home Act (WISH) Act. No bill number. Discussed expanding workplace retirement plan coverage. No bill number. Discussed the Retirement Savings for Americans Act. No bill number. Discussed closing loopholes in fiduciary requirements for retirement plans. No bill number. Discussed work and save plans. No bill number. Discussed tax incentives for retirement plans. H.R. 2023, the Women's Retirement Protection Act of 2025. S. 988, the Women's Retirement Protection Act of 2025. No bill number. Discussed retirement issues. No bill number. Discussed the taxation of Social Security benefits. H.R. 1130, the Bonus Tax Relief for Americas Seniors Act. No bill number. Discussed protecting Social Security, its benefits, and financial status. No bill number. Discussed customer service and operations at the Social Security Administration. H.R. 34, the LASSO Act of 2025. S. 1234/H.R. 2540, the SSI Savings Penalty Elimination Act of 2025.

Client expense: $6,630,000 · Firm income: Not reported

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

ALS Better Care Act (Draft legislation) - Discussion around re introduction and provisions related to supplemental payment to designated ALS clinics that provide multidisciplinary services to people living with ALS. HELP Copays Act (S.864) -- Provisions related to health insurance plans requirement to apply payments made by or on behalf of plan enrollees toward a plan's cost-sharing requirements, i.e. a ban on copay-accumulator adjust programs. CONNECT for Health Act (S.1261) - provisions related to permanent telehealth services in Medicare and interstate telehealth services. Alleviating Barriers for Caregivers (ABC) Act (H.R.2491) - All provisions. Lifespan Respite Care Reauthorization Act (H.R. 2560/S.830) - all provisions H.R. 3514 / S. 1816 - Improving Seniors Timely Access to Care Act of 2025 All provisions relating to prior authorization usage under Medicare Advantage Plans.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE