To amend title XVIII to reform the Medicare Advantage program.

Issues concerning access to and reimbursement for the Medicare Hospice benefit. H.R. 3467, to amend Title XVIII to reform the Medicare Advantage program as it relates to hospice services. Medicare Advantage and the hospice benefit. Issues regarding program integrity. National Moratorium on Hospice and Home Health Enrollment. Monitored The Hospice Special Focus Program. Issues related to regulatory relief and audit burden. H.R. 1720, Hospice Recertification Flexibility Act. Issues regarding telehealth and hospice care. S. 1261, CONNECT for Health Act of 2025; H.R. 5081 / S. 2709, Telehealth Modernization Act. S. 1935, Expanding Access to Palliative Care Act. Monitored H.R. 7148 (P.L. 119-75), Consolidated Appropriations Act of 2026, as it relates to implementation of Medicare extenders. S. 4118 / H.R. 7966, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act of 2026. H.R. 8883, Protecting Seniors and Stopping Fraudsters Act. FY'27 Hospice Wage Index and Payment Rate Final Rule including the Service and Spending Variation Index (SSVI). FY'27 Home Health Proposed Rule and S. 5250, Medicare Home Health Payment Integrity and Protection Act of 2026.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

Medicare Observation Stays. The Improving Access to Medicare Coverage Act (H.R. 3954/S. 4641): Proposals to count time spent in observation status toward the three-day prior inpatient stay required under Medicare for coverage of a subsequent stay in a skilled nursing facility. Medicare Drug Costs. The Pharmaceutical Research Transparency Act (No bill): Proposal to amend the Public Health Service Act and the Security Exchange Act to require pharmaceutical manufacturers to report their costs related to clinical trials and research and development. Medicare Prescription Drugs. Drug Costs. Inflation Reduction Act (Public Law No: 117-169): Law to allow Medicare to negotiate prices with drug makers, cap prices at inflation in Part B and D, cap beneficiary out-of-pocket costs in Part D, eliminate cost-sharing for vaccines, eliminate cost-sharing in the catastrophic phase of Part D, and to raise the income threshold for the Low-Income Subsidy program offering assistance in paying for drugs. Medicare Prescription Drugs. (No bill): A regulatory proposal encouraging the Secretaries of the Departments of Health and Human Services (HHS) and Commerce to exercise march in rights that would aim to better control the pricing of prescription drugs. Medicare Prescription Drugs. (No bill): An HHS regulatory proposal to ensure robust negotiation rules and processes that aim to curtail the cost of certain prescription drugs, as authorized by the Inflation Reduction Act (Public Law No: 117-169). Medicare and Medicaid Prescription Drugs. (No bill): Joined comments with 19 other organizations urging HHS to use its existing authority to license competition in order to lower consumer and taxpayer costs for semaglutide drugs treating diabetes and weight management (e.g., Ozempic and Wegovy). Medicare Savings Program and Low-Income Subsidy (LIS) Programs. (No bill): Proposals to make enrollment of dually eligible individuals in the Medicare Savings Programs (MSP) and the LIS program easier, so that low-income beneficiaries can more readily access financial assistance for Medicare copayments, premiums and deductibles, and to be able to access needed medications at prices they can afford. Medicare Reform. The Assuring Medicares Promise Act (H.R. 609): Proposals to close the loophole for wealthy individuals who bypass paying net investment income tax (NIIT) and directing the revenue to the Hospital Insurance Trust Fund, which pays for Medicare Part A that covers inpatient care in hospitals, and to the Social Security Trust Funds. Medicare Dental, Hearing and Vision Coverage. Medicare Dental, Vision, and Hearing Benefit Act of 2025 (H.R. 2045): Proposal to add dental, vision and hearing benefits to Medicare. Medicare Hearing Coverage: The Medicare Hearing Aid Coverage Act of 2025 (H.R. 500): Proposals to add hearing benefits to Medicare. Medicare Advantage (MA). (No bill): Proposals to create transparency around Medicare Advantage plans using prior authorization and supplemental benefits that are not offered under traditional Medicare. Medicare Advantage. (No bill): Proposals to apply a higher coding adjustment factor to fully account for intensive upcoding by MA plans and to exclude certain information for MA risk adjustment scores and payments; to use two years of traditional Medicare and MA diagnostic data for calculating MA risk-adjusted payments; and to promulgate more fundamental changes to the Hierarchical Condition Category (HCC) risk adjustment model. Medicare Advantage. (H.R. 3467) Proposal to make Medicare Advantage plans the default choice during initial enrollment periods. Medicare Privatization (No bill): Proposals to create policies in traditional Medicare that mimic those used by private health insurance plans. Medicaid. The HCBS Access Act (H.R. 8540/S. 5321): Proposals to expand Medicaid home and community-based services (HCBS) by elevating them to a mandatory entitlement. H.R. 8540 would reduce waitlists and guarantee seniors and individuals with disabilities a choice between home care and institutional care. Would also establish new grant programs and a technical assistance center to improve the wages, benefits, and training pathways for the direct care workforce. Medicare, Medicaid and Social Security. The Alleviating Barriers for Caregivers (ABC) Act (H.R. 2491 and S. 1227): Proposals would require HHS and SSA to review application processes, procedures, forms, and communications for Medicare, Medicaid, Childrens Health Insurance Program, and Social Security programs in order to reduce administrative barriers facing family caregivers. The bill requires agencies to identify and report to Congress on actions that can be taken to streamline eligibility and assistance for family caregivers within existing programs. Medicare, Medicaid Nursing Homes. The Protecting Americas Seniors Access to Care Act (H.R. 1303): Proposal to prohibit the HHS Secretary from promulgating national staffing standards in nursing homes. Medicare, Medicaid Nursing Homes. The Nurses Belong in Nursing Homes Act (S. 3886): Proposal aims to establish federal minimum staffing standards, specifically requiring 3.48 hours per resident per day (HPRD) of total nursing care and 24/7 on-site Registered Nurse (RN) coverage. Medicare, Medicaid Nursing homes. The Safe Staffing Saves Lives Act (H.R. 8100): Proposals to establish a minimum of 4.1 hours of direct nursing home care per resident per day, and a Registered Nurse on duty on-site 24/7. Adds penalties for facilities failing to meet required minimums. Medicare, Medicaid Nursing Homes. The Building Americas Health Care Workforce Act (No bill): Proposal to allow time spent working in a nursing home (prior to any formal training, and permitted during the COVID-19 pandemic) to count toward a 75-hour minimum federal training standard that is required for certified nursing assistants. Medicare, Medicaid Nursing Homes. The Ensuring Seniors Access to Quality Care Act (H.R. 7096): Proposal to repeal regulations that prohibit certified nursing assistant training and competency evaluation programs in skilled nursing facilities that have a record of health and safety deficiencies and have incurred penalties (e.g., civil monetary penalties for substandard quality of care). Medicare Treatment for Osteoporosis (No bill): Support for making payment revisions to the 2026 Physician Fee Schedule that would accelerate treatment improvements for beneficiaries with osteoporosis and help prevent repeat fractures. Medicare and Medicaid Waste, Fraud and Abuse (No bill): Submitted comments with other organizations to a CMS Request for Information (RFI) Related to Comprehensive Regulations To Uncover Suspicious Healthcare (CRUSH), 91 Fed. Reg. 9803 (February 27, 2026) CMS-6098-NC. Medicaid Work Requirements Affecting Eligibility (No bill): Submitted comments with other organizations to request CMS to clarify in regulations that people with disabilities, older adults, and caregivers are exempt from the Medicaid working requirements in P.L. 119-21. Health Insurance. Health Insurance Premium Fairness Act (H.R. 6455). Proposal to close loophole that penalizes couples with one spouse in Medicare and one receiving health care through Affordable Care Act (ACA) exchanges, by allowing for subtraction of Medicare premiums from the maximum premium paid for a marketplace plan. Health Insurance. (H.R. 1834). Proposals to extend the Enhanced Premium Tax Credits for ACA marketplace health insurance plans. Health Insurance. The Lower Health Care Premiums for All Americans Act (H.R. 6703) Proposals to weakening consumer protections and destabilizing markets by allowing skimpier, less‑regulated plans that can cherry‑pick healthier groups and leave higher‑cost enrollees in the ACA‑regulated small‑group and individual markets with higher premiums. Medicaid and Health Insurance. Protecting Health Care and Lowering Costs Act (S. 2556, H.R. 4849): Proposals to restore massive funding cuts to Medicaid that were included in the 2025 budget reconciliation law, and to make permanent ACA enhanced premium tax credits. Medicare. The Medicare Cost Cap Act (S. 4886): Proposals to add a $5,000 annual cap on out-of-pocket costs for traditional Medicare (Part A and Part B) beneficiaries. Would require Medicare to pay 100 percent of covered health care costs once the $5,000 cap is reached. Prescription Drugs. The Affordable Pricing for Taxpayer-Funded Prescription Drugs Act (H.R. 10094): Proposals that would lower prices or shorten exclusivity periods when revenues exceed targets, which exceed a standard of cost per health benefit achieved, and constitute significant barriers to access or fiscal burdens on patients.

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

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

Medicare Advantage (MA) Policy and Reimbursement Medicare Part D Issues Medicaid Policy Issues Including Dual Eligibles Pharmacy Benefit Managers (PBM) and Pharmacy Policy and Reimbursement Issues Home Health Policy and Reimbursement Issues Implementation of Inflation Reduction Act of 2022 Public Law No. 117-169 H.R. 3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025 (119th Congress) Prior Authorization Policy and Regulatory Issues CMS-4185-F2 Medicare Advantage Risk Adjustment Data Validation Final Rule Primary Care and Value-Based Care Policy and Reimbursement Clinical Policy Issues Including Workforce and Mental Health Hospital Outpatient Prospective Payment System (OPPS): Remedy for the 340B-Acquired Drug Payment Policy for Calendar Years 2018-2022 Final Rule (CMS 1793-F) Implementation of CMS Interoperability and Prior Authorization final rule (CMS-0057-F) Contract Year 2025 Medicare Advantage and Part D Final Rule (CMS-4205-F) Announcement of Calendar Year (CY) 2025 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies Final Calendar Year (CY) 2025 Part D Redesign Program Instructions PL 119-21, One Big Beautiful Bill Act S.1105, No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act H.R. 3467, Medicare Advantage Reform Act Policy issues related to VA-eligible Medicare beneficiaries Final Calendar Year (CY) 2026 Part D Redesign Program Instructions Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly (CMS-4208-F) Final Guidance for Medicare Drug Price Negotiation Program guidance for initial price applicability year 2028 CMS Health Tech Ecosystem initiative H.R. 1732, GUARD VA Benefits Act H.R. 5454/S. 2789, Medicare Advantage Prompt Pay Act Contract Year 2027 Medicare Advantage and Part D Final Rule (CMS-4208-F3/CMS-4212-F) Calendar Year (CY) 2027 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the CY 2027 Rate Announcement) 2026 CMS Interoperability Standards and Prior Authorization for Drugs Proposed Rule (CMS-0062-P) Medicare Drug Price Negotiation Program Proposed Rule (CMS-4215-P) Healthcare cybersecurity and Artificial Intelligence (AI) policy issues Request for Information (RFI): Pharmacy Benefit Manager Compensation and Data Collection (CMS-4218-NC) Consolidated Appropriations Act of 2026 Fiscal Year 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements Final Rule (CMS-1851-F) Fiscal Year 2027 Skilled Nursing Facility Prospective Payment System Final Rule (CMS 1843-F) Manufacturer Effectuation of MFP Draft Guidance for 2028 Medicare Drug Price Negotiation Calendar Year (CY) 2027 Medicare Physician Fee Schedule Proposed Rule (CMS-1848-P) Calendar Year (CY) 2027 Home Health Prospective Payment System Proposed Rule (CMS-1844-P) Request for Information (RFI): Medicare Part D Reasonable and Relevant Pharmacy Contracting Standards (CMS-4217-NC)

Client expense: $1,520,000 · Firm income: Not reported

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

Medicare and Medicaid dual eligible integration; Issues related to Medicare Advantage, including automatic enrollment and assignment, benchmark setting for payment, health risk assessments and chart review, hospice and MA, prior authorization, quality and star ratings, two years of data for payment; S. 1105, No UPCODE Act; H.R. 3467, To amend title XVIII to reform the Medicare Advantage program; Medicare Advantage (MA) quality Star ratings

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to Third Party Marketing Organizations Issues relating to The Patient Protection and Affordable Care Act Issues relating to Healthcare.gov and Medicare.gov under the Labor/HHS Appropriations Act Issues related to efficient online and telephonic enrollment into Medicare Advantage and Medicare Prescription Drug Plans Issues related to Medicare Advantage and Part D Plan broker compensation Issues related to lead generation policies Issues relating to the Telephone Consumer Protection Act regarding lead generation for health plan coverage Issues related to Individual CHOICE HRAs (ICHRA), including S. 2875, the CHOICE Act, and H.R. 5463, The CHOICE Arrangements Act of 2025 Issues pertaining to short-term limited duration plans Issues relating to H.R. 2079 and S. 976, the Insurance Fraud Accountability Act Issues pertaining to HR 3467, to amend tile XVIII to reform the Medicare Advantage program Issues pertaining to H.R. 5498, the Small Business Health Options Awareness Act of 2025 Issues pertaining to H.R. 9395, the Transparency in Medicare Advantage Steering Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

Support for extending the telehealth flexibility for the face-to-face (F2F) encounter required during recertification of hospice eligibility - H.R.4206/S. 1261 - CONNECT for Health Act of 2025; H.R. 3467 a bill concerning hospice and MA; H.R. 8883 The Protecting Seniors and Stopping Fraudsters Act; H.R.7966/S. 4118 - Hospice CARE Act of 2026

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS' Medicare compare website H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 497 - Medicaid Third Party Liability Act - Rep. Crenshaw, Dan - Medicaid liable third-party exceptions H.R. 538 - Critical Access Hospital Relief Act - Rep. Smith, Adrian - Medicare physician certification requirement H.R. 584 - No Medicaid for Illegal Immigrants Act - Rep. Kiley, Kevin - Medicaid eligibility requirements H.R. 608 - COVER Now Act - Rep. Doggett, Lloyd - Medicaid expansion demo H.R. 610 - Close the Medigap Act - Rep. Doggett, Lloyd - Medigap plan reform H.R. 879 - Medicare Patient Access and Practice Stabilization Act - Rep. Murphy, Gregory - Medicare physician reimbursement H.R. 936 - Medicaid Improvement and State Flexibility Act - Rep. Green, Mark - Medicaid demonstration programs H.R. 1019 - Medicaid Program Improvement Act - Rep. Miller-Meeks, Mariannette - Medicaid management care reporting H.R. 1059 - Jobs and Opportunities for Medicaid Act - Rep. Crenshaw, Dan - Medicaid eligibility requirements H.R. 1162 - Medicaid Primary Care Improvement Act - Rep. Crenshaw, Dan - Medicaid direct primary care arrangements H.R. 1191 - Supporting Access to Rural Community Hospitals Act - Rep. Flood, Mike - Medicare critical access hospitals definition H.R. 1195 - Protect Medicaid Act - Rep. Hudson, Richard - Medicaid eligibility requirements H.R. 1279 - To amend title XIX of the Social Security Act to establish a community engagement requirement for certain individuals under the Medicaid program. - Rep. Bean, Aaron - Medicaid eligibility requirements H.R. 1403 - LIVE Beneficiaries Act - Rep. Bilirakis, Gus - Medicaid registration audits H.R. 1598 - Ensuring Access to Medicaid Buy-in Programs Act - Rep. Ciscomani, Juan - Medicaid eligibility requirements H.R. 1683 - Protecting Rural Seniors' Access to Care Act - Rep. Fischbach, Michelle - Minimum nursing home staffing H.R. 1775 - Second Chances for Rural Hospitals Act - Rep. Arrington, Jodey -Definition of rural emergency hospitals H.R. 1805 - ARCH Act - Rep. Miller, Carol - Extend Medicare-dependent and low-value hospitals payments H.R. 1924 - Securing Access to Care for Seniors in Critical Condition Act - Rep. Hern, Kevin - Medicare site-neutral payments for LTC hospitals H.R. 2045 - Medicare Dental, Vision, and Hearing Benefit Act - Rep. Doggett, Lloyd - Medicare dental, vision, and hearing coverage H.R. 2263 - Telehealth Coverage Act - Rep. Khanna, Ro - Telehealth flexibilities in Medicare H.R. 2309 - Medicare and Medicaid Fraud Prevention Act - Rep. Peters, Scott - provider screening for Federal programs H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act - Rep. Green, Mark - Medicare Advantage prior authorization H.R. 2533 - EASE Act - Rep. Arrington, Jodey - CMS model for virtual technology H.R. 2586 - Reentry Act - Rep. Tonko, Paul - Medicaid coverage for incarcerated population H.R. 2590 - Mental and Physical Health Care Comorbidities Act - Rep. Boyle, Brendan - CMS demonstration to treat comorbidities H.R. 2610 - Protecting Options for Seniors Act - Rep. Tenney, Claudia - MA wage index reclassification H.R. 3023 - Preventing Hospital Overbilling of Medicare Act - Rep. Spartz, Victoria - Site-neutral payment reform H.R. 3069 - Medicare for All Act - Rep. Jayapal, Pramila - New national health insurance program H.R. 3222 - SMART Health Care Act - Rep. Spartz, Victoria - MA risk adjustment H.R. 3263 - PATCH Act - Rep. Tokuda, Jill - Medicare geographic practice cost indices H.R. 3321 - Ending Medicaid Discrimination Against the Most Vulnerable Act - Rep. Roy, Chip - Enhance FMAP phase out H.R. 3415 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Rep. Schakowsky, Janice - Nurse staffing ratio requirements H.R. 3467 - To amend title XVIII to reform the Medicare Advantage program - Rep. Schweikert, David - MA reforms H.R. 3808 - Expanding Seniors Access to Mental Health Services Act - Rep. Fitzpatrick, Brian - Medicare mental health services H.R. 4093 - Apples to Apples Comparison Act - Rep. Bean, Aaron - Medicare and Medicare Advantage spending reports H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4277 - Rural Emergency Hospital Financial Stability Act - Rep. Davis, Donald - Medicaid treatment of rural emergency hospitals H.R. 4313 - Hospital Inpatient Services Modernization Act - Rep. Buchanan, Vern - Acute hospital care at home waiver H.R. 4559 - Prompt and Fair Pay Act - Rep. Doggett, Lloyd - Payment parity for MA and FFS; MA reimbursement requirements H.R. 4641 - Keep Kids Covered Act - Rep. Castor, Kathy - Continuous eligibility for children in Medicaid/CHIP H.R. 4807 - Protect Our Hospitals Act - Rep. Landsman, Greg - Medicaid provider tax repeal H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. - Rep. McClellan, Jennifer - MA supplemental benefits data reporting H.R. 5281 - REAL Health Providers Act - Rep. Panetta, Jimmy - MA provider directory requirements H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - Impact of Third Party Liability on MCOs H.R. 6109 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to rates of reversed prior authorization coverage determinations under Medicare Advantage plans. - Rep. Pocan, Mark - prior authorization under Medicare Advantage H.R. 6110 - To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage. - Rep. Pocan, Mark - reconsider denials under Medicare Advantage H.R. 6111 - To amend title XVIII of the Social Security Act to require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan. - Rep. Pocan, Mark - advertise rates of prior authorization denials under Medicare Advantage H.R. 6112 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to the average monthly cost to provide coverage to an enrollee under Medicare Advantage plans. - Rep. Pocan, Mark - require monthly coverage cost to enrollees under Medicare Advantage H.R. 6113 - To amend title XVIII of the Social Security Act to impose limitations on contracts with Medicare Advantage organizations offering multiple Medicare Advantage plans under the Medicare program. - Rep. Pocan, Mark - limit multiple Medicare Advantage plans H.R. 6114 - To prohibit funds made available to the Department of Health and Human Services by previous Appropriations Acts from being used for any activity that makes Medicare Advantage the default under the Medicare program. - Rep. Pocan, Mark - prohibit Medicare Advantage from becoming the default H.R. 6254 - Medicaid Staffing Flexibility and Protection Act of 2025 - Rep. Carter, Earl - extend eligibility determinations and redeterminations for Medicaid H.R. 6361 - Ban AI Denials in Medicare Act - Rep. Landsman, Greg - limit WISeR model H.R. 6951 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - State Medicaid cost recoupment H.R. 6974 - Improving MA SNP Act of 2026 - Rep. Arrington, Jodey - MA SNP beneficiary approval H.R. 7189 - PrEP Access Act - Rep. Pocan, Mark - HIV prevention services under Medicare H.R. 7409 - Defend Rural Health Act - Rep. Taylor, Dave - Medicare definition of rural hospital H.R. 7727 - Sustaining Rural Healthcare Act - Rep. Alford, Mark - Medicare CAH designation H.R. 7778 - Medicaid PNA Modernization Act - Rep. Subramanyam, Suhas - Medicaid minimum monthly personal needs allowance H.R. 7803 - Save Medicare Act - Rep. Pocan, Mark - Renames Medicare Advantage H.R. 7871 - MVP Act - Rep. Guthrie, Brett - Value-based purchasing arrangements in Medicaid H.R. 8375 - Medicare Advantage Improvement Act - Rep. Joyce, John - MA programmatic reforms H.R. 8377 - Stop Deadly Denials Act - Rep. Khanna, Ro - MA prior authorization prohibition H.R. 8875 - Improving Home Dialysis Act - Rep. Miller, Carol - Home dialysis coverage under Medicare S. 523 - Protect Medicaid Act - Sen. Cassidy, Bill - Medicaid eligibility requirements S. 678 - LIVE Beneficiaries Act - Sen. Scott, Rick - Medicaid enrollment audits S. 717 - Increasing Access to Quality Cardiac Rehabilitation Care Act - Sen. Capito, Shelley Moore - Expanding cardiac care coverage in Medicare S. 750 - Protecting Rural Seniors' Access to Care Act - Sen. Fischer, Deb - Medicaid nursing home staff requirements S. 752 - Accelerating Kids' Access to Care Act - Sen. Grassley, Chuck - Out-of-state provider access for Medicaid S. 939 - Medicare Dental, Hearing, and Vision Expansion Act - Sen. Sanders, Bernard - Medicare coverage requirements S. 1082 - Safeguarding Medicaid Act - Sen. Barrasso, John - Medicaid enrollee asset verification S. 1105 - No UPCODE Act - Sen. Cassidy, Bill - MA risk adjustment S. 1264 - Mental and Physical Health Care Comorbidities Act - Sen. Bennet, Michael - CMS demonstration to treat comorbidities S. 1399 - Health Tech Investment Act - Sen. Rounds, Mike - Medicare coverage for algorithm-based services S. 1506 - Medicare for All Act - Sen. Sanders, Bernard - New national health insurance program S. 1624 - PATCH Act - Sen. Schatz, Brian - Medicare geographic practice cost indices S. 1629 - Same Care, Lower Cost Act - Sen. Kennedy, John - Medicare site-neutral payment reform S. 1637 - MVP Act - Sen. Mullin, Markwayne - Medicaid value-based purchasing agreements S. 1709 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Sen. Padilla, Alex - Nurse staffing ratio requirements S. 1816 - Improving Seniors' Timely Access to Care Act - Sen. Marshall, Roger - MA prior authorization S. 1903 - A bill to prohibit changes to Medicare and Medicaid in reconciliation - Sen. Reed, Jack - Medicare and Medicaid safeguards against reconciliation cuts S. 2237 - Hospital Inpatient Services Modernization Act - Sen. Scott, Tim - Acute hospital care at home waiver S. 2279 - Protect Medicaid and Rural Hospitals Act - Sen. Hawley, Josh - Medicaid provider tax and State directed payments S. 2289 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - Medicaid/CHIP maternal health coverage improvements S. 2496 - Keep Kids Covered Act - Sen. Bennet, Michael - Continuous eligibility for children in Medicaid/CHIP S. 2497 - Fair Billing Act - Sen. Hassan, Maggie - Medicare site-neutral transparency and identification requirements S. 2556 - Protecting Healthcare and Lowering Costs Act - Sen. Schumer, Charles - repeal of Medicaid provisions in the One Big Beautiful Bill Act S. 2793 - Ensuring Access to Essential Providers Act - Sen. Cassidy, Bill - Essential community provider coverage requirements for MA S. 3642 - WALZ Act - Sen. Marshall, Roger - Medicaid payment investigation and audits S. 3690 - Ensuring Access to Medicaid Buy-in Programs - Sen. Blackburn, Marsha - Medicaid eligibility parameters S. 3727 - Putting an N to Learing about Fraud Act - Sen. Ernst, Joni - Federal program fraud prevention S. 3729 - PBM Reporting Transparency Act - Sen. Warner, Mark - MedPAC reports on PBMs S. 3750 - REAL Health Providers Act - Sen. Bennet, Michael - MA provider directory accuracy S. 3762 - Prior Authorization Relief Act - Sen. Whitehouse, Sheldon - MA prior authorization restrictions S. 3848 - Apples to Apples Comparison Act - Sen. Scott, Tim - Medicare and Medicare Advantage spending reports S. 3886 - Nurses Belong in Nursing Homes Act - Sen. Wyden, Ron - Nursing home staffing hours S. 4384 - Medicare Advantage Improvement Act - Sen. Marshall, Roger - MA programmatic reforms Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicare Transparency in Coverage; Waste Fraud and Abuse; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; value of Medicare Advantage; Medicare Advantage Health Risk Assessment and chart reviews; Medicare Advantage supplemental benefits and Social Determinants of health; CBO estimates of MA and FFS costs; coverage of weight loss drugs; Inflation Reduction Act implementation; Medicare Advantage Rate Notice; Part D Payment Issues; Part D VBID Issues; RADV; MA payment issues; Part D issues; prior authorization; MA prompt pay; agent/broker issues; MA reporting requirements; MA provider networks and network adequacy; implementation of the One Big Beautiful Bill Act; Medicaid provider taxes; Medicaid community engagement requirements; and VA's community care program.

Client expense: $3,010,000 · Firm income: Not reported

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

Medicare Advantage (MA) Policy and Reimbursement Medicare Part D Issues Medicaid Policy Issues Including Dual Eligibles Pharmacy Benefit Managers (PBM) and Pharmacy Policy and Reimbursement Issues Home Health Policy and Reimbursement Issues Implementation of Inflation Reduction Act of 2022 Public Law No. 117-169 H.R. 3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025 (119th Congress) Prior Authorization Policy and Regulatory Issues CMS-4185-F2 Medicare Advantage Risk Adjustment Data Validation Final Rule Primary Care and Value-Based Care Policy and Reimbursement Clinical Policy Issues Including Workforce and Mental Health Hospital Outpatient Prospective Payment System (OPPS): Remedy for the 340B-Acquired Drug Payment Policy for Calendar Years 2018-2022 Final Rule (CMS 1793-F) Implementation of CMS Interoperability and Prior Authorization final rule (CMS-0057-F) Contract Year 2025 Medicare Advantage and Part D Final Rule (CMS-4205-F) Announcement of Calendar Year (CY) 2025 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies Final Calendar Year (CY) 2025 Part D Redesign Program Instructions PL 119-21, One Big Beautiful Bill Act S.1105, No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act H.R. 3467, Medicare Advantage Reform Act Policy issues related to VA-eligible Medicare beneficiaries Final Calendar Year (CY) 2026 Part D Redesign Program Instructions Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly (CMS-4208-F) Final Guidance for Medicare Drug Price Negotiation Program guidance for initial price applicability year 2028 CMS Health Tech Ecosystem initiative H.R. 1732, GUARD VA Benefits Act H.R. 5454/S. 2789, Medicare Advantage Prompt Pay Act Calendar Year (CY) 2026 Home Health Prospective Payment System Final Rule (CMS-1828-F) Contract Year 2027 Medicare Advantage and Part D Final Rule (CMS-4208-F3/CMS-4212-F) Calendar Year (CY) 2027 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the CY 2027 Rate Announcement) Fiscal Year (FY) 2027 Skilled Nursing Facility Prospective Payment System Proposed Rule (CMS 1843-P) Fiscal Year (FY) 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements Proposed Rule (CMS-1851-P) 2026 CMS Interoperability Standards and Prior Authorization for Drugs Proposed Rule (CMS-0062-P) Medicare Drug Price Negotiation Program Proposed Rule (CMS-4215-P) Healthcare cybersecurity and Artificial Intelligence (AI) policy issues Pharmacy Benefit Manager Compensation and Data Collection (CMS-4218-NC)

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

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

Medicare and Medicaid dual eligible integration; Issues related to Medicare Advantage, including automatic enrollment and assignment, benchmark setting for payment, health risk assessments and chart review, hospice and MA, prior authorization, quality and star ratings, two years of data for payment; S. 1105, No UPCODE Act; H.R. 3467, To amend title XVIII to reform the Medicare Advantage program; Medicare Advantage (MA) quality Star ratings

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 8883, Protecting Seniors and Stopping Fraudsters Act; Medicare Home Health benefit; Medicaid Home and Community-Based Services (HCBS) benefits; Medicare Hospice benefit; Home Health Perspective Payment System (HH PPS) Final Rule for CY 2026 (CMS-1828-F); H.R. 3467, To amend title XVIII to reform the Medicare Advantage program; H.R. 5142, Home Health Stabilization Act of 2025; Hospice MA Carve-in; Issues related to Medicare and Medicaid fraud; Issues related to Senate Finance Dear Colleague Process

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Issues concerning access to and reimbursement for the Medicare Hospice benefit. Medicare Advantage and the hospice benefit. H.R. 3467, to amend Title XVIII to reform the Medicare Advantage program as it relates to hospice services. Monitored the Hospice Special Focus Program. Issues regarding program integrity. National Moratorium on Hospice and Home Health Agency Enrollment. Issues related to regulatory relief. H.R.1720, Hospice Recertification Flexibility Act. Issues regarding telehealth and hospice care. S.1261, CONNECT for Health Act of 2025; H.R. 5081 / S. 2709, Telehealth Modernization Act. S. 1935, Expanding Access to Palliative Care Act. Monitored H.R. 7148 (P.L. 119-75), Consolidated Appropriations Act of 2026, as it relates to implementation of Medicare extenders. S. 4118 / H.R. 7966, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act of 2026. H.R. 8883, Protecting Seniors and Stopping Fraudsters Act. FY'27 Hospice and Wage Index Payment Rate Proposed Rule.

Client expense: $230,000 · Firm income: Not reported

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

Issues concerning access to and reimbursement for the Medicare Hospice benefit. Medicare Advantage and the hospice benefit. H.R. 3467, to amend Title XVIII to reform the Medicare Advantage program as it relates to hospice services. Monitored the Hospice Special Focus Program. Issues regarding program integrity. National Moratorium on Hospice and Home Health Agency Enrollment. Issues related to regulatory relief. H.R.1720, Hospice Recertification Flexibility Act. Issues regarding telehealth and hospice care. S.1261, CONNECT for Health Act of 2025; H.R. 5081 / S. 2709, Telehealth Modernization Act. S. 1935, Expanding Access to Palliative Care Act. Monitored H.R. 7148 (P.L. 119-75), Consolidated Appropriations Act of 2026, as it relates to implementation of Medicare extenders. S. 4118 / H.R. 7966, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act of 2026. H.R. 8883, Protecting Seniors and Stopping Fraudsters Act. FY'27 Hospice and Wage Index Payment Rate Proposed Rule.

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

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

Issues concerning access to and reimbursement for the Medicare Hospice benefit. H.R. 3467, to amend Title XVIII to reform the Medicare Advantage program as it relates to hospice services. Medicare Advantage and the hospice benefit. Issues regarding program integrity. National Moratorium on Hospice and Home Health Enrollment. Monitored The Hospice Special Focus Program. Issues related to regulatory relief and audit burden. H.R. 1720, Hospice Recertification Flexibility Act. Issues regarding telehealth and hospice care. S. 1261, CONNECT for Health Act of 2025; H.R. 5081 / S. 2709, Telehealth Modernization Act. S. 1935, Expanding Access to Palliative Care Act. Monitored H.R. 7148 (P.L. 119-75), Consolidated Appropriations Act of 2026, as it relates to implementation of Medicare extenders. S. 4118 / H.R. 7966, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act of 2026. H.R. 8883, Protecting Seniors and Stopping Fraudsters Act. FY'27 Hospice Wage Index and Payment Rate Proposed Rule.

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

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

Medicare and Medicaid dual eligible integration; Issues related to Medicare Advantage, including automatic enrollment and assignment, benchmark setting for payment, health risk assessments and chart review, hospice and MA, prior authorization, quality and star ratings, two years of data for payment; S. 1105, No UPCODE Act; H.R. 3467, To amend title XVIII to reform the Medicare Advantage program; Medicare Advantage (MA) quality Star ratings

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to Third Party Marketing Organizations Issues relating to The Patient Protection and Affordable Care Act Issues relating to Healthcare.gov and Medicare.gov under the Labor/HHS Appropriations Act Issues related to efficient online and telephonic enrollment into Medicare Advantage and Medicare Prescription Drug Plans Issues related to Medicare Advantage and Part D Plan broker compensation Issues related to lead generation policies Issues relating to the Telephone Consumer Protection Act regarding lead generation for health plan coverage Issues related to Individual CHOICE HRAs (ICHRA), including S. 2875, the CHOICE Act, and H.R. 5463, The CHOICE Arrangements Act of 2025 Issues pertaining to short-term limited duration plans Issues relating to H.R. 2079 and S. 976, the Insurance Fraud Accountability Act Issues pertaining to HR 3467, to amend tile XVIII to reform the Medicare Advantage program Issues pertaining to H.R. 5498, the Small Business Health Options Awareness Act of 2025 Issues pertaining to H.R. 9395, the Transparency in Medicare Advantage Steering Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

Work on hospital payment matters, including Rural Health Transformation funding and Medicaid provider tax provisions as passed under HR 1, the Working Families Tax Cut Act. Also, work on Medicare Advantage and value-based care models, including HR 3467.

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

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

Support for extending the telehealth flexibility for the face-to-face (F2F) encounter required during recertification of hospice eligibility - H.R.4206/S. 1261 - CONNECT for Health Act of 2025; issues around hospice payment and benefits legislation; H.R. 3467 a bill concerning hospice and MA; H.R. 8883 The Protecting Seniors and Stopping Fraudsters Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid dual eligible integration; Issues related to Medicare Advantage, including automatic enrollment and assignment, benchmark setting for payment, health risk assessments and chart review, hospice and MA, prior authorization, quality and star ratings, two years of data for payment; S. 1105, No UPCODE Act; H.R. 3467, To amend title XVIII to reform the Medicare Advantage program; Medicare Advantage (MA) quality Star ratings

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Home Health benefit; Medicaid Home and Community-Based Services (HCBS) benefits; Medicare Hospice benefit; Home Health Perspective Payment System (HH PPS) Final Rule for CY 2026 (CMS-1828-F); H.R. 3467, To amend title XVIII to reform the Medicare Advantage program; H.R. 5142, Home Health Stabilization Act of 2025; Hospice MA Carve-in

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS Medicare compare website H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 497 - Medicaid Third Party Liability Act - Rep. Crenshaw, Dan - Medicaid liable third-party exceptions H.R. 538 - Critical Access Hospital Relief Act - Rep. Smith, Adrian - Medicare physician certification requirement H.R. 584 - No Medicaid for Illegal Immigrants Act - Rep. Kiley, Kevin - Medicaid eligibility requirements H.R. 608 - COVER Now Act - Rep. Doggett, Lloyd - Medicaid expansion demo H.R. 610 - Close the Medigap Act - Rep. Doggett, Lloyd - Medigap plan reform H.R. 879 - Medicare Patient Access and Practice Stabilization Act - Rep. Murphy, Gregory - Medicare physician reimbursement H.R. 936 - Medicaid Improvement and State Flexibility Act - Rep. Green, Mark - Medicaid demonstration programs H.R. 1019 - Medicaid Program Improvement Act - Rep. Miller-Meeks, Mariannette - Medicaid management care reporting H.R. 1059 - Jobs and Opportunities for Medicaid Act - Rep. Crenshaw, Dan - Medicaid eligibility requirements H.R. 1162 - Medicaid Primary Care Improvement Act - Rep. Crenshaw, Dan - Medicaid direct primary care arrangements H.R. 1191 - Supporting Access to Rural Community Hospitals Act - Rep. Flood, Mike - Medicare critical access hospitals definition H.R. 1195 - Protect Medicaid Act - Rep. Hudson, Richard - Medicaid eligibility requirements H.R. 1279 - To amend title XIX of the Social Security Act to establish a community engagement requirement for certain individuals under the Medicaid program. - Rep. Bean, Aaron - Medicaid eligibility requirements H.R. 1403 - LIVE Beneficiaries Act - Rep. Bilirakis, Gus - Medicaid registration audits H.R. 1598 - Ensuring Access to Medicaid Buy-in Programs Act - Rep. Ciscomani, Juan - Medicaid eligibility requirements H.R. 1683 - Protecting Rural Seniors Access to Care Act - Rep. Fischbach, Michelle - Minimum nursing home staffing H.R. 1775 - Second Chances for Rural Hospitals Act - Rep. Arrington, Jodey -Definition of rural emergency hospitals H.R. 1805 - ARCH Act - Rep. Miller, Carol - Extend Medicare-dependent and low-value hospitals payments H.R. 1924 - Securing Access to Care for Seniors in Critical Condition Act - Rep. Hern, Kevin - Medicare site-neutral payments for LTC hospitals H.R. 2045 - Medicare Dental, Vision, and Hearing Benefit Act - Rep. Doggett, Lloyd - Medicare dental, vision, and hearing coverage H.R. 2263 - Telehealth Coverage Act - Rep. Khanna, Ro - Telehealth flexibilities in Medicare H.R. 2309 - Medicare and Medicaid Fraud Prevention Act - Rep. Peters, Scott - provider screening for Federal programs H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act - Rep. Green, Mark - Medicare Advantage prior authorization H.R. 2533 - EASE Act - Rep. Arrington, Jodey - CMS model for virtual technology H.R. 2586 - Reentry Act - Rep. Tonko, Paul - Medicaid coverage for incarcerated population H.R. 2590 - Mental and Physical Health Care Comorbidities Act - Rep. Boyle, Brendan - CMS demonstration to treat comorbidities H.R. 2610 - Protecting Options for Seniors Act - Rep. Tenney, Claudia - MA wage index reclassification H.R. 3023 - Preventing Hospital Overbilling of Medicare Act - Rep. Spartz, Victoria - Site-neutral payment reform H.R. 3069 - Medicare for All Act - Rep. Jayapal, Pramila - New national health insurance program H.R. 3222 - SMART Health Care Act - Rep. Spartz, Victoria - MA risk adjustment H.R. 3263 - PATCH Act - Rep. Tokuda, Jill - Medicare geographic practice cost indices H.R. 3321 - Ending Medicaid Discrimination Against the Most Vulnerable Act - Rep. Roy, Chip - Enhance FMAP phase out H.R. 3415 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Rep. Schakowsky, Janice - Nurse staffing ratio requirements H.R. 3467 - To amend title XVIII to reform the Medicare Advantage program - Rep. Schweikert, David - MA reforms H.R. 3808 - Expanding Seniors Access to Mental Health Services Act - Rep. Fitzpatrick, Brian - Medicare mental health services H.R. 4093 - Apples to Apples Comparison Act - Rep. Bean, Aaron - Medicare and Medicare Advantage spending reports H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4277 - Rural Emergency Hospital Financial Stability Act - Rep. Davis, Donald - Medicaid treatment of rural emergency hospitals H.R. 4313 - Hospital Inpatient Services Modernization Act - Rep. Buchanan, Vern - Acute hospital care at home waiver H.R. 4559 - Prompt and Fair Pay Act - Rep. Doggett, Lloyd - Payment parity for MA and FFS; MA reimbursement requirements H.R. 4641 - Keep Kids Covered Act - Rep. Castor, Kathy - Continuous eligibility for children in Medicaid/CHIP H.R. 4807 - Protect Our Hospitals Act - Rep. Landsman, Greg - Medicaid provider tax repeal H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. - Rep. McClellan, Jennifer - MA supplemental benefits data reporting H.R. 5281 - REAL Health Providers Act - Rep. Panetta, Jimmy - MA provider directory requirements H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - Impact of Third Party Liability on MCOs H.R. 6109 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to rates of reversed prior authorization coverage determinations under Medicare Advantage plans. - Rep. Pocan, Mark -prior authorization under Medicare Advantage H.R. 6110 -To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage. - Rep. Pocan, Mark - reconsider denials under Medicare Advantage H.R. 6111 - To amend title XVIII of the Social Security Act to require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan. - Rep. Pocan, Mark - advertise rates of prior authorization denials under Medicare Advantage H.R. 6112 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to the average monthly cost to provide coverage to an enrollee under Medicare Advantage plans. - Rep. Pocan, Mark - require monthly coverage cost to enrollees under Medicare Advantage H.R. 6113 - To amend title XVIII of the Social Security Act to impose limitations on contracts with Medicare Advantage organizations offering multiple Medicare Advantage plans under the Medicare program. - Rep. Pocan, Mark - limit multiple Medicare Advantage plans H.R. 6114 - To prohibit funds made available to the Department of Health and Human Services by previous Appropriations Acts from being used for any activity that makes Medicare Advantage the default under the Medicare program. - Rep. Pocan, Mark - prohibit Medicare Advantage from becoming the default H.R. 6254 - Medicaid Staffing Flexibility and Protection Act of 2025 - Rep. Carter, Earl - extend eligibility determinations and redeterminations for Medicaid H.R. 6361 - Ban AI Denials in Medicare Act - Rep. Landsman, Greg - limit WISeR model H.R. 6951 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - State Medicaid cost recoupment H.R. 6974 - Improving MA SNP Act of 2026 - Rep. Arrington, Jodey - MA SNP beneficiary approval H.R. 7189 - PrEP Access Act - Rep. Pocan, Mark - HIV prevention services under Medicare H.R. 7409 - Defend Rural Health Act - Rep. Taylor, Dave - Medicare definition of rural hospital H.R. 7727 - Sustaining Rural Healthcare Act - Rep. Alford, Mark - Medicare CAH designation H.R. 7778 - Medicaid PNA Modernization Act - Rep. Subramanyam, Suhas - Medicaid minimum monthly personal needs allowance H.R. 7803 - Save Medicare Act - Rep. Pocan, Mark - Renames Medicare Advantage H.R. 7871 - MVP Act - Rep. Guthrie, Brett - Value-based purchasing arrangements in Medicaid S. 523 - Protect Medicaid Act - Sen. Cassidy, Bill - Medicaid eligibility requirements S. 678 - LIVE Beneficiaries Act - Sen. Scott, Rick - Medicaid enrollment audits S. 717 - Increasing Access to Quality Cardiac Rehabilitation Care Act - Sen. Capito, Shelley Moore - Expanding cardiac care coverage in Medicare S. 750 - Protecting Rural Seniors Access to Care Act - Sen. Fischer, Deb - Medicaid nursing home staff requirements S. 752 - Accelerating Kids Access to Care Act - Sen. Grassley, Chuck - Out-of-state provider access for Medicaid S. 939 - Medicare Dental, Hearing, and Vision Expansion Act - Sen. Sanders, Bernard - Medicare coverage requirements S. 1082 - Safeguarding Medicaid Act - Sen. Barrasso, John - Medicaid enrollee asset verification S. 1105 - No UPCODE Act - Sen. Cassidy, Bill - MA risk adjustment S. 1264 - Mental and Physical Health Care Comorbidities Act - Sen. Bennet, Michael - CMS demonstration to treat comorbidities S. 1399 - Health Tech Investment Act - Sen. Rounds, Mike - Medicare coverage for algorithm-based services S. 1506 - Medicare for All Act - Sen. Sanders, Bernard - New national health insurance program S. 1624 - PATCH Act - Sen. Schatz, Brian - Medicare geographic practice cost indices S. 1629 - Same Care, Lower Cost Act - Sen. Kennedy, John - Medicare site-neutral payment reform S. 1637 - MVP Act - Sen. Mullin, Markwayne - Medicaid value-based purchasing agreements S. 1709 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Sen. Padilla, Alex - Nurse staffing ratio requirements S. 1816 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - MA prior authorization S. 1903 - A bill to prohibit changes to Medicare and Medicaid in reconciliation - Sen. Reed, Jack - Medicare and Medicaid safeguards against reconciliation cuts S. 2237 - Hospital Inpatient Services Modernization Act - Sen. Scott, Tim - Acute hospital care at home waiver S. 2279 - Protect Medicaid and Rural Hospitals Act - Sen. Hawley, Josh - Medicaid provider tax and State directed payments S. 2289 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - Medicaid/CHIP maternal health coverage improvements S. 2496 - Keep Kids Covered Act - Sen. Bennet, Michael - Continuous eligibility for children in Medicaid/CHIP S. 2497 - Fair Billing Act - Sen. Hassan, Maggie - Medicare site-neutral transparency and identification requirements S. 2556 - Protecting Healthcare and Lowering Costs Act - Sen. Schumer, Charles - repeal of Medicaid provisions in the One Big Beautiful Bill Act S. 2793 - Ensuring Access to Essential Providers Act - Sen. Cassidy, Bill - Essential community provider coverage requirements for MA S. 3642 - WALZ Act - Sen. Marshall, Roger - Medicaid payment investigation and audits S. 3690 - Ensuring Access to Medicaid Buy-in Programs - Sen. Blackburn, Marsha - Medicaid eligibility parameters S. 3727 - Putting an N to Learing about Fraud Act - Sen. Ernst, Joni - Federal program fraud prevention S. 3729 - PBM Reporting Transparency Act - Sen. Warner, Mark - MedPAC reports on PBMs S. 3750 - REAL Health Providers Act - Sen. Bennet, Michael - MA provider directory accuracy S. 3762 - Prior Authorization Relief Act - Sen. Whitehouse, Sheldon - MA prior authorization restrictions S. 3848 - Apples to Apples Comparison Act - Sen. Scott, Tim - Medicare and Medicare Advantage spending reports S. 3886 - Nurses Belong in Nursing Homes Act - Sen. Wyden, Ron - Nursing home staffing hours Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicare Transparency in Coverage; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; value of Medicare Advantage; Medicare Advantage Health Risk Assessment and chart reviews; Medicare Advantage supplemental benefits and Social Determinants of health; CBO estimates of MA and FFS costs; coverage of weight loss drugs; Inflation Reduction Act implementation; Medicare Advantage Rate Notice; Part D Payment Issues; Part D VBID Issues; RADV; MA payment issues; Part D issues; prior authorization; MA prompt pay; agent/broker issues; implementation of the One Big Beautiful Bill Act; provider taxes; Medicaid community engagement requirements; and VAs community care program.

Client expense: $5,320,000 · 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 access to and reimbursement for the Medicare Hospice benefit. H.R. 3467, to amend Title XVIII to reform the Medicare Advantage program as it relates to hospice services. Medicare Advantage and the hospice benefit. Issues regarding program integrity. The Hospice Special Focus Program. Issues related to regulatory relief and audit burden. H.R. 1720, Hospice Recertification Flexibility Act. Issues regarding telehealth and hospice care. S. 1261, CONNECT for Health Act of 2025; H.R. 5081 / S. 2709, Telehealth Modernization Act. S. 1935, Expanding Access to Palliative Care Act. H.R. 5371 (P.L. 119-37), Continuing Appropriations Act, 2026, as it relates to Medicare extenders. H.R. 7148 (P.L. 119-75), Consolidated Appropriations Act of 2026, as it relates to Medicare extenders. S. 4118 / H.R. 7966, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act of 2026.

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

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

Issues concerning access to and reimbursement for the Medicare Hospice benefit. Medicare Advantage and the hospice benefit. Monitored the Hospice Special Focus Program. Issues regarding program integrity. Issues related to regulatory relief. H.R.1720, Hospice Recertification Flexibility Act. H.R. 3467, to amend Title XVIII to reform the Medicare Advantage program as it relates to hospice services. Issues regarding telehealth and hospice care. S.1261, CONNECT for Health Act of 2025;H.R. 5081 / S. 2709, Telehealth Modernization Act. S. 1935, Expanding Access to Palliative Care Act. H.R. 5371 (P.L. 119-37), Continuing Appropriations Act, 2026,as it relates to Medicare extenders. H.R. 7148 (P.L. 119-75), Consolidated Appropriations Act of 2026, as it relates to Medicare extenders. S. 4118 / H.R. 7966,Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act of 2026.

Client expense: $205,000 · Firm income: Not reported

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

Issues concerning access to and reimbursement for the Medicare Hospice benefit. Medicare Advantage and the hospice benefit. Monitored the Hospice Special Focus Program. Issues regarding program integrity. Issues related to regulatory relief. H.R.1720, Hospice Recertification Flexibility Act. H.R. 3467, to amend Title XVIII to reform the Medicare Advantage program as it relates to hospice services. Issues regarding telehealth and hospice care. S.1261, CONNECT for Health Act of 2025; H.R. 5081 / S. 2709, Telehealth Modernization Act. S. 1935, Expanding Access to Palliative Care Act. H.R. 5371 (P.L. 119-37), Continuing Appropriations Act, 2026, as it relates to Medicare extenders. H.R. 7148 (P.L. 119-75), Consolidated Appropriations Act of 2026, as it relates to Medicare extenders. S. 4118 / H.R. 7966, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act of 2026.

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

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

Medicare Advantage (MA) Policy and Reimbursement Medicare Part D Issues Medicaid Policy Issues Including Dual Eligibles Pharmacy Benefit Managers (PBM) and Pharmacy Policy and Reimbursement Issues Home Health Policy and Reimbursement Issues Implementation of Inflation Reduction Act of 2022 Public Law No. 117-169 H.R. 3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025 (119th Congress) Prior Authorization Policy and Regulatory Issues CMS-4185-F2 Medicare Advantage Risk Adjustment Data Validation Final Rule Primary Care and Value-Based Care Policy and Reimbursement Clinical Policy Issues Including Workforce and Mental Health Hospital Outpatient Prospective Payment System (OPPS): Remedy for the 340B-Acquired Drug Payment Policy for Calendar Years 2018-2022 Final Rule (CMS 1793-F) Implementation of CMS Interoperability and Prior Authorization final rule (CMS-0057-F) Calendar Year (CY) 2025 Home Health Prospective Payment System Final Rule (CMS-1803-F) Contract Year 2025 Medicare Advantage and Part D Final Rule (CMS-4205-F) Announcement of Calendar Year (CY) 2025 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies Final Calendar Year (CY) 2025 Part D Redesign Program Instructions Fiscal Year (FY) 2025 Hospice Payment Rate Update Final Rule (CMS-1810-F) PL 119-21, One Big Beautiful Bill Act S.1105, No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act H.R. 3467, Medicare Advantage Reform Act Policy issues related to VA-eligible Medicare beneficiaries Final Calendar Year (CY) 2026 Part D Redesign Program Instructions Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly (CMS-4208-F) Fiscal Year (FY) 2026 Skilled Nursing Facility (SNF) Prospective Payment System Final Rule (CMS-1827-F) Final Guidance for Medicare Drug Price Negotiation Program guidance for initial price applicability year 2028 CMS Health Tech Ecosystem initiative H.R. 1732, GUARD VA Benefits Act H.R. 5454/S. 2789, Medicare Advantage Prompt Pay Act Calendar Year (CY) 2026 Home Health Prospective Payment System Final Rule (CMS-1828-F) Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program (CMS-4212-P) Calendar Year (CY) 2027 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the CY 2027 Advance Notice)

Client expense: $2,550,000 · Firm income: Not reported

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

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

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

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

Issues relating to Third Party Marketing Organizations Issues relating to The Patient Protection and Affordable Care Act Issues relating to Healthcare.gov and Medicare.gov under the Labor/HHS Appropriations Act Issues related to efficient online and telephonic enrollment into Medicare Advantage and Medicare Prescription Drug Plans Issues related to Medicare Advantage and Part D Plan broker compensation Issues related to lead generation policies Issues relating to the Telephone Consumer Protection Act regarding lead generation for health plan coverage Issues related to Individual CHOICE HRAs (ICHRA), including S. 2875, the CHOICE Act, and H.R. 5463, The CHOICE Arrangements Act of 2025 Issues pertaining to short-term limited duration plans Issues relating to H.R. 2079 and S. 976, the Insurance Fraud Accountability Act Issues pertaining to HR 3467, to amend tile XVIII to reform the Medicare Advantage program Issues pertaining to H.R. 5498, the Small Business Health Options Awareness Act of 2025

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

Work on hospital payment matters, including Rural Health Transformation funding and Medicaid provider tax provisions as passed under HR 1, the Working Families Tax Cut Act. Also, work on Medicare Advantage and value-based care models, including HR 3467.

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

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

Support for extending the telehealth flexibility for the face-to-face (F2F) encounter required during recertification of hospice eligibility - H.R.4206/S. 1261 - CONNECT for Health Act of 2025; issues around hospice payment and benefits legislation; H.R. 3467 a bill concerning hospice and MA.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to coverage of spiritual care - no specific legislation. Issues related to religious non-medical health care institutions - no specific legislation. S. 1816, Improving Seniors Timely Access to Care Act of 2025. H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R. 3467, To amend title XVIII to reform the Medicare Advantage program.

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Personnel Management (OPM), SENATE, White House Office

Issues related to coverage of spiritual care - no specific legislation. Issues related to religious non-medical health care institutions - no specific legislation. S. 1816, Improving Seniors Timely Access to Care Act of 2025. H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R. 3467, To amend title XVIII to reform the Medicare Advantage program.

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

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

Issues related to coverage of spiritual care - no specific legislation. Issues related to religious non-medical health care institutions - no specific legislation. S. 1816, Improving Seniors Timely Access to Care Act of 2025. H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R. 3467, To amend title XVIII to reform the Medicare Advantage program.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Personnel Management (OPM)

Issues related to coverage of spiritual care - no specific legislation. Issues related to religious non-medical health care institutions - no specific legislation. S. 1816, Improving Seniors Timely Access to Care Act of 2025. H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R. 3467, To amend title XVIII to reform the Medicare Advantage program.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Office of Personnel Management (OPM)

Issues related to coverage of spiritual care - no specific legislation. Issues related to religious non-medical health care institutions - no specific legislation. S. 1816, Improving Seniors Timely Access to Care Act of 2025. H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R. 3467, To amend title XVIII to reform the Medicare Advantage program.

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

Government targets: HOUSE OF REPRESENTATIVES

Issues related to coverage of spiritual care - no specific legislation. Issues related to religious non-medical health care institutions - no specific legislation. S. 1816, Improving Seniors Timely Access to Care Act of 2025. H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R. 3467, To amend title XVIII to reform the Medicare Advantage program.

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

Government targets: HOUSE OF REPRESENTATIVES

Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS Medicare compare website H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 497 - Medicaid Third Party Liability Act - Rep. Crenshaw, Dan - Medicaid liable third-party exceptions H.R. 538 - Critical Access Hospital Relief Act - Rep. Smith, Adrian - Medicare physician certification requirement H.R. 584 - No Medicaid for Illegal Immigrants Act - Rep. Kiley, Kevin - Medicaid eligibility requirements H.R. 608 - COVER Now Act - Rep. Doggett, Lloyd - Medicaid expansion demo H.R. 610 - Close the Medigap Act - Rep. Doggett, Lloyd - Medigap plan reform H.R. 879 - Medicare Patient Access and Practice Stabilization Act - Rep. Murphy, Gregory - Medicare physician reimbursement H.R. 936 - Medicaid Improvement and State Flexibility Act - Rep. Green, Mark - Medicaid demonstration programs H.R. 1019 - Medicaid Program Improvement Act - Rep. Miller-Meeks, Mariannette - Medicaid management care reporting H.R. 1059 - Jobs and Opportunities for Medicaid Act - Rep. Crenshaw, Dan - Medicaid eligibility requirements H.R. 1162 - Medicaid Primary Care Improvement Act - Rep. Crenshaw, Dan - Medicaid direct primary care arrangements H.R. 1191 - Supporting Access to Rural Community Hospitals Act - Rep. Flood, Mike - Medicare critical access hospitals definition H.R. 1195 - Protect Medicaid Act - Rep. Hudson, Richard - Medicaid eligibility requirements H.R. 1279 - To amend title XIX of the Social Security Act to establish a community engagement requirement for certain individuals under the Medicaid program. - Rep. Bean, Aaron - Medicaid eligibility requirements H.R. 1403 - LIVE Beneficiaries Act - Rep. Bilirakis, Gus - Medicaid registration audits H.R. 1598 - Ensuring Access to Medicaid Buy-in Programs Act - Rep. Ciscomani, Juan - Medicaid eligibility requirements H.R. 1683 - Protecting Rural Seniors Access to Care Act - Rep. Fischbach, Michelle - Minimum nursing home staffing H.R. 1775 - Second Chances for Rural Hospitals Act - Rep. Arrington, Jodey -Definition of rural emergency hospitals H.R. 1805 - ARCH Act - Rep. Miller, Carol - Extend Medicare-dependent and low-value hospitals payments H.R. 1924 - Securing Access to Care for Seniors in Critical Condition Act - Rep. Hern, Kevin - Medicare site-neutral payments for LTC hospitals H.R. 2045 - Medicare Dental, Vision, and Hearing Benefit Act - Rep. Doggett, Lloyd - Medicare dental, vision, and hearing coverage H.R. 2263 - Telehealth Coverage Act - Rep. Khanna, Ro - Telehealth flexibilities in Medicare H.R. 2309 - Medicare and Medicaid Fraud Prevention Act - Rep. Peters, Scott - provider screening for Federal programs H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act - Rep. Green, Mark - Medicare Advantage prior authorization H.R. 2533 - EASE Act - Rep. Arrington, Jodey - CMS model for virtual technology H.R. 2586 - Reentry Act - Rep. Tonko, Paul - Medicaid coverage for incarcerated population H.R. 2590 - Mental and Physical Health Care Comorbidities Act - Rep. Boyle, Brendan - CMS demonstration to treat comorbidities H.R. 2610 - Protecting Options for Seniors Act - Rep. Tenney, Claudia - MA wage index reclassification H.R. 3023 - Preventing Hospital Overbilling of Medicare Act - Rep. Spartz, Victoria - Site-neutral payment reform H.R. 3069 - Medicare for All Act - Rep. Jayapal, Pramila - New national health insurance program H.R. 3222 - SMART Health Care Act - Rep. Spartz, Victoria - MA risk adjustment H.R. 3263 - PATCH Act - Rep. Tokuda, Jill - Medicare geographic practice cost indices H.R. 3321 - Ending Medicaid Discrimination Against the Most Vulnerable Act - Rep. Roy, Chip - Enhance FMAP phase out H.R. 3415 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Rep. Schakowsky, Janice - Nurse staffing ratio requirements H.R. 3467 - To amend title XVIII to reform the Medicare Advantage program - Rep. Schweikert, David - MA reforms H.R. 3808 - Expanding Seniors Access to Mental Health Services Act - Rep. Fitzpatrick, Brian - Medicare mental health services H.R. 4093 - Apples to Apples Comparison Act - Rep. Bean, Aaron - Medicare and Medicare Advantage spending reports H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4277 - Rural Emergency Hospital Financial Stability Act - Rep. Davis, Donald - Medicaid treatment of rural emergency hospitals H.R. 4313 - Hospital Inpatient Services Modernization Act - Rep. Buchanan, Vern - Acute hospital care at home waiver H.R. 4559 - Prompt and Fair Pay Act - Rep. Doggett, Lloyd - Payment parity for MA and FFS; MA reimbursement requirements H.R. 4641 - Keep Kids Covered Act - Rep. Castor, Kathy - Continuous eligibility for children in Medicaid/CHIP H.R. 4807 - Protect Our Hospitals Act - Rep. Landsman, Greg - Medicaid provider tax repeal H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. - Rep. McClellan, Jennifer - MA supplemental benefits data reporting H.R. 5281 - REAL Health Providers Act - Rep. Panetta, Jimmy - MA provider directory requirements H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - Impact of Third Party Liability on MCOs H.R. 6109 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to rates of reversed prior authorization coverage determinations under Medicare Advantage plans. - Rep. Pocan, Mark -prior authorization under Medicare Advantage H.R. 6110 -To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage. - Rep. Pocan, Mark - reconsider denials under Medicare Advantage H.R. 6111 - To amend title XVIII of the Social Security Act to require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan. - Rep. Pocan, Mark - advertise rates of prior authorization denials under Medicare Advantage H.R. 6112 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to the average monthly cost to provide coverage to an enrollee under Medicare Advantage plans. - Rep. Pocan, Mark - require monthly coverage cost to enrollees under Medicare Advantage H.R. 6113 - To amend title XVIII of the Social Security Act to impose limitations on contracts with Medicare Advantage organizations offering multiple Medicare Advantage plans under the Medicare program. - Rep. Pocan, Mark - limit multiple Medicare Advantage plans H.R. 6114 - To prohibit funds made available to the Department of Health and Human Services by previous Appropriations Acts from being used for any activity that makes Medicare Advantage the default under the Medicare program. - Rep. Pocan, Mark - prohibit Medicare Advantage from becoming the default H.R. 6254 - Medicaid Staffing Flexibility and Protection Act of 2025 - Rep. Carter, Earl - extend eligibility determinations and redeterminations for Medicaid H.R. 6361 - Ban AI Denials in Medicare Act - Rep. Landsman, Greg - limit WISeR model S. 523 - Protect Medicaid Act - Sen. Cassidy, Bill - Medicaid eligibility requirements S. 678 - LIVE Beneficiaries Act - Sen. Scott, Rick - Medicaid enrollment audits S. 717 - Increasing Access to Quality Cardiac Rehabilitation Care Act - Sen. Capito, Shelley Moore - Expanding cardiac care coverage in Medicare S. 750 - Protecting Rural Seniors Access to Care Act - Sen. Fischer, Deb - Medicaid nursing home staff requirements S. 752 - Accelerating Kids Access to Care Act - Sen. Grassley, Chuck - Out-of-state provider access for Medicaid S. 939 - Medicare Dental, Hearing, and Vision Expansion Act - Sen. Sanders, Bernard - Medicare coverage requirements S. 1082 - Safeguarding Medicaid Act - Sen. Barrasso, John - Medicaid enrollee asset verification S. 1105 - No UPCODE Act - Sen. Cassidy, Bill - MA risk adjustment S. 1264 - Mental and Physical Health Care Comorbidities Act - Sen. Bennet, Michael - CMS demonstration to treat comorbidities S. 1399 - Health Tech Investment Act - Sen. Rounds, Mike - Medicare coverage for algorithm-based services S. 1506 - Medicare for All Act - Sen. Sanders, Bernard - New national health insurance program S. 1624 - PATCH Act - Sen. Schatz, Brian - Medicare geographic practice cost indices S. 1629 - Same Care, Lower Cost Act - Sen. Kennedy, John - Medicare site-neutral payment reform S. 1637 - MVP Act - Sen. Mullin, Markwayne - Medicaid value-based purchasing agreements S. 1709 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Sen. Padilla, Alex - Nurse staffing ratio requirements S. 1816 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - MA prior authorization S. 1903 - A bill to prohibit changes to Medicare and Medicaid in reconciliation - Sen. Reed, Jack - Medicare and Medicaid safeguards against reconciliation cuts S. 2237 - Hospital Inpatient Services Modernization Act - Sen. Scott, Tim - Acute hospital care at home waiver S. 2279 - Protect Medicaid and Rural Hospitals Act - Sen. Hawley, Josh - Medicaid provider tax and State directed payments S. 2289 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - Medicaid/CHIP maternal health coverage improvements S. 2496 - Keep Kids Covered Act - Sen. Bennet, Michael - Continuous eligibility for children in Medicaid/CHIP S. 2497 - Fair Billing Act - Sen. Hassan, Maggie - Medicare site-neutral transparency and identification requirements S. 2556 - Protecting Healthcare and Lowering Costs Act - Sen. Schumer, Charles - repeal of Medicaid provisions in the One Big Beautiful Bill Act S. 2793 - Ensuring Access to Essential Providers Act - Sen. Cassidy, Bill - Essential community provider coverage requirements for MA Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicare Transparency in Coverage; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; value of Medicare Advantage; Medicare Advantage Health Risk Assessment and chart reviews; Medicare Advantage supplemental benefits and Social Determinants of health; CBO estimates of MA and FFS costs; coverage of weight loss drugs; Inflation Reduction Act implementation; Medicare Advantage Rate Notice; Part D Payment Issues; Part D VBID Issues; RADV; MA payment issues; Part D issues; prior authorization; MA prompt pay; agent/broker issues; implementation of the One Big Beautiful Bill Act; provider taxes; Medicaid community engagement requirements; and VAs community care program.

Client expense: $4,120,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA), White House Office

Medicare and Medicaid dual eligible integration; Issues related to Medicare Advantage, including automatic enrollment and assignment, benchmark setting for payment, health risk assessments and chart review, hospice and MA, prior authorization, quality and star ratings, two years of data for payment; S. 1105, No UPCODE Act; H.R. 3467, To amend title XVIII to reform the Medicare Advantage program.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Home Health benefit; Medicaid Home and Community-Based Services (HCBS) benefits; Medicare Hospice benefit; Home Health Perspective Payment System (HH PPS) Final Rule for CY 2026 (CMS-1828-F); H.R. 3467, To amend title XVIII to reform the Medicare Advantage program; H.R. 5142, Home Health Stabilization Act of 2025; Hospice MA Carve-in

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Advantage (MA) Policy and Reimbursement Enactment of policies in Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies Medicare Part D Issues Medicaid Policy Issues Including Dual Eligibles Pharmacy Benefit Managers (PBM) and Pharmacy Policy and Reimbursement Issues Home Health Policy and Reimbursement Issues Implementation of Inflation Reduction Act of 2022 Public Law No. 117-169 H.R. 3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025 (119th Congress) Prior Authorization Policy and Regulatory Issues CMS-4185-F2 Medicare Advantage Risk Adjustment Data Validation Final Rule Primary Care and Value-Based Care Policy and Reimbursement Clinical Policy Issues Including Workforce and Mental Health Calendar Year (CY) 2024 Home Health Prospective Payment System Final Rule (CMS-1780-F) Hospital Outpatient Prospective Payment System (OPPS): Remedy for the 340B-Acquired Drug Payment Policy for Calendar Years 2018-2022 Final Rule (CMS 1793-F) Implementation of CMS Interoperability and Prior Authorization final rule (CMS-0057-F) Calendar Year (CY) 2025 Home Health Prospective Payment System Final Rule (CMS-1803-F) Contract Year 2025 Medicare Advantage and Part D Final Rule (CMS-4205-F) Announcement of Calendar Year (CY) 2025 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies Final Calendar Year (CY) 2025 Part D Redesign Program Instructions Fiscal Year (FY) 2025 Hospice Payment Rate Update Final Rule (CMS-1810-F) PL 119-21, One Big Beautiful Bill Act S.1105, No Unreasonable Payments, Coding, or Diagnoses for the Elderly Act H.R. 3467, Medicare Advantage Reform Act Policy issues related to VA-eligible Medicare beneficiaries Final Calendar Year (CY) 2026 Part D Redesign Program Instructions Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly (CMS-4208-F) Announcement of Calendar Year (CY) 2026 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (CY 2026 Rate Announcement) Fiscal Year (FY) 2026 Skilled Nursing Facility (SNF) Prospective Payment System Final Rule (CMS-1827-F) Final Guidance for Medicare Drug Price Negotiation Program guidance for initial price applicability year 2028 CMS Health Tech Ecosystem initiative H.R. 1732, GUARD VA Benefits Act H.R. 5454/S. 2789, Medicare Advantage Prompt Pay Act Calendar Year (CY) 2026 Home Health Prospective Payment System Final Rule (CMS-1828-F) Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F) Medicare Shared Savings Program Changes Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program (CMS-4212-P)

Client expense: $800,000 · Firm income: Not reported

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

Issues concerning access to and reimbursement for the Medicare Hospice benefit. Medicare Advantage and the hospice benefit. The Hospice Special Focus Program. Issues regarding program integrity. Issues related to regulatory relief. H.R.1720, Hospice Recertification Flexibility Act. H.R. 3467, to amend Title XVIII to reform the Medicare Advantage program as it relates to hospice services. Issues regarding telehealth and hospice care. S.1261, CONNECT for Health Act of 2025; H.R.5081 / S. 2709, Telehealth Modernization Act. S. 1935, Expanding Access to Palliative Care Act. H.R. 5371 (P.L. 119-37), Continuing Appropriations Act, 2026, as it relates to Medicare extenders.

Client expense: $205,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Issues concerning access to and reimbursement for the Medicare Hospice benefit. Medicare Advantage and the hospice benefit. The Hospice Special Focus Program. Issues regarding program integrity. Issues related to regulatory relief. H.R.1720, Hospice Recertification Flexibility Act. H.R. 3467, to amend Title XVIII to reform the Medicare Advantage program as it relates to hospice services. Issues regarding telehealth and hospice care. S.1261, CONNECT for Health Act of 2025; H.R. 5081 / S. 2709, Telehealth Modernization Act. S. 1935, Expanding Access to Palliative Care Act. H.R. 5371 (P.L. 119-37), Continuing Appropriations Act, 2026, as it relates to Medicare extenders.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to coverage of spiritual care - no specific legislation. Issues related to religious non-medical health care institutions - no specific legislation. S. 1816, Improving Seniors Timely Access to Care Act of 2025. H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R. 3467, To amend title XVIII to reform the Medicare Advantage program.

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

Government targets: HOUSE OF REPRESENTATIVES

Issues related to coverage of spiritual care - no specific legislation. Issues related to religious non-medical health care institutions - no specific legislation. S. 1816, Improving Seniors Timely Access to Care Act of 2025. H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R. 3467, To amend title XVIII to reform the Medicare Advantage program.

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

Government targets: HOUSE OF REPRESENTATIVES

Issues concerning access to and reimbursement for the Medicare Hospice benefit. H.R. 3467, to amend Title XVIII to reform the Medicare Advantage program as it relates to hospice services. Medicare Advantage and the hospice benefit. Issues regarding program integrity. The Hospice Special Focus Program. Issues related to regulatory relief and audit burden. H.R. 1720, Hospice Recertification Flexibility Act. Issues regarding telehealth and hospice care. S. 1261, CONNECT for Health Act of 2025; H.R. 5081 / S. 2709, Telehealth Modernization Act. S. 1935, Expanding Access to Palliative Care Act. H.R. 5371 (P.L. 119-37), Continuing Appropriations Act, 2026, as it relates to Medicare extenders.

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

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE