Hospital Inpatient Services Modernization Act

Home care; hospital at home; SNF at home; chronic care; Hospital Inpatient Services Modernization Act (H.R. 4313/S. 2237).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.1261/H.R. 4206 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; H.R. 2332/S.1101 States Handling Access to Reciprocity for Employment (SHARE) Act; H.R. 1407 Permanent Telehealth from Home Act; S. 763/H.R.1650 Telehealth Expansion Act of 2025; H.R. 2902 SPEAK Act of 2025; H.R. 1899 Audio-Only Telehealth Access Act of 2025; H.R. 2263 Telehealth Coverage Act of 2025; H.R. 1867 Behavioral Health Accessibility Act; Telehealth Modernization Act; S. 1248/H.R. 2533 EASE Act; H.R 1. One Big Beautiful Bill Act; S.2011/H.R. 3884 Telemental Health Care Access Act of 2025; H.R. 3419 Reauthorization of telehealth network and telehealth resource centers grant programs; S.1535/H.R. 3108 Rural Patient Monitoring (RPM) Access Act; H.R. 4313/S. 2237 Hospital Inpatient Services Modernization Act; H.R. 1614 Expanded Telehealth Access Act; H.R. 1627 Telehealth Response for E-prescribing Addiction Therapy Services Act; H.R.8261 Chronic Care Management Improvement Act of 2026

Client expense: Not reported · Firm income: $75,000

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

S.1261/H.R. 4206 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; H.R. 2332/S.1101 States Handling Access to Reciprocity for Employment (SHARE) Act; H.R. 1407 Permanent Telehealth from Home Act; S. 763/H.R.1650 Telehealth Expansion Act of 2025; H.R. 2902 SPEAK Act of 2025; H.R. 1899 Audio-Only Telehealth Access Act of 2025; H.R. 2263 Telehealth Coverage Act of 2025; H.R. 1867 Behavioral Health Accessibility Act; Telehealth Modernization Act; S. 1248/H.R. 2533 EASE Act; H.R 1. One Big Beautiful Bill Act; S.2011/H.R. 3884 Telemental Health Care Access Act of 2025; H.R. 3419 Reauthorization of telehealth network and telehealth resource centers grant programs; S.1535/H.R. 3108 Rural Patient Monitoring (RPM) Access Act; H.R. 4313/S. 2237 Hospital Inpatient Services Modernization Act; H.R. 1614 Expanded Telehealth Access Act; H.R. 1627 Telehealth Response for E-prescribing Addiction Therapy Services Act; H.R.8261 Chronic Care Management Improvement Act of 2026

Client expense: Not reported · Firm income: $75,000

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

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

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

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

Issues related to Medicaid access and reimbursement. Issues related to Medicare COVID-19 Telehealth Waivers/Flexibilities. Support for Hospital Inpatient Services Modernization Act (H.R. 4313/ S. 2237)

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicaid access and reimbursement. Issues related to Medicare COVID-19 Telehealth Waivers/Flexibilities. Support for Hospital Inpatient Services Modernization Act (H.R. 4313/ S. 2237)

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Medicaid State Directed Payments; 340B modernization; funding for Disproportionate Share Hospitals (Medicaid DSH); funding for Medicare graduate medical education (GME); Medicare site neutrality policies; support of telehealth policies; impact of regional oversaturation of trauma care on patient outcomes and health system costs; H.R. 4313/S. 2237, Hospital Inpatient Services Modernization Act; H.R. 267, the Health Care Price Transparency Act; H.R. 2590/S. 1264, the Mental and Physical Health Care Comorbidities Act of 2025; H.R. 8375/S. 4384, Medicare Advantage Improvement Act of 2026.

Client expense: $210,000 · 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. 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

Client expense: $20,000 · 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

H.R. 5347: Health Care Efficiency Through Flexibility Act H.R. 786/ S. 1460: Preserving Patient Access to Accountable Care Act S. 1816/ 3514: Improving Seniors Timely Access to Care Act S. 1105: No UPCODE Act S. 2561/ H.R. 5768: Skin Substitute Access and Payment Reform Act H.R. 4773/ S.3350: ACO Assignment Improvement Act H.R. 4313/ S.2237: Hospital Inpatient Services Modernization Act H.R. 8129: To amend title XVIII of the Social Security Act to establish a full risk ACO program H.R. 6852: Advanced Wound Care and Regenerative Medicine Access and Reform Act H.R. 8375/ S.4384: Medicare Advantage Improvement Act H.R. 8163: Provider Reimbursement Stability Act H.R. 8622: Medicare Physician Data Driven Performance Payment System H.J. Res 187/ S.J. Res 192: Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services of the Department of Health and Human Services relating to Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model. Issues related to Medicare payments, Medicare Shared Savings Program, ACO REACH, Medicare Advantage, alternative payment model incentives, telehealth, and fraud, waste, abuse.

Client expense: $142,230 · Firm income: Not reported

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

Home care; hospital at home; SNF at home; chronic care; Hospital Inpatient Services Modernization Act (H.R. 4313/S. 2237).

Client expense: Not reported · Firm income: $110,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.1261/H.R. 4206 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; H.R. 2332/S.1101 States Handling Access to Reciprocity for Employment (SHARE) Act; H.R. 1407 Permanent Telehealth from Home Act; S. 763/H.R.1650 Telehealth Expansion Act of 2025; H.R. 2902 SPEAK Act of 2025; H.R. 1899 Audio-Only Telehealth Access Act of 2025; H.R. 2263 Telehealth Coverage Act of 2025; H.R. 1867 Behavioral Health Accessibility Act; Telehealth Modernization Act; S. 1248/H.R. 2533 EASE Act; H.R 1. One Big Beautiful Bill Act; S.2011/H.R. 3884 Telemental Health Care Access Act of 2025; H.R. 3419 Reauthorization of telehealth network and telehealth resource centers grant programs; S.1535/H.R. 3108 Rural Patient Monitoring (RPM) Access Act; H.R. 4313/S. 2237 Hospital Inpatient Services Modernization Act; H.R. 1614 Expanded Telehealth Access Act; H.R. 1627 Telehealth Response for E-prescribing Addiction Therapy Services Act; H.R.8261 Chronic Care Management Improvement Act of 2026

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

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

S.1261/H.R. 4206 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; H.R. 2332/S.1101 States Handling Access to Reciprocity for Employment (SHARE) Act; H.R. 1407 Permanent Telehealth from Home Act; S. 763/H.R.1650 Telehealth Expansion Act of 2025; H.R. 2902 SPEAK Act of 2025; H.R. 1899 Audio-Only Telehealth Access Act of 2025; H.R. 2263 Telehealth Coverage Act of 2025; H.R. 1867 Behavioral Health Accessibility Act; Telehealth Modernization Act; S. 1248/H.R. 2533 EASE Act; H.R 1. One Big Beautiful Bill Act; S.2011/H.R. 3884 Telemental Health Care Access Act of 2025; H.R. 3419 Reauthorization of telehealth network and telehealth resource centers grant programs; S.1535/H.R. 3108 Rural Patient Monitoring (RPM) Access Act; H.R. 4313/S. 2237 Hospital Inpatient Services Modernization Act; H.R. 1614 Expanded Telehealth Access Act; H.R. 1627 Telehealth Response for E-prescribing Addiction Therapy Services Act; H.R.8261 Chronic Care Management Improvement Act of 2026

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

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

Legislation to improve care at the end of life; including H.R. 4313 / S. 2237; PCHETA (S. 2287/H.R.4425); Improving Access to Advance Care Planning Act (S.2865); Alzheimer's Screening and Prevention (ASAP) Act (H.R. 6130); Medicare Advance Planning (MAP) for Care Act (S. 3473).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation to improve care at the end of life; including H.R. 4313 / S. 2237; PCHETA (S. 2287/H.R.4425); Improving Access to Advance Care Planning Act (S.2865); Alzheimer's Screening and Prevention (ASAP) Act (H.R. 6130); Medicare Advance Planning (MAP) for Care Act (S. 3473).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Budget Reconciliation: SConRes7; HConRes14; PBM reform; telehealth; HR 1; HR5371; HR4313; S2237;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Budget Reconciliation; SConRes7; HConRes14; PBM reform; site neutrality; Telehealth; 340B Program; HR1; Hospital at Home S2237; HR4313; H1-B visas for health care providers;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Budget Reconciliation; SConRes7; HConRes14; PBM reform; site neutrality; Telehealth; Medicare extenders; Health @ Home program; DSH; 340B Program; HR1; HR4313; S2237; HR5371; 340B proposed changes by CMS to rebate program;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

Client expense: $821,438 · Firm income: Not reported

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

Home care; hospital at home; SNF at home; chronic care; Hospital Inpatient Services Modernization Act (H.R. 4313/S. 2237).

Client expense: Not reported · Firm income: $110,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.1261/H.R. 4206 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; H.R. 2332/S.1101 States Handling Access to Reciprocity for Employment (SHARE) Act; H.R. 1407 Permanent Telehealth from Home Act; S. 763/H.R.1650 Telehealth Expansion Act of 2025; H.R. 2902 SPEAK Act of 2025; H.R. 1899 Audio-Only Telehealth Access Act of 2025; H.R. 2263 Telehealth Coverage Act of 2025; H.R. 1867 Behavioral Health Accessibility Act; Telehealth Modernization Act; S. 1248/H.R. 2533 EASE Act; H.R 1. One Big Beautiful Bill Act; S.2011/H.R. 3884 Telemental Health Care Access Act of 2025; H.R. 3419 Reauthorization of telehealth network and telehealth resource centers grant programs; S.1535/H.R. 3108 Rural Patient Monitoring (RPM) Access Act; H.R. 4313/S. 2237 Hospital Inpatient Services Modernization Act; H.R. 1614 Expanded Telehealth Access Act; H.R. 1627 Telehealth Response for E-prescribing Addiction Therapy Services Act; H.R.8261 Chronic Care Management Improvement Act of 2026.

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

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

S.1261/H.R. 4206 Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act; H.R. 2332/S.1101 States Handling Access to Reciprocity for Employment (SHARE) Act; H.R. 1407 Permanent Telehealth from Home Act; S. 763/H.R.1650 Telehealth Expansion Act of 2025; H.R. 2902 SPEAK Act of 2025; H.R. 1899 Audio-Only Telehealth Access Act of 2025; H.R. 2263 Telehealth Coverage Act of 2025; H.R. 1867 Behavioral Health Accessibility Act; Telehealth Modernization Act; S. 1248/H.R. 2533 EASE Act; H.R 1. One Big Beautiful Bill Act; S.2011/H.R. 3884 Telemental Health Care Access Act of 2025; H.R. 3419 Reauthorization of telehealth network and telehealth resource centers grant programs; S.1535/H.R. 3108 Rural Patient Monitoring (RPM) Access Act; H.R. 4313/S. 2237 Hospital Inpatient Services Modernization Act; H.R. 1614 Expanded Telehealth Access Act; H.R. 1627 Telehealth Response for E-prescribing Addiction Therapy Services Act; H.R.8261 Chronic Care Management Improvement Act of 2026.

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

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

Issues related to home health, community-based services, behavioral health, adoption of electronic health records, and telehealth, generally, issues related to AI and digital health, generally; hospital at home, generally; H.R. 5371, The Continuing Appropriations and Extensions Act, 2026, issues related to health care, generally; S.2882 - Continuing Appropriations and Extensions and Other Matters Act, 2026, issues related to health care, generally; H.R.5142, Home Health Stabilization Act of 2025; H.R.4313/S.2237, Hospital Inpatient Services Modernization Act; H.R.4206/S.1261, CONNECT for Health Act of 2025; H.R.4993, Joe Fiandra Access to Home Infusion Act of 2025.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the Medicare Hospital at Home program. H.R.4313 - Hospital Inpatient Services Modernization Act - issues related to the hospital care at home. Monitor proposals related to NIH's calculation of indirect costs. H.R. 7148 - Consolidated Appropriations Act, 2026 - issues related to agencies supporting health care research in the U.S

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

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

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

Client expense: $5,320,000 · Firm income: Not reported

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

Budget Reconciliation: SConRes7; HConRes14; PBM reform; telehealth; HR 1; HR5371; HR4313; S2237;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Budget Reconciliation; SConRes7; HConRes14; PBM reform; site neutrality; Telehealth; 340B Program; HR1; Hospital at Home S2237; HR4313; H1-B visas for health care providers;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Budget Reconciliation; SConRes7; HConRes14; PBM reform; site neutrality; Telehealth; Medicare extenders; Health @ Home program; DSH; 340B Program; HR1; HR4313; S2237; HR5371; 340B proposed changes by CMS to rebate program;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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. 4313 / S. 2237, Hospital Inpatient Services Modernization Act of 2025, all provisions; S. 1261 / H.R. 4206, CONNECT for Health Act of 2025, all provisions; H.R. 1805, Assistance for Rural Community Hospitals (ARCH) Act, 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 / H.R. 6240 , 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; DRAFT, Blood Pressure MATTERS Act, all provisions; H.R. 5454/S. 2879, the Medicare Advantage Prompt Pay Act, all provisions; DRAFT, Rural Teaching Hospital Relief, all provisions; S. 2793, Ensuring Access to Essential Providers, all provisions; H.R. 10136, Promoting Fairness for Medicare Providers Act, all provisions; H.R. 7409, Defend Rural Health Act, all provisions; H.R. 7830, Women Expansion of Learning and Labor Safety (WELLS) Act, all provisions; Centers for Medicare and Medicaid Services (CMS), Issues pertaining completing the CMS Outpatient Prospective Payment System Drug Acquisition Cost Survey; Centers for Medicare and Medicaid Services (CMS), Issues pertaining to written guidance on acceptable signage and other materials that hospitals can use in their emergency departments to discourage violent behavior; Centers for Medicare and Medicaid Services (CMS), Issue pertaining to the proposed rule on the Increasing Organ Transplant Access Model; Centers for Medicare and Medicaid Services (CMS), Comments pertaining to proposed rule on the Global Benchmark for Efficient Drug Pricing model; The Medicare Payment Advisory Commission (MedPAC), Issues related to proposed payment updates and Medicare Advantage program; Centers for Medicare and Medicaid Services (CMS), Medicare Program Contract Year 2027 Policy and Technical Changes to the Medicare Advantage Program, Issue pertaining to proposed rule for policy and technical changes to the Medicare Advantage and Part D programs in contract year 2027; Centers for Medicare and Medicaid Services (CMS), Issue pertaining to the upcoming rulemaking implementing requirements related to hospital off-campus provider-based departments; Centers for Medicare and Medicaid Services (CMS), Issue pertaining to the Comprehensive Regulations To Uncover Suspicious Healthcare (CRUSH), which includes efforts to combat fraud waste and abuse in federal health care programs; Centers for Medicare and Medicaid Services (CMS), Issue pertaining to the proposed rulemaking on potential options to foster a more resilient supply chain for American-made personal protective equipment and essential medicines; Centers for Medicare and Medicaid Services (CMS), Issue pertaining to expanding the use of Medicare Conditions of Participation (CoP); Centers for Medicare and Medicaid Services (CMS), Issues pertaining to the proposed Notice of Benefit and Payment Parameters for 2027; Centers for Medicare and Medicaid Services (CMS), Issues pertaining to implementation of unique national provider (NPI) for hospital off-campus provider-based departments as outlined in Consolidated Appropriations Act of 2026; Medicaid Program, Issues pertaining to Medicaid program and how states finance programs, reimburse providers, and determine beneficiary eligibility, and implementation of H.R. 1 provisions related to state directed payments and provider taxes; Site Neutral Payments, Issues related to site neutral payment cuts; 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; Provider Reimbursements, Issues related to provider reimbursement, site neutral payment cuts, Medicare/Medicaid program funding, facility fees, DSH cuts, oversight; Expiring Health Care Provisions, Issues pertaining to Telehealth, Hospital at Home, MDH/LVA, Medicaid DSH Program; Post Acute Care, Issues pertaining to expanding and protecting patients access to services provided by long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities, and home health agencies; Rural Community Hospital Demonstration Project, Issues related to ending the Rural Community Hospital Demonstration Project.

Client expense: $6,080,000 · Firm income: Not reported

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

Medicaid State Directed Payments; 340B modernization; funding for Disproportionate Share Hospitals (Medicaid DSH); funding for Medicare graduate medical education (GME); Medicare site neutrality policies; support of telehealth policies; impact of regional oversaturation of trauma care on patient outcomes and health system costs; H.R. 4313/S. 2237, Hospital Inpatient Services Modernization Act; H.R. 267, the Health Care Price Transparency Act; H.R. 2590/S. 1264, the Mental and Physical Health Care Comorbidities Act of 2025.

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

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

Legislation to improve care at the end of life, including the Hospice Recertification Flexibility Act (H.R. 1720); Expanding Access to Palliative Care Act (S. 1935); Hospice Inpatient Modernization Act: H.R. 4313 / S. 2237; PCHETA (S. 2287/H.R.4425); Improving Access to Advance Care Planning Act (S.2865)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation to improve care at the end of life, including the Hospice Recertification Flexibility Act (H.R. 1720); Expanding Access to Palliative Care Act (S. 1935); Hospice Inpatient Modernization Act: H.R. 4313 / S. 2237; PCHETA (S. 2287/H.R.4425); Improving Access to Advance Care Planning Act (S.2865)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 3439/H.R. 6735, Connecting Caregivers to Medicare Act. S. 1227/H.R. 2491, Alleviating Barriers for Caregivers Act. P.L. 119-21, the One Big Beautiful Bill Act. H.R. 6766/S. 3492, the Essential Caregivers Act. H.R. 7966/S. 4118, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act. H.R. 7618, Stopping Addiction and Falls for the Elderly (SAFE) Act. S. 2237/H.R. 4313, Hospital Inpatient Services Modernization Act. H.R. 8100, Safe Staffing Saves Lives Act. S. 3886, Nurses Belong in Nursing Homes Act. H.R. 7966/S. 4118, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act. S. 3886, Nurses Belong in Nursing Homes Act. No bill number. Discussed Medicare payment models. No bill number. Discussed Medicare waste, fraud, and abuse. No bill number. Discussed health technology, data security, enrollee accounts, and access. No bill number. Discussed Medicaid and waste, fraud, and abuse. No bill number. Discussed Medicaid community engagement requirements and Data Strategy for Family Caregiver Verification. No bill number. Discussed nursing home staffing standards, safety, and quality. No bill number. Discussed nursing home transparency and ownership requirements. No bill number. Discussed home health, hospice, and long-term care. No bill number. Discussed Medicare Advantage. No bill number. Discussed the Medicare Prescription Drug Benefit Program. No bill number. Discussed the Medicare Cost Plan Program. No bill number. Discussed Medicare Advantage Capitation Rates. No bill number. Discussed Medicare Part C and Part D payment policies. No bill number. Discussed Medicare Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH). No bill number. Discussed AI tools for Medicare Experience modernization. No bill number. Discussed Medicare Advantage provider networks. No bill number. Discussed fraud in Medicare and Medicaid. No bill number. Discussed long-term services and supports. No bill number. Discussed home and community-based services. No bill number. Discussed the Money Follows the Person Rebalancing Demonstration Program. No bill number. Discussed Medicaid home and community-based services (HCBS) spousal impoverishment protections. No bill number. Discussed the direct care workforce. No bill number. Discussed family caregiver exemption from Medicaid community engagement requirements. No bill number. Discussed falls prevention. No bill number. Discussed age-friendly communities. No bill number. Discussed health at home. No bill number. Discussed the National Strategy to Support Family Caregivers. No bill number. Discussed the Older Americans Act reauthorization. No bill number. Discussed Medicaid HCBS waivers. No bill number. Discussed the health care workforce.

Client expense: $3,830,000 · 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

S. 925/H.R. 2036, Credit for Caring Act. S. 1565/H.R. 138, Lowering Costs for Caregivers Act. S. 3439/H.R. 6735, Connecting Caregivers to Medicare Act. S. 1227/H.R. 2491, Alleviating Barriers for Caregivers Act. P.L. 119-21, One Big Beautiful Bill Act. S. 830/H.R. 2560, the Lifespan Respite Care Reauthorization Act. H.R. 3089, the More Paid Leave for More Americans Act. H.R. 8100, the Safe Staffing Saves Lives Act. S. 3886, the Nurses Belong in Nursing Homes Act. H.R. 6766/S. 3492, the Essential Caregivers Act of 2025. H.R. 7966/S. 4118, the Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act S.2120, the Older Americans Act Reauthorization Act of 2025. H.R. 5575, the Firefighters Assisting Seniors to Emergency Response (FASTER) Act of 2025. H.R. 7567, the Farm, Food, and National Security Act of 2026. HR 1538, the Delivering for Rural Seniors Act of 2025. H.R. 1782, the Supporting all Healthy Options when Purchasing Produce (SHOPP) Act of 2025. S. 2237/H.R. 4313, the Hospital Inpatient Services Modernization Act. No bill number. Discussed paid leave for family caregivers. No bill number. Discussed support for family caregivers. No bill number. Discussed minimum staffing standards for long-term care facilities. No bill number. Discussed the Senior Hunger Prevention Act. No bill number. Discussed Nursing Home staffing standards, safety, and quality. No bill number. Discussed Nursing home transparency and ownership requirements. No bill number. Discussed SNAP, TEFAP, OAA nutrition programs, senior nutrition and food security. No bill number. Discussed home health, hospice, and long-term care. No bill number. Discussed falls prevention. No bill number. Discussed social isolation. No bill number. Discussed family caregiver exemption from Medicaid community engagement requirements and Data Strategy for Family Caregiver Verification. No bill number. Discussed fraud in Medicare and Medicaid, long-term services and supports, and home and community-based services. No bill number. Discussed research and data on family caregivers. No bill number. Discussed Medicare Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH). No bill number Discussed the direct care workforce. No bill number. Discussed family caregiver exemption from Medicaid community engagement requirements. No bill number. Discussed falls prevention. No bill number. Discussed health at home. No bill number. Discussed the National Strategy to Support Family Caregivers. No bill number. Discussed the Older Americans Act reauthorization. No bill number. Discussed Medicaid HCBS waivers. No bill number. Discussed the health care workforce. No bill number. Discussed end-of-life. No bill number. Discussed Assisting Caregivers Today (ACT) Caucus. No bill number. Discussed long-term care affordability. No bill number. Discussed long-term care.

Client expense: $3,830,000 · 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

S. 3439/H.R. 6735, Connecting Caregivers to Medicare Act. S. 1227/H.R. 2491, Alleviating Barriers for Caregivers Act. S. 2237/H.R. 4313, Hospital Inpatient Services Modernization Act. H.R. 8100, Safe Staffing Saves Lives Act. S. 3886, Nurses Belong in Nursing Homes Act. H.R. 6766/S. 3492, the Essential Caregivers Act. H.R. 7966/S. 4118, Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act. S.2120, the Older Americans Act Reauthorization Act. H.R. 5575, the Firefighters Assisting Seniors to Emergency Response (FASTER) Act. S. 668/H.R. 3183, Supporting Access to Falls Education and Prevention and Strengthening Training Efforts and Promoting Safety Initiatives (SAFE STEPS) for Veterans Act. H.R. 7618, Stopping Addiction and Falls for the Elderly (SAFE) Act. No bill number. Discussed minimum staffing standards. No bill number. Discussed Nursing Home staffing standards, safety, and quality. No bill number. Discussed Nursing home transparency and ownership requirements. No bill number. Discussed health technology, data security, and access. No bill number. Discussed senior nutrition and food security programs. No bill number. Discussed home health, hospice, and long-term care. No bill number. Discussed falls prevention. No bill number. Discussed social isolation. No bill number. Discussed enhanced premium tax credits for health insurance. No bill number. Discussed artificial intelligence in clinical care. No bill number. Discussed Health Data, Technology, and Interoperability (HTI-5) Proposed Rule. No bill number. Discussed Affordable Care Act Benefit and Payment Parameters. No bill number. Discussed electronic notification by health insurance plans. No bill number. Discussed fraud in Medicare and Medicaid. No bill number. Discussed long-term services and supports. No bill number. Discussed home and community-based services. No bill number. Discussed Medicaid HCBS. No bill number. Discussed Medicare Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH). No bill number Discussed direct care workforce. No bill number. Discussed family caregiver exemption from Medicaid community engagement requirements. No bill number. Discussed falls prevention. No bill number. Discussed health at home. No bill number. Discussed the National Strategy to Support Family Caregivers. No bill number. Discussed the Older Americans Act reauthorization. No bill number. Discussed Medicaid HCBS waivers. No bill number. Discussed the health care workforce. No bill number. Discussed end-of-life. No bill number. Discussed health savings accounts. No bill number. Discussed prescription drugs. No bill number. Discussed health care workforce issues.

Client expense: $3,830,000 · Firm income: Not reported

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

Issues related to Medicare graduate medical education residency positions. Issues related to Medicaid payments for safety net providers. Issues related to Medicaid disproportionate share hospital payments. Issues related to the Medicaid institutions for mental disease exclusion. Issues related to Medicare reimbursement for hospitals. Issues related to the Acute Hospital Care At Home program and S. 2237 / H.R. 4313, Hospital Inpatient Services Modernization Act. Issues related to telehealth. Issues related to the implementation of H.R. 1 (P.L. 119-21), One Big Beautiful Bill Act, as it relates to Medicaid and hospitals. H.R. 7148 (P.L. 119-75), Consolidated Appropriations Act, 2026, as it relates to Medicare extenders.

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

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

Monitored issues regarding PPS exempt hospitals. Issues concerning reimbursement for hospital services. Issues regarding hospital transparency. Issues regarding healthcare sector consolidation. Issues related to the extension of the Acute Care Hospital at Home program and S. 2237 / H.R. 4313, Hospital Inpatient Services Modernization Act. Issues related to telehealth. H.R. 1509 / S. 752, Accelerating Kids Access to Care Act. Monitored implementation of H.R. 1 (P.L. 119-21), One Big Beautiful Bill Act, as it relates to Medicaid and hospitals. Issues regarding organ transplantation. H.R. 7148 (P.L. 119-75), Consolidated Appropriations Act of 2026, as it relates to Medicare extenders.

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

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

H.R. 483: Health Care Efficiency Through Flexibility Act H.R. 5347: Health Care Efficiency Through Flexibility Act H.R. 786/ S. 1460: Preserving Patient Access to Accountable Care Act S.891: Bipartisan Health Care Act H.R. 1768: Lower Costs for Everyday Americans Act S. 1816/ 3514: Improving Seniors Timely Access to Care Act S. 1105: No UPCODE Act S. 2561/ H.R. 5768: Skin Substitute Access and Payment Reform Act H.R. 4773/ S. 3350: ACO Assignment Improvement Act H.R. 4313/ S.2237: Hospital Inpatient Services Modernization Act H.R. 8129: To amend title XVIII of the Social Security Act to establish a full risk ACO program H.R. 6852: Advanced Wound Care and Regenerative Medicine Access and Reform Act Issues related to Medicare payments, Medicare Shared Savings Program, ACO REACH, Medicare Advantage, alternative payment model incentives, telehealth, and fraud, waste, abuse

Client expense: $183,336 · Firm income: Not reported

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

Issues related to Medicaid access and reimbursement. Issues related to Medicare COVID-19 Telehealth Waivers/Flexibilities. Support for Hospital Inpatient Services Modernization Act (H.R. 4313/ S. 2237)

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicaid access and reimbursement. Issues related to Medicare COVID-19 Telehealth Waivers/Flexibilities. Support for Hospital Inpatient Services Modernization Act (H.R. 4313/ S. 2237)

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

340B Drug Pricing Program Acute Hospital at Home program FY2027 Labor-HHS-Education Appropriations (provisions pertaining to the Agency for Healthcare Research and Quality, Centers for Disease Control, and the Mission Zero program) Hospital Inpatient Services Modernization Act (H.R. 4313/S. 2237)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

Client expense: $577,720 · 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. 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.

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

Issues regarding reimbursement for hospital services. S. 2355, Patients Deserve Price Tags Act. Issues related to transparency. Issues concerning Medicaid services. Issues regarding health care sector consolidation. Issues concerning the extension of Acute Care Hospital at Home program and telehealth flexibilities. S. 2237 / H.R. 4313, Hospital Inpatient Services Modernization Act. Monitored implementation of H.R. 1 (P.L. 119-21), One Big Beautiful Bill Act, as it relates to Medicaid and hospitals. H.R. 7148 (P.L. 119-75), Consolidated Appropriations Act of 2026, as it relates to Medicare extenders.

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

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

Extension of Acute Hospital Care at Home waiver program; Hospital Inpatient Services Modernization Act (H.R. 4313/S. 2237); Telehealth Modernization Act of 2025 (H.R. 5081/S. 2709); H.R. 7148, Consolidated Appropriations Act, 2026

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE