Apples to Apples Comparison Act of 2025

Medicare Advantage & Medicare Part D Prescription Drug Program Medicare Advantage Supplemental Benefits In-Home Health Risk Assessments and Chart Review Medicare Stars Program The Apples-to-Apples Comparison Act (H.R. 4093 & S. 3848) No UPCODE Act (S. 1105) Puerto Rico Medicaid Program Funding - Federal Matching Assistance Percentage (FMAP) Medicaid Managed Care Medicaid Eligibility and Redetermination Medicare Site Neutrality Medicare & Medicaid Social Determinants of Health (SDOH) One Big Beautiful Bill Act (H.R. 1)

Client expense: $1,410,000 · Firm income: Not reported

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

Medicare Advantage, Medicare Part D, Medicaid Managed Care. Issues related to prescription drug costs and delivery. PBM Reform issues. CY 2027 Medicare Advantage Rate Notice. S. 1105 - No UPCODE Act. H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. H.R. 4093 - Apples to Apples Comparison Act of 2026.

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

Issues related to Medicare and Medicaid payments and the Medicare Advantage Prescription Drug Pricing program. S.1105 - No UPCODE Act CY 2027 Medicare Advantage Rate Notice. H.R. 4093 - Apples to Apples Comparison Act of 2025. H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage.

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

Q3 Lobbying Report (July 1-September 30) HCR FEMA re: COVID-19 related reimbursement Critical Access Hospital Relief Act (H.R. 538) Rural Hospital Support Act (S. 335) Expanding Medical Education Act (H.R. 2106) Preserving Emergency Access in Key Sites Act (H.R. 3778/S.1860) Improving Seniors Timely Access to Care Act (H.R. 3514/S.1816) Prompt and Fair Pay Act (H.R. 4559) Medicare Advantage Prompt Pay Act (H.R.5454) Apples to Apples Comparison Act of 2025 (H.R. 4093) Protect Our Hospitals Act (H.R. 4807) Resident Physician Shortage Reduction Act of 2025 (H.R. 4731/S.2439) H-1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961) Tax Exempt Hospital Transparency Act (H.R. 9504) MMM Graduate Medical Education (GME) funding Telehealth flexibilities and payment Californias Medicaid Hospital Quality Assurance Fee Program Medicaid 340B Restoring Rural Health Act (S. 3047) Rural Hospital Fairness Act (H.R. 5821) Defend Rural Health Act of 2026 (H.R.7409) BUD FY 2026 budget FY 2026 appropriations One Big Beautiful Bill Act (H.R. 1) Submitted Comment Letters Regulatory Comment Letter Re: Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes (CMS-2452-P) Re: Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; Including the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Program; Request for Information on Strengthening the Standardization and Comparability of Hospital Price Transparency (HPT) Data; Prior Authorization; Accrediting Organization (AO) Deeming for Emergency Medical Treatment and Labor Act (EMTALA); and Notices of Closure of Teaching Hospitals and Opportunities To Apply for Available Slots (CMS-1850-P)

Client expense: $370,000 · Firm income: Not reported

H.R. 4093 - Apples to Apples Comparison Act of 2025, all provisions H.R. 483 - Health Care Efficiency Through Flexibility Act, all provisions H.R. 6728 - Linking Seniors to Needed Legal Services Act of 2025, all provisions H.R. 9393 - Lower Costs, More Transparency Act, all provisions H.R. 9397 - Premium Transparency Act, all provisions H.R. 9468 - Saving Today's Ascute-Care Resouces (STAR) act, all provisions H.R. 9693 - The Patients First Act of 2026 - all provisions H.R.1 - An act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (PL 119-21), provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R.1317 - I CAN Act, all provisions H.R.1614 - To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015 (PL 114-10) H.R.2120 - ROCR Value Based Program Act, all provisions H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2902 - SOAR Act of 2025, all provisions H.R.3069 - Medicare for All Act, all provisions H.R.3108 - RPM Access Act, all provisions, all provisions H.R.3514 - Improving Seniors Timely Access to Care Act of 2025, all provisions H.R.3878 - RNs for Rural Health Act of 2025, all provisions H.R.4002 - Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R.4206 - CONNECT for Health Act of 2025, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.4977 - Connected MOM Act, all provisions H.R.5081 - Telehealth Modernization Act, all provisions H.R.5178 - Sickle Cell Disease Comprehensive Care Act, all provisions H.R.5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. H.R.5347 - Health Care Efficiency Through Flexibility Act, all provisions H.R.539 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R.5467 - PAAT Act, all provisions H.R.5940 - Seniors Deserve SMARTER Care Act of 2025, all provisions H.R.6160 - Strengthening Medicare for Patients and Providers Act, all provisions H.R.6280 - Access to Genetic Counselor Services Act of 2025, all provisions H.R.7520 - Efficiency Adjustment Delay Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.7905 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions H.R.8129 - To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R.8163 - Provider Reimbursement Stability Act of 2026, all provisions H.R.8261 - Chronic Care Management Improvement Act of 2026, all provisions H.R.8375 - Medicare Advantage Improvement Act of 2026, all provisions H.R.8500 - Timely Access to Coverage Decisions Act of 2026, all provisions H.R.8622 - Medicare Physician Data-driven Performance Payment System Act of 2026, all provisions H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions H.R.9392 - Medicare Advantage Cost Transparency Act, all provisions H.R.9644 - Medicare Advantage MLR Transparency Act, all provisions S.1031 - ROCR Value Based Program Act, all provisions S.106 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S.1105 - No UPCODE Act, all provisions S.1261 - CONNECT for Health Act of 2025, all provisions S.1399 - Health Tech Investment Act, all provisions S.141 - Connected MOM Act, all provisions S.1460 - Preserving Patient Access to Accountable Care Act, all provisions S.1535 - Rural Patient Monitoring (RPM) Access Act, all provisions S.1640 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1816 - Improving Seniors Timely Access to Care Act of 2025, all provisions S.1996 - Medicare Audiology Access Improvement Act of 2025, all provisions S.2709 - Telehealth Modernization Act, all provisions S.3480 - Seniors Deserve SMARTER Care Act of 2025, all provisions S.3607 - Access to Genetic Counselor Services Act of 2026, all provisions S.5168 - Provider Reimbursement Stability Act of 2026, all provisions S.5180 - Provider Reimbursement Stability Act, all provisions S.665 - Fatal Overdose Reduction Act of 2025, all provisions S.721 - Sickle Cell Disease Comprehensive Care Act, all provisions S.891 - Bipartisan Health Care Act, all provisions Comment Letter: [CMS 0057 F] 2024 CMS Interoperability and Prior Authorization final rule Comment Letter: [CMS-0062-P] Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Interoperability Standards and Prior Authorization for Drugs for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges Comment Letter: [CMS-1844-P] CY 2027 Home Health Prospective Payment System proposed rule Comment Letter: [CMS-1848-P] Medicare Physician Fee Schedule, including conversion factors, Modifier -25 payment reduction, efficiency adjustment, RPM/RTM, Maternity Care Services codes, CPT request for information, MIPS/MVP transition, Medicare Shared Savings Program, and Qualifying APM Participant determinations Comment Letter: [CMS-1850-P] Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; Including the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Program; Request for Information on Strengthening the Standardization and Comparability of Hospital Price Transparency (HPT) Data; Prior Authorization; Accrediting Organization (AO) Deeming for Emergency Medical Treatment and Labor Act (EMTALA); and Notices of Closure of Teaching Hospitals and Opportunities To Apply for Available Slots Comment Letter: [CMS-2452-P] Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes Comment Letter: [CMS-2454-IFC] Medicaid Program; Community Engagement Requirement for Certain Individuals Comment Letter: [CMS-3847-NC] Regulatory Alignment for Predictable and Immediate Device (RAPID) coverage pathway Comment Letter: [CMS-9874-NC] Request for Information; Comprehensive Review of the Essential Health Benefits Framework and Typical Employer Plan Standard Comment Letter: [HHS-OS-2026-0332] Request for Information: Categories Used in Federal Vaccine Recommendations and the Role of Shared Clinical Decision-Making Comment Letter: Request for Information (RFI) Strengthening the Medicare Physician Payment System Statement for the Record: Examining Legislative Proposals to Reform Medicare Provider Payment and Bolster Health Care Cybersecurity Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: ACO/APM flexibilities Medicare program: Advanced APM reporting Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: AI services/payment Medicare program: Aligned Networks and interoperability Medicare program: Alternative Payment Models (APMs) Medicare program: Certified electronic health record and PI Medicare program: Coding Medicare program: Data privacy/cybersecurity Medicare program: Data-Driven Performance Payment System Medicare program: Digital quality measures Medicare program: G2211 Inherent Complexity Code Medicare program: Health Information Technology/physician burdens Medicare program: Indirect practice expense Medicare program: Informed decision-making among beneficiaries Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Medicare Diabetes Prevention Program Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare Part D issues Medicare program: Medicare physician payment/budget neutrality Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS Promoting Interoperability Medicare program: MIPS quality and cost measures Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Promoting Interoperability (PI) Program Medicare program: Provider directories Medicare program: Public Health Reporting and Data Exchange Medicare program: Quality Payment Program Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: RVS Update Committee (RUC) and Current Procedural Terminology (CPT) issues Medicare program: Shared Savings Program Medicare program: Site Neutral Payment Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model Medicaid program: Changes in Children's Health Insurance Program (CHIP) and Affordable Care Act insurance marketplaces Medicaid program: Community engagement/medical frailty exemption Medicaid program: Practice of Medicine Medicaid program: State directed payments Medicaid program: Work requirements, per capita caps, provider taxes, Federal Medical Assistance Percentage (FMAP) changes Medicare and Medicaid programs: ACO REACH (Realizing Equity, Access, and Community Health) Model Reform Medicare and Medicaid programs: Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model reform. Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: Evaluation and Management (E/M) codes Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicare and Medicaid programs: Indirect Practice Expense Relative Value Updates (RVU) changes Medicare and Medicaid programs: Interoperability Medicare and Medicaid programs: LEAD (Long-term Enhanced ACO Design) Model Reform Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: Prior authorization Medicare and Medicaid programs: TEAM (Transforming Episode Accountability Model) changes Medicare and Medicaid programs: Telehealth and Digital Health Draft: Artificial intelligence in prior authorization denials by Medicare Advantage organizations Draft: GOLD CARD Act Draft: MACRA/MIPS program reform Draft: Transparency in Downcoding Model Act Draft: Value in Health Care Act Matters related to downcoding by Insurace plans Matters related to drug price negotiations Matters related to expiring Medicare Physician payment rates Matters related to Modifier-25/Multiple Procedure Payment Reductions

H.R.1, One Big Beautiful Bill Act H.R. 3164/S. 2426, Main Street Pharmacy Access Act H.R. 3514/S. 1816, Improving Seniors Timely Access to Care Act H.R. 4093/S. 3848, Apples to Apples Comparison Act H.R. 4731/S. 2439, Resident Physician Shortage Reduction Act H.R. 5269/S. 2761, Reforming and Enhancing Sustainable Updates to Laboratory Services Act H.R. 5347, Health care Efficiency Through Flexibility Act U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Medicaid Program; Community Engagement Requirement for Certain Individuals Interim Final Rule with Comment Period (CMS-2454-IFC) U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Medicare and Medicaid Programs; CY 2027 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program (CMS-1848-P)

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

H.R. 3164/S. 2426, Ensuring Community Access to Pharmacist Services Act H.R. 4093, S. 3848, Apples to Apples Comparison Act H.R. 4731/S. 2439, Resident Physician Shortage Reduction Act H.R. 6010/S. 1105, No UPCODE Act H.R. 6130/ S. 3267, Alzheimers Screening and Prevention Act U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Medicare Program; Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program (CMS-4212-P) U.S Department of Health and Human Services, Centers for Medicare & Medicaid ServicesAdvance Notice of Methodological Changes for Calendar Year (CY) 2027 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (CMS-2026-0034) U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program (CMS-9883-P) U.S. Department of Health and Human Services, Office of the Assistant Secretary for Technology Policy Health Data, Technology, and Interoperability: ASTP/ONC Deregulatory Actions to Unleash Prosperity (HTI-5) Proposed Rule (RIN 0955-AA09) U.S. Department of Health and Human Services, Office of the Assistant Secretary for Technology Policy Request for Information: Accelerating the Adoption and Use of Artificial Intelligence as Part of Clinical Care (RIN 0955-AA13)

Client expense: $200,000 · Firm income: Not reported

H.R. 3164/S. 2426, Ensuring Community Access to Pharmacist Services Act H.R. 4093, S. 3848, Apples to Apples Comparison Act H.R. 4731/S. 2439, Resident Physician Shortage Reduction Act H.R. 6010/S. 1105, No UPCODE Act H.R. 6130/ S. 3267, Alzheimers Screening and Prevention Act U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Medicare Program; Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program (CMS-4212-P) U.S Department of Health and Human Services, Centers for Medicare & Medicaid ServicesAdvance Notice of Methodological Changes for Calendar Year (CY) 2027 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (CMS-2026-0034) U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program (CMS-9883-P) U.S. Department of Health and Human Services, Office of the Assistant Secretary for Technology Policy Health Data, Technology, and Interoperability: ASTP/ONC Deregulatory Actions to Unleash Prosperity (HTI-5) Proposed Rule (RIN 0955-AA09) U.S. Department of Health and Human Services, Office of the Assistant Secretary for Technology Policy Request for Information: Accelerating the Adoption and Use of Artificial Intelligence as Part of Clinical Care (RIN 0955-AA13)

Client expense: $200,000 · Firm income: Not reported

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

Issues related to Medicare Part D, Medicare Advantage, Medicaid, mental health, and telehealth. Issues related to pharmacy testing, vaccination, and treatment. Issues related to Accountable Care Organizations. Issues related to Medicare Shared Savings Program. Issues related to Medicaid. S. 882, The Patients Before Middlemen (PBM) Act S. 927, The Protecting Pharmacies in Medicaid Act S. 1105 - No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act S. 3345, The PBM Price Transparency and Accountability Act H.R. 4317, The Pharmacy Benefit Manager (PBM) Reform Act H.R. 4093, Apple to Apples Comparison Act H.R. 6575, CommonGround for Affordable Health Care Act H.R. 6703, The Lower Healthcare Premiums for All Americans Act H.R.6609, Pharmacists Fight Back in Medicare and Medicaid Act

Client expense: $3,570,000 · Firm income: Not reported

Medicare Advantage Supplemental Benefits In-Home Health Risk Assessments and Chart Review The Apples-to-Apples Comparison Act (H.R. 4093 & S. 3848) No UPCODE Act Puerto Rico Medicaid Program Funding - Federal Matching Assistance Percentage (FMAP) Puerto Rico Medicare Program Funding Medicare Advantage & Medicare Part D Prescription Drug Program Medicaid Managed Care Medicaid Eligibility and Redetermination Medicare Site Neutrality Medicare & Medicaid Social Determinants of Health (SDOH) Medicare Advantage - 2026 CMS Advance Rate Notice for MA and Parts D program One Big Beautiful Bill Act (H.R. 1) Medicare Advantage Risk Adjustment

Client expense: $2,290,000 · Firm income: Not reported

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. H.R. 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 H.R. 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--Broker Compensation Bill--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 APM incentives H.R. 8375--Medicare Advantage Improvement Act--Prior authorization reform, plan transparency, prompt pay, and coverage standards alignment Issues related to data collection and sharing among health plans, providers, and community-based organizations issues Issues related to mental and behavioral health issues in Medicare Advantage Rural Network Adequacy Issues

Q2 Lobbying Report (April 1-June 30) HCR FEMA re: COVID-19 related reimbursement Critical Access Hospital Relief Act (H.R. 538) Rural Hospital Support Act (S. 335) Expanding Medical Education Act (H.R. 2106) Preserving Emergency Access in Key Sites Act (H.R. 3778/S.1860) Improving Seniors Timely Access to Care Act (H.R. 3514/S.1816) Prompt and Fair Pay Act (H.R. 4559) Medicare Advantage Prompt Pay Act (H.R.5454) Apples to Apples Comparison Act of 2025 (H.R. 4093) Protect Our Hospitals Act (H.R. 4807) Resident Physician Shortage Reduction Act of 2025 (H.R. 4731/S.2439) H-1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961) Tax Exempt Hospital Transparency Act (H.R. 9504) MMM Graduate Medical Education (GME) funding Telehealth flexibilities and payment Californias Medicaid Hospital Quality Assurance Fee Program Medicaid 340B Restoring Rural Health Act (S. 3047) Rural Hospital Fairness Act (H.R. 5821) Defend Rural Health Act of 2026 (H.R.7409) BUD FY 2025 budget FY 2026 appropriations One Big Beautiful Bill Act (H.R. 1)

Client expense: $410,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Medicare Advantage, Risk Adjustment, Star Ratings, Prior Authorization, Site Neutral Payments, Prompt Pay, Provider Directories 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.

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

Medicare Advantage Supplemental Benefits In-Home Health Risk Assessments and Chart Review The Apples-to-Apples Comparison Act (H.R. 4093 & S. 3848) No UPCODE Act Puerto Rico Medicaid Program Funding - Federal Matching Assistance Percentage (FMAP) Puerto Rico Medicare Program Funding Medicare Advantage & Medicare Part D Prescription Drug Program Medicaid Managed Care Medicaid Eligibility and Redetermination Medicare Site Neutrality Medicare & Medicaid Social Determinants of Health (SDOH) Medicare Advantage - 2027 CMS Advance Rate Notice for MA and Parts D program Medicare Administrative Contractor Local Coverage Determination (LCD) Process One Big Beautiful Bill Act (H.R. 1)

Client expense: $1,720,000 · Firm income: Not reported

Medicare Advantage Supplemental Benefits In-Home Health Risk Assessments and Chart Review The Apples-to-Apples Comparison Act (H.R. 4093 & S. 3848) No UPCODE Act Puerto Rico Medicaid Program Funding - Federal Matching Assistance Percentage (FMAP) Puerto Rico Medicare Program Funding Medicare Advantage & Medicare Part D Prescription Drug Program Medicaid Managed Care Medicaid Eligibility and Redetermination Medicare Site Neutrality Medicare & Medicaid Social Determinants of Health (SDOH) Medicare Advantage - 2027 CMS Advance Rate Notice for MA and Parts D program Medicare Administrative Contractor Local Coverage Determination (LCD) Process One Big Beautiful Bill Act (H.R. 1)

Client expense: $2,070,000 · Firm income: Not reported

Issues related to Medicare Part D, Medicare Advantage, Medicaid, mental health, and telehealth. Issues related to pharmacy testing, vaccination, and treatment. Issues related to Accountable Care Organizations. Issues related to Medicare Shared Savings Program. Issues related to Medicaid. S. 882, The Patients Before Middlemen (PBM) Act S. 927, The Protecting Pharmacies in Medicaid Act S. 1105 - No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act S. 3345, The PBM Price Transparency and Accountability Act H.R. 4317, The Pharmacy Benefit Manager (PBM) Reform Act H.R. 4093, Apple to Apples Comparison Act H.R. 6575, CommonGround for Affordable Health Care Act H.R. 6703, The Lower Healthcare Premiums for All Americans Act H.R.6609, Pharmacists Fight Back in Medicare and Medicaid Act

Client expense: $3,320,000 · Firm income: Not reported

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

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 Issues related to data collection and sharing among health plans, providers, and community-based organizations issues In-home Heath Risk Assessments issues Issues related to mental and behavioral health issues in Medicare Advantage Rural Network Adequacy Issues CY2027 Medicare Advantage and Part D Rate Notice

Medicare Advantage, Risk Adjustment, Star Ratings, Health Equity Index/EHO4A, Prior Authorization, Site Neutral Payments, Prompt Pay 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.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Q1 Lobbying Report (Jan. 1-March 31) HCR FEMA re: COVID-19 related reimbursement Critical Access Hospital Relief Act (H.R. 538) Rural Hospital Support Act (S. 335) Expanding Medical Education Act (H.R. 2106) Preserving Emergency Access in Key Sites Act (H.R. 3778/S.1860) Improving Seniors Timely Access to Care Act (H.R. 3514/S.1816) Prompt and Fair Pay Act (H.R. 4559) Medicare Advantage Prompt Pay Act (H.R.5454) Apples to Apples Comparison Act of 2025 (H.R. 4093) Protect Our Hospitals Act (H.R. 4807) Resident Physician Shortage Reduction Act of 2025 (H.R. 4731/S.2439) H-1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961) MMM Graduate Medical Education (GME) funding Telehealth flexibilities and payment Californias Medicaid Hospital Quality Assurance Fee Program Medicaid 340B Restoring Rural Health Act (S. 3047) Rural Hospital Fairness Act (H.R. 5821) Defend Rural Health Act of 2026 (H.R.7409) BUD FY 2025 budget FY 2026 appropriations One Big Beautiful Bill Act (H.R. 1)

Client expense: $500,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

H.R. 3164/S. 2426, Ensuring Community Access to Pharmacist Services Act H.R. 4093, S. 3848, Apples to Apples Comparison Act H.R. 4731/S. 2439, Resident Physician Shortage Reduction Act H.R. 6010/S. 1105, No UPCODE Act H.R. 6130/ S. 3267, Alzheimers Screening and Prevention Act U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Medicare Program; Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program (CMS-4212-P) U.S Department of Health and Human Services, Centers for Medicare & Medicaid ServicesAdvance Notice of Methodological Changes for Calendar Year (CY) 2027 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (CMS-2026-0034) U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program (CMS-9883-P) U.S. Department of Health and Human Services, Office of the Assistant Secretary for Technology Policy Health Data, Technology, and Interoperability: ASTP/ONC Deregulatory Actions to Unleash Prosperity (HTI-5) Proposed Rule (RIN 0955-AA09) U.S. Department of Health and Human Services, Office of the Assistant Secretary for Technology Policy Request for Information: Accelerating the Adoption and Use of Artificial Intelligence as Part of Clinical Care (RIN 0955-AA13)

Client expense: $200,000 · Firm income: Not reported

Q4 Lobbying Report (October 1-December 31) HCR FEMA re: COVID-19 related reimbursement Critical Access Hospital Relief Act (H.R. 538) Rural Hospital Support Act (S. 335) Expanding Medical Education Act (H.R. 2106) Preserving Emergency Access in Key Sites Act (H.R. 3778/S.1860) Improving Seniors Timely Access to Care Act (H.R. 3514/S.1816) Prompt and Fair Pay Act (H.R. 4559) Medicare Advantage Prompt Pay Act (H.R.5454) Apples to Apples Comparison Act of 2025 (H.R. 4093) Protect Our Hospitals Act (H.R. 4807) Resident Physician Shortage Reduction Act of 2025 (H.R. 4731/S.2439) MMM Graduate Medical Education (GME) funding Telehealth flexibilities and payment Californias Medicaid Hospital Quality Assurance Fee Program Medicaid 340B Restoring Rural Health Act (S. 3047) Rural Hospital Fairness Act (H.R. 5821) BUD FY 2025 budget FY 2026 appropriations One Big Beautiful Bill Act (H.R. 1)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

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

Issues related to Medicare Part D, Medicare Advantage, Medicaid, mental health, and telehealth. Issues related to pharmacy testing, vaccination, and treatment. Issues related to Accountable Care Organizations. Issues related to Medicare Shared Savings Program. Issues related to Medicaid. S. 882, The Patients Before Middlemen (PBM) Act S. 927, The Protecting Pharmacies in Medicaid Act S. 1105 - No Unreasonable Payments, Coding, Or Diagnoses for the Elderly Act S. 3345, The PBM Price Transparency and Accountability Act H.R. 4317, The Pharmacy Benefit Manager (PBM) Reform Act H.R. 4093, Apple to Apples Comparison Act H.R. 6575, CommonGround for Affordable Health Care Act H.R. 6703, The Lower Healthcare Premiums for All Americans Act H.R.6609, The Pharmacists Fight Back in Medicare and Medicaid Act

Client expense: $2,270,000 · Firm income: Not reported

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. 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.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 Comparison Act--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. In-home Heath Risk Assessments Rural Network Adequacy Issues H.R. 6010--Fix It Act

H.R. 1708/S. 1087, Rebuild Americas Health Care Schools Act H.R. 4093, Apples to Apples Comparison Act H.R. 5269/S. 2761, Reforming and Enhancing Sustainable Updates on Laboratory Testing Services Act (RESULTS) H.R. 5371, Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act H.R. 6010/S. 1105, No UPCODE Act

Client expense: $180,000 · Firm income: Not reported

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

Q3 Lobbying Report (July 1-September 30) HCR FEMA re: COVID-19 related reimbursement Critical Access Hospital Relief Act (H.R. 538) Rural Hospital Support Act (S. 335) Expanding Medical Education Act (H.R. 2106) Preserving Emergency Access in Key Sites Act (H.R. 3778/S.1860) Improving Seniors Timely Access to Care Act (H.R. 3514/S.1816) Prompt and Fair Pay Act (H.R. 4559) Apples to Apples Comparison Act of 2025 (H.R. 4093) Protect Our Hospitals Act (H.R. 4807) Resident Physician Shortage Reduction Act of 2025 (H.R. 4731/S.2439) MMM Graduate Medical Education (GME) funding Telehealth flexibilities and payment Californias Medicaid Hospital Quality Assurance Fee Program Medicaid 340B BUD FY 2025 budget FY 2026 appropriations One Big Beautiful Bill Act (H.R. 1) Submitted Comments (regulatory comment letters) Preserving Medicaid Funding for Vulnerable Populations: Closing a Health Care-Related Tax Loophole Proposed Rule Calendar Year 2026 Home Health Prospective Payment System Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies Proposed Rule 340B Rebate Model Pilot Program Notice CMS Hospital Price Transparency Accuracy and Completeness Request for Information Calendar Year 2026 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program Proposed Rule Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Ratings; and Hospital Price Transparency Proposed Rule

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 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 Medicare Advantage Supplemental Benefits Transparency Act--Improving Supplemental Benefits for MA beneficiaries Addressing Whole Health in Medicare Advantage Act--Supplemental Benefits for chronically Ill enrollees Gold Card Act of 2023--Exemptions to Prior Authorization in Medicare Advantage DUALS Act of 2024--Care Delivery for those eligible for Medicare and Medicaid 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. Issues related to data collection and sharing among health plans, providers, and community-based organizations issues In-home Heath Risk Assessments issues Issues related to mental and behavioral health issues in Medicare Advantage Rural Network Adequacy Issues