Save Healthcare Workers Act

Childrens Hospitals Graduate Medical Education (CHGME) program - Urged increased funding for CHGME to align the program levels with other federal physician training programs. Continued healthcare access - Advocated for a more resilient healthcare infrastructure and policies that provide the staffing and technological infrastructure necessary to maintain essential services, encouraged continuing funding for Community Health Centers beyond current expiration. Continued monitoring and encouraged passage of the Biosimilar Red Tape Elimination Act (S.1954). Continued monitoring and encouraged passage of the Improving Seniors' Timely Access to Care Act (H.R. 3514/S.1816). Continued monitoring and encouraged passage of the Mapping Americas Pharmaceutical Supply (MAPS) Act (S.1784/H.R.4191). Continued monitoring and encouraged passage of the Protect Medicaid and Rural Hospitals Act (S.2279) . Continued monitoring and encouraged passage of the Protecting Health Care and Lowering Costs Act (S.2556). Continued monitoring and encouraged passage of the Resident Physician Shortage Reduction Act of 2025 (S.2439/H.R.3890/H.R.4731). Continued monitoring and encouraged passage of the Save Healthcare Workers Act (S.1600/H.R.3178). Drug Shortages - Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Encouraged improved stakeholder communication and increased notification by manufacturers for surges in demand. Continued monitoring and encouraged passage of the Drug Origin Transparency Act of 2026 (HR.8339). Hospital Data and Analytics - Provided education on the types of clinical, operational, financial and quality data hospitals collect and monitor to improve patient care, including how providers use data to assess and integrate emerging healthcare technologies. Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations (GPOs) provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers, as well as key differences between traditional GPOs and PBMs. Price Transparency - Encouraged policies that minimize administrative burden on providers associated with implementing and complying with price transparency requirements. Supply Assurance - Continued advocacy for policies that support resilient healthcare supply chains and help ensure reliable access to critical medical products and supplies. Urged passage of legislation to reauthorize The Pandemic and All-Hazards Preparedness Act (PAHPA). Telehealth - Encouraged the adoption of additional permanent telehealth policies to extend certain telemedicine flexibilities beyond their current expiration date. Workforce - Advocated for strengthening the health workforce and preventing workforce shortages through policies that support education, training, recruitment and retention efforts. User Fee Acts - Engaged on the User Fee Acts (UFAs) reauthorization process and provided feedback on related policy considerations.

Client expense: $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

S. 4994, ONSHORE Manufacturing Act S. 998, H.R. 2213 Medical Supply Chain Resiliency Act S. 1058, H.R. 2172 Preserving Patients Access to Home Infusion Act H.R. 4559 Prompt and Fair Pay Act H.R. 5031 Preserving Patient Access to Long-Term Care Pharmacies Act S. 709, H.R.1585 Conrad State 30 and Physician Access Reauthorization Act H.R. 483 Health Care Efficiency Through Flexibility Act S. 1460, H.R. 786 Preserving Patient Access to Accountable Care Act S. 1816, H.R. 3514 Improving Seniors' Timely Access to Care Act S. 1600, H.R. 3178 Save Healthcare Workers Act H.R. 2433 Reducing Medically Unnecessary Delays in Care Act S. 2439, H.R. 4731 Resident Physician Shortage Reduction Act H.R. 4464 Preventative Health Savings Act Incentivizing domestic manufacturing of critical medical supplies Issues related to health care costs and transparency Electronic prior authorization and administrative simplification Health care supply chain resiliency 340B Drug discount program Reauthorization of Pandemic and All Hazards Preparedness Act Hospital finance issues Healthcare workforce issues (graduate medical education, health professional training, recruitment and retention, minimum staffing requirements) Medicare payment policies Alternative payment models and related policies Medicare home infusion policy Expanding access to interoperable health tech in long term and post-acute care settings Maternal and infant health Health care workplace violence and worker safety Artificial intelligence in healthcare Cybersecurity and privacy issues for hospitals and health systems CMS annual payment updates for acute and non-acute providers

Client expense: $260,000 · 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. 9504 - Tax Exempt Hospital Transparency Act; H.R. 9393 - Lower Cost More Transparency Act; H.R 9390 - Prices on the Wall Act; H.R. 5582, S. 2355 - Patients Deserve Price Tags Act: Provisions related to hospital price transparency. P.L. 119-21: Issues related to the implementation of provisions regarding Essential Plan Cuts, Medicaid financing and eligibility, and other issues impacting hospitals. H.R. 3178; S. 1600 - Save Healthcare Workers Act: Provisions related to protections for health care workers. H.R. 3890 - Resident Physician Shortage Reduction Act: Provisions related to graduate medical education. Issues related to Section 340B drug pricing and proposed Outpatient Prospective Payment System (OPPS) cuts, healthcare workforce, telehealth, community engagement and health insurance.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health Information Technology Health workforce shortage issues, Title VII and Title VIII of the Public Health Service Act, nursing, graduate nursing education, nursing-managed health clinics Health wellness and prevention programs Research tobacco, e-cigarettes and flavorings University Center for Excellence in Developmental Disabilities (UCEDD) Leadership Education in Neurodevelopmental Disabilities (LEND) program Rural Communities Opioid Response Program Rural Centers of Excellence H.R. 3178/S. 4771, Save Healthcare Workers Act (SAVE Act) Fetal Alcohol Syndrome Disorders H.R. 5684, Medical Foods and Formulas Access Act of 2025 Emergency Medical Services for Children (EMSC) program H.R. 2483, FASD Respect Act Hospital price transparency

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues concerning Safety from Violence for Healthcare Employees. H.R. 3178 / S.1600, Save Healthcare Workers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1600 / H.R. 3178, the Save Healthcare Workers Act, as it relates to ensuring a safe and secure environment for the healthcare workforce. Issues regarding healthcare workplace safety.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues regarding the mental health of healthcare workers. S. 1600 / H.R. 3178, the Save Healthcare Workers Act, as it relates to ensuring a safe and secure environment for the healthcare workforce. S. 547, Train More Nurses Act, as it relates to grant programs to support the nursing workforce.

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

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

Issues involving violence against healthcare employees. H.R. 3178 / S. 1600, Save Healthcare Workers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Workplace Violence Prevention NIH and Research issues Mission Zero Physician Payment Graduate Medical Education Save Healthcare Workers Act HR3178 Outpatient Prospective Payment System

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medical Center related issues, generally Medicare reimbursement issues, generally 340B Drug Pricing related issues Monitor the following: H.R.3178/S.1600, Save Healthcare Workers Act, Entirety H.R.9504, Tax Exempt Hospital Transparency Act, Entirety Public Law 119-21, One Big Beautiful Bill Act, Hospital related issues Community Health Centers Plastics and human health related issues and initiatives Artificial Intelligence, Medical Center related issues Organ transplant issues Prescription drug pricing, generally Laboratory development test issues

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

P.L.119-21 - One Big Beautiful Bill Act H.R.1 and Senate-Passed Amendment to H.R.1 Fiscal Year 2025 Budget Reconciliation H.Con.Res.14 Fiscal Year 2026 Budget Reconciliation Fiscal Year 2027 Budget Reconciliation Issue: Educate Congress on potential financial implications of Medicare and Medicaid cuts and entitlement reform on academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. Support preservation of non-profit tax status of AAMC member institutions. Oppose reduction in Medicare hospital outpatient department reimbursement and site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital and provider cuts, including Medicare graduate medical education (GME) reforms, reduction or elimination of bad debt reimbursement, reforming Medicare disproportionate share hospital payments and uncompensated care, prevention of rural reclassification, and reductions in wage index. Oppose cuts to federal Medicaid funding, including reductions to the federal medical assistance percentage (FMAP), changes to provider taxes and state-directed payments, and the implementation of per-capita caps or block grants. Oppose policies that restrict access to coverage and care for the Medicaid population, such as work/community engagement requirements, more frequent eligibility redeterminations, and additional cost-sharing. Oppose limits on Affordable Care Act (ACA) premium tax credit eligibility and restrictions on eligibility for and enrollment in ACA Marketplace plans. Oppose reducing Medicare reimbursement for 340B-acquired drugs. Issue: Oppose restrictions on federal Medicaid funding for certain disfavored services Issue: Educate lawmakers on the need to delay, undo, or revise pending new restrictions on to provider taxes and state-directed payments, along with implement strategies to mitigate coverage losses due to the One Big Beautiful Bill Acts (OBBBA) work requirements and more frequent eligibility redeterminations for the Affordable Care Act (ACA) expansion population. Issue: Educate lawmakers on the importance of academic health systems, teaching hospitals, and physician practice eligibility for Rural Health Transformation Program (RHTP), support increased funding for RHTP. Issue: Educate Congress and policymakers on the financial challenges facing academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. H.R.7409 - Defend Rural Health Act Issue: Oppose efforts to repeal or curtail the ability of urban hospitals to become rural referral centers or reclassify for the purposes of their wage index. Issue: Educate Congress and policymakers on the role academic health systems, teaching hospitals, medical schools, and faculty practices play in caring for rural patients and communities, training providers to practice in rural communities, and ensuring access to critical health care services not otherwise available. Issue: Educate Congress on impact of Statutory Pay-As-You-Go Act Medicare sequester H.R.1835 - Breaking the Gridlock Act S.3385 - Lower Health Care Costs Act S.3386 - Health Care Freedom for Patients Act of 2025 Issue: Support clean extension of Affordable Care Act (ACA) enhanced premium tax credits (EPTCs) set to expire at the end of 2025 H.R.4371/S.2439 - Resident Physician Shortage Reduction Act of 2025 Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.2314/S.2715 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.1153 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare graduate medical education (GME) payment formulas that reduce current Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments to teaching hospitals. Issue: Educate Congress on teaching health system and hospital graduate medical education (GME) data collection practices and concerns related to duplicative reporting requirements. H.R.3178/S.2600 - Save Healthcare Workers Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. Issue: Oppose legislation that pays for workforce investments and mitigation of Medicaid Disproportionate Share Hospital (DSH) program cuts paid for by cuts to hospital outpatient departments. Issue: Support legislation that ensures the move to value-based care. Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported graduate medical education (GME) slots from the Consolidated Appropriations Act (CAA), 2021 and 2023. Issue: Educate Congress on status of Centers for Medicare and Medicaid Services (CMS) distribution of the 1,000 new graduate medical education (GME) slots authorized by the Consolidated Appropriations Act (CAA), 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: CAA, 2021 Sec. 131 extension and RTP thresholds Issue: Support Medicare graduate medical education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose the redesign of Medicare Indirect Medical Education (IME) financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient Indirect Medical Education (IME) payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support efforts to reform the Medicare physician fee schedule. H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025 H.R.9693 - Patients First Act of 2026 H.R.8163 - Provider Reimbursement Stability Act of 2026 Issue: Support Medicare Physician Fee Schedule (PFS) reform. P.L.119-4 - Full-Year Continuing Appropriations and Extensions Act, 2025 P.L.118-158 - American Relief Act 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule (PFS) cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. H.R.5582/S.2355 - Patients Deserve Price Tags Act H.R.9393 - Lower Costs, More Transparency Act of 2026 H.R.9390 - Prices on the Wall Act of 2026 Issue: Oppose efforts to increase administrative burden on hospitals through expanded reporting measures. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. H.R.9504 - Tax Exempt Hospital Transparency Act Issue: Oppose efforts that increase duplicative and burdensome reporting requirements on tax exempt hospitals through expanded IRS reporting measures. H.R.3514/ S.1816 - Improving Seniors' Timely Access to Care Act of 2025 Issue: Support efforts to decrease the burden of prior authorization in Medicare Advantage plans Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support elimination of scheduled reductions to the Medicaid disproportionate share hospital (DSH) program. H.R.8163 - Provider Reimbursement Stability Act of 2026 Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. H.R.4313 - Hospital Inpatient Services Modernization Act Issue: Support extension of the Acute Hospital Care at Home program. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove the requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support legislation to eliminate the 190-day Lifetime Limit policy in the Medicare program. Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). S.2761/H.R.5269 - Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare. Issue: Oppose Department Homeland Security (DHS) proposed rule to expand public charge definition and educate Congress on potential impacts to health care providers.

Client expense: $431,446 · Firm income: Not reported

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

S 266/HR 929, the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; HR 935, the Health Care Workforce Innovation Act of 2025; S. 1600/HR 3178, the Save Healthcare Workers Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Transparency 340B drug pricing program Rural health transformation program Save Healthcare Workers Act, H.R.3178 Behavioral health CHGME Health care consolidation, mergers and acquisition H1-B Visas

Client expense: $270,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Oppose H.R. 1 limitations on premium tax credit eligibility. Support Restoring Essential Plan Coverage Act, H.R. 10692/S.5619, repealing H.R. premium tax credit eligibility restrictions and creating permanent option for expanded basic health plan. Support permanently extending Affordable Care Act enhanced premium tax credits. Support 340B Drug Pricing Program and discuss certain changes: oppose 340B ACCESS Act, SECURE 340B Act, HRSA Rebate Model Pilot Program, support enforcement action against manufacturer claims data policies. Support recommendations to address workforce shortages for nursing and ancillary health care workforce: faculty recruitment and retention, additional financial support for supervision and precepting students, Medicare payment for nursing and allied health, testing new workforce models, establishing incentives and early recruitment strategies, providing funding for clinical training sites, and immigration reforms that expedite entry for foreign health care workers. Support SAVE Healthcare Workers Act (H.R. 3178/S. 1600). Discuss New York State transition from Affordable Care Act Section 1332 State Innovation Waiver to Section 1331 Basic Health Plan. Discuss legislative proposals to regulate the use of artificial intelligence in health care settings. Discuss non-profit tax-exempt status of hospitals and examples of community benefit for IRS purposes (H.R. 9504, Tax Exempt Hospital Transparency Act). Discuss price transparency regulations and legislative proposals: Lower Costs, More Transparency Act; Patients Deserve Price Tags Act; Prices on the Wall Act; Transparency in Billing Act, Health Care Price Certainty for All Americans Act. Support commercial insurance reforms. Discuss antitrust exemption for National Resident Matching Program. Discuss organ donation policies.

Client expense: $550,000 · Firm income: Not reported

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

Congressional outreach and monitoring regarding the following: -H.R. 3178/S.1600, Save Healthcare Workers Act. -H.R. 9504, Tax Exempt Hospital Transparency Act. -H.R. 9599, SECURE 340B Act. -H.R. 7961, H-1Bs for Physicians and the Healthcare Workforce Act. -H.R. 5269/S. 2761, RESULTS ACT. -S.4994, ONSHORE Manufacturing Act. -340B policy issues. -Site Neutral Payment Proposals. -Healthcare and hospital workforce budget and appropriations, generally. -Medicare and Medicaid reimbursements.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Congressional outreach and monitoring regarding the following: -H.R. 3178/S.1600, Save Healthcare Workers Act. -H.R. 9504, Tax Exempt Hospital Transparency Act. -H.R. 9599, SECURE 340B Act. -H.R. 7961, H-1Bs for Physicians and the Healthcare Workforce Act. -H.R. 5269/S. 2761, RESULTS ACT. -S.4994, ONSHORE Manufacturing Act. -340B policy issues. -Site Neutral Payment Proposals. -Healthcare and hospital workforce budget and appropriations, generally. -Medicare and Medicaid reimbursements.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health care quality; physician and hospital quality; health care innovation; Patient Protection and Affordable Care Act/health care reform implementation; unique device identifier policy and post-market surveillance for medical devices; clinical trial design; HIPAA and registries; federal funding/appropriations for HHS, NIH, AHRQ, CDC, FDA, HRSA and the Childrens Hospital Graduate Medical Education payment program, the Prevention & Public Health Fund, medical research, and prevention; research and scholarly communication policy; implementation and oversight of 21st Century Cures Act; data blocking/interoperability of electronic data; artificial intelligence/machine learning; algorithm transparency; health disparities; reduction/oversight of prior authorization and other administrative burdens; digital health; Sect. 1557 Nondiscrimination in Health Programs and Activities; cardiomyopathy education and awareness; peripheral arterial disease (PAD) education and awareness; VA Mission Act implementation; COVID-19 and implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act , the Coronavirus Aid, Relief, and Economic Security Act, Coronavirus Provider Protection Act, and clinician mental health and wellbeing; patient identification; Pandemic and All Hazards Preparedness; RAPID coverage program and Breakthrough Device policy; Amputation Reduction and Compassion (ARC) Act (H.R. 307); Resident Education Deferred Interest (REDI) Act (H.R. 2028/S. 942); Implementation and funding for the Cardiomyopathy Health, Education, Awareness, Research and Training in Schools (HEARTS) Act (P.L. 118-176); provide AEDs in transportation facilities with the Public Access to Defibrillation in Transportation Facilities Act (H.R. 5897); Residential AED and CPR Preparedness Act of 2026 (H.R. 9058); Lorna Breen Health Care Provider Protection Reauthorization Act (H.R. 929/S. 266; Physician Led and Rural Access to Access to Quality Care Act (H.R. 2191/S. 1390); Section 232, National Security Investigation of Imports of Pharmaceuticals and Pharmaceutical Ingredients; and to protect health care workers from violence with the Save Healthcare Workers Act (H.R. 3178/S. 1600), Front of Package Food Labeling, The Medically Tailored Home-Delivered Meals Program Pilot Act (H.R. 5439/S. 2834); The Nursing is a Professional Degree Act (H.R. 8691/S. 4568), H.R.9260 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027; and the H-1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961); Protecting Patients from Automated Denials Act (H.R. 9734); and the Doctors Not AI Act (H.R. 101210).

Client expense: $600,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

Graduate Medical Education Certified Anesthesiologist Assistants Anesthesia workforce shortages HR 3890, Resident Physician Shortage Reduction Act of 2025: residency positions S.709, Conrad State 30 and Physician Access Reauthorization Act: Foreign physician immigration status S. 1380, Specialty Physicians Advancing Rural Care (SPARC) Act: physician shortages in rural areas HR 2028; Resident Education Deferred Interest Act (REDI Act): Student loan relief Anesthesia Research Funding Scope of Practice Merit-based Incentive Payment System, MIPS, MIPS Value Pathway Quality Payment Program, QPP Alternative Payment Model, APM QCDR - Qualified Clinical Data Registry Evaluation and Monitoring codes & cuts Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Brain health CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services Conditions of Participation - Anesthesia services, opt-outs, supervision CMS: Federal Independent Dispute Resolution (IDR) Process, Batching H.R.27, HALT Fentanyl Act: fentanyl scheduling and registration requirements H.R. 1227/S.475, Alternatives to PAIN Act of 2025: access to non-opioid pain management options Pain Medicine Prescription Drug Abuse CDC Opioid Prescribing Guideline H.R. 3595, Safe Prescribing Through Reporting Act of 2025: disclosure of certain records relating to substance use disorder medications to State prescription drug monitoring programs Drug shortages DEA Scheduling Propofol FDA Safe Use Initiative FDA Operating Room Fires FDA Opioids FDA Network of Experts FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) USP - US Pharmacopeia Compounding NIH Interagency Pain Research Coordinating Committee NIH: Funding, Indirect Costs, Indirect Grants, Overhead Agency for Healthcare Research and Quality (AHRQ) funding Long COVID research 21st Century Cures Initiative Out of Network/Out of Network Payment Network Adequacy Pre-authorization; prior authorization Insurance reform, shared savings, insurer accountability Affordable Care Act reform efforts Provider Nondiscrimination Change Healthcare, Change Healthcare data breach HR 292 Lorna Breen Reauthorization H.R. 3178, SAVE Healthcare Workers Act: To protect hospital personnel from violence, and for other purposes Maternal Mortality/Maternal Care Deserts Blood management 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care S. 2759/H.R. 5283, the Healthcare Workforce Resilience Act, Exemption for Physicians from New H-1B Visa Policy and $100,000 Fee Medical journal fees No Surprises Act (NSA) - H.R.4710 / S. 2420, the No Surprises Enforcement Act H.R. 3164, the Ensuring Community Access to Pharmacist Services Act Advance Premium Tax Credits (APTCs) Federal regulation of commercial health insurance companies One Big Beautiful Bill (OBBB) Commercial payer/payment H.R.7961: H-1Bs for Physicians and the Healthcare Workforce Act S.3822: Breaking Up Big Medicine Act H.R. 4681: Specialty Physicians Advancing Rural Care (SPARC) Act Low-carbon anesthesia OMB Proposed Rule on federal funding / grants U.S. Departments of State and Homeland Security Visa delays Venezuelan patients Pain management in C-sections DEA Regulations Controlled Substances Act Amendments

Client expense: $270,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Fentanyl analogues scheduling extension H.R. 3178-Save Healthcare Workers Act, to establish federal criminal penalties for violence against health care workers H.R. 5864-Improving Police CARE Act, to provide standards for trauma kits purchased using Byrne JAG grant funds S. 1595-Improving Police CARE Act, to provide standards for trauma kits purchased using Byrne JAG grant funds S. 1600-Save Healthcare Workers Act, to establish federal criminal penalties for violence against health care

Client expense: $498,299 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Transparency FEMA COVID Assistance Funds Save Healthcare Workers Act, H.R.3178 Behavioral health CHGME Health care consolidation, mergers and acquisition H1-B Visas H.R. 9393, Lower Costs, More Transparency Act of 2026 H.R. 9390, Prices on the Wall Act Critical Access Hospital Relief Act (H.R. 538) Rural Hospital Support Act (S. 335) Medicare Advantage Prompt Pay Act (H.R.5454) Protect Our Hospitals Act (H.R. 4807) Resident Physician Shortage Reduction Act of 2025 (H.R. 4731/S.2439) H-1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961) Tax Exempt Hospital Transparency Act (H.R. 9504)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Congressional outreach and monitoring regarding the following: -H.R. 1, One Big Beautiful Bill Act (P.L. 119-21). -H.R. 3178, Save Healthcare Workers Act. -H.R. 9504, Tax Exempt Hospital Transparency Act. -340B policy issues. -H.R. 4581 / S. 2372 - 340B PATIENTS Act of 2025 -H-1B Visa restrictions. -2027 federal budget. -Prior authorization reform and insurer prompt-pay legislation. -Centers for Medicare & Medicaid Services Regulatory Proposals. -Site Neutral Payment Proposals. -Healthcare and hospital workforce budget and appropriations, generally.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Congressional outreach and monitoring regarding the following: -H.R. 1, One Big Beautiful Bill Act (P.L. 119-21). -H.R. 3178, Save Healthcare Workers Act. -H.R. 9504, Tax Exempt Hospital Transparency Act. -340B policy issues. -H.R. 4581 / S. 2372 - 340B PATIENTS Act of 2025 -2027 federal budget. -Prior authorization reform and insurer prompt-pay legislation. -Centers for Medicare & Medicaid Services Regulatory Proposals. -Site Neutral Payment Proposals. -Healthcare and hospital workforce budget and appropriations, generally.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4581 / S.2372, 340B PATIENTS Act, all provisions; H.R. 3178 / S. 1600, The Save Healthcare Workers Act, all provisions; H.R. 929 / S. 266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions; H.R. 1585 / S. 709, Conrad State 30 and Physician Access Reauthorization Act, all provisions; S. 1874, Title VIII Nursing Workforce Reauthorization Act, all provisions; S. 2169, Rural Hospital Cybersecurity Enhancement Act, all provisions; H.R. 5283 / S. 2759, Healthcare Workforce Resilience Act, all provisions; S. 3315, Health Care Cybersecurity and Resiliency Act of 2025, all provisions; H.R. 5256, 340B Access Act, all provisions; S. 2355 / H.R. 5582, Patients Deserve Price Tags Act, all provisions; H.R. 7961, Physicians and the Healthcare Workforce Act, all provisions; S. 3435 / H.R. 6607, The Future Advancement of Academic Nursing, all provisions; S. 4637, Physician Workforce Optimization Act, all provisions; S.3788 / H.R. 8269, Consumer Labeling for Enhanced API Reporting and Legitimate Accountability for Base Entity Listings Act, all provisions; DRAFT, Issues pertaining to post-market surveillance of devices; S.Res.230, A resolution supporting the goals and ideals of National Hospital Week, to be observed from May 11 through May 17, 2025, all provisions; DRAFT, Issues pertaining to medical debt; S. 4568 / H.R. 8691, Nursing is a Professional Degree Act, all provisions; S.J. Res 196, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Education relating to "Reimagining and Improving Student Education-Federal Student Loan Program Final Regulations", all provisions; H.R. 6718, Professional Student Degree Act, all provisions; DRAFT, Lower Costs More Transparency Act of 2026, all provisions; DRAFT, To amend title XXVII of the Public Health Service Act to require hospitals to post prices on the walls, all provisions; DRAFT, To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to ensure health insurer accountability through publishing of overhead costs and claim payments, all provisions; DRAFT, To amend title XVIII of the Social Security Act and title XXVII of the Public Health Service Act to require the displaying of claim denial rates, all provisions; DRAFT, To amend title XI of the Social Security Act to require mandatory reporting with respect to certain health-related ownership information, all provisions; S. 1482, National Nursing Workforce Center, all provisions; S. 4027, Healthy Competition for Better Care Act, all provisions; H.R. 5629, To provide that the final rule of the Department of Health and Human Services titled Medications for the Treatment of Opioid Use Disorder, except for the portion of the final rule relating to accreditation of opioid treatment programs, shall have no force or effect; all provisions; H.R. 8726, the Protecting Authority and Restoring Tools Necessary for Enforcement by Regulatory States Act of 2026 PARTNERS Act, all provisions; S.3364, Fast Track Healthcare Apprenticeships Act, all provisions; S.4252, WIPP Economic Assistance Assurance Act of 2026, all provisions; H.R. 4470, Removing Burdens From Organ Donation Act, all provisions; U.S. Department of Health & Human Services / Office of the National Coordinator for Health Information Technology, Issue pertaining to standardized set of data elements intended to support nationwide, interoperable electronic data exchange to help ensure consistent health information exchange throughout a patient's health care journey; Health Resources & Services Administration (HRSA), Issue pertaining a revised version of a 340B rebate model pilot program; Health Resources & Services Administration (HRSA), Issue pertaining to Eli Lilly 340B program decisions; Federal Trade Commission & Department of Justice, Issues pertaining to the effectiveness of the Hart-Scott-Rodino (HSR) premerger notification form and implications for hospital field; Enhanced Premium Tax Credits, Extension of Enhanced Premium Tax Credits; Rural Health Care Access, Issues to protect access to rural health care; 340B Program, Issues pertaining to protecting 340B Program, including 340B Rebate Model Pilot Program; Maternal and Child Health, Access to maternal and child health care and addressing related workforce shortages, conditions of participation (COP); Behavioral Health, Issues related to expanding access to care and reducing regulatory barriers; Workforce, Issues pertaining to workforce development programs, supporting health care workforce and physician shortages, loan repayment programs for providers in rural and underserved areas, Graduate Medical Education program; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay, white-bagging and brown-bagging policies; Health Care Resiliency & Preparedness, Issues pertaining to natural disasters, strengthen health care cybersecurity, cybersecurity workforce, and securing drug supply chains, hospital preparedness program, PAHPA reauthorization; Healthcare Price Transparency, Issues related to health care price transparency; Affordability, Issues and policy solutions pertaining to health care affordability and rising costs of health care; Tax-exempt status, Issues pertaining to not-for-profit hospitals' tax exempt status and tax-exempt private activity bonds; Immigration, Proposed H1-B Visa Program changes and impact to health care workforce; AI in Healthcare, Issues pertaining to the use of AI in healthcare; Professional Degree Program Changes, Issues pertaining to new student loan borrowing limits and professional degree programs changes; Drug Prices, Issues pertaining to lowering drug prices, securing drug supply chain, and transparency; Rural Health Transformation Fund, Issues pertaining to implementation of the Rural Health Transformation program.

Client expense: $4,470,000 · Firm income: Not reported

Government targets: Education, Dept of, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Justice, Dept of (DOJ), SENATE

Oppose H.R. 1 limitations on Affordable Care Act premium tax credit eligibility and support legislatively delaying implementation. Support permanently extending Affordable Care Act enhanced premium tax credits. Support 340B Drug Pricing Program with Congressional staff and discuss certain changes: oppose 340B ACCESS Act, SECURE 340B Act, support PATIENTS Act, oppose HRSA back-end rebate models, support enforcement action against manufacturer claims data policies. Support recommendations to address workforce shortages for nursing and ancillary health care workforce: faculty recruitment and retention, additional financial support for supervision and precepting students, Medicare payment for nursing and allied health, testing new workforce models, establishing incentives and early recruitment strategies, providing funding for clinical training sites, and immigration reforms that expedite entry for foreign health care workers. Support SAVE Healthcare Workers Act (H.R. 3178/S. 1600). Support revisions to Conrad 30 waiver program to increase the number of foreign physicians that may remain in the US after completing GME: S.665/H.R.4942, S.2719/H.R.6980, H.R. 4875. Support Improving Seniors Timely Access to Care Act (S. 4532/H.R. 8702). Support SEPSIS Act (S.1929). Discuss New York State transition from Affordable Care Act Section 1332 State Innovation Waiver to Section 1331 Basic Health Plan. Discuss legislative proposals to regulate the use of artificial intelligence in health care settings with Congressional staff. Discuss non-profit tax-exempt status of hospitals and examples of community benefit for IRS purposes. Discuss price transparency regulations and legislative proposals: Lower Costs, More Transparency Act; Patients Deserve Price Tags Act; Prices on the Wall Act; Transparency in Billing Act. Support commercial insurance reforms. Oppose HSA and price transparency provisions in H.R. 8324. Discuss antitrust exemption for National Resident Matching Program.

Client expense: $580,000 · 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

Health Information Technology Health workforce shortage issues, Title VII and Title VIII of the Public Health Service Act, nursing, graduate nursing education, nursing-managed health clinics Health wellness and prevention programs Research tobacco, e-cigarettes and flavorings University Center for Excellence in Developmental Disabilities (UCEDD) Leadership Education in Neurodevelopmental Disabilities (LEND) program Rural Communities Opioid Response Program Rural Centers of Excellence H.R. 3178/S. 4771, Save Healthcare Workers Act (SAVE Act) Fetal Alcohol Syndrome Disorders H.R. 5684, Medical Foods and Formulas Access Act of 2025 Emergency Medical Services for Children (EMSC) program

Client expense: $220,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Health care quality; physician and hospital quality; health care innovation; Patient Protection and Affordable Care Act/health care reform implementation; unique device identifier policy and post-market surveillance for medical devices; clinical trial design; HIPAA and registries; federal funding/appropriations for HHS, NIH, AHRQ, CDC, FDA, HRSA and the Childrens Hospital Graduate Medical Education payment program, the Prevention & Public Health Fund, medical research, and prevention; research and scholarly communication policy; implementation and oversight of 21st Century Cures Act; data blocking/interoperability of electronic data; artificial intelligence/machine learning; algorithm transparency; health disparities; reduction/oversight of prior authorization and other administrative burdens; digital health; Sect. 1557 Nondiscrimination in Health Programs and Activities; cardiomyopathy education and awareness; peripheral arterial disease (PAD) education and awareness; VA Mission Act implementation; COVID-19 and implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act , the Coronavirus Aid, Relief, and Economic Security Act, Coronavirus Provider Protection Act, and clinician mental health and wellbeing; patient identification; Pandemic and All Hazards Preparedness; MCIT/TCET/Breakthrough devices; Amputation Reduction and Compassion (ARC) Act (H.R. 307); Resident Education Deferred Interest (REDI) Act (H.R. 2028/S. 942); Implementation and funding for the Cardiomyopathy Health, Education, Awareness, Research and Training in Schools (HEARTS) Act (P.L. 118-176); provide AEDs in transportation facilities with the Public Access to Defibrillation in Transportation Facilities Act (H.R. 5897); Lorna Breen Health Care Provider Protection Reauthorization Act (H.R. 929/S. 266; Physician Led and Rural Access to Access to Quality Care Act (H.R. 2191/S. 1390); Section 232, National Security Investigation of Imports of Pharmaceuticals and Pharmaceutical Ingredients; and to protect health care workers from violence with the Save Healthcare Workers Act (H.R. 3178/S. 1600), Front of Package Food Labeling, The Medically Tailored Home-Delivered Meals Program Pilot Act (H.R. 5439/S. 2834); The Nursing is a Professional Degree Act (H.R. 8691/S. 4568), H.R.9260 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027; and the H-1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961).

Client expense: $680,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

Childrens Hospitals Graduate Medical Education (CHGME) program - Urged increased funding in FY 2027 to fund CHGME with the same priority as other federal physician training programs Continued healthcare access - Advocated for a more resilient healthcare infrastructure and policies that provide the staffing and technological infrastructure necessary to maintain essential services Continued monitoring and encouraged passage of the Biosimilar Red Tape Elimination Act (S.1954) Continued monitoring and encouraged passage of the Improving Seniors' Timely Access to Care Act (H.R. 3514/S.1816) Continued monitoring and encouraged passage of the Mapping Americas Pharmaceutical Supply (MAPS) Act (S.1784/H.R.4191) Continued monitoring and encouraged passage of the Protect Medicaid and Rural Hospitals Act (S.2279) Continued monitoring and encouraged passage of the Protecting Health Care and Lowering Costs Act (S.2556) Continued monitoring and encouraged passage of the Resident Physician Shortage Reduction Act of 2025 (S.2439/H.R.3890/H.R.4731) Continued monitoring and encouraged passage of the Save Healthcare Workers Act (S.1600/H.R.3178). Drug shortages - Supported elements to increase transparency in prescription drug supply chain and increase reimbursement for generic prescription drugs; issues related to compounding; issues related to buffer inventory. Encouraged improved stakeholder communication and increased notification by manufacturers for surges in demand Endorsed and encouraged passage of the Drug Origin Transparency Act of 2026 (HR.8339) Hospital Data and Analytics - Provided education and information on the types of clinical, operational, financial and quality data hospitals collect and monitor to improve patient care. Hospital Group Purchasing - Advocated to highlight the value that hospital group purchasing organizations (GPOs) provide to hospitals and suppliers. Provided education on how GPOs work in the healthcare supply chain and the role they play in delivering value to healthcare providers, as well as key differences between traditional GPOs and PBMs. Supply Assurance - Responded to a Senate Special Committee on Aging inquiry on vulnerabilities in the U.S. pharmaceutical supply chain highlighting the work done by GPOs to improve supply chain resiliency and encouraging additional healthcare supply chain visibility. Urged passage of legislation to reauthorize The Pandemic and All-Hazards Preparedness Act (PAHPA) Telehealth - Encouraged the adoption of additional permanent telehealth policies to extend certain telemedicine flexibilities beyond their current expiration date. United States Core Data for Interoperability Draft Version 7 - Respond to the Office of the National Coordinator for Health Information Technology Policy (ONC) on issues raised in Standards Bulletin 2026-1 (SB26-1) and offered comments to constructively improve certain data elements of Draft USCDI v7. Offered recommendations for future iterations of USCDI standards. Workforce - Advocated for strengthening the health workforce and preventing workforce shortages through policies that support education, training, recruitment and retention efforts.

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

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

Issues concerning Safety from Violence for Healthcare Employees. H.R. 3178 / S.1600, Save Healthcare Workers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Workforce: H.R. 1585/ S.709- The Conrad State 30 and Physician Access Reauthorization Act; would modify the Conrad 30 Waiver program, which incentivizes qualified foreign physicians to serve in underserved communities. H.R.3178- The Save Health Care Workers Act; would make it a federal crime to assault or intimidate hospital workers. S. 2031- Workforce Mobility Act; would prohibit certain noncompete agreements. H.R. 7961- H-1Bs for the Physicians and Healthcare Workforce Act; would exempt physicians and health professionals from the $100,000 H-1B filing fee imposed by the Department of Homeland Security.

Client expense: $182,593 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

- Medicare Site Neutrality and Medicare Advantage Reform - FY27 Appropriations Priorities (NIH, NCI, CDC, HRSA) - Save Healthcare Workers Act (H.R. 3178/S.1600) - H.R.2531 - Workplace Violence Prevention for Health Care and Social Service Workers Act - Request for casework on SAMHSA Grant - Title VII & VIII Funding Support - FQHC SAMSHA Application Issue

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

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

H.R. 9504 - Tax Exempt Hospital Transparency Act; H.R. 9393 - Lower Cost More Transparency Act; H.R 9390 - Prices on the Wall Act; H.R. 5582, S. 2355 - Patients Deserve Price Tags Act: Provisions related to hospital price transparency and Form 990 reporting. P.L. 119-21: Issues related to the implementation of provisions regarding Essential Plan Cuts, Medicaid financing and eligibility, and other issues impacting hospitals. H.R. 3178; S. 1600 - Save Healthcare Workers Act: Provisions related to protections for health care workers. H.R. 3890 - Resident Physician Shortage Reduction Act: Provisions related to graduate medical education. Issues related to Section 340B drug pricing, healthcare workforce, telehealth, community engagement and health insurance.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 266/HR 929, the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; HR 935, the Health Care Workforce Innovation Act of 2025; S. 1600/HR 3178, the Save Healthcare Workers Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 998, H.R. 2213 Medical Supply Chain Resiliency Act S. 1058, H.R. 2172 Preseving Patients Access to Home Infusion Act H.R. 4559 Prompt and Fair Pay Act H.R. 5031 Preserving Patient Access to Long-Term Care Pharmacies Act S. 709, H.R.1585 Conrad State 30 and Physician Access Reauthorization Act H.R. 483 Health Care Efficiency Through Flexibility Act S. 1460, H.R. 786 Preserving Patient Access to Accountable Care Act S. 1816, H.R. 3514 Improving Seniors' Timely Access to Care Act S. 1600, H.R. 3178 Save Healthcare Workers Act H.R. 2433 Reducing Medically Unnecessary Delays in Care Act S. 2439, H.R. 4731 Resident Physician Shortage Reduction Act H.R. 4464 Preventative Health Savings Act Incentivizing domestic manufacturing of critical medical supplies Issues related to health care costs and transparency Electronic prior authorization and administrative simplification Health care supply chain resiliency 340B Drug discount program Reauthorization of Pandemic and All Hazards Preparedness Act Hospital finance issues Healthcare workforce issues (graduate medical education, health professional training, recruitment and retention, minimum staffing requirements) Medicare payment policies Alternative payment models and related policies Medicare home infusion policy Reauthorization of Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act Expanding access to interoperable health tech in long term and post-acute care settings Maternal and infant health Health care workplace violence and worker safety Artificial intelligence in healthcare Medicaid Disproportionate Hospital Share cuts Cybersecurity and privacy issues for hospitals and health systems Comment letters for PFS, OPPS, and HH.

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

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

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

Client expense: $821,438 · 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 the 340B Drug Pricing program Issues related to hospital infrastructure S.1261 CONNECT for Health Act of 2025 HR 2213 - Medical Supply Chain Resiliency Act S.1600/HR 3178 - Save Healthcare Workers Act HR333 - MORE Nurses Act S.2355 - the Patients Deserve Price Tags Act Issues related to hospital closures Issues related to research facilities and administrative costs Issues related to hospital workforce Issues related to GME Issues related to hospital price transparency

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

HR 2332 SHARE Act HR 3178/S 1600 SAVE Healthcare Workers Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Workplace Violence Prevention NIH and Research issues CDC Mission Zero Physician Payment Graduate Medical Education Save Healthcare Workers Act HR3178

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.3178/S.1600, Save Healthcare Workers Act, Entirety H.R.9504, Tax Exempt Hospital Transparency Act, Entirety Monitor the following; Public Law 119-21, One Big Beautiful Bill Act, Hospital related issues Medicare reimbursement issues, generally Community Health Centers Plastics and human health related issues and initiatives Artificial Intelligence, Medical Center related issues 340B Drug Pricing related issues Organ transplant issues Prescription drug pricing, generally Laboratory development test issues

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

Government targets: HOUSE OF REPRESENTATIVES

Transparency 340B drug pricing program Rural health transformation program FEMA COVID Assistance Funds Save Healthcare Workers Act, H.R.3178 Behavioral health CHGME Health care consolidation, mergers and acquisition H1-B Visas

Client expense: $270,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Graduate Medical Education Certified Anesthesiologist Assistants Anesthesia workforce shortages HR 3890, Resident Physician Shortage Reduction Act of 2025: residency positions S.709, Conrad State 30 and Physician Access Reauthorization Act: Foreign physician immigration status S. 1380, Specialty Physicians Advancing Rural Care (SPARC) Act: physician shortages in rural areas HR 2028; Resident Education Deferred Interest Act (REDI Act): Student loan relief Anesthesia Research Funding Scope of Practice Merit-based Incentive Payment System, MIPS, MIPS Value Pathway Quality Payment Program, QPP Alternative Payment Model, APM QCDR - Qualified Clinical Data Registry Evaluation and Monitoring codes & cuts Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Brain health CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services Conditions of Participation - Anesthesia services, opt-outs, supervision CMS: Federal Independent Dispute Resolution (IDR) Process, Batching H.R.27, HALT Fentanyl Act: fentanyl scheduling and registration requirements H.R. 1227/S.475, Alternatives to PAIN Act of 2025: access to non-opioid pain management options Pain Medicine Prescription Drug Abuse CDC Opioid Prescribing Guideline H.R. 3595, Safe Prescribing Through Reporting Act of 2025: disclosure of certain records relating to substance use disorder medications to State prescription drug monitoring programs Drug shortages DEA Scheduling Propofol FDA Safe Use Initiative FDA Operating Room Fires FDA Opioids FDA Network of Experts FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) USP - US Pharmacopeia Compounding NIH Interagency Pain Research Coordinating Committee NIH: Funding, Indirect Costs, Indirect Grants, Overhead Agency for Healthcare Research and Quality (AHRQ) funding Long COVID research 21st Century Cures Initiative Out of Network/Out of Network Payment Network Adequacy Pre-authorization; prior authorization Insurance reform, shared savings, insurer accountability Affordable Care Act reform efforts Provider Nondiscrimination Change Healthcare, Change Healthcare data breach HR 292 Lorna Breen Reauthorization H.R. 3178, SAVE Healthcare Workers Act: To protect hospital personnel from violence, and for other purposes Maternal Mortality/Maternal Care Deserts Blood management 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care S. 2759/H.R. 5283, the Healthcare Workforce Resilience Act, Exemption for Physicians from New H-1B Visa Policy and $100,000 Fee Medical journal fees No Surprises Act (NSA) - H.R.4710 / S. 2420, the No Surprises Enforcement Act H.R. 3164, the Ensuring Community Access to Pharmacist Services Act Advance Premium Tax Credits (APTCs) Federal regulation of commercial health insurance companies One Big Beautiful Bill (OBBB) Commercial payer/payment H.R.7961: H-1Bs for Physicians and the Healthcare Workforce Act S.3822: Breaking Up Big Medicine Act H.R. 4681: Specialty Physicians Advancing Rural Care (SPARC) Act Low-carbon anesthesia OMB Proposed Rule on federal funding / grants U.S. Departments of State and Homeland Security Visa delays Venezuelan patients Pain management in C-sections

Client expense: $270,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Save Healthcare Workers Act (S.1600/H.R.3178) Title VIII Nursing Workforce Reauthorization Act (S.1874/H.R.3595) Title VIII Nursing Workforce Development Programs and National Institute for Nursing Research FY 2027 Appropriations Request

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues involving violence against healthcare employees. H.R. 3178 / S. 1600, Save Healthcare Workers Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1600 / H.R. 3178, the Save Healthcare Workers Act, as it relates to ensuring a safe and secure environment for the healthcare workforce. Issues regarding healthcare workplace safety.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues regarding the mental health of healthcare workers. S. 1600 / H.R. 3178, the Save Healthcare Workers Act, as it relates to ensuring a safe and secure environment for the healthcare workforce. S. 547, Train More Nurses Act, as it relates to grant programs to support the nursing workforce.

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

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