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Legislative Progress
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0
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93pct
156d open
vs 10,940 other HR bills in the 119th — cohort avg 30d
Kayla Hamilton Act This bill requires the Department of Health and Human Services (HHS) to consider additional information when it makes placement determinations for unaccompanied alien children in its custody. Under federal law, an unaccompanied alien child is a minor with no lawful immigration status and no parent or legal guardian in the United States to provide care and physical custody. Current law requires HHS to (1) place a child in the least restrictive setting that is in the child's best interest, and (2) assess the safety and suitability of a sponsor prior to placing a child with that sponsor. In determining the least restrictive setting, this bill requires (currently, permits) HHS to consider the child's danger to self, danger to the community, and flight risk. Additionally, the bill requires placement in a secure facility in the case of a child who is 13 years of age or older and has gang-related markings or tattoos or a history of gang-related arrests or criminal conduct. In assessing the safety and suitability of a sponsor, this bill requires HHS to collect and provide to the Department of Homeland Security information about all adult residents of the household, including name, date of birth, Social Security number, immigration status, contact information, and the results of all background and criminal records checks. The bill also prohibits HHS from placing a child with a sponsor who is unlawfully present in the United States.
Yes
433
No
419
Present
0
Not Voting
14
Party Breakdown
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Filing registrants (9)
Received in the Senate.
The title of the measure was amended. Agreed to without objection.
Motion to reconsider laid on the table Agreed to without objection.
On passage Passed by the Yeas and Nays: 225 - 201 (Roll no. 340). (text of amendment in the nature of a substitute: CR H5921-5922)
HousePassed/agreed to in House: On passage Passed by the Yeas and Nays: 225 - 201 (Roll no. 340). (text of amendment in the nature of a substitute: CR H5921-5922)
HouseOn motion to recommit Failed by the Yeas and Nays: 208 - 218 (Roll no. 339).
HouseConsidered as unfinished business. (consideration: CR H5933-5934)
POSTPONED PROCEEDINGS - At the conclusion of debate H.R. 4371, the Chair put the question on motion to recommit and announced that the ayes had prevailed. Ms. Stansbury demanded the yeas and nays and the Chair postponed further proceedings until a time to be announced.
Bills with similar content found using semantic analysis.
Sources: Congress.gov · House Clerk roll-call votes
| #339 | house | On Motion to Recommit | Failed | December 16, 2025 |
| #340 | house | On Passage | Passed | December 16, 2025 |
2026 · third_quarter · Medicare/Medicaid
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
2026 · first_quarter · Immigration
S. 455 - Protect Sensitive Locations Act S.398 - No BAN Act S. 2212 - VISIBLE Act H.R. 1061 - Protect Sensitive Locations Act H.R. 924 - No BAN Act H.R. 4667 - VISIBLE Act H.R. 4371 - Kayla Hamilton Act House unnumbered immigration enforcement reform House unnumbered GRACE Act Senate unnumbered GRACE Act H.R. 6397 Dignity for Detained Immigrants Immigration arrests and detentions of DACA recipients and Dreamers Restart the United States Refugee Admissions Program, resettle already approved refugees, and FY26 Presidential Determination Disentangle military from immigration enforcement Public Charge 2025 Naturalization Civics Test implementation
Client expense: $1,000,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, State, Dept of (DOS)
2026 · second_quarter · Medicare/Medicaid
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
2026 · first_quarter · Immigration
S. 455 - Protect Sensitive Locations Act S.398 - No BAN Act S. 2212 - VISIBLE Act H.R. 1061 - Protect Sensitive Locations Act H.R. 924 - No BAN Act H.R. 4667 - VISIBLE Act H.R. 4371 - Kayla Hamilton Act House unnumbered immigration enforcement reform House unnumbered GRACE Act Senate unnumbered GRACE Act H.R. 6397 Dignity for Detained Immigrants Immigration arrests and detentions of DACA recipients and Dreamers Restart the United States Refugee Admissions Program, resettle already approved refugees, and FY26 Presidential Determination Disentangle military from immigration enforcement Public Charge 2025 Naturalization Civics Test implementation
Client expense: $1,000,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, State, Dept of (DOS)
2026 · first_quarter · Immigration
H.R.3763/S.1965, Protect Vulnerable Immigrant Youth Act H.R. 4371, Kayla Hamilton Act S.1297, Fair Day in Court for Kids Act of 2025 H.R.1, One Big Beautiful Bill Act (provisions related to unaccompanied children) H.R.6938/S.2354, Commerce, Justice, Science, and Related Agencies Appropriations Act, 2026 (issues related to specialized juvenile dockets, EOIR reporting, Legal Orientation program, and fee exemptions) H.R.5304/S.2587, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026 (issues related to funding for UC legal services) Issues related to State, Foreign Operations, and Related Programs Appropriations Act, 2026 H.R.1144, Frederick Douglass Trafficking Victims Prevention and Protection Reauthorization Act of 2025 S.455, Protecting Sensitive Locations Act S.3683, Stop Excessive Force in Immigration Act of 2026 Issues related to limiting military transport and mandatory detention of unaccompanied children; Issues related to mental health impacts of prolonged detention of children Issues related to DNA testing of children Issues related to access to reproductive health services at San Benito, TX shelter Issues related to limiting detention of children and immigration enforcement at sensitive locations Issues related to the Refugee Protection Act Issues related to specialized juvenile dockets Issues related to unaccompanied children fee exemptions Issues related to detention of immigrant children Issues related to victim-centered protections Issues related to oversight of UAC Safety Verification Initiative Issues related to exempting unaccompanied children from OBBBA fees Issues related to parental interests of adults detained by ICE Issues related to missing unaccompanied children Issues related to Plyler v. Doe Issues related to Special Order Hour on immigrant children Issues related to DHS accountability Issues related to the Immigration Court Efficiency and Childrens Court Act Issues related to unaccompanied children's legal and social services and child advocates Issues related to unaccompanied children's legal services contract Issues related to anti-trafficking solutions for unaccompanied children Issues related to family separation and detention Issues related to unaccompanied children's immigration court dockets Issues related to biometrics collection Issues related to HHS Ombuds Issues related to family detention oversight visit Issues related to FY27 appropriations, including legal services for unaccompanied children and funding for child welfare professionals in border patrol facilities Issues related to continued funding for child welfare professionals in the FY27 DHS budget Issues related to education for children in ICE facilities Issues related to prolonged detention of unaccompanied children and unlawful summary removals of kids Issues related to Dignity Act Issues related to juvenile docket court observation in NYC Issues related to Special Immigrant Juvenile Status Issues related to ORR detention and shelter Issues related to ORR sponsor vetting Issues related to bipartisan immigration reform legislation Issues related to the DHS Child Well-Being Program HELP Separated Children Act Executive Office for Immigration Review, Appellate Procedures for the Board of Immigration Appeals (Docket No. EOIR-26-AB37; Dir. Order No. 02-2026] RIN 1125-AB37) Issues related to Executive Order 12866 Issues related to return and reintegration of unaccompanied children Issues related to ORR, including ORR oversight
Client expense: $130,000 · Firm income: Not reported
Government targets: Bureau of Citizenship & Immigration Services (BCIS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), U.S. Immigration & Customs Enforcement (ICE)
2026 · first_quarter · Medicare/Medicaid
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.
2026 · first_quarter · Immigration
H.R. 2 / S. 2824,Secure the Border Act H.R. 7296 / S. 3752 / S. 1383 Safeguard American Voter Eligibility (SAVE America) Act H.R. 22 / S. 128, Safeguard American Voter Eligibility (SAVE) Act H.R. 151 / S. 2205, Equal Representation Act H.R. 4371, Kayla Hamilton Act H.R. 7744, Department of Homeland Security Appropriations Act, 2026 H.R. 7148, Consolidated Appropriations Act, 2026 H.R.7147, Further Additional Continuing Appropriations Act, 2026 H.R. 1958, Deporting Fraudsters Act H.R. 4638, Federal Working Animal Protection Act S. 3857 / H.R. 7780, One Nation, One Visa Policy Act S. 3955, Migrant Crime Reporting Act S. 3909, Stop Illegal Alien Cops Act S. 3674 / H.R. 7156, Stop Citizenship Abuse and Misrepresentation (SCAM) Act Department of Homeland Security Reconciliation Package
Client expense: $44,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2025 · fourth_quarter · Immigration
S. 455 - Protect Sensitive Locations Act S.398 - No BAN Act S. 2212 - VISIBLE Act H.R. 1061 - Protect Sensitive Locations Act H.R. 924 - No BAN Act H.R. 4667 - VISIBLE Act H.R. 4371 - Kayla Hamilton Act House unnumbered immigration enforcement reform House unnumbered GRACE Act Senate unnumbered GRACE Act H.R. 6397 Dignity for Detained Immigrants Immigration arrests and detentions of DACA recipients and Dreamers Restart the United States Refugee Admissions Program, resettle already approved refugees, and FY26 Presidential Determination Disentangle military from immigration enforcement Public Charge 2025 Naturalization Civics Test implementation
Client expense: $1,000,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, State, Dept of (DOS)
2025 · fourth_quarter · Immigration
S. 455 - Protect Sensitive Locations Act S.398 - No BAN Act S. 2212 - VISIBLE Act H.R. 1061 - Protect Sensitive Locations Act H.R. 924 - No BAN Act H.R. 4667 - VISIBLE Act H.R. 4371 - Kayla Hamilton Act House unnumbered immigration enforcement reform House unnumbered GRACE Act Senate unnumbered GRACE Act H.R. 6397 Dignity for Detained Immigrants Immigration arrests and detentions of DACA recipients and Dreamers Restart the United States Refugee Admissions Program, resettle already approved refugees, and FY26 Presidential Determination Disentangle military from immigration enforcement Public Charge 2025 Naturalization Civics Test implementation
Client expense: $1,000,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, State, Dept of (DOS)
2025 · fourth_quarter · Immigration
S. 455 - Protect Sensitive Locations Act S.398 - No BAN Act S. 2212 - VISIBLE Act H.R. 1061 - Protect Sensitive Locations Act H.R. 924 - No BAN Act H.R. 4667 - VISIBLE Act H.R. 4371 - Kayla Hamilton Act House unnumbered immigration enforcement reform House unnumbered GRACE Act Senate unnumbered GRACE Act H.R. 6397 Dignity for Detained Immigrants Immigration arrests and detentions of DACA recipients and Dreamers Restart the United States Refugee Admissions Program, resettle already approved refugees, and FY26 Presidential Determination Disentangle military from immigration enforcement Public Charge 2025 Naturalization Civics Test implementation
Client expense: $1,000,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, State, Dept of (DOS)
2025 · fourth_quarter · Immigration
Legislation and policies related to: Detentions and deportation of children and families with children Authorization of the Deferred Action for Childhood Arrivals program Implementation of provisions of the One Big, Beautiful Bill Act (PL 119-21) H.R. 1061/S. 455, Protecting Sensitive Locations Act H.R. 4371, Kayla Hamilton Act H.R. 5319, Limiting ICEs Nationwide Encroachment (LINE) Act
Client expense: Not reported · Firm income: $24,000
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE
2025 · fourth_quarter · Immigration
H.R.32 - No Bailout for Sanctuary Cities Act. H.R.3486 - Stop Illegal Entry Act of 2025. H.R.4371 - Kayla Hamilton Act.
Client expense: Not reported · Firm income: $30,000
Government targets: HOUSE OF REPRESENTATIVES
2025 · fourth_quarter · Immigration
H.R.32 - No Bailout for Sanctuary Cities Act. H.R.3486 - Stop Illegal Entry Act of 2025. H.R.4371 - Kayla Hamilton Act.
Client expense: Not reported · Firm income: $60,000
Government targets: HOUSE OF REPRESENTATIVES
2025 · fourth_quarter · Immigration
H.R.3763/S.1965, Protect Vulnerable Immigrant Youth Act H.R. 4371, Kayla Hamilton Act S.3322/H.R.6389, Upholding Protections for Unaccompanied Children Act of 2025 S.1297/H.R 3763, Fair Day in Court for Kids Act of 2025 S.3146/H.R.5941, Restoring Access for Detainees Act H.R. 6091/S. 3187, Bivens Act of 2025 H.R.1, One Big Beautiful Bill Act (provisions related to unaccompanied children) H.R.5342/S.2354, Commerce, Justice, Science, and Related Agencies Appropriations Act, 2026 (issues related to Legal Orientation Program funding and specialized childrens dockets reporting) H.R.5304/S.2587, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026 Issues related to about legal services funding, removals of unaccompanied children, changes in OBBBA fees and fines affecting unaccompanied children Issues related to family separation Issues related to the Family Reunification Task Force Act Issues related to ICE enforcement and detention Issues related to the POD Act Issues related to Special Immigrant Juvenile Status Issues related to ORR detention and shelter Issues related to ORR sponsor vetting/release policies Issues related to HSI interviews of children in ORR custody Issues related to Childrens Safe Welcome Act Issues related to incentivized, summary returns, and voluntary departure of unaccompanied children Issues related to TVPRA reauthorization Issues related to fines for unaccompanied childrens entry into the United States Issues related to Restoring Access to Detainees Act Issues related to protections for children in HHS custody Issues related to Operation Freaky Friday and payment of stipends Issues related to limiting mandatory detention of children Issues related to the use of military to transport children Issues related to legal representation Issues related to immigration enforcement Issues related to immigration reform Issues related to Immigration Court Efficiency and Childrens Court Act Issues related to unaccompanied children returns and reintegration Expedited OMB Review and Public Comment: Placement and Transfer of Unaccompanied [Alien] Children into ORR Care Provider Facilities (OMB #: 0970-0554) Removal of the Automatic Extension of Employment Authorization Documents, CIS No. 2826-25; DHS Docket No. USCIS- 2025-0271, 90 Fed. Reg. 48799 (Oct. 30, 2025) Public Charge Ground of Inadmissibility, [CIS No. 2836-25; DHS Docket No. USCIS- 2025-0304], 90 Fed. Reg. 52168 (Nov. 19, 2025) DHS Docket No. USCIS-2025-0205, RIN 1615-AC99, Collection and Use of Biometrics by U.S. Citizenship and Immigration Services, 90 Fed. Reg. 49062 (Nov. 3, 2025)
2025 · fourth_quarter · Medicare/Medicaid
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 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 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. 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: 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. 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 allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their disproportionate share hospital (DSH) cap. 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.
2025 · fourth_quarter · Civil Rights/Civil Liberties
LEGISLATION: S. 1748-Kids Online Safety Act-Issues Lobbied: Free Speech, Privacy, Civil Rights and Liberties. S. 3663-Kids Online Safety Act-Issues Lobbied: Free Speech, Privacy. S. 9-Protection of Women and Girls in Sports Act of 2025-Issues Lobbied: LGBTQ Rights. S. 894-Do No Harm Act-Issues Lobbied: Religious Liberty. S. 128-SAVE Act-Issues Lobbied: Voting Rights. S. 1503-Equality Act-Issues Lobbied: LGBTQ Rights. S. 2164-Algorithmic Accountability Act of 2025-Issues Lobbied: Algorithmic Justice. S. 1957-No Place for LGBTQ+ Hate Act-Issues Lobbied: LGBTQ Rights. S. 1829-STOP CSAM Act of 2025-Issues Lobbied: Free Speech, Privacy. S. 2150-Womens Health Protection Act of 2025-Issues Lobbied: Reproductive Rights. S. 2296-National Defense Authorization Act for Fiscal Year 2026-Issues Lobbied: LGBTQ Rights, Death Penalty, Immigration, Law Enforcement, National Security, Intelligence Authorization Act, ECSP Fix, Defense Authorization Bill, DETERRENCE Act, New Death Penalty Provision in the US Military Code, Federal Sentencing, Civil Rights and Liberties. S. 2212-VISIBLE Act-Issues Lobbied: Immigration, Federal Policing Reform. S. 188-Free Speech Protection Act-Issues Lobbied: Free Speech. S. 2523-John R. Lewis Voting Rights Advancement Act of 2025-Issues Lobbied: Voting Rights. S. 2902-Hidden Foster Care Transparency Act-Issues Lobbied: Womens Rights. S. 1071-National Defense Authorization Act for Fiscal Year 2026-Issues Lobbied: LGBTQ Rights, Immigrants Rights, Racial Justice, Privacy & Technology, Crime Related Amendments, Trans Justice, Systemic Equality, Reproductive Rights. S.3386-Health Care Freedom for Patients Act of 2025-Issues Lobbied: LGBTQ Rights, Reproductive Rights, Immigrants Rights. S. 2198-Military in Law Enforcement Accountability Act-Issues Lobbied: Domestic Deployment of the Military, Law Enforcement, National Security, Immigration, Abuse of Power. S. 2316-Cooper Davis and Devin Norring Act-Issues Lobbied: Free Speech, Privacy. S. 836-Children and Teens Online Privacy Protection Act-Issues Lobbied: Privacy. S. 3495-Artificial Intelligence Scam Prevention Act-Issues Lobbied: Artificial Intelligence. S. 1691-Traveler Privacy Protection Act of 2025-Issues Lobbied: Privacy. S. 278-Kids Off Social Media Act-Issues Lobbied: Free Speech, Privacy. S. 3308-Artificial Intelligence Civil Rights Act of 2025-Issues Lobbied: Algorithmic Justice. S. 3167-No Troops in Our Streets Act of 2025-Issues Lobbied: Law Enforcement Deployment. S. 2975-PIPELINE Safety Act of 2025-Issues Lobbied: Pipeline Harassment. S. 2803-SUN Act-Issues Lobbied: Law Enforcement, National Security. S. 3326-Temporary Immigration Judge Integrity Act-Issues Lobbied: Immigration. S. 3396-Domestic Workers Bill of Rights Act-Issues Lobbied: Immigration, Womens Rights. S. 2070-Insurrection Act of 2025-Issues Lobbied: Civil Rights and Liberties. S. 2149-Health Equity and Access under the Law for Immigrant Families Act of 2025-Issues Lobbied: Reproductive Rights, Immigration. S. 3077-Safer Supervision Act of 2025-Issues Lobbied: Federal Supervision, Re-Entry. S. 3385-Lower Health Care Costs Act-Issues Lobbied: Disability Rights. S. 3448-Keeping All Students Safe Act-Issues Lobbied: Disability Rights. H.R. 14-John R. Lewis Voting Rights Advancement Act of 2025-Issues Lobbied: Voting Rights. H.R. 12-Womens Health Protection Act of 2025-Issues Lobbied: Reproductive Rights. H.R. 28-Protection of Women and Girls in Sports Act of 2025-Issues Lobbied: LGBTQ Rights. H.R. 2487-Transgender Health Care Access Act-Issues Lobbied: LGBTQ Rights. H.R. 1954-Do No Harm Act-Issues Lobbied: Religious Liberty. H.R. 22-SAVE Act-Issues Lobbied: Voting Rights. H.R. 1-One Big Beautiful Bill Act-Issues Lobbied: Algorithmic Justice (Reconciliation Package/AI moratorium), Letter to Senate Aging Committee for hearing on HCBS and impact of H.R. 1. H.R. 15-Equality Act-Issues Lobbied: LGBTQ Rights. H.R. 3492-Protect Childrens Innocence Act-Issues Lobbied: LGBTQ Rights, Trans Justice. H.R. 3944-Military Construction, Veterans Affairs, and Related Agencies Appropriations Act-Issues Lobbied: Civil Rights and Liberties. H.R. 3708-No Place for LGBTQ+ Hate Act-Issues Lobbied: LGBTQ Rights. H.R. 4121-Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2026-Issues Lobbied: Reproductive Rights. H.R. 151-Equal Representation Act-Issues Lobbied: Census. H.R. 3838-Streamlining Procurement for Effective Execution and Delivery and National Defense Authorization Act for Fiscal Year 2026-Issues Lobbied: LGBTQ Rights, Civil Rights and Liberties. H.R. 4016-Department of Defense Appropriations Act-Issues Lobbied: Reproductive Rights, Diversity Equity and Inclusion. H.R. 3486-Stop Illegal Entry Act of 2025-Issues Lobbied: Mandatory Minimums, Sentencing Reform, Mass Incarceration. H.R. 5304-Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026-Issues Lobbied: Reproductive Rights, Disability Rights, Healthcare Access, Civil Rights and Liberties. H.R. 1880-Broadcast Freedom and Independence Act of 2025-Issues Lobbied: Free Speech. H.R. 5371-Continuing Appropriations and Extensions Act, 2026-Issues Lobbied: Government Funding, Impoundments, Government Shutdown. H.R. 4922-D.C. Criminal Reforms to Immediately Make Everyone Safe Act of 2025-Issues Lobbied: Criminal Justice, Criminal Penalties. H.R. 5143-District of Columbia Policing Protection Act of 2025-Issues Lobbied: Criminal Justice. H.R. 5125-District of Columbia Judicial Nominations Reform Act of 2025-Issues Lobbied: Criminal Justice. H.R. 5140-To lower the age at which a minor may be tried as an adult for certain criminal offenses in the District of Columbia to 14 years of age Act-Issues Lobbied: Criminal Justice. H.R. 5068-MORE Act-Issues Lobbied: Marijuana Decriminalization. H.R. 59-Mens Rea Reform Act of 2025-Issues Lobbied: Sentencing Reform. H.R. 4371-Kayla Hamilton Act-Issues Lobbied: Immigration, Child Immigrants. H.R. 5342-Commerce, Justice, Science, and Related Agencies Appropriations Act, 2026-Issues Lobbied: Criminal Legal Reform. H.R. 4553-Energy and Water Development and Related Agencies Appropriations Act, 2026-Issues Lobbied: Civil Rights and Liberties. H.R. 5166-Financial Services and General Government Appropriations Act, 2026-Issues Lobbied: DC Home Rule. H.R. 4213-Department of Homeland Security Appropriations Act, 2026-Issues Lobbied: Immigration. H.R. 4889-To prohibit States from carrying out more than one Congressional redistricting after a decennial census and apportionment-Issues Lobbied: Voting Rights. H.R. 4358-Anti-Rigging Act of 2025-Issues Lobbied: Voting Rights. H.R. 5507-Hidden Foster Care Transparency Act-Issues Lobbied: Womens Rights. H.R. 498-Do No Harm in Medicaid Act-Issues Lobbied: LGBTQ Rights, Trans Justice. H.R. 5604-National Guard Proper Use Act-Issues Lobbied: Domestic Deployment of the Military, Law Enforcement, National Security, Immigration. H.R. 4518-Cooper Davis and Devin Norring Act-Issues Lobbied: Free Speech, Privacy. H.R. 3921-STOP CSAM Act of 2025-Issues Lobbied: Free Speech, Privacy. H.R. 6291-Children and Teens Online Privacy Protection Act-Issues Lobbied: Privacy. H.R. 2683-Remote Access Security Act-Issues Lobbied: Privacy. H.R. 4831-ENFORCE Act-Issues Lobbied: Privacy. H.R. 5214-District of Columbia Cash Bail Reform Act of 2025-Issues Lobbied: Bail in DC. H.R. 780-Alexandras Law Act of 2025-Issues Lobbied: Admonition for Fentanyl Sales. H.R. 4998-SUN Act-Issues Lobbied: Law Enforcement, National Security. H.R. 6397-Dignity for Detained Immigrants Act-Issues Lobbied: Immigration Detention. H.R. 2870-Working Families Flexibility Act of 2025-Issues Lobbied: Womens Rights. H.R. 6521-Immigration Court Due Process Protection Act of 2025-Issues Lobbied: Immigration. H.R. 4611-EACH Act of 2025-Issues Lobbied: Reproductive Rights. H.R. 6703-Lower Health Care Premiums for All Americans Act-Issues Lobbied: Reproductive Rights. H.R. 6091-Bivens Act of 2025-Issues Lobbied: Policing Reform, Cause of Action for Victims, Abuse of Power. H.R. 6617-Keeping All Students Safe Act-Issues Lobbied: Disability Rights. H.R. 2918-Fair Housing for Survivors Act of 2023-Issues Lobbied: Womens Rights. H.R. 3971-Domestic Workers Bill of Rights Act-Issues Lobbied: Womens Rights. H.R. 4250-PRESS Act-Issues Lobbied: First Amendment. LEGISLATION WITH NO BILL NUMBER AND APPOINTMENTS: Additional legislation not yet introduced - Patenting of genes and gene research legislation; Legislation relating to defining antisemitism in education programs - First Amendment protections; Draft legislation on artificial intelligence and implementation of EO on artificial intelligence - free speech, privacy, nondiscrimination; Oversight over counterterrorism policy and practices - torture, detention, drones, war authority, Guantanamo Bay; Section 702 reauthorization - civil liberties and national security; Car privacy; General age verification and privacy; Mental Health Justice Act - community safety; Cannabis Administration and Opportunity Act - marijuana decriminalization; Section 230 of Communications Decency Act proposals - free speech, internet integrity; Amendments to the Privacy Act of 1974; TSA use of facial recognition technology; DHS data consolidation; FCC First Amendment violations - free speech; Censorship; Protest Rights; Domestic deployment of the military; Continued funding for Affordable Connectivity Act - ensuring continued funding for broadband subsidy; DC Statehood; Civil liberties; Free speech; Algorithmic justice; Reproductive rights; FY26 Federal Funding; ICE detainment of students for protesting - free speech; Administration First Amendment violations; Immigration enforcement oversight; ICE Use of Force Act - federal policing reform; Removing body worn camera paywall - policing reform; Kinetic impact weapons regulation; New death penalty provision in the US military code; Privacy Act of 1974 reforms; Federal consumer privacy framework; Federal AI use case inventories; Law Enforcement Deployment; National Security; Jawboning; No Political Enemies Act; Bivens remedy; Free speech on campus; Federal Domestic Workers Bill of Rights; Aging in place hearing; Future abortion codification legislation; Womens rights; Disability rights; Appropriations - LGBTQ rights, reproductive rights; Stop Terror-Financing and Tax Penalties on American Hostages Act - nonprofits tax status and material support for terrorism; Fourth Amendment is Not For Sale Act - prohibiting data purchases by law enforcement and intelligence agencies; Legislative proposal on reproductive rights and access; Immigration detention - advising on oversight; Accountability for ICE/federal immigration agency violations - prospective bills; PROTECT Immigration Act - state and local involvement in immigration; Third country removal accountability; Immigrant children warrant bill; Criminal legal reform; Response to potential invocation of Insurrection Act; Freedom to Vote Act; Voter challenge legislation; Automatic Voter Registration Act; Administration attacks on Head Start; Fair Wages for Home Care Workers Act; Legal authority related to military strikes/Venezuela/boats - presidential action and concurrent resolutions, use of lethal force; FCC commissioner pressuring private companies in violation of First Amendment; Continuing Resolutions for FY26 - Protecting existing nondiscrimination provisions. AGENCIES: Agency - Homeland Security - Issues Lobbied: Federal artificial intelligence use case inventories, algorithmic justice, Dignity for Detained Immigrants Act, immigration detention conditions, MOC access to detention facilities, temporary protected status, travel ban. Agency - Office of Science and Technology Policy - Issues Lobbied: Use of AI in hiring, healthcare, and other protected areas, algorithmic justice. Agency - Labor - Issues Lobbied: Use of AI in hiring, healthcare, and other protected areas, algorithmic justice. Agency - U.S. Trade Representative - Issues Lobbied: U.S. commitments at WTO, open internet. Agency - National Security Council - National Security memo on uses of AI, privacy. Agency - Education - Issues Lobbied: Legislation relating to defining antisemitism in education programs, First Amendment protections, statement opposing breakup of Department of Education, disability rights. Agency - NIST - Issues Lobbied: Use of AI in hiring, healthcare, and other protected areas, algorithmic justice, supply chains and digital trade. Agency - Office of the Director of National Intelligence - Issues Lobbied: Section 702 of Foreign Intelligence Surveillance Act, related legislation and hearings, civil liberties and national security issues. Agency - Department of Health and Human Services - Issues Lobbied: NIH data sharing platform, privacy, Executive Order 12866-HHS/CMS proposed rules, LGBTQ Rights. Agency - Federal Communications Commission - Issues Lobbied: First Amendment violations, FCC commissioner pressuring private companies in violation of First Amendment. Agency - Department of Justice - Issues Lobbied: Executive Order 12866-DOJ/BOP PREA proposed rule, LGBTQ Rights, Executive Order 14168, Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government, federal prisons. Agency - Executive Office of the President - Issues Lobbied: FCC commissioner pressuring private companies in violation of First Amendment, privacy. Agency - Department of State - Issues Lobbied: Travel ban. Agency - Office of Management and Budget - Issues Lobbied: Executive Order 14168, Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government, federal prisons.
2025 · fourth_quarter · Immigration
S. 455 - Protect Sensitive Locations Act S.398 - No BAN Act S. 2212 - VISIBLE Act H.R. 1061 - Protect Sensitive Locations Act H.R. 924 - No BAN Act H.R. 4667 - VISIBLE Act H.R. 4371 - Kayla Hamilton Act House unnumbered immigration enforcement reform House unnumbered GRACE Act Senate unnumbered GRACE Act H.R. 6397 Dignity for Detained Immigrants Immigration arrests and detentions of DACA recipients and Dreamers Restart the United States Refugee Admissions Program, resettle already approved refugees, and FY26 Presidential Determination Disentangle military from immigration enforcement Public Charge 2025 Naturalization Civics Test implementation
Client expense: $1,000,000 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, State, Dept of (DOS)
2025 · fourth_quarter · Civil Rights/Civil Liberties
H.R.22 SAVE Act - opposed. No Political Enemies (NOPE) Act - in support. H.R.4371 - Kayla Hamilton Act - opposed.
Client expense: Not reported · Firm income: $20,000
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2025 · fourth_quarter · Immigration
In support of the Protecting Sensitive Locations Act (H.R.1061/S.455). In opposition to the an NPRM on the Public Charge Ground of Inadmissibility, Re: DHS Docket No. USCIS-2025-0304, U.S. Citizenship and Immigration Services. In opposition to the Kayla Hamilton Act (H.R.4371).
Client expense: Not reported · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2025 · fourth_quarter · Immigration
H.R. 2 / S. 2824,Secure the Border Act H.R. 22 / S. 128, Safeguard American Voter Eligibility (SAVE) Act H.R. 151 / S. 2205, Equal Representation Act H.R. 4371, Kayla Hamilton Act H.R. 5371, Continuing Appropriations and Extensions Act, 2026 H.R. 5450, Continuing Appropriations and Extensions and Other Matters Act, 2026 S. 2296, National Defense Authorization Act for Fiscal Year 2026 H.R. 3838, Streamlining Procurement for Effective Execution and Delivery and National Defense Authorization Act for Fiscal Year 2026 S. 1071, National Defense Authorization Act for Fiscal Year 2026 H.R 6057, Criminal Alien Removal Clarification Act S. 3584, Stop Illegal Aliens Drunk Driving Act
Client expense: $36,515 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2025 · third_quarter · Immigration
H.R. 2 / S. 2824,Secure the Border Act H.R. 1 / Senate Amendment to H.R. 1, reconciliation package H.R. 875,the Jeremy and Angel Seay and Sergeant Brandon Mendoza Protect Our Communities from DUIs Act H.R. 3486, the Stop Illegal Entry Act H.R. 22 / S. 128, Safeguard American Voter Eligibility (SAVE) Act H.R. 151 / S. 2205, Equal Representation Act S. 2821, American Tech Workforce Act H.R. 4234, Safeguarding Americans From Extremist Risk (SAFER) at the Border Act H.R. 5232, Domestic Jobs Protection Act H.R. 5005, Sanctuary Penalty and Public Protection Act S. 2555, Student Visa Integrity Act H.R. 4371, Kayla Hamilton Act H.R. 5371, Continuing Appropriations and Extensions Act, 2026 H.R. 5450, Continuing Appropriations and Extensions and Other Matters Act, 2026
Client expense: $29,515 · Firm income: Not reported
Government targets: HOUSE OF REPRESENTATIVES, SENATE
2025 · third_quarter · Immigration
H.R.3763/S.1965, Protect Vulnerable Immigrant Youth Act H.R.4, Rescissions Act of 2025 H.R.4817, Immigrant Witness and Victim Protection Act of 2025 H.R.4393, To secure the border and reform the immigration laws (Dignity Act) H.R.1, One Big Beautiful Bill Act (provisions related to unaccompanied children) H.R.4213, Department of Homeland Security Appropriations Act, 2026 H.R.1144, Frederick Douglass Trafficking Victims Prevention and Protection Reauthorization Act of 2025 H.R. 4371, To amend the William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008 to enhance efforts to combat the trafficking of children H.R. 4176, No Secret Policy Act of 2025 S.3178/H.R.6145, Immigration Court Efficiency and Childrens Court Act S.455/H.R.1061, Protecting Sensitive Locations Act Issues related to Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026 Issues related to Departments of Commerce, Justice, Science, and Related Agencies Appropriations Act, 2026 Issues related to State, Foreign Operations, and Related Programs Appropriations Act, 2026 Issues related to family separation Issues related to trafficking and exploitation of unaccompanied children Issues related to ICE check-ins Issues related to fees for Special Immigrant Juvenile status and border apprehensions Issues related to data on removals of unaccompanied children Issues related to unaccompanied child application fees Issues related to ORR sponsor vetting/release policies Issues related to immigration court practices Issues related to HSI interviews of children in ORR custody Issues related to unaccompanied children returns and reintegration Issues related to ORR/DHS information sharing Issues related to legal representation Issues related to incentivized child returns Issues related to immigration reform Issues related to Asylum Cooperative Agreements (ACAs) Issues related to the arming of USCIS agents Issues related to removals of Guatemalan unaccompanied children DHS/USCIS on Agency Information Collection Activities; Revision of a Currently Approved Collection: Biometric Information (for Deferred Action)( Office of Management and Budget # 1615-0008 (90 Fed. Reg. 22752, May 29, 2025), and related Correction (90 Fed. Reg. 23947, June 5, 2025) Department of Educations Notice of Proposed Rulemaking [RIN 1801-AA28] Expedited Office of Management and Budget Review and Public Comment: Placement and Transfer of Unaccompanied [Alien] Children into ORR Care Provider Facilities (OMB #: 0970-0554) Issues related to Flores settlement FY26 CJS report language on EOIR Directors Memorandum 24-01 Issues related to Alex Adams confirmation
2025 · third_quarter · Medicare/Medicaid
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 Issue: Educate Congress on potential financial implications of Medicare and Medicaid cuts and entitlement reform on teaching hospitals and health systems, 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, reductions in wage index. Oppose cuts to federal Medicaid funding, including through 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 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 teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on impact of Statutory Pay-As-You-Go Act Medicare sequester H.R.4371/S.2439 - Resident Physician Shortage Reduction Act of 2025 Issue: Support increased Medicare funding for graduate medical education (GME). Issue: Support codification of Rural Residency Planning and Development grants. 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 continued 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: 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. 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 allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their disproportionate share hospital (DSH) cap. 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. 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 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). 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.
2025 · third_quarter · Civil Rights/Civil Liberties
LEGISLATION: S. 1748-Kids Online Safety Act-Issues Lobbied: Free Speech, Privacy, Civil Rights and Liberties. S. 3663-Kids Online Safety Act-Issues Lobbied: Free Speech, Privacy. S. 1080-Cooper Davis Act-Issues Lobbied: Free Speech, Privacy. S. 1199-Strengthening Transparency and Obligations to Protect Children Suffering from Abuse and Mistreatment Act of 2023-Issues Lobbied: Free Speech, Privacy. S. 1291-Protecting Kids on Social Media Act-Issues Lobbied: Free Speech, Privacy. S. 1939-FAA Reauthorization Act of 2024-Issues Lobbied: Privacy. S. 1418-Children and Teens Online Privacy Protection Act-Issues Lobbied: Privacy. S. 1-Freedom to Vote Act-Issues Lobbied: Voting Rights. S. 4213-Kids Off Social Media Act-Issues Lobbied: Free Speech, Privacy. S. 3361-Traveler Privacy Protection Act of 2023-Issues Lobbied: Privacy. S. 5152-Artificial Intelligence Civil Rights Act of 2024-Issues Lobbied: Algorithmic Justice. S. 9-Protection of Women and Girls in Sports Act of 2025-Issues Lobbied: LGBTQ Rights. S. 894-Do No Harm Act-Issues Lobbied: Religious Liberty. S. 128-SAVE Act-Issues Lobbied: Voting Rights. S. 1503-Equality Act-Issues Lobbied: LGBTQ Rights. S. 2164-Algorithmic Accountability Act-Issues Lobbied: Algorithmic Justice. S. 1957-No Place for LGBTQ+ Hate Act-Issues Lobbied: LGBTQ Rights. S. 1829-STOP CSAM Act of 2025-Issues Lobbied: Free Speech. S. 2150-Womens Health Protection Act of 2025-Issues Lobbied: Reproductive Rights. S. 558-Antisemitism Awareness Act of 2025-Issues Lobbied: Free Speech. S. 2296-National Defense Authorization Act for Fiscal Year 2026-Issues Lobbied: LGBTQ Rights, Foreign Agents Registration Act, Domestic Deployments, Death Penalty, Immigration. S.J.Res. 75-A joint resolution terminating the emergency determined by the President on August 11, 2025, in the Executive Order titled "Declaring a crime emergency in the District of Columbia"-Issues Lobbied: Justice. S. 2212-VISIBLE Act-Issues Lobbied: Immigration, Federal Policing Reform. S. 188-Free Speech Protection Act-Issues Lobbied: Free Speech. S. 478-Veterans 2nd Amendment Protection Act of 2025-Issues Lobbied: Disability Rights. S. 2342-Intelligence Authorization Act for Fiscal Year 2026-Issues Lobbied: CIA and ODNI GC provisions, AI and CAI related issues. S. 2457-Domestic Terrorism Prevention Act of 2025-Issues Lobbied: Civil Rights and Liberties. S. 2523-John R. Lewis Voting Rights Advancement Act of 2025-Issues Lobbied: Voting Rights. S. 2106-SECURE Act-Issues Lobbied: Pathway to Citizenship. S. 2902-Hidden Foster Care Transparency Act-Issues Lobbied: Womens Rights. S. 2556-Protecting Health Care and Lowering Costs Act-Issues Lobbied: Disability Rights. H.R. 6943-No Artificial Intelligence Fake Replicas and Unauthorized Duplications Act of 2024-Issues Lobbied: Artificial Intelligence Use. H.R. 6881-AI Foundation Model Transparency Act of 2023-Issues Lobbied: Algorithmic Justice. H.R. 6886-Transparent Automated Governance Act-Issues Lobbied: Algorithmic Justice. H.R. 7520-Protecting Americans Data from Foreign Adversaries Act of 2024-Issues Lobbied: Privacy. H.R. 8818-American Privacy Rights Act of 2024-Issues Lobbied: Privacy. H.R. 8038-21st Century Peace Through Strength Act-Issues Lobbied: Privacy. H.R. 7890-Children and Teens Online Privacy Protection Act-Issues Lobbied: Privacy. H.R. 8152-Remote Access Security Act-Issues Lobbied: Privacy. H.R. 8315-Enhancing National Frameworks for Overseas Restriction of Critical Exports Act-Issues Lobbied: Privacy. H.R. 14-John R. Lewis Voting Rights Advancement Act of 2025-Issues Lobbied: Voting Rights. H.R. 12-Womens Health Protection Act of 2023-Issues Lobbied: Reproductive Rights. H.R. 9730-Detection at Range Technology for Screening of Passengers Act-Issues Lobbied: Privacy. H.R. 6090-Antisemitism Awareness Act-Issues Lobbied: Free Speech. H.R. 28-Protection of Women and Girls in Sports Act of 2025-Issues Lobbied: LGBTQ Rights. H.R. 2487-Transgender Health Care Access Act-Issues Lobbied: LGBTQ Rights. H.R. 1954-Do No Harm Act-Issues Lobbied: Religious Liberty. H.R. 22-SAVE Act-Issues Lobbied: Voting Rights. H.R. 1041-Veterans 2nd Amendment Protection Act-Issues Lobbied: Disability Rights. H.R. 1-One Big Beautiful Bill Act-Issues Lobbied: LGBTQ Rights, Algorithmic Justice (Reconciliation Package/AI moratorium) Immigration, Disability Rights, Reproductive Rights, Systemic Equity, Democracy, Data Privacy, Federal Funding, Medicaid. H.R. 15-Equality Act-Issues Lobbied: LGBTQ Rights. H.R. 3492-Protect Childrens Innocence Act-Issues Lobbied: LGBTQ Rights. H.R. 2617-Say No to Indoctrination Act-Issues Lobbied: Free Speech. H.R. 3944-Military Construction, Veterans Affairs, and Related Agencies Appropriations Act-Issues Lobbied: LGBTQ Rights, Reproductive Rights. H.R. 3708-No Place for LGBTQ+ Hate Act-Issues Lobbied: LGBTQ Rights. H.R. 4121-Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2026-Issues Lobbied: Reproductive Rights. H.R. 151-Equal Representation Act-Issues Lobbied: Census. H.R. 3838-Streamlining Procurement for Effective Execution and Delivery and National Defense Authorization Act for Fiscal Year 2026-Issues Lobbied: LGBTQ Rights, Foreign Agents Registration Act, Domestic Deployments, Death Penalty, Immigration. H.R. 4016-Department of Defense Appropriations Act-Issues Lobbied: LGBTQ Rights, Reproductive Rights, Diversity Equity and Inclusion. H.R. 7534-Verifying Kids Online Privacy Act-Issues Lobbied: Privacy. H.R. 3486-Stop Illegal Entry Act of 2025-Issues Lobbied: Immigration, Mandatory Minimums, Sentencing Reform, Mass Incarceration. H.R. 4843-CLEAR ID Act-Issues Lobbied: Immigration. H.R. 5304-Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026-Issues Lobbied: Appropriations, Reproductive Rights, Disability Rights, Healthcare Access. H.R. 7120-George Floyd Justice in Policing Act of 2020-Issues Lobbied: Police Accountability, Policing. H.J.Res. 115-Terminating the emergency determined by the President on August 11, 2025, in the Executive Order titled "Declaring a crime emergency in the District of Columbia"-Issues Lobbied: Justice. H.R. 4667-VISIBLE Act-Issues Lobbied: Immigration. H.R. 1007-Antisemitism Awareness Act-Issues Lobbied: Free Speech. H.R. 5181-SOAR Act Improvements Act-Issues Lobbied: Religious Liberty. H.R. 1880-Broadcast Freedom and Independence Act of 2025-Issues Lobbied: Free Speech. H.R. 4849-Protecting Health Care and Lowering Costs Act of 2025-Issues Lobbied: Disability Rights. H.R. 5390-FAMILY Act-Issues Lobbied: Womens Rights. H.R. 5167-Intelligence Authorization Act for Fiscal Year 2026-Issues Lobbied: CIA and ODNI GC provisions, AI and CAI related issues. H.R. 3245-American Privacy Restoration Act-Issues Lobbied: Civil Rights and Liberties. H.R. 5300-Department of State Policy Provisions Act-Issues Lobbied: Passport Stripping Provision. H.R. 5371-Continuing Appropriations and Extensions Act, 2026-Issues Lobbied: Reproductive Rights, Government Funding, Impoundments, Government Shutdown. H.R. 4922-D.C. Criminal Reforms to Immediately Make Everyone Safe Act of 2025-Issues Lobbied: Criminal Justice. H.R. 5143-District of Columbia Policing Protection Act of 2025-Issues Lobbied: Criminal Justice. H.R. 5125-District of Columbia Judicial Nominations Reform Act of 2025-Issues Lobbied: Criminal Justice. H.R. 5140-To lower the age at which a minor may be tried as an adult for certain criminal offenses in the District of Columbia to 14 years of age-Issues Lobbied: Criminal Justice. H.R. 1589-American Dream and Promise Act of 2025-Issues Lobbied: Path to Citizenship. H.R. 5068-MORE Act-Issues Lobbied: Marijuana Decriminalization. H.R. 59-Mens Rea Reform Act of 2025-Issues Lobbied: Sentencing Reform. H.R. 2-Secure the Border Act of 2023-Issues Lobbied: Immigration. H.R. 4371-Kayla Hamilton Act-Issues Lobbied: Immigration. H.R. 5342-Commerce, Justice, Science, and Related Agencies Appropriations Act, 2026-Issues Lobbied: Criminal Legal Reform. H.R. 4553-Energy and Water Development and Related Agencies Appropriations Act, 2026-Issues Lobbied: Civil Rights and Liberties. H.R. 5166-Financial Services and General Government Appropriations Act, 2026-Issues Lobbied: DC Home Rule. H.R. 4213-Department of Homeland Security Appropriations Act, 2026-Issues Lobbied: Immigration. H.R. 4889-To prohibit States from carrying out more than one Congressional redistricting after a decennial census and apportionment-Issues Lobbied: Voting Rights. H.R. 4358-Anti-Rigging Act of 2025-Issues Lobbied: Voting Rights. H.R. 5507-Hidden Foster Care Transparency Act-Issues Lobbied: Womens Rights. H.R. 4022-Increasing Behavioral Health Treatment Act-Issues Lobbied: Disability Rights. LEGISLATION WITH NO BILL NUMBER AND APPOINTMENTS: Additional legislation not yet introduced - Patenting of genes and gene research legislation; Legislation relating to defining antisemitism in education programs - First Amendment protections; Draft legislation on artificial intelligence and implementation of EO on artificial intelligence - free speech, privacy, nondiscrimination; Oversight over counterterrorism policy and practices - torture, detention, drones, war authority, Guantanamo Bay; Section 702 reauthorization - civil liberties and national security; Car privacy; General age verification and privacy; Mental Health Justice Act - community safety; Cannabis Administration and Opportunity Act and Marijuana Opportunity Reinvestment and Expungement Act - marijuana decriminalization; George Floyd Justice In Policing Act - policing reform; Safer Supervision Act - federal sentencing, re-entry; Section 230 of Communications Decency Act proposals - free speech, internet integrity; Department of Governmental Efficiency Actions - privacy; Amendments to the Privacy Act of 1974; TSA use of facial recognition technology; DHS data consolidation; Bivens Act - policing reform; Traveler Privacy Protection Act; FCC First Amendment violations - free speech; Censorship; ICE wearing masks; Protest Rights; EACH Act - reproductive rights; HEAL for Immigrant Families Act - reproductive rights, immigration; Let Doctors Provide Reproductive Health Care Act; Domestic deployment of the military; Continued funding for Affordable Connectivity Act; DC Statehood; War authority related to military strikes/Iran - presidential action and concurrent resolutions; Immigration; Civil liberties; Free speech; Reproductive Data Privacy and Protection Act; Algorithmic justice; Increase in criminal penalties; Mass incarceration; Prisons; Criminal justice oversight; Reproductive rights; FY26 Federal Funding; ICE detention of journalist Mario Guevara - free speech; ICE detainment of students for protesting - free speech; Conflicts from Political Fundraising Act; Administration First Amendment violations; Universal service fund - broadband. Continuing resolution and Affordable Care Act tax credits - abortion, LGBTQ rights, abuse of power, access to healthcare; Right to Abortion Bill; Email Privacy Act; Cloud Act reform - encryption; Political prosecutions; Jimmy Kimmel suspension and attacks on speech; Immigration enforcement oversight; Federal troop and law enforcement oversight; ICE Use of Force Act - federal policing reform. Prison Litigation Reform Act - federal prison reform; Removing body worn camera paywall - policing reform; Kinetic impact weapons regulation; New death penalty provision in the US military code; Dignity Act - immigration; Democracy reform package - voting rights; Detention oversight visits; Budget reconciliation; Letter to Congress in support of funding for Department of Labor Womens Bureau; Administration attacks on Head Start. AGENCIES: Agency - Homeland Security - Issues Lobbied: Federal artificial intelligence use case inventories, algorithmic justice. Agency - Office of Science and Technology Policy - Issues Lobbied: Use of AI in hiring, healthcare, and other protected areas, algorithmic justice. Agency - Labor - Issues Lobbied: Use of AI in hiring, healthcare, and other protected areas, algorithmic justice. Agency - U.S. Trade Representative - Issues Lobbied: U.S. commitments at WTO, open internet. Agency - National Security Council - National Security memo on uses of AI, privacy. Agency - Education - Issues Lobbied: Legislation relating to defining antisemitism in education programs, First Amendment protections. Agency - NIST - Issues Lobbied: Use of AI in hiring, healthcare, and other protected areas, algorithmic justice, supply chains and digital trade. Agency - Office of the Director of National Intelligence - Issues Lobbied: Section 702 of Foreign Intelligence Surveillance Act, related legislation and hearings, civil liberties and national security issues. Agency - Department of Defense - Issues Lobbied: Domestic deployment of the military. Agency - Department of Health and Human Services - Issues Lobbied: NIH data sharing platform, privacy, disability rights. Agency - Federal Communications Commission - Issues Lobbied: The Kids Online Safety Act, First Amendment violations. Agency - Department of Governmental Efficiency - Issues Lobbied: Privacy. Agency - Department of Justice - Issues Lobbied: Increase in criminal penalties, mass incarceration, categories for release, clemency. Agency - Executive Office of the President - Issues Lobbied: Ending Crime and Disorder on Americas Streets Executive Order, criminalization of homelessness. Agency - Office of Information and Regulatory Affairs - Issues Lobbied: Letter expressing concern about Administration regulatory actions impacting women at work.
The previous question on the motion to recommit was ordered pursuant to clause 2(b) of rule XIX.
Ms. Stansbury moved to recommit to the Committee on the Judiciary. (text: CR H5927)
The previous question was ordered pursuant to the rule.
DEBATE - The House proceeded with one hour of debate on H.R. 4371.
Rule provides for consideration of H.R. 4776, H.R. 1366, H.R. 845, H.R. 3616, H.R. 3632 and H.R. 4371. The resolution provides for consideration of H.R. 4776, under a structured rule and H.R. 1366, H.R. 845, H.R. 3616, H.R. 3632, and H.R. 4371 under a closed rule. The resolution provides one motion to recommit on each bill.
Considered under the provisions of rule H. Res. 951. (consideration: CR H5921-5927)
Rule H. Res. 951 passed House.
Rules Committee Resolution H. Res. 951 Reported to House. Rule provides for consideration of H.R. 4776, H.R. 1366, H.R. 845, H.R. 3616, H.R. 3632 and H.R. 4371. The resolution provides for consideration of H.R. 4776, under a structured rule and H.R. 1366, H.R. 845, H.R. 3616, H.R. 3632, and H.R. 4371 under a closed rule. The resolution provides one motion to recommit on each bill.
Placed on the Union Calendar, Calendar No. 297.
Reported (Amended) by the Committee on Judiciary. H. Rept. 119-345.
Congress.gov source codes: 5000, H12200
Ordered to be Reported (Amended) by the Yeas and Nays: 16 - 13.
Committee Consideration and Mark-up Session Held
Referred to the House Committee on the Judiciary.
Introduced in House
Congress.gov source codes: 1000, Intro-H
| Markup By |
| September 10, 2025 |
| Judiciary Committee | House | Referred To | July 14, 2025 |
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
Client expense: $120,000 · Firm income: Not reported
Government targets: Bureau of Citizenship & Immigration Services (BCIS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), U.S. Immigration & Customs Enforcement (ICE)
Client expense: $708,395 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: $520,000 · Firm income: Not reported
Government targets: Director of National Intelligence (ODNI), Education, Dept of, Executive Office of the President (EOP), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institute of Standards & Technology (NIST), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE, State, Dept of (DOS), U.S. Trade Representative (USTR)
Client expense: $140,000 · Firm income: Not reported
Government targets: Bureau of Citizenship & Immigration Services (BCIS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), U.S. Immigration & Customs Enforcement (ICE)
Client expense: $758,175 · Firm income: Not reported
Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE
Client expense: $400,000 · Firm income: Not reported
Government targets: Defense, Dept of (DOD), Director of National Intelligence (ODNI), Education, Dept of, Executive Office of the President (EOP), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institute of Standards & Technology (NIST), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE, U.S. Trade Representative (USTR)