To amend title XVIII of the Social Security Act to limit the coinsurance amount for certain services furnished in an ambulatory surgical center.

Issues related to Medicare physician payment, specifically proposed changes by CMS to reimbursement for services provided on the same day using Modifier 25. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. H.R.7520, Efficiency Adjustment Delay Act. H.R.8163/S.5180, Provider Reimbursement Stability Act of 2026. H.R.9260, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027. H.R.9693, Patients First Act of 2026. S.1105, No UPCODE Act. Commented to Centers for Medicare & Medicaid Services Administrator Mehmet Oz on August 21, 2026, regarding CY 2027 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the Extended HH Value-Based Purchasing Model; Medicare Provider Enrollment, Durable Medical Equipment (DME), and DME, Prosthetics, Orthotics, and Supplies (DMEPOS) Policies [CMS-1844-P]. Commented to Centers for Medicare & Medicaid Services Administrator Mehmet Oz on September 11, 2026, regarding CY 2027 Medicare Physician Fee Schedule and Quality Payment Program proposed rule [CMS-1848-P]. Submitted statement for the record supporting H.R. 4331, the Access to Claims Data Act, on September 15, 2026, at the House Energy and Commerce Health Subcommittee hearing: Examining Legislative Proposals to Reform Medicare Provider Payment and Bolster Health Care Cybersecurity.

Client expense: $388,538 · Firm income: Not reported

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

Issues related to Medicare physician payment, specifically proposed changes by CMS to reimbursement for services provided on the same day using Modifier 25. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.929/S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. H.R.2028/S.942, Resident Education Deferred Interest (REDI) Act. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3164/S.2426, Ensuring Community Access to Pharmacist Services (ECAPS) Act. H.R.3170/S.3296, Improving Access to Workers' Compensation for Injured Federal Workers Act. H.R.3277/S.1677, Ensuring Lasting Smiles Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4606/S.3400, Allys Act. H.R.4681/S.1380, Specialty Physicians Advancing Rural Care (SPARC) Act. H.R.4710/S.2420, No Surprises Act Enforcement Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5435/S.2842, Stop CMV Act of 2025. H.R.5509/S.2903, Safe Step Act. H.R. 5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. H.R. 7520, Efficiency Adjustment Delay Act. H.R.8163/S.5180, Provider Reimbursement Stability Act of 2026. H.R.9237, Take Care of Americas Veterans Act. H.R.9260, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027. H.R.9693, Patients First Act of 2026. S.1105, No UPCODE Act. Commented to Office of Management and Budget Director Russell Vought on July 13, 2026, regarding regulation for Federal Financial Assistance [OMB-2026-0034]. Commented to Centers for Medicare & Medicaid Services Administrator Mehmet Oz on August 21, 2026, regarding CY 2027 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the Extended HH Value-Based Purchasing Model; Medicare Provider Enrollment, Durable Medical Equipment (DME), and DME, Prosthetics, Orthotics, and Supplies (DMEPOS) Policies [CMS-1844-P]. Commented to Centers for Medicare & Medicaid Services Administrator Mehmet Oz on September 11, 2026, regarding CY 2027 Medicare Physician Fee Schedule and Quality Payment Program proposed rule [CMS-1848-P]. Submitted statement for the record supporting H.R. 4331, the "Access to Claims Data Act," on September 15, 2026, at the House Energy and Commerce Health Subcommittee hearing: "Examining Legislative Proposals to Reform Medicare Provider Payment and Bolster Health Care Cybersecurity."

- H.R. 1539, Medical Device Electronic Labeling Act, regarding all provisions - H.R. 929/S. 266, the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, regarding all provisions - H.R. 946 ORPHAN Cures Act, regarding all provisions - S.864, HELP Copays Act, regarding all provisions - H.R. 2214, Delinking Revenue from Unfair Gouging (DRUG) Act, regarding all provisions - H.R. 1492/S. 832, Ensuring Pathways to Innovative Cures (EPIC) Act - S. 1954/ H.R. 5526 Biosimilar Red Tape Elimination Act, regarding all provisions - H.R.2527, Early Detection of Vision Impairments for Children Act of 2025, regarding all provisions - PL117-169 The Inflation Reduction Act, regarding all provisions related to drug pricing and implementation - H.R.5343/S. 1717, the Ensuring Patient Access to Critical Breakthrough Products Act of 2025, regarding all provisions - H.R.4282, Contact Lens Prescription Verification Modernization Act, regarding all provisions - H.R. 4299, Protecting Patient Access to Cancer and Complex Therapies Act, regarding all provisions - S.1399 / H.R. 6197, the Health Tech Investment Act, regarding all provisions - H.R. 3521, the Clinical Trial Modernization Act, regarding all provisions - H.R. 3006 / S.1776, the Medicare Beneficiary Co-Pay Fairness Act, regarding all provisions - H.R. 3514, the Improving Seniors Timely Access to Care Act of 2025, regarding all provisions - H.R. 6549, the VA Contracting and Procurement Act, regarding all provisions - H.R. 5509 / S. 2903, Safe Step Act, regarding all provisions - H.R. 5256, 340B ACCESS Act, regarding all provisions - H.R. 7391, Community Health Center Drug Pricing Protection Act, regarding all provisions Issues related to - direct to consumer advertising - clinical trial modernization - biosimilars - cardiovascular health - 340B and 340B Rebate Pilot - Heart Recovery Awareness Day & H.Res. 1301, designating February 20th Heart Recovery Awareness Day - obesity treatments - MFN - Foreign Reference Pricing - CMS Outpatient Prospective Payment System rule - peripheral artery disease (PAD) - PBM and Insurer Reforms

Access and reimbursement of medical devices in Medicare program. Issues related to capping beneficiary copayments for Medicare beneficiaries in ambulatory surgery centers, included in Medicare Beneficiary Co-Pay Fairness Act of 2025(H.R. 3006/S. 1776) The Ensuring Patient Access to Critical Breakthrough Products Act (H.R. 5343/S. 1717)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocacy for increased patient access and reimbursement to ambulatory surgical centers. Issues related to Medicare beneficiary patients to ASCs. Medicare Beneficiary Co-Pay Fairness Act of 2025 (H.R. 3006/S. 1776) Outpatient Surgery Access Act of 2026 (H.R. 8091)

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

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

Supporting the Medicare Beneficiary Co-Pay Fairness Act of 2025 (H.R. 3006, S. 1776) Legislation to extend the hospital coinsurance cap to ASCs Outpatient Surgery Access Act of 2026 (H.R. 8091, S.4963)

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

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

Issues related to Medicare physician payment. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.929/S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. H.R.2028/S.942, Resident Education Deferred Interest (REDI) Act. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3164, Ensuring Community Access to Pharmacist Services (ECAPS) Act. H.R.3170, Improving Access to Workers' Compensation for Injured Federal Workers Act. H.R.3277/S.1677, Ensuring Lasting Smiles Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4606/S.3400, Ally's Act. H.R.4681/S.1380, Specialty Physicians Advancing Rural Care (SPARC) Act. H.R.4710/S.2420, No Surprises Act Enforcement Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5435/S.2842, Stop CMV Act of 2025. H.R.5509/S.2903, Safe Step Act. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. H.R.7520, Efficiency Adjustment Delay Act. H.R.8163, Provider Reimbursement Stability Act of 2026. H.R.9237, Take Care of America's Veterans Act. H.R.9260, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027. S.1105, No UPCODE Act. Commented on May 20, 2026, House Energy and Commerce Health Subcommittee hearing regarding Medicare Physician Fee Schedule, MACRA, and opportunities for payment reforms. Provided comments to Representatives Greg Murphy, MD; John Joyce, MD; and Kim Schrier, MD; regarding their April 23 discussion draft of legislation to modernize the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Provided comments to Representatives Greg Murphy, MD; John Joyce, MD; and Kim Schrier, MD; urging them to include provisions in their physician payment reform legislation that would address the impending cut to the Medicare Physician Fee Schedule scheduled to take effect in 2027 and address the efficiency adjustment cuts expected to continue on an indefinite three-year cycle.

Issues related to Medicare physician payment. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. H.R.7520, Efficiency Adjustment Delay Act. H.R.8163, Provider Reimbursement Stability Act of 2026. H.R.9260, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027. S.1105, No UPCODE Act. Commented on May 20, 2026, House Energy and Commerce Health Subcommittee hearing regarding Medicare Physician Fee Schedule, MACRA, and opportunities for payment reforms. Provided comments to Representatives Greg Murphy, MD; John Joyce, MD; and Kim Schrier, MD; regarding their April 23 discussion draft of legislation to modernize the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Provided comments to Representatives Greg Murphy, MD; John Joyce, MD; and Kim Schrier, MD; urging them to include provisions in their physician payment reform legislation that would address the impending cut to the Medicare Physician Fee Schedule scheduled to take effect in 2027 and address the efficiency adjustment cuts expected to continue on an indefinite three-year cycle.

Artificial Intelligence and Machine Learning regulation and Medicare payment; Medicare Coverage of Innovative Medical Device; Medicare Physician Payment; Medicare Ambulatory Surgery Center and Hospital Outpatient Payment; Co-Pay Cap - H.R. 3006; S. 1776;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Access and reimbursement of medical devices in Medicare program. Issues related to capping beneficiary copayments for Medicare beneficiaries in ambulatory surgery centers, included in Medicare Beneficiary Co-Pay Fairness Act of 2025(H.R. 3006/S. 1776) The Ensuring Patient Access to Critical Breakthrough Products Act (H.R. 5343/S. 1717)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

- H.R. 1539, Medical Device Electronic Labeling Act, regarding all provisions - H.R. 929/S. 266, the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, regarding all provisions - H.R. 946 ORPHAN Cures Act, regarding all provisions - S.864, HELP Copays Act, regarding all provisions - H.R. 2214, Delinking Revenue from Unfair Gouging (DRUG) Act, regarding all provisions - H.R. 1492/S. 832, Ensuring Pathways to Innovative Cures (EPIC) Act - S. 1954/ H.R. 5526 Biosimilar Red Tape Elimination Act, regarding all provisions - H.R.2527, Early Detection of Vision Impairments for Children Act of 2025, regarding all provisions - PL117-169 The Inflation Reduction Act, regarding all provisions related to drug pricing and implementation - H.R.5343/S. 1717, the Ensuring Patient Access to Critical Breakthrough Products Act of 2025, regarding all provisions - H.R.4282, Contact Lens Prescription Verification Modernization Act, regarding all provisions - H.R. 4299, Protecting Patient Access to Cancer and Complex Therapies Act, regarding all provisions - S.1399 / H.R. 6197, the Health Tech Investment Act, regarding all provisions - H.R. 3521, the Clinical Trial Modernization Act, regarding all provisions - H.R. 3006 / S.1776, the Medicare Beneficiary Co-Pay Fairness Act, regarding all provisions - H.R. 3514, the Improving Seniors Timely Access to Care Act of 2025, regarding all provisions - H.R. 6549, the VA Contracting and Procurement Act, regarding all provisions - H.R. 5509 / S. 2903, Safe Step Act, regarding all provisions - H.R. 5256, 340B ACCESS Act, regarding all provisions - H.R. 7391, Community Health Center Drug Pricing Protection Act, regarding all provisions Issues related to - direct to consumer advertising - clinical trial modernization - biosimilars - cardiovascular health - 340B and 340B Rebate Pilot - Heart Recovery Awareness Day & H.Res. 1301, designating February 20th Heart Recovery Awareness Day - obesity treatments - MFN - Foreign Reference Pricing - CMS Outpatient Prospective Payment System rule - peripheral artery disease (PAD) - PBM and Insurer Reforms

Advocacy for increased patient access and reimbursement to ambulatory surgical centers. Issues related to Medicare beneficiary patients to ASCs. Medicare Beneficiary Co-Pay Fairness Act of 2025 (H.R. 3006/S. 1776) Outpatient Surgery Access Act of 2026 (H.R. 8091)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Supporting the Medicare Beneficiary Co-Pay Fairness Act of 2025 (H.R. 3006, S. 1776) Legislation to extend the hospital coinsurance cap to ASCs Outpatient Surgery Access Act of 2026 (H.R. 8091)

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

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

Issues related to Medicare physician payment. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5304/S.2587, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. H.R. 7520, Efficiency Adjustment Delay Act S.1105, No UPCODE Act. Commented on policies to modernize the Medicare Access and CHIP Reauthorization Act of 2015. Submitted comments to CMS on CY 2027 Medicare Advantage and Part D Advance Notice Submitted response to CMS RFI on Comprehensive Regulations to Uncover Suspicious Healthcare Activity (CRUSH) Regulation RFI

Client expense: $319,200 · Firm income: Not reported

Issues related to Medicare physician payment. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.929/S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. H.R.2028/S.942, Resident Education Deferred Interest (REDI) Act. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3164, Ensuring Community Access to Pharmacist Services (ECAPS) Act. H.R.3170, Improving Access to Workers' Compensation for Injured Federal Workers Act. H.R.3277/S.1677, Ensuring Lasting Smiles Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4606/S.3400, Ally's Act. H.R.4681/S.1380, Specialty Physicians Advancing Rural Care (SPARC) Act. H.R.4710/S.2420, No Surprises Act Enforcement Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5304/S.2587, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026. H.R.5435/S.2842, Stop CMV Act of 2025. H.R.5509/S.2903, Safe Step Act. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. H.R. 7520, Efficiency Adjustment Delay Act. S.1105, No UPCODE Act. Commented on policies to modernize the Medicare Access and CHIP Reauthorization Act of 2015. Commented on the Department of Homeland Security proclamation Restriction on Entry of Certain Nonimmigrant Workers. Submitted an Appropriations request of $310 million for smoking cessation programs in the Centers for Disease Control Submitted comments to CMS on CY 2027 Medicare Advantage and Part D Advance Notice Submitted response to CMS RFI on Comprehensive Regulations to Uncover Suspicious Healthcare Activity (CRUSH) Regulation RFI

Issues related to Medicare physician payment. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.929/S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. H.R.2028/S.942, Resident Education Deferred Interest (REDI) Act. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3164, Ensuring Community Access to Pharmacist Services (ECAPS) Act. H.R.3170, Improving Access to Workers' Compensation for Injured Federal Workers Act. H.R.3277/S.1677, Ensuring Lasting Smiles Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4606/S.3400, Ally's Act. H.R.4681/S.1380, Specialty Physicians Advancing Rural Care (SPARC) Act. H.R.4710/S.2420, No Surprises Act Enforcement Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5304/S.2587, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026. H.R.5435/S.2842, Stop CMV Act of 2025. H.R.5509/S.2903, Safe Step Act. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. S.1105, No UPCODE Act. Commented to House and Senate leadership opposing provision in CY2026 Medicare Physician Fee Schedule final rule that reduces the work Relative Value Units (RVUs) and intra-service time for all non-time-based codes by 2.5 percent in 2026, with additional reductions expected every three years indefinitely. Commented to House Appropriations Committee commending them for adopting an amendment to the FY2026 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act that would halt funding to implement the Medicare Wasteful and Inappropriate Service Reduction (WISeR) Model.

Issues related to Medicare physician payment. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5304/S.2587, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. S.1105, No UPCODE Act. Commented to House and Senate leadership opposing provision in CY2026 Medicare Physician Fee Schedule final rule that reduces the work Relative Value Units (RVUs) and intra-service time for all non-time-based codes by 2.5 percent in 2026, with additional reductions expected every three years indefinitely. Commented to House Appropriations Committee commending them for adopting an amendment to the FY2026 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act that would halt funding to implement the Medicare Wasteful and Inappropriate Service Reduction (WISeR) Model.

Client expense: $260,000 · Firm income: Not reported

Access and reimbursement of medical devices in Medicare program. Issues related to capping beneficiary copayments for Medicare beneficiaries in ambulatory surgery centers, included in Medicare Beneficiary Co-Pay Fairness Act of 2025(H.R. 3006/S. 1776) The Ensuring Patient Access to Critical Breakthrough Products Act (H.R. 5343/S. 1717)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocacy for increased patient access and reimbursement to ambulatory surgical centers. Issues related to Medicare beneficiary patients to ASCs. Medicare Beneficiary Co-Pay Fairness Act of 2025 (H.R. 3006/S. 1776)

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

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

Supporting the Medicare Beneficiary Co-Pay Fairness Act of 2025 (H.R. 3006, S. 1776) Legislation to extend the hospital coinsurance cap to ASCs

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

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

Access and reimbursement of medical devices in Medicare program. Issues related to capping beneficiary copayments for Medicare beneficiaries in ambulatory surgery centers. Medicare Beneficiary Co-Pay Fairness Act of 2025 (H.R. 3006/S. 1776)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocacy for increased patient access and reimbursement to ambulatory surgical centers. Issues related to Medicare beneficiary patients to ASCs. Medicare Beneficiary Co-Pay Fairness Act of 2025 (H.R. 3006/S. 1776)

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

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

Supporting the Medicare Beneficiary Co-Pay Fairness Act of 2025 (H.R. 3006, S. 1776) Legislation to extend the hospital coinsurance cap to ASCs

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare physician payment. H.R.1/P.L.119-21, One Big Beautiful Bill Act (specifically provisions related to Medicare physician payment, pass-through entity taxes (PTET) for specified service trades or businesses (SSTBs), and federal student loans). H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.929/S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. H.R.2028/S.942, Resident Education Deferred Interest (REDI) Act. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3164, Ensuring Community Access to Pharmacist Services (ECAPS) Act. H.R.3170, Improving Access to Workers' Compensation for Injured Federal Workers Act. H.R.3277/S.1677, Ensuring Lasting Smiles Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4016/S.2572, Department of Defense Appropriations Act, 2026. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5304/S.2587, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026. H.R.5435/S.2842, Stop CMV Act of 2025. S.1105, No UPCODE Act. Commented to House Ways and Means Health Subcommittee on reforms to Medicares Merit-Based Incentive Payment System (MIPS). Commented to CMS on Wasteful and Inappropriate Service Reduction (WISeR) Model. Commented to House Ways and Means Health Subcommittee and Oversight Subcommittee on Medicare Advantage. Commented to House Energy and Commerce Committee and House Appropriations Committee on preserving NIHs National Institute on Deafness and Other Communication Disorders (NIDCD) independence and funding levels. Commented to FDA on proposed rule creating nicotine standard for cigarettes and other combustible devices. Commented to Department of Education urging Secretary to maintain her authority regarding student loan flexibility. Commented to CMS on FY 2026 Medicare Physician Fee Schedule/Quality Payment Program Proposed Rule. Commented to CMS on FY 2026 Hospital Outpatient Prospective Payment System/Ambulatory Surgical Center Proposed Rule.

Issues related to Medicare physician payment. H.R.1/P.L.119-21, One Big Beautiful Bill Act (specifically provisions related to Medicare physician payment, pass-through entity taxes (PTET) for specified service trades or businesses (SSTBs), and federal student loans). H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5304/S.2587, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026. S.1105, No UPCODE Act. Commented to House Ways and Means Health Subcommittee on reforms to Medicares Merit-Based Incentive Payment System (MIPS). Commented to CMS on Wasteful and Inappropriate Service Reduction (WISeR) Model. Commented to House Ways and Means Health Subcommittee and Oversight Subcommittee on Medicare Advantage. Commented to CMS on FY 2026 Medicare Physician Fee Schedule/Quality Payment Program Proposed Rule. Commented to CMS on FY 2026 Hospital Outpatient Prospective Payment System/Ambulatory Surgical Center Proposed Rule.

Client expense: $319,233 · Firm income: Not reported

Issues related to Transitional Coverage for Emerging Technologies (TCET)(CMS-3421-NC), including S. 1717, Ensuring Patient Access to Critical Breakthrough Products Act of 2025. Access to and reimbursement of medical devices in Medicare program. Issues related to capping beneficiary copayments for Medicare beneficiaries in ambulatory surgery centers. Medicare Beneficiary Co-Pay Fairness Act of 2025 (H.R. 3006/S. 1776)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Access and reimbursement of medical devices in Medicare program. Issues related to capping beneficiary copayments for Medicare beneficiaries in ambulatory surgery centers. Medicare Beneficiary Co-Pay Fairness Act of 2025 (H.R. 3006/S. 1776)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocacy for increased patient access and reimbursement to ambulatory surgical centers. Issues related to Medicare beneficiary and commercially insured patients to ASCs. Medicare Beneficiary Co-Pay Fairness Act of 2025 (H.R. 3006/S. 1776)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare physician payment. H.R.1/P.L.119-21, One Big Beautiful Bill Act (specifically provisions related to Medicare physician payment, pass-through entity taxes (PTET) for specified service trades or businesses (SSTBs), and federal student loans). H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.929/S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. H.R.2028/S.942, Resident Education Deferred Interest (REDI) Act. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3170, Improving Access to Workers' Compensation for Injured Federal Workers Act. H.R.3277/S.1677, Ensuring Lasting Smiles Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.3890, Resident Physician Shortage Reduction Act of 2025. Commented to HHS on termination of CDC Advisory Committee on Immunization Practices (ACIP). Commented to CMS on deregulation of Medicare program. Commented to DOJ on anticompetitive regulations, specifically barriers to competition and consolidation in the healthcare market. Commented to House and Senate appropriations committees regarding elimination of CDC Office of Smoking and Health (OSH) and requested renewed appropriations in FY26. Requested FY26 appropriations for Neglected Surgical Conditions program. Requested FY26 appropriations for Congressionally Directed Medical Research Program's Hearing Restoration Research Program.

Client expense: $216,660 · Firm income: Not reported

Issues related to Medicare physician payment. H.R.1/P.L.119-21, One Big Beautiful Bill Act (specifically provisions related to Medicare physician payment, pass-through entity taxes (PTET) for specified service trades or businesses (SSTBs), and federal student loans). H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.3890, Resident Physician Shortage Reduction Act of 2025. Commented to CMS on deregulation of Medicare program.

Client expense: $216,660 · Firm income: Not reported

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

Support: H.R. 879 - Medicare Patient Access and Practice Stabilization Act: stop the current Medicare Physician Fee Schedule reimbursement, account for rising inflationary costs with a two percent payment increase for 2025. H.R. 1968 - Full-Year Continuing Appropriations and Extensions Act, 2025: include provisions of HR 879 in continuing resolution. Support: H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025: reform prior authorization under Medicare and Medicare Advantage. Oppose: S.106/HR 539 - Chiropractic Medicare Coverage Modernization Act of 2025. Support:S.1640 - Medicare Patient Access and Practice Stabilization Act of 2025. Support: S.1776/HR 3006 - Medicare Beneficiary Co-Pay Fairness Act. Oppose: H.R.2757 - Medicare Audiology Access Improvement Act of 2025. Support: H.R.3890 - Resident Physician Shortage Reduction Act of 2025. H.Con.Res. 14 - Oppose student loan provisions. HR 1- One Big Beautiful Bill Act: Include provisions addressing the 2025 Medicare physician payment cuts and accelerating alignment with a full annual Medicare Economic Index (MEI) inflation update; protect access to federal student loans by opposing proposed borrowing caps and preserving full access to Grad PLUS and Unsubsidized Direct Loans; prevent coverage losses by addressing provisions in the reconciliation bill that could increase the number of uninsured and protect Medicaid access for individuals without other coverage options.

Client expense: $132,896 · Firm income: Not reported

Supporting the Medicare Beneficiary Co-Pay Fairness Act of 2025 (H.R. 3006, S. 1776) Legislation to extend the hospital coinsurance cap to ASCs

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues regarding the social work workforce and social worker shortages S. 931/H.R. 2509 The Connecting Our Medical Providers with Links to Expand Tailored and Effective Care Act Issues regarding the social work workforce and social worker shortages H.R. 3006 More Social Workers in Libraries Act S. 1452/ H.R. 3073 Community Mental Wellness and Resilience Act S. 1378/H.R. 5819 The Connecting Our Medical Providers with Links to Expand Tailored and Effective Care Act H.R. 9581 STAR Plus Scholarship Act

Client expense: $17,037 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE