Improving Seniors’ Timely Access to Care Act of 2025

Issues related to vaccine access and evidence-based resources for patients and pharmacists (generally, no specific legislation). Tylers Law (H.R. 2004), the ALERT Communities Act (H.R. 1561), and the HERO Act (H.R. 7994), issues related to access to fentanyl test strips and medications for opioid use disorder (MOUD). The Eliminating Thickets to Increase Competition Act (ETHIC) Act (H.R. 3269), the Affordable Prescriptions for Patents Act (H.R. 1768), the Skinny Labels, Big Savings Act (H.R. 6485), the Medication Affordability and Patent Integrity Act (S. 2658), and the Ensuring Timely Access to Generics Act of 2025 (S. 3014), issues related to drug pricing, drug shortages, drug importation plans, and the drug supply chain. Issues related to telehealth and pharmacist provision of testing and vaccination (generally, no specific legislation). Patient access to pharmacist provided services for respiratory illnesses, initiation of oral antivirals, buprenorphine, and other pharmacist services authorized under state law (generally, no specific legislation). Issues related to healthcare workforce shortages (generally, no specific legislation). The Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (H.R. 929/S. 266), provisions related to supporting health workers mental health and well-being. Issues related to implementation of the Inflation Reduction Act (generally, no specific legislation). The Drug-Price Transparency for Consumers (DTC) Act (H.R.3789), issues related to direct-to-consumer (DTC) prescription drug advertising. The Agriculture, Rural Development, Food and Drug Administration, and Related Agency Appropriations Act, 2027 (H.R. 8646), issues related to funding of FDA. Issues related to the Substance Abuse and Mental Health Services Administration (SAMHSA) decision to end the use of federal funds to purchase fentanyl test strips or other substance test kits, including xylazine and medetomidine test strips, that are distributed for individual use. Issues related to pharmacist deprescribing medications (generally, no specific legislation). The Medication Affordability and Patent Integrity Act, issues related to preventing manufacturers from filing inconsistent information with the Food and Drug Administration and the U.S. Patent and Trademark Office, with the intent to unfairly extend product exclusivity. The Improving Seniors Timely Access to Care Act of 2025 (H.R. 3514) and the Prior Authorization Accountability Act (H.R. 9396), issues related to prior authorization.

Client expense: $250,000 · Firm income: Not reported

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

-S. 494/H.R. 1189, National Plan for Epilepsy Act, support passage -P.L. 119-21, support policies and processes that reduce the impact of the cuts and changes to Medicaid on people with serious and chronic conditions, people with disabilities, and caregivers; express concerns with the Medicaid work reporting requirements Interim Final Rule -P.L. 119-21, express concerns with the proposed rule implementing the provider tax provisions -Budget Reconciliation Packages, oppose additional cuts to Medicaid -No Surprises Act, ask Congress to address issues with the Independent Dispute Resolution (IDR) process -S. 5428/H.R. 930, Stop the Wait Act, support passage -Requests to join the Congressional Epilepsy Caucus -S. 2903/H.R. 5509, Safe Step Act, support passage -S. 864/H.R. 6423, HELP Copays Act, support passage -WISeR Model, express concern with how it could impede access to some epilepsy treatments -PBM Reform, support legislative and regulatory policies on PBM reform and the inclusion of patient-centric policies -Medicare Part Ds Six Protected Classes policy, support coverage of and access to all epilepsy treatments and express concerns with the impact of the GUARD Model on the Six Protected Classes policy. -Essential Health Benefits (EHB) Proposed Rule, express concerns with changes to EHB -Telehealth, support extensions of telehealth flexibilities including the prescribing of epilepsy medications that are controlled substances -S. 1024/H.R. 2151, Seizure Awareness and Preparedness Act, support passage -U.S. Department of Health and Human Services (HHS), support protecting the current structure of HHS and express concerns with HHS staffing changes and cuts -NIH, support the current structure, current facilities and administrative cost structure, and grantmaking process of the NIH; express concerns with leadership and staffing changes and an expansion of multiyear funding -Support programs that assist caregivers -Oppose legislative or regulatory policies that rely on metrics like Quality-Adjusted Life Years -Support safe and legal access to medical cannabis, including supporting rescheduling and expressing concerns about the ban on intoxicating hemp -S. 1816/ H.R. 3514, Improving Seniors Timely Access to Care Act, support passage -Express concerns with legislative and regulatory policies that would restrict the use of animals in research -Support legislation and policy preserving charitable giving -S. 3607/H.R. 6280, Access to Genetic Counselor Services Act, support passage -S. 4440/H.R. 3521, Clinical Trial Modernization Act, support passage -Support legislation and regulations that protect Medicaid Home- and Community-Based Services (HCBS) and increase access to these services -Federal Finance Assistance Proposed Rule, express concerns with impact on medical research and nonprofit missions -Healthy People 2030, support the inclusion of an epilepsy objective

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

Issues related to the Medicare Physician Fee Schedule, including in S. 891, the Bipartisan Health Care Act. H.R. 879, the Medicare Patient Access and Practice Stabilization Act. Issues related to patient access. Issues related to telehealth and health IT. S. 1168/H.R. 2477, the Portable Ultrasound Reimbursement Equity Act of 2025. S. 1261/H.R. 4206, the CONNECT For Health Act of 2025. H.R. 1614, To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program. S. 1816/H.R. 3514, Improving Seniors' Timely Access to Care Act. H.R. 9693, the Patients First Act. H.R. 9844, the Connecting Health and Records Technology for Seniors (CHARTS) Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1390/H.R.2191, Physician-Led and Rural Access to Quality Care Act: To revise certain physician self-referral exemptions relating to physician-owned hospitals. S. 1640, the Medicare Patient Access and Practice Stabilization Act: Io increase support for physicians and other practitioners in adjusting to Medicare payment changes S. 1816/H.R.3514, Improving Seniors Timely Access to Care Act of 2025: Prior authorization reform in Medicare Advantage S. 2439/H.R.3890, Resident Physician Shortage Reduction Act: Medicare funding for medical residency training. S.5180/H.R. 8163, Provider Reimbursement Stability Act: Modifying Medicare's budget neutrality rules under the Medicare physician fee schedule. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. H.R. 4331, Access to Claims Data Act: To establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement. H.R.6160, Strengthening Medicare for Patients and Providers Act: To provide for an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index. H.R. 7520, Efficiency Adjustment Delay Act: To delay the implementation of an efficiency adjustment to work relative value units under the Medicare physician fee schedule. H.R. 8622. Medicare Physician Data-Driven Performance Payment System Act: To reform the Merit-based Incentive Payment System into the Data-driven Performance Payment System under the Medicare physician fee schedule. H.R.9693, Patients First Act: To modify MACRA to reform the Medicare physician payment system, including positive payment updates and improvements to the quality payment program. No Bill: Urging Congress to prevent funding for the proposed CMMI Wasteful and Inappropriate Service Reduction (WISeR) Model in the Medicare Fee-for-Service (FFS) program, which expandsprior authorization to traditional Medicare.

Client expense: $35,000 · Firm income: Not reported

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

S. 1390/H.R.2191, Physician-Led and Rural Access to Quality Care Act: To revise certain physician self-referral exemptions relating to physician-owned hospitals. S. 1640, the Medicare Patient Access and Practice Stabilization Act: Io increase support for physicians and other practitioners in adjusting to Medicare payment changes S. 1816/H.R.3514, Improving Seniors Timely Access to Care Act of 2025: Prior authorization reform in Medicare Advantage S. 2439/H.R.3890, Resident Physician Shortage Reduction Act: Medicare funding for medical residency training. S.5180/H.R. 8163, Provider Reimbursement Stability Act: Modifying Medicare's budget neutrality rules under the Medicare physician fee schedule. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. H.R. 4331, Access to Claims Data Act: To establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement. H.R.6160, Strengthening Medicare for Patients and Providers Act: To provide for an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index. H.R. 7520, Efficiency Adjustment Delay Act: To delay the implementation of an efficiency adjustment to work relative value units under the Medicare physician fee schedule. H.R. 8622. Medicare Physician Data-Driven Performance Payment System Act: To reform the Merit-based Incentive Payment System into the Data-driven Performance Payment System under the Medicare physician fee schedule. H.R.9693, Patients First Act: To modify MACRA to reform the Medicare physician payment system, including positive payment updates and improvements to the quality payment program. No Bill: Urging Congress to prevent funding for the proposed CMMI Wasteful and Inappropriate Service Reduction (WISeR) Model in the Medicare Fee-for-Service (FFS) program, which expands prior authorization to traditional Medicare.

Client expense: $35,000 · Firm income: Not reported

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

Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Mental Health Care, Youth Mental Health; Site neutral payment reform; Program Fraud, Waste, and Abuse H.R. 7996, Improving CARE for Youth Act (118th) To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.2556 - Improving CARE for Youth Act (118th) To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Carper, Thomas R. [D-DE] H.R.4077 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Rep. Doggett, Lloyd [D-TX-37] S.2145 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Sen. Warren, Elizabeth [D-MA] H.R.668 - Coordinating Care for Senior Veterans and Wounded Warriors Act To require the Secretary of Veterans Affairs to carry out a pilot program to coordinate, navigate, and manage care and benefits for veterans enrolled in both the Medicare program and the system of annual patient enrollment of the Department of Veterans Affairs. Sponsor: Rep. Ciscomani, Juan [R-AZ-6] S.506 - Coordinating Care for Senior Veterans and Wounded Warriors Act This bill requires the Department of Veterans Affairs (VA) to implement a three-year pilot program to coordinate, navigate, and manage care and benefits for veterans who are enrolled in both the Medicare program and the VA health care system. Sponsor: Sen. Moran, Jerry [R-KS] H.R.9392 - Medicare Advantage Cost Transparency Act To amend title XVIII of the Social Security Act to require the inclusion of certain information in Medicare Advantage encounter data. Sponsor: Rep. DeGette, Diana [D-CO-1] H.R. 5243 - Supplemental Benefits Transparency Bill To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. Sponsor: Rep. McClellan, Jennifer L. [D-VA-4] H.R.3514 - Improving Seniors Timely Access to Care Act of 2025 To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Sponsor: Rep. Kelly, Mike [R-PA-16] H.R.8883 - Protecting Seniors and Stopping Fraudsters Act To amend title XVIII of the Social Security Act to provide for additional oversight of hospice programs and home health agencies under the Medicare program, and for other purposes. Sponsor: Rep. Van Duyne, Beth [R-TX-24] H.R.8871 - DME Scammer Prevention Act of 2026 To amend title XVIII of the Social Security Act to promote Medicare program integrity with respect to certain medical equipment and supplies. Sponsor: Rep. Bean, Aaron [R-FL-4] H.R.9847 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services or substance use disorder services and primary care services furnished on the same day. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.5236 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.9693 - Patients First Act of 2026 To amend title XVIII of the Social Security Act to modify certain physician payments under the Medicare program. Sponsor: Rep. Joyce, John [R-PA-13] H.R.8375 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Rep. Joyce, John [R-PA-13] S.4384 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS]

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

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

Access to care and improving cardiovascular health; FY27 Appropriations Bill; The Treat and Reduce Obesity Act (TROA), H.R. 4818 / S. 2407; H.R. 307, the ARC Act of 2025; H.R. 1672, the Maintaining Investments in New Innovation (MINI) Act; H.R. 7417 / S. 3944, the Women's Heart Health Expansion Act of 2026; Meeting with Administrator of Centers for Medicare and Medicaid Services, regarding access to Transcatheter Aortic Valve Replacement (TAVR), Peripheral Artery Disease (PAD) screening, and LDL (bad cholesterol) target; H.R. 3514, the Improving Seniors' Timely Access to Care Act of 2025; Medicare drug pricing policy: Request for Information on policy options to lower prescription drug prices, decrease patient out-of-pocket expenses, and bolster biopharmaceutical innovation; HHS coverage and Medicare Payment on cardiovascular-Kidney-Metabolic syndrome; Centers for Medicare & Medicaid Services' (CMS) Proposed Decision Memorandum for Transcatheter Aortic Valve Replacement (TAVR)(comment); also contacted CMS to follow-up on previous ABC meetings.

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

Government targets: Centers For Medicare and Medicaid Services (CMS)

Site neutral payment reform; Program Fraud, Waste, and Abuse H.R.3514 - Improving Seniors Timely Access to Care Act of 2025 - To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans.

Client expense: $820,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES

H.R. 2484, Seniors Access to Critical Medications Act of 2025 (Support: Allows medically integrated physician dispensing flexibilities); H.R. 879, Medicare Patient Access and Practice Stabilization Act of 2025 (Support: Increases provider reimbursement in the Physician Fee Schedule); H.R. 2120, ROCR Value Based Program Act (Support: Modifies Medicare payment system for radiation oncology services); S. 1816 H.R. 3514, Improving Seniors' Timely Access to Care Act of 2025 (Support: Streamlines prior authorization process); Medicare Physician Payment; Site Neutral Payment Reform; CY2026 Medicare Physician Fee Schedule Proposed Rule; Health Data, Artificial Intelligence, Interoperability and ePrior Authorization; H.R. 4299, Protecting Patient Access to Cancer and Complex Therapies Act of 2025 (Support: Provide for a rebate by manufacturers for selected drugs and biological products subject to maximum fair price negotiation); PBM Transparency; Emergency Preparedness.

Client expense: $610,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, White House Office

H.R.6160, Strengthening Medicare for Patients and Providers Act H.R.9693, Patients First Act of 2026 H.R.5454/S.2879, Medicare Advantage Prompt Pay Act. H.R.3514/S.1816, Improving Seniors Timely Access to Care Act. H.R.9970, the RESCUE Act Issues related to implementation of healthcare provisions in H.R.1. Issues related to CMS telehealth policies. Issues related to hospital outpatient reimbursement. Issues related to the Medicare area wage index. Issues related to Medicare Advantage. Issues related to Medicare GME. Issues related to Medicaid. Issues related to CMS ACCESS Model.

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

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

SB 864 - HELP Copays Act HR 946 - Orphan Cures Act SB 832/ HR 1492 - EPIC Act HR 1520 - Charlotte Woodward Organ Transplant Discrimination Prevention Act HR 3514 - Improving Seniors Timely Access to Care Act of 2025 SB 2426 - Equitable Community Access to Pharmacist Services Act H.R. 3826/ S.B. 1925 - Expanding Access to Diabetes Self-Management Training Act of 2025 SB 1140 - Health ACCESS Act Health Accelerating Consumers Care by Expediting Self-Scheduling Act H.R. 5256 - 340B ACCESS Act 340B Affording Care for Communities and Ensuring a Strong Safety-net Act SB 1973 - Treat and Reduce Obesity Act of 2025 SB 2761/ H.R. 5269 - Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act. SB 932 - Give Kids a Chance Act of 2025 SB 339- Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act H.R. 4317- PBM Reform Act of 2025 Pharmacy Benefit Manager Reform Act of 2025 H.R. 1244 - Reducing Drug Prices for Seniors Act H.R. 8270 - Every Dollar Counts Acr of 2026 H.R. 9599 - SECURE 340B Act

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid payment issues, alternative payment models, value-based healthcare/Medicare shared savings program; Health care workforce; Health care pricing transparency and tax-exempt organization policy; Site Neutral; 340B Program and Drug Pricing; MA prior authorization (S. 1816 / H.R. 3514); Telehealth and digital health and remote monitoring; Home health / Hospice; Rural health and Rural Hospital Support Act (S. 335); Graduate medical education; Artificial intelligence; RESULTS Act (H.R. 5269 / S. 2761); Equitable Community Access to Pharmacist Services (ECAPS) Act (H.R. 3164 / S. 2426); 340B PATIENTS Act (H.R. 4581 / S. 2372); CONNECT for Health Act (H.R. 4206 / S. 1261); H.R. 1708 / S. 1087 Rebuild America's Healthcare Schools Act of 2025; Medicare Physician Reimbursement/MACRA reform.

Client expense: Not reported · Firm income: $80,000

Government targets: Centers For Medicare and Medicaid Services (CMS)

H.R. 5444 - Medical Laboratory Personnel Shortage Relief Act of 2025 H.R. 7961 - Physicians and Healthcare Workforce Act S. 2355/H.R. 5582 - Patients Deserve Price Tags Act H.R. 9393 - Lower Costs, More Transparency Act of 2026 Federal policies related to prior authorization for medical services S.1816/H.R. 3514 - Improving Seniors Timely Access to Care Act of 2025 H.R. 8890 - The Enhancing Clinical Laboratory Innovation and Access (Enhancing CLIA) Act of 2026 H.R. 8413 - SECURE Data Act CMS HealthTech Ecosystem and Interoperability AI policies related to health care

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

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

H.R. 1805, Assistance for Rural Community Hospitals (ARCH) Act, all provisions; S. 1261 / H.R. 4206, CONNECT for Health Act of 2025, all provisions; H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions; S. 335, Rural Hospital Support Act, all provisions; S.1816 / H.R.3514, Improving Seniors Timely Access to Care Act, all provisions; S. 502, Rural Hospital Closure Relief Act, all provisions; S. 2439 / H.R. 4731, Resident Physician Shortage Reduction Act of 2025, all provisions; H.R. 4002, Patient Access to Higher Quality Health Care Act, all provisions; H.R. 5454/S. 2879, the Medicare Advantage Prompt Pay Act, all provisions; H.R. 6240, Rural Hospital Closure Relief Act of 2025, all provisions; H.R. 8375/ S. 4384, Medicare Advantage Improvement Act, all provisions; H.R. 8967 / S. 4460, Rural Community Hospital Demonstration Program Reauthorization, all provisions; H.R. 9468, Saving Today's Acute Care Resources (STAR) Act, all provisions; H.R. 8891, Rural Maternity Options for Medial Support (Rural MOMS) Act, all provisions; H.R. 3108 / S. 1535, Rural Patient Monitoring Access Act (RPM Access Act), all provisions; S. 2761 / H.R. 5269, the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act , all provisions; H.R. 5142, The Home Health Stabilization Act, all provisions; H.R. 8261, Chronic Care Management Improvement Act, all provisions; DRAFT, HCA Mission Act, all provisions; H.R. 9642, Medicare Access to Rural Anesthesiology Act, all provisions; H.R. 9644, Medicare Advantage MLR Transparency Act, all provisions; H.R. 9693, Patients First Act of 2026, all provisions; H.R. 8163, Provider Reimbursement Stability Act of 2026, all provisions; H.R. 8622, Medicare Physician Data-driven Performance Payment system, all provisions; DRAFT, Medicare Provider Reimbursement Step to Stabilization Act of 2026, Issues pertaining to physician fee schedule reforms; H.R.10666, Frontier Community Health Integration Project Extension Act, all provisions; H.R. 1775, Second Chances for Rural Hospitals Act, all provisions; Centers for Medicare & Medicaid Services (CMS), Issues regarding proposed rule on Medicaid managed care state-directed payments and Medicaid fee-for-service targeted practitioner payments; Centers for Medicare & Medicaid Services (CMS), Issues pertaining to funding from the Rural Health Transformation Program and how it is distributed to hospitals; Centers for Medicare & Medicaid Services (CMS), Issues pertaining to the physician fee schedule and updates for the CY2027; Centers for Medicare & Medicaid Services (CMS), "Comments pertaining to the proposed rule regarding the indirect hold harmless threshold of healthcare-related taxes. "; Centers for Medicare & Medicaid Services (CMS), Issues pertaining to interim final rule on community engagement requirements for certain Medicaid beneficiaries; Centers for Medicare & Medicaid Services (CMS), Issues pertaining to the hospital outpatient prospective payment system and ambulatory surgical center payment system proposed rule for calendar year 2027; Centers for Medicare & Medicaid Services (CMS), Issues pertaining to the calendar year 2027 home health prospective payment system proposed rule; Centers for Medicare & Medicaid Services (CMS), Issues pertaining to the CMS proposed rule implementing and codifying the Medicare Drug Benefit Program under the Inflation Reduction Act of 2022; Centers for Medicare & Medicaid Services (CMS), Issues pertaining to Essential Health Benefits framework and Affordable Care Act requirements; Medicaid Program, Issues pertaining to Medicaid program and how states finance programs, reimburse providers, and determine beneficiary eligibility, and implementation and mitigation of H.R. 1 provisions related to state directed payments, provider taxes and community engagement requirements; Site Neutral Payments, Issues related to site neutral payment cuts and facility fees; Rural Hospitals, Issues pertaining to the sustainability of MDHS, CAHs, SCHs, REH's, implementation of Rural Health Transformation Program, rural reclassification policy; Physician Payments, Issues pertaining to alternative payment models, mental health of workforce, physician reimbursement cuts, Medicare Access & CHIP Reauthorization (MACRA) Reforms; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay and cost-based reimbursement for critical access hospitals under Medicare Advantage, Wasteful and Inappropriate Services Reduction (WISeR) model, transparency in plan denial signatures, inappropriate downcoding, reducing administrative burdens; Provider Reimbursements, Issues related to provider reimbursement, site neutral payment cuts, Medicare/Medicaid program funding, facility fees; Post Acute Care, Issues pertaining to expanding patients' access to crucial services provided by long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities, hospital at home, and home health agencies; Expiring Health Care Programs, Issues pertaining to expiring health care programs such as GPCI, Physician reimbursement, Medicare Dependent Hospital Program, and Low-Volume Adjustment program.

Client expense: $3,840,000 · Firm income: Not reported

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

H.R. 3164: Ensuring Community Access to Pharmacist Services Act; all provisions H.R. 3514: Improving Seniors' Timely Access to Care Act of 2025; all provisions H.R. 4710: No Surprises Act Enforcement Act; all provisions H.R. 6160: Strengthening Medicare for Patients and Providers Act; provisions related to Medicare physician payments S. 1816: Improving Seniors Timely Access to Care Act of 2025; all provisions S. 2420: No Surprise Act Enforcement Act; all provisions HHS-OS-2026-0332-0001: Categories Used in Federal Vaccine Recommendations and the Roles of Shared Clinical Decision-Making; all provisions

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

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

Medicaid Reform Implementation, Medicare Advantage, Risk Adjustment, Star Ratings, Prior Authorization, Site Neutral Payments, Prompt Pay, Provider Directories, Transparency H.R.8375 - Medicare Advantage Improvement Act of 2026 - A bill to provide for certain reforms under the Medicare Advantage program, and for other purposes. S. 1105 - No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act (No UPCODE) Act - This bill modifies certain factors that are used to determine Medicare Advantage (MA) payments, particularly relating to health status and related data. H.R. 4077/S. 2145 - GUARD Veterans Health Care Act - To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. H.R. 3514/S. 1816 - Improving Seniors Timely Access to Care Act of 2025 - To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. S. 3848/H.R. 4093 - Apples to Apples Comparison Act of 2025 - to require the Secretary of Health and Human Services to publish information on expenditures under the Medicare program, and for other purposes. H.R.5243 - A bill to increase data transparency for supplemental benefits under Medicare Advantage. H.R. 9392, Medicare Advantage Cost Transparency Act - A bill to require MA plans to report specified information on encounter data submitted to CMS. H.R. 9395, Transparency in Medicare Advantage Steering Act - Requires MA plans to annually identify individuals enrolled by an agent, broker or other third-party and report information about compensation paid.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2120--Older Americans Act Reauthorization Act of 2025--Reauthorizes through FY2030, modifies, and establishes programs under the Older Americans Act, which supports social services and activities for individuals aged 60 years or older. S.1105--No Unreasonable Payments, Coding, or Diagnoses for the Elderly (No UPCODE) Act--An act to improve the way Medicare Advantage plans assess patients health risks and reduce overpayments for care. H.R 4093--Apples to Apples--An act to require the Secretary of Health and Human Services to publish information on expenditures under the Medicare program, and for other purposes. S. 2625--Independent BROKERS TIME Act of 2025--An Act to carry out certain activities relating to the regulation of independent agents and brokers and third-party marketing organizations under parts C and D of the Medicare program, and for other purposes. H.R 5243--Increase data transparency for supplemental benefits under Medicare Advantage--An Act to increase data transparency around Medicare Advantage supplemental benefits for seniors. S. 2793--Require Medicare Advantage plans to cover items and services furnished by certain essential community providers within a service area--An act to add an Essential Community Provider (ECP) requirement to Medicare Advantage networks. H.R. 5454--Medicare Advantage Prompt Pay Act--An act to improve Medicare Advantages (MA) billing practices, offer certainty health care providers who contract with MA plans, and ensure that seniors arent stuck with unfair, confusing, or delayed bills after receiving critical care. HR 5746--Addressing Whole Health in Medicare Advantage Act--Supplemental Benefits for chronically Ill enrollees S. 3573--Medicare Advantage Supplemental Benefits Transparency Act--Improving Supplemental Benefits for MA beneficiaries HR 3514--To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans--Prior Authorization in Medicare Advantage S 1816--A bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans-Prior Authorization in Medicare Advantage H.R. 9393--Lower Costs, More Transparency Act of 2026--Promotes price transparency across hospitals, Ambulatory Surgical Centers (ASCs), and the broader health care sector H.R. 9392--Medicare Advantage Cost Transparency Act--An act to require MA plans and commercial plans to publicly post PA approval/denial rates, appeal outcomes, and average determination timelines H.R. 9395--Transparency in Medicare Advantage Steering Act--Statutory caps on compensation paid by MA organizations to agents and brokers H.R. 9544--Saving MEDICARE Act of 2026--To amend title XVIII of the Social Security Act to ensure appropriate payments under Medicare Advantage, and for other purposes. H.R.8163--Provider Reimbursement Stability Act of 2026--Medicare physician payment reform and Alternative Payment Model (APM) incentives H.R. 8375--Medicare Advantage Improvement Act--Prior authorization reform, plan transparency, prompt pay, and coverage standards alignment H.R. 9397--Premium Transparency Act--Requires MA plans to publish overhead costs, claims payment data, and MLR revenue detail H.R. 9396-Prior Authorization Accountability Act--Public posting of PA approval/denial rates, appeal outcomes, and processing times H.R. 9693--Patients First Act--Physician Fee Schedule reform H.R. 9645--Health Care Price Certainty for All Americans Act--Price transparency reform Health CARE Act of 2026--Reverse health care provisions from H.R. 1

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

- H.R. 1539, Medical Device Electronic Labeling Act, regarding all provisions - H.R. 929/S. 266, the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, regarding all provisions - H.R. 946 ORPHAN Cures Act, regarding all provisions - S.864, HELP Copays Act, regarding all provisions - H.R. 2214, Delinking Revenue from Unfair Gouging (DRUG) Act, regarding all provisions - H.R. 1492/S. 832, Ensuring Pathways to Innovative Cures (EPIC) Act, regarding all provisions - S. 1954/ H.R. 5526 Biosimilar Red Tape Elimination Act, regarding all provisions - H.R.2527, Early Detection of Vision Impairments for Children Act of 2025, regarding all provisions - PL117-169 The Inflation Reduction Act, regarding all provisions related to drug pricing and implementation - H.R.5343/S. 1717, the Ensuring Patient Access to Critical Breakthrough Products Act of 2025, regarding all provisions - H.R.4282, Contact Lens Prescription Verification Modernization Act, regarding all provisions - H.R. 4299, Protecting Patient Access to Cancer and Complex Therapies Act, regarding all provisions - S.1399 / H.R. 6197, the Health Tech Investment Act, regarding all provisions - H.R. 3521, the Clinical Trial Modernization Act, regarding all provisions - H.R. 3006 / S.1776, the Medicare Beneficiary Co-Pay Fairness Act, regarding all provisions - H.R. 3514, the Improving Seniors Timely Access to Care Act of 2025, regarding all provisions - H.R. 6549, the VA Contracting and Procurement Act, regarding all provisions - H.R. 5509 / S. 2903, Safe Step Act, regarding all provisions - H.R. 5256, 340B ACCESS Act, regarding all provisions - H.R. 7391, Community Health Center Drug Pricing Protection Act, regarding all provisions - H.R. 3953 / S. 1874 Title VIII Nursing Workforce Reauthorization Act, regarding all provisions Issues related to - direct to consumer advertising - clinical trial modernization - biosimilars - cardiovascular health - 340B and 340B Rebate Pilot - Heart Recovery Awareness Day & H.Res. 1301, designating February 20th Heart Recovery Awareness Day - MFN - Foreign Reference Pricing - CMS Outpatient Prospective Payment System rule - peripheral artery disease (PAD) - PBM and Insurer Reforms

Client expense: $2,220,000 · Firm income: Not reported

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

Issues: Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Mental Health Care, Youth Mental Health; Site neutral payment reform; Program Fraud, Waste, and Abuse Bills: H.R.4077 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Rep. Doggett, Lloyd [D-TX-37] S.2145 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Sen. Warren, Elizabeth [D-MA] H.R.668 - Coordinating Care for Senior Veterans and Wounded Warriors Act To require the Secretary of Veterans Affairs to carry out a pilot program to coordinate, navigate, and manage care and benefits for veterans enrolled in both the Medicare program and the system of annual patient enrollment of the Department of Veterans Affairs. Sponsor: Rep. Ciscomani, Juan [R-AZ-6] S.506 - Coordinating Care for Senior Veterans and Wounded Warriors Act This bill requires the Department of Veterans Affairs (VA) to implement a three-year pilot program to coordinate, navigate, and manage care and benefits for veterans who are enrolled in both the Medicare program and the VA health care system. Sponsor: Sen. Moran, Jerry [R-KS] H.R.9392 - Medicare Advantage Cost Transparency Act To amend title XVIII of the Social Security Act to require the inclusion of certain information in Medicare Advantage encounter data. Sponsor: Rep. DeGette, Diana [D-CO-1] H.R. 5243 - Supplemental Benefits Transparency Bill To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. Sponsor: Rep. McClellan, Jennifer L. [D-VA-4] H.R.3514 - Improving Seniors Timely Access to Care Act of 2025 To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Sponsor: Rep. Kelly, Mike [R-PA-16] H.R.8883 - Protecting Seniors and Stopping Fraudsters Act To amend title XVIII of the Social Security Act to provide for additional oversight of hospice programs and home health agencies under the Medicare program, and for other purposes. Sponsor: Rep. Van Duyne, Beth [R-TX-24] H.R.8871 - DME Scammer Prevention Act of 2026 To amend title XVIII of the Social Security Act to promote Medicare program integrity with respect to certain medical equipment and supplies. Sponsor: Rep. Bean, Aaron [R-FL-4] H.R.9693 - Patients First Act of 2026 To amend title XVIII of the Social Security Act to modify certain physician payments under the Medicare program. Sponsor: Rep. Joyce, John [R-PA-13] H.R.8375 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Rep. Joyce, John [R-PA-13] S.4384 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS]

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

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

Hematology/oncology drug research and approval issues Clinical trials regulations and coverage Issues impacting coverage for hematologic diseases and conditions Implementation of No Surprises Act (P.L. 116-260) Sickle cell disease/trait issues Issues related to maternal health care and hematology Issues related to healthcare workforce Issues impacting drug shortages Sickle cell disease quality measures FDA guidance impacting hematology Access to safe and effective vaccines Impact of restructuring and reorganization of federal public health and research agencies Issues related to H-1B visas for physician workforce Sickle Cell Disease Comprehensive Care Act (S. 721 / H.R. 5178) Implementation of One Big Beautiful Bill Act (Public Law No. 119-21) Improving Access to Transfusion Care for Hospice Patients Act (S. 1936) Improving Seniors Timely Access to Care Act (H.R. 3514 / S. 1816) CONNECT for Health Act (H.R. 4206 / S. 1261) Sickle Cell Care Expansion Act of 2026 (S. 5489) Sickle Cell Disease Treatment Centers Act of 2026 (S. 5488) Resolutions expressing support for the designation of September 2026 as "Sickle Cell Disease Awareness Month" (H.Res. 1577 / S.Res. 940)

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

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

Coverage of blood transfusions under Medicare hospice benefit Medicare physician reimbursement issues CMS national coverage determinations for autologous stem cell transplantation for multiple myeloma Medicaid coverage for sickle cell disease Issues related to telehealth and extension of telehealth flexibilities Sickle cell disease/trait issues, including coverage for cell and gene therapies Prior authorization Implementation of the Inflation Reduction Act of 2022 (P.L. 117-169) Dental coverage for Medicare beneficiaries Sickle cell disease quality measures Issues impacting drug shortages Access to safe and effective vaccines Issues related to CAR-T/cellular and gene therapies Local Coverage Decisions for hematopoietic stem cell transplantation (HSCT) for lymphoma Local Coverage Decisions for next generation sequencing Medicare Patient Access and Practice Stabilization Act of 2025 (H.R. 879) Issues related to Social Security Administration disability evaluations for sickle cell disease Impact of Medicaid funding cuts on hematology Medicare codes for Chronic Care Management (CCM) and Principal Care Management (PCM) Implementation of One Big Beautiful Bill Act (Public Law No. 119-21) Community engagement requirements of One Big Beautiful Bill Act (Public Law No. 119-21) Sickle Cell Disease Comprehensive Care Act (S. 721 / H.R. 5178) Improving Access to Transfusion Care for Hospice Patients Act (S. 1936 / H.R. 9703) Improving Seniors Timely Access to Care Act (H.R. 3514 / S. 1816) CONNECT for Health Act (H.R. 4206 / S. 1261)

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

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

Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Mental Health Care, Youth Mental Health; Site neutral payment reform; Program Fraud, Waste, and Abuse H.R. 7996, Improving CARE for Youth Act (118th) To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.2556 - Improving CARE for Youth Act (118th) To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Carper, Thomas R. [D-DE] H.R.4077 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Rep. Doggett, Lloyd [D-TX-37] S.2145 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Sen. Warren, Elizabeth [D-MA] H.R.668 - Coordinating Care for Senior Veterans and Wounded Warriors Act To require the Secretary of Veterans Affairs to carry out a pilot program to coordinate, navigate, and manage care and benefits for veterans enrolled in both the Medicare program and the system of annual patient enrollment of the Department of Veterans Affairs. Sponsor: Rep. Ciscomani, Juan [R-AZ-6] S.506 - Coordinating Care for Senior Veterans and Wounded Warriors Act This bill requires the Department of Veterans Affairs (VA) to implement a three-year pilot program to coordinate, navigate, and manage care and benefits for veterans who are enrolled in both the Medicare program and the VA health care system. Sponsor: Sen. Moran, Jerry [R-KS] H.R.9392 - Medicare Advantage Cost Transparency Act To amend title XVIII of the Social Security Act to require the inclusion of certain information in Medicare Advantage encounter data. Sponsor: Rep. DeGette, Diana [D-CO-1] H.R. 5243 - Supplemental Benefits Transparency Bill To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. Sponsor: Rep. McClellan, Jennifer L. [D-VA-4] H.R.3514 - Improving Seniors Timely Access to Care Act of 2025 To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Sponsor: Rep. Kelly, Mike [R-PA-16] H.R.8883 - Protecting Seniors and Stopping Fraudsters Act To amend title XVIII of the Social Security Act to provide for additional oversight of hospice programs and home health agencies under the Medicare program, and for other purposes. Sponsor: Rep. Van Duyne, Beth [R-TX-24] H.R.8871 - DME Scammer Prevention Act of 2026 To amend title XVIII of the Social Security Act to promote Medicare program integrity with respect to certain medical equipment and supplies. Sponsor: Rep. Bean, Aaron [R-FL-4] H.R.9847 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services or substance use disorder services and primary care services furnished on the same day. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.5236 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.9693 - Patients First Act of 2026 To amend title XVIII of the Social Security Act to modify certain physician payments under the Medicare program. Sponsor: Rep. Joyce, John [R-PA-13] H.R.8375 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Rep. Joyce, John [R-PA-13] S.4384 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS]

Client expense: $1,240,000 · 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

AI Diabetic Retinopathy Screening H.R.3277/S. 1677- Ensuring Lasting Smiles Act Medicare Access and CHIP Reauthorization Act (P.L.114-10) Improvement Issues Medicare Physician Payment Issues Drug Pricing and Shortages Issues Medicare Part B Drug Price Issues Expansion of Telehealth Services Vision Research Funding and proposed policy changes for federal research programs Step therapy requirements reforms Medicare Coverage for Low Vision Devices Modifications for federal student loan programs Modifications to the Medicaid Program H.R. 879, the Medicare Patient Access and Practice Stabilization Act of 2025 Healthcare Workforce Issues S. 864, the Help Ensure Lower Patient Copays Act (HELP Copays Act) S. 1105, the No Upcode Act Funding for the Pediatric Specialty Loan Repayment Program H.R. 2527, the Early Detection of Vision Impairments for Children Act of 2024 (EDVI Act) H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 H.R. 3514/S. 1816- The Improving Seniors Timely Access to Care Act H.R. 7520, the Efficiency Adjustment Delay Act H.R. 3277/S. 1677, the Ensuring Lasting Smiles Act H.R. 10476, The Glaucoma Vision Act of 2026 H.R. 9693/S. 5672, the Patients First Act

Client expense: $254,772 · Firm income: Not reported

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

Issues: Medicare Advantage & MA Rate Notice; Medicare/Transparency; Mental Health Care, Youth Mental Health; Site neutral payment reform; Program Fraud, Waste, and Abuse Bills: H.R.4077 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Rep. Doggett, Lloyd [D-TX-37] S.2145 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Sen. Warren, Elizabeth [D-MA] H.R.9392 - Medicare Advantage Cost Transparency Act To amend title XVIII of the Social Security Act to require the inclusion of certain information in Medicare Advantage encounter data. Sponsor: Rep. DeGette, Diana [D-CO-1] H.R. 5243 - Supplemental Benefits Transparency Bill To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. Sponsor: Rep. McClellan, Jennifer L. [D-VA-4] H.R.3514 - Improving Seniors Timely Access to Care Act of 2025 To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Sponsor: Rep. Kelly, Mike [R-PA-16] H.R.8883 - Protecting Seniors and Stopping Fraudsters Act To amend title XVIII of the Social Security Act to provide for additional oversight of hospice programs and home health agencies under the Medicare program, and for other purposes. Sponsor: Rep. Van Duyne, Beth [R-TX-24] H.R.8871 - DME Scammer Prevention Act of 2026 To amend title XVIII of the Social Security Act to promote Medicare program integrity with respect to certain medical equipment and supplies. Sponsor: Rep. Bean, Aaron [R-FL-4] H.R.9693 - Patients First Act of 2026 To amend title XVIII of the Social Security Act to modify certain physician payments under the Medicare program. Sponsor: Rep. Joyce, John [R-PA-13] H.R.8375 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Rep. Joyce, John [R-PA-13] S.4384 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS]

Client expense: $276,347 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment under Medicare (general); Medicare Physician Fee Schedule Efficiency Adjustment (general); Graduate medical education (general); S.1816/H.R. 3514, Improving Seniors Timely Access to Care Act of 2025; Prior authorization in Medicare (general); Medicaid (general); Physician payment under Medicaid (general); Medicaid work requirements (general); CMS billing and coding procedures (general); preserving postpartum Medicaid extension (general); implementation of P.L. 119-21, One Big, Beautiful Bill Act; telehealth (general); H.R. 7520, Efficiency Adjustment Delay Act; H.R. 8163, Provider Reimbursement Stability Act; FMAP for Puerto Rico; unbundling of obstetric codes in Medicare; H.R. 4731/S. 2439, Resident Physician Shortage Reduction Act; H.R. 9693, Patients First Act; S. 5037, MediKids Act

Client expense: $250,000 · Firm income: Not reported

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

H.R. 1 - One Big Beautiful Bill Act (implementation) H.R. 1509 - Accelerating Kids' Access to Care Act of 2025 H.R. 2036 - Credit for Caring Act of 2025 H.R. 2079 - Insurance Fraud Accountability Act H.R. 2320 - Mobility Means Freedom Tax Credit Act H.R. 2560 - Lifespan Respite Care Reauthorization Act of 2025 H.R. 3417 - Websites and Software Applications Accessibility Act of 2025 H.R. 3514 - Improving Seniors' Timely Access to Care Act of 2025 H.R. 3907 - ENROLL Act of 2025 H.R.4317 - PBM Reform Act of 2025 H.R.5081 - Telehealth Modernization Act H.R. 5940, the Seniors Deserve Streamlined Medical Approvals for Timely, Efficient, Recovery (SMARTER) Care Act of 2025 H.R.6183 - To amend the Internal Revenue Code of 1986 to reform certain rules related to health savings accounts. H.R.6837 - To amend the Employee Retirement Income Security Act of 1974 to ensure that pharmacy benefit managers are considered fiduciaries, and for other purposes. H.R. 8270: Every Dollar Counts Act of 2026 S. 752 - Accelerating Kids' Access to Care Act S. 830 - Lifespan Respite Care Reauthorization Act of 2025 S. 925 - Credit for Caring Act of 2025 S. 976 - Insurance Fraud Accountability Act S. 1816 - Improving Seniors' Timely Access to Care Act of 2025 S. 2024 - ENROLL Act of 2025 S. 3549 - PBM FAIR Act S. 3386 - Health Care Freedom for Patients Act of 2025 National MS Society submitted comments to the Centers for Medicare and Medicaid Service's (CMS) request for information on essential health benefits (EHB) urging the agency to monitor the provision of EHB as well and to update and strengthen benefit standards The National MS Society responded to CMS request for information (RFI) around implementing certain pharmacy benefit manager (PBM) reforms passed by Congress in January 2026. The Society comments focused on the need to better understand the complexities of the drug supply chain system by collecting as much information as possible from the broadest number of stakeholders. Additionally, comments outlined the access concerns many people living with MS face as a result of the system as it currently stands. The National MS commented on the Calendar Year 2026 Hospital Outpatient Prospective Payment System (OPPS) Proposed Rule, to preserve patient access to affordable outpatient care and ensure adequate reimbursement policies that support access to infusion therapies, specialty services, and other critical treatments for people living with MS

Client expense: $76,247 · Firm income: Not reported

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

Issues: Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Mental Health Care, Youth Mental Health; Site neutral payment reform; Program Fraud, Waste, and Abuse Bills: H.R.4077 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Rep. Doggett, Lloyd [D-TX-37] S.2145 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Sen. Warren, Elizabeth [D-MA] H.R.668 - Coordinating Care for Senior Veterans and Wounded Warriors Act To require the Secretary of Veterans Affairs to carry out a pilot program to coordinate, navigate, and manage care and benefits for veterans enrolled in both the Medicare program and the system of annual patient enrollment of the Department of Veterans Affairs. Sponsor: Rep. Ciscomani, Juan [R-AZ-6] S.506 - Coordinating Care for Senior Veterans and Wounded Warriors Act This bill requires the Department of Veterans Affairs (VA) to implement a three-year pilot program to coordinate, navigate, and manage care and benefits for veterans who are enrolled in both the Medicare program and the VA health care system. Sponsor: Sen. Moran, Jerry [R-KS] H.R.9392 - Medicare Advantage Cost Transparency Act To amend title XVIII of the Social Security Act to require the inclusion of certain information in Medicare Advantage encounter data. Sponsor: Rep. DeGette, Diana [D-CO-1] H.R. 5243 - Supplemental Benefits Transparency Bill To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. Sponsor: Rep. McClellan, Jennifer L. [D-VA-4] H.R.3514 - Improving Seniors Timely Access to Care Act of 2025 To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. Sponsor: Rep. Kelly, Mike [R-PA-16] H.R.8883 - Protecting Seniors and Stopping Fraudsters Act To amend title XVIII of the Social Security Act to provide for additional oversight of hospice programs and home health agencies under the Medicare program, and for other purposes. Sponsor: Rep. Van Duyne, Beth [R-TX-24] H.R.8871 - DME Scammer Prevention Act of 2026 To amend title XVIII of the Social Security Act to promote Medicare program integrity with respect to certain medical equipment and supplies. Sponsor: Rep. Bean, Aaron [R-FL-4] H.R.9693 - Patients First Act of 2026 To amend title XVIII of the Social Security Act to modify certain physician payments under the Medicare program. Sponsor: Rep. Joyce, John [R-PA-13] H.R.8375 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Rep. Joyce, John [R-PA-13] S.4384 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS]

Client expense: Not reported · Firm income: Not reported

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549 Chronic Care Management Act of 2026ﾠHR 8261 Prior Authorization Reform for Autoimmune & Blood Disorders ActﾠHR 9192 Patient Access to Autoimmune Treatments ActﾠHR 5467 Patients First Act H.R. 9693 Expedited Access to Biosimilars Act H.R. 9661/ S. 1414 Protecting Approved Care Act H.R. 10394 Doctors Not AI Act of 2026 H.R. 10210 Protecting Patients from Automatic Denials Act H.R. 9734

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

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549 Chronic Care Management Act of 2026ﾠHR 8261 Prior Authorization Reform for Autoimmune & Blood Disorders ActﾠHR 9192 Patient Access to Autoimmune Treatments ActﾠHR 5467 Patients First Act H.R. 9693 Expedited Access to Biosimilars Act H.R. 9661/ S. 1414 Protecting Approved Care Act H.R. 10394 Doctors Not AI Act of 2026 H.R. 10210 Protecting Patients from Automatic Denials Act H.R. 9734

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

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549 Chronic Care Management Act of 2026ﾠHR 8261 Prior Authorization Reform for Autoimmune & Blood Disorders ActﾠHR 9192 Patient Access to Autoimmune Treatments ActﾠHR 5467 Patients First Act H.R. 9693 Expedited Access to Biosimilars Act H.R. 9661/ S. 1414 Protecting Approved Care Act H.R. 10394 Doctors Not AI Act of 2026 H.R. 10210 Protecting Patients from Automatic Denials Act H.R. 9734

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

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

HR 3514 / S 1816, the Improving Seniors Timely Access to Care Act; HR 5243, a bill to increase data transparency for supplemental benefits under Medicare Advantage; HR 8375 / S 4384, the Medicare Advantage Improvement Act; HR 9392, Medicare Advantage Cost Transparency Act; S 1105, No UPCODE Act; S 1629, Same Care, Lower Cost Act; S 1936, Improving Access to Transfusion Care for Patients Act; S 4886, Medicare Cost Cap Act; CMS Interim Final Rule on Medicaid Work Requirements; Regulatory and legislative proposals to expand site-neutral payment in Medicare; Implementation of the Accelerating Kids Access to Care Act (HR 1509, S 752) Regulatory proposals related to most-favored nation drug pricing; Issues related to the cost of care, including consolidation and anti-competitive contracting

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

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

Support BRAIN Initiative and VA Neurology Centers of Excellence appropriations; Support H.R. 9693 Patients First Act; Support H.R. 5509/S. 2903 SAFE STEP Act; Support H.R. 3514/S.1816 Seniors Timely Access to Care Act; Support H.R. 929/S. 266 Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Support H.R. 7961 H-1B Visas for Physicians and the Healthcare Workforce Act; Oppose H.R. 139 Sunshine Protection Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1096: HOPE and Mental Wellbeing Act of 2025 mandates coverage of three annual primary care visits without cost-sharing under Medicare and Medicaid. H.R. 1867: Removes in-person requirements for mental health services under Medicare. H.R. 1598: Ensuring Access to Medicaid Buy-in Programs Act lifts the age cap for Medicaid buy-in programs for those with disabilities who choose to work S. 752/H.R. 1509: Accelerating Kids Access to Care Act expands Medicaid enrollment across state lines. S. 683: More Behavioral Health Providers Act of 2025 creates workforce incentives under Medicare. H.R. 2540: SSI Savings Penalty Elimination Act updates resource limits for SSI income eligibility. Reject cuts to Medicaid and other mental health and or substance use disorder programs in the reconciliation process. Support for state waivers for federal financial participation for services furnished to Medicaid members during short-term stays for acute care in psychiatric hospitals or residential treatment facilities that qualify as institutions for mental disease. -- H.R. 1: One Big Beautiful Bill Act reauthorizes and reforms major federal programs including Medicaid. H.R. 2590: Mental and Physical Health Care Comorbidities Act of 2025 establishes a Medicare demonstration program to promote collaborative treatment of mental and physical health comorbidities. S. 1264/H.R. 3320: Strengthening Medicaid for Serious Mental Illness Act increases federal Medicaid funding for states providing intensive community-based services for adults with serious mental illness. H.R. 4022: Increasing Behavioral Health Treatment Act removes the Medicaid exclusion for mental health services in institutions for mental diseases for patients under 65. S. 2011/H.R. 3884: Telemental Health Care Access Act removes the statutory requirement that Medicare beneficiaries be seen in-person within six months of being treated for mental and behavioral health services through telehealth. S. 2024/H.R. 3907: Expand Navigators Resources for Outreach, Learning, and Longevity (ENROLL) Act strengthens and expands the navigator program by increasing funding, broadening duties, and ensuring nonprofit participation. H.R. 2495: Nutrition CARE Act of 2025 provides Medicare coverage for medical nutrition therapy for individuals with eating disorders. H.R. 2263: Telehealth Coverage Act of 2025: permanently expands telehealth services under Medicare H.R. 3384 Telemental Health Care Access Act: Expands Medicaid to include both mental and behavioral health services provided by telehealth. H.R. 4037/S.2847: Occupational Therapy Mental Health parity Act: Clarifies that Medicare covers occupational therapy for mental health and substance use disorders HR 4619 Medicare Mental Health Impatient Equity Act of 2025: Removes the 190-day lifetime limit on Medicare coverage on inpatient Psychiatric hospital services. HR 5462: Michelle Alyssa Go Act: Would expand Medicaid coverage for mental health and substance use disorder treatment by increasing the facility size limit from 16 to 36 beds. S. 2401/H.R. 4745: Medicaid Bump Act: Increase federal Medicaid funds for certain mental health services S. 1797 Expanding Seniors Access to Mental Health Services Act: expands Medicaid coverage and reimbursement for clinical social workers to provide mental health services S.2050 ASSIST Act: Increases federal Medicaid funding for school-based behavioral health services S.2069/HR 4028: Stabilize Medicaid and CHIP Coverage Act: mandates 12-month continuous enrollment for all individuals in Medicaid and CHIP S.2037/H.R.4313 Hospital Inpatient Services Modernization Act: Extends Medicare's acute hospital care at home waiver flexibilities S.2709/ H.R.5081: Telehealth Modernization Act: Extends and expands Medicare telehealth flexibilities S.3300/H.R.6408: ANCHOR Act of 2025 allows states to expand Medicaid coverage to low income, uninsured individuals with serious mental illness or substance use disorders S.3486 Expand the Behavioral Health Workforce Now Act: Requires federal guidance to help states strengthen the behavioral health workforce in Medicaid and CHIP S. 3522 No Red Tape for Addiction Treatment Act: Requires State Medicaid programs to cover at least one formulation of each medication for opioid use disorder without prior Authorization H.R. 6096 NEST Act funds and distributes essential newborn supply kits to mothers. S.1816/ H.R. 3514: Improving Seniors' Timely Access to Care Act: Streamlining prior authorization to increase timely access to care. Support for the extension of the enhanced advance premium tax credits (eAPTC) Support for an extension or permanent authorization of telehealth/telemental health flexibilities Support for continued access to Medicaid Ensuring that new community engagement requirements do not lead to individuals being unfairly removed from Medicaid. H.R. 7535: Second Chance Mental Health Access Act of 2026 requires Medicaid to cover 12 annual mental health telehealth visits for individuals transitioning from incarceration to home confinement. H.R. 5662: Improving Access to Institutional Mental Health Care Act removes the Medicaid exclusion for coverage of services provided to patients in mental health institutions. H.R. 6296: Advancing Access to Telehealth Act makes several telehealth flexibilities permanent under Medicare. H.R. 6727: Repealing the IMD Exclusion Act removes the Medicaid exclusion for mental health and substance use disorder treatment in institutions for mental diseases. H.R. 7324: More Behavioral Health Providers Act of 2026 expands Medicare bonus payments to a wider range of behavioral health practitioners. S. 2709: Telehealth Modernization Act extends and expands Medicare telehealth flexibilities. S. 3521/H.R. 6841: PEERS Act of 2025 expands Medicare to cover peer support services for mental health and substance use recovery. S. 3690: Ensuring Access to Medicaid Buy-in Programs Act of 2026 removes the age limit for working adults with disabilities to qualify for Medicaid buy-in programs. S. 3750: REAL Health Providers Act requires Medicare Advantage plans to maintain accurate provider directories. S. 4076: Removing Medicare Mental Health Inpatient Limitations Act of 2026 removes the 190-day lifetime limit on Medicare coverage for inpatient psychiatric hospital services. S. 4202: Mental Health Access and Provider Support Act of 2026 increases Medicare reimbursement rates for certain mental health providers. ___ H.R. 3514: Improving Seniors Timely Access to Care Act of 2025 requires Medicare Advantage plans to implement electronic prior authorization, increase transparency, protect enrollees, and adhere to new response timeframes H.R. 5944: Restoring Inpatient Mental Health Access Act of 2025 allows federal Medicaid funding for inpatient mental health services in institutions for mental diseases H.R. 8081: Mental Health Access and Provider Support Act of 2026 increases Medicare reimbursement rates for certain mental health providers H.R. 8487: Ensuring Excellence in Mental Health Act expands and standardizes Certified Community Behavioral Health Clinics under Medicaid and Medicare H.R.8261: Chronic Care Management Improvement Act of 2026 eliminates all cost-sharing for chronic care management services under Medicare Part B S. 4481: IMPACT to Save Moms Act demonstration project for states to test innovative Medicaid and CHIP payment models for maternity care __ Support for the continuation of the enhanced FMAP rate for mobile crisis response programs. H.R. 10240: Behavioral Health Crisis Services Expansion Act of 2026 requires Medicare, Medicaid, CHIP, TRICARE, veterans health care, FEHB, and private health insurance to cover behavioral health crisis response services. H.R. 10270: Supporting 988 Crisis Stabilization Act revises Medicaid's IMD exclusion to expand coverage for crisis stabilization and urgent mental health care facilities. H.R. 10287: 988 Crisis Response Act increases funding and expands Medicaid coverage for mental health crisis response services. H.R. 8540: HCBS Access Act a comprehensive legislative proposal aimed at transforming the delivery and accessibility of Home and Community-Based Services (HCBS) under Medicaid. H.R. 8891: Rural MOMS Act of 2026 amends Medicare regulations to exclude beds used solely for labor and delivery from the acute care inpatient bed count for critical access hospitals. H.R. 9488: Health Disparity Zones Act of 2026 establishes designated areas with significant health disparities and provides tax incentives, grants, loan repayment programs, and increased Medicare payments. H.R. 9538: Residential Recovery for Seniors Act establish Medicare coverage for residential substance use disorder services. H.R. 9847: Improving CARE for Youth Act requires Medicaid to cover and reimburse for mental health, substance use disorder, and primary care services provided to the same individual on the same day. H.R. 9867: Expand the Behavioral Health Workforce Now Act requires federal guidance to states on using Medicaid and CHIP to strengthen the behavioral health workforce. S. 5231: Equity in Pretrial Health Coverage Act removes federal restrictions that previously denied Medicaid, Medicare, CHIP, and VA health benefits to individuals in custody pending trial. S. 5236: Improving CARE for Youth Act requires Medicaid to cover both mental health and primary care services provided to an individual on the same day. S. 5321: HCBS Access Act expands and standardizes access to HCBS under Medicaid. S. 5428/H.R. 930 Stop the Wait Act eliminates the waiting periods for Social Security Disability Insurance and Medicare coverage.

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

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

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

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

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

Removal of Section 510 from FY27 Labor-HHS-Education Appropriations bill, co-sponsorship for HR 2002 and S 5246, the Patient Matching and Transparency in Certified Health IT (MATCH IT) Act, support for legislative proposals related to studying and provide education on non-clinical artificial intelligence in healthcare, driving co-sponsorship for S.3303, the LINC VA Act, HR.935/S.4254, the Health Care Workforce Innovation Act of 2025, and HR.3514/S.1816, the Improving Seniors' Timely Access to Care Act of 2025, and supporting federal funding for AHRQ.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 7336/S.3763 - ALS Better Care Act - All provisions. H.R. 6423/S. 864 - HELP Copays Act -- Provisions related to health insurance plans requirement to apply payments made by or on behalf of plan enrollees toward a plan's cost-sharing requirements, i.e. a ban on copay-accumulator adjust programs. H.R. 4206 / S. 1261 - CONNECT for Health Act - Provisions related to permanent telehealth services in Medicare and interstate telehealth services. H.R. 2491 / S. 1227 - Alleviating Barriers for Caregivers (ABC) Act - All provisions. H.R. 2560 / S.830 - Lifespan Respite Care Reauthorization Act - All provisions H.R. 3514 / S. 1816 - Improving Seniors Timely Access to Care Act of 2025 All provisions relating to prior authorization usage under Medicare Advantage Plans. H.R. 6280/S. 3607- Genetic Counselor Services Act - All provisions H.R.2172/S.1058 - Preserving Patient Access to Home Infusion Act - All Provisions H.R.8375/S.4284 - Medicare Advantage Improvement Act of 2026 - Provisions related to expedited care authorizations, increased transparency and oversight, align coverage criteria with traditional Medicare, and strengthen beneficiary protections, in Medicare Advantage plans. H.R.8500 - Timely Access to Coverage Decisions Act of 2026 - All Provisions H.R. 9364 FAST Repairs for Wheelchairs Act - All provisions H.R. 10787-the Access to Medical Supplies Act - All provisions

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues surrounding Medicare reimbursement and coverage denials Issues surrounding 2025 conversion factor and Medicare reimbursement reform (H.R. 3514/S.1816) Improving Seniors' Timely Access to Care Act (H.R. 1) One Big Beautiful Bill Act [P.L. No. 119-21] (H.R.4204) Medicare Patient Choice Act (H.R.4475/S.2329) Medicare Orthotics and Prosthetics Patient-Centered Care Act (H.R. 8163) Provider Reimbursement Stability Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

2027 Medicare Physician Fee Schedule Proposed Rule: Submitted comments in response to the 2027 Medicare Physician Fee Schedule Proposed Rule that included recommendations on proposals related to Medicare physician payment, value-based care, MIPS, remote patient monitoring, and more. Joined coalition letter urging CMS to withdraw proposed changes to remote patient monitoring. Joined coalition of physician specialty organizations in urging CMS and the Administration (OMB and DPC) to withdraw its proposed policy to reduce payment by 50 percent when a separately identifiable office/outpatient (O/O) evaluation and management (E/M) service reported with modifier -25 is furnished on the same day as a procedure with a 0-, 10-, or 90-day global period. Medicare Physician Payment: Submitted Statement for the Record supporting the Patients First Act (H.R. 9693), the Provider Reimbursement Stability Act (H.R. 8163), and the Medicare Physician Data-driven Performance Payment System Act (H.R. 8622), three pieces of Medicare payment legislation that were discussed in the House Energy and Commerce Subcommittee on Health legislative hearing. Supported the introduction of the Patients First Act (H.R. 9693) that would make structural reforms to Medicare reimbursement. Medicare Enrollment: Submitted comments in response to the 2027 Home Health Prospective Payment System Proposed Rule urging CMS to withdraw Medicare enrollment proposals. Joined a coalition letter of provider organizations urging CMS to reconsider its proposed Medicare enrollment changes. H-1B: Submitted comments urging the Department of Homeland Security to exempt all healthcare workers from proposed $103,265 H-1B visa fees. Value-Based Care: Joined a coalition of provider groups in a letter to CMS urging the agency to support accountable care in Medicare. Prior Authorization: Supported the passage of the Improving Seniors Timely Access to Care Act (H.R. 3514), legislation that would reform prior authorization in Medicare Advantage, through both the Ways and Means and Energy and Commerce Committee. Medicare Advantage: Supported the introduction of the Protecting Approved Care Act (H.R. 10394) that would prohibit Medicare Advantage organizations from reversing payment decisions or downcoding after the plan approves prior authorization for an item or service.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), SENATE

2027 Medicare Physician Fee Schedule Proposed Rule: Submitted comments in response to the 2027 Medicare Physician Fee Schedule Proposed Rule that included recommendations on proposals related to Medicare physician payment, value-based care, MIPS, remote patient monitoring, and more. Joined coalition letter urging CMS to withdraw proposed changes to remote patient monitoring. Joined coalition of physician specialty organizations in urging CMS and the Administration (OMB and DPC) to withdraw its proposed policy to reduce payment by 50 percent when a separately identifiable office/outpatient (O/O) evaluation and management (E/M) service reported with modifier -25 is furnished on the same day as a procedure with a 0-, 10-, or 90-day global period. Medicare Physician Payment: Submitted Statement for the Record supporting the Patients First Act (H.R. 9693), the Provider Reimbursement Stability Act (H.R. 8163), and the Medicare Physician Data-driven Performance Payment System Act (H.R. 8622), three pieces of Medicare payment legislation that were discussed in the House Energy and Commerce Subcommittee on Health legislative hearing. Supported the introduction of the Patients First Act (H.R. 9693) that would make structural reforms to Medicare reimbursement. Medicare Enrollment: Submitted comments in response to the 2027 Home Health Prospective Payment System Proposed Rule urging CMS to withdraw Medicare enrollment proposals. Joined a coalition letter of provider organizations urging CMS to reconsider its proposed Medicare enrollment changes. H-1B: Submitted comments urging the Department of Homeland Security to exempt all healthcare workers from proposed $103,265 H-1B visa fees. Value-Based Care: Joined a coalition of provider groups in a letter to CMS urging the agency to support accountable care in Medicare. Prior Authorization: Supported the passage of the Improving Seniors Timely Access to Care Act (H.R. 3514), legislation that would reform prior authorization in Medicare Advantage, through both the Ways and Means and Energy and Commerce Committee. Medicare Advantage: Supported the introduction of the Protecting Approved Care Act (H.R. 10394) that would prohibit Medicare Advantage organizations from reversing payment decisions or downcoding after the plan approves prior authorization for an item or service.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), SENATE

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

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

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

H.R. 929/S.266 - Lorna Breen Health Care Provider Protection Reauthorization H.R. 593 - Strengthening Pathways to Health Professions Act H.R. 1153 - Rural America Health Corps Act H.R. 1227/S.475 - Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 1735/S.779 - EARLY Minds Act H.R. 1448 - PEER for Mental Health Act H.R. 1909/S.2621 - Preventing Maternal Deaths Reauthorization Act of 2025 H.R. 957 - Parity Enforcement Act H.R. 2509/S.931 - COMPLETE Care Act H.R. 4206/S.1261 - CONNECT for Health Act H.R. 2586 - Reentry Act of 2025 H.R. 3884/S.2011 - Telemental Health Care Access Act of 2025 H.R. 4619 - Medicare Mental Health Inpatient Equity Act S. 1062 - Suicide Prevention Act H.R. 912 - 9-8-8 Lifeline Cybersecurity Act H.R. 2483/S.2121 - SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 3655 - STAR Plus Scholarship Act H.R. 3885/S.3989 - Community TEAMS Act H.R. 3164 - Ensuring Community Access to Pharmacist Services (ECAPS) Act H.R. 4681/S. 1379 - Specialty Physicians Advancing Rural Care (SPARC) Act Conversations with Congressional offices on Teaching Health Center Graduate Medical Education (THCGME) H.R.3505/S.5558 - Barriers to Suicide Act H.R. 5434/S. 2826 - 988 LGBTQ+ Youth Access Act H.R.5509 /S.2903 - Safe Step Act H.R. 5557 - Mental Health Services for Students Act H.R. 3514/S.1816 - Improving Seniors Timely Access to Care Act S. 3064 - Relief of Chronic Pain Act H.R.6672 - Mental Health Professionals Workforce Shortage Loan Repayment Act Conversations regarding mental health parity enforcement Communication with Congressional offices on SAMHSA grant terminations Input on Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) modernization Communication with Congressional offices on ghost networks H.R.7092 - RAYS Act Support of funding for gun violence prevention research at CDC, NIH and NIJ. S.4076 - Removing Medicare Mental Health Inpatient Limitations Act of 2026 Letter supporting funding for Maternal Mental Health and Substance Use Disorder Programs (MMHSUD) and National Maternal Mental Health Hotline. H.R. 5629 - To provide that the final rule of the Department of Health and Human Services titled Medications for the Treatment of Opioid Use Disorder except for the portion of the final rule relating to accreditation of opioid treatment programs, shall have no force or effect H.R. 7994 - The HERO Act H.R. 8124 - STOP Suicide Act H.R. 8201 - Expanding Community Access to Health Services Act Letter expressing concerns over H.R. 5629 and H.R. 5630 H.R. 9044 - Minority Fellowship Program Reauthorization Act of 2026 H.R. 8163 - Provider Reimbursement Stability Act H.R.8961 - Student Suicide Prevention Awareness Act H.Res.1329 - Expressing support for the designation of May 2026 as Mental Health Awareness Month H.R.8989 - Evidence-Based Youth Suicide Prevention Act of 2026 H.R.8122/ S.4640 - 9-8-8 Connect Act H.R.8811/S.4552 - Moms Matter Act H.R.9257 - Primary and Behavioral Health Care Access Act H.R.8487/S.3401 - Ensuring Excellence in Mental Health Act H.R. 9948 - Addictive Design Act H.R. 9551 - Mental Health Parity Enforcement and Funding Act H.R. 9693 - Patients First Act S.4916 - Aging with Artificial Intelligence Act of 2026 H.R.9538 - Residential Recovery for Seniors Act H.R.10216 - Public Transit Mental Health Awareness Act H.R. 8657 - Campus Lifeline Act H.R. 10349 - Emergency Responders Mental Health Training (EMT) Act H.R. 10210 - Doctors Not AI Act H.R. 8693/S.3062 - GUARD Act H.R.10280 - 9-8-8 Implementation Act of 2026 Letter supporting Project AWARE funding Letter urging prior authorization and step therapy reform National Health Service Corps extension Community Health Center funding extension H.R. 1 implementation impacts on Medicaid Conversation regarding vaccine recommendations and public health Response to HRSA RFI on the Safe Administration of Psychedelic Therapies

Client expense: $144,050 · Firm income: Not reported

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

(H.R. 1317/S. 575) I CAN Act Issues surrounding Medicaid reforms Issues surrounding nurse payment policies (H.R. 1) One Big Beautiful Bill Act [P.L. No. 119-21] (H.R. 10410) Educating Future Nurses Act (S. 2279) Protect Medicaid and Rural Hospitals Act (H.R. 4849/S. 2556) Protecting Health Care and Lowering Costs Act (H.R. 4206) CONNECT for Health Act Issues surrounding incident-to billing (S. 4076) Removing Medicare Mental Health Inpatient Limitations Act (H.R. 7106) Enhancing Skilled Nursing Facilities Act (S. 3350) ACO Assignment Improvement Act (H.R. 3514/S. 1816) Improving Seniors Timely Access to Care Act (S. 3886) Nurses Belong in Nursing Homes Act (H.R. 2172/S. 1058) Preserving Patient Access to Home Infusion Act Issues surrounding MACRA reform (H.R. 9693) Patients First Act of 2026 (H.R. 1616/S. 1805) The Promoting Access to Diabetic Shoes Act (H.R. 10056/S. 5319) Nurse Overtime and Patient Safety Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Oppose CMS's "efficiency adjustment" Support for structural changes that lead to delivering high quality care for patients while increasing efficiencies and promoting Medicare sustainability; oppose radiation oncology benefit managers Support for reforming the way Medicare pays for radiation oncology services by tying payments to quality and value Support for protecting access to care for Medicare patients Oppose physician fee schedule cuts due to clinical labor price updates Support for H.R. 2120 and S. 1031, a bill to modernize radiation oncology reimbursement - The Radiation Oncology Case Rate Value Based Program Act of 2025 Support for H.R. 879, to fix Medicare Physician Fee Schedule's physician payment reimbursement cuts Support H.R.3514, S.1816, the Improving Seniors' Timely Access to Care Act Support for H.R. 6160, Strengthening Medicare for Patients and Providers Act Support for H.R. 9693, Patients First Act

Client expense: $213,718 · 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

H.R.5509/S.2903, The Safe Step Act. Issues related to coverage of products under drug formulary. In general, policies reforming prior authorization of physician services. In general, policies impacting physician burden and sustaining the private practice physician model. Center for Consumer Information and Insurance Oversight guidance on ACA preventive services and coverage of surveillance colonoscopy. H.R.3514/S.1816, Improving Seniors Timely Access to Care Act of 2025. Screening concerns per younger incidence colorectal cancer. Office of Management and Budget's Proposed Rule on Uniform Guidance/Uniform Grants Regulation.

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

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

H.R.879, Medicare Patient Access and Practice Stabilization Act of 2025. General provisions to address Medicare physician fee schedule payment policies and access to physician services. In general, policies impacting physician burden and sustaining the private practice physician model. H.R.3514/S.1816, Improving Seniors Timely Access to Care Act of 2025. Pub. L. No. 119-21, One Big Beautiful Bill Act, provisions regarding Medicare physicians payment increase, reform. H.R.9693, Patients First Act. H.R.8163/S.5180, Provider Reimbursement Stability Act. H.R.8375/S.4384, Medicare Advantage Improvement Act.

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

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