Prompt and Fair Pay Act

Medicare reimbursements for physicians Prior Authorization reform Medicare Advantage reforms to reduce administrative burdens HR 2433 H.R.1, the One Big Beautiful Bill Act Implementation S.1105 S.1816/H.R.3514 HR.4559 Provider Reimbursement Stability Act H.R. 7520 Medicare Provider Enrollment Issues Medicare HETS System Changes Medicare Program Integrity Initiatives Patients First Act Protecting Approved Care Act RESULTS Act Medicare Targeted Probe and Educate Program

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

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

Connect for Health Act - S.1261 - Fixes telehealth reimbursement for RHCs Seeking to create a reimbursement benefit for RHCs vis a vis Medicare Advantage Informing Members of Congress of the impacts of Medicaid cut proposals on RHCs H.R. 1 - One Big Beautiful Bill Act - Opposing cuts to Medicaid Strengthening Pathways to Health Professions Act (H.R.593) Provides tax relief for certain health professional scholarships and loan payments intended to increase availability of health care services in underserved or health professional shortage areas. Rural Health Care Access Act of 2025 (H.R.771) Removes the requirement that prevents hospitals from pursuing a Critical Access Hospital (CAH) designation if it falls within 35-miles of another CAH. Improving Care and Access to Nurses Act (H.R.1317) Under Medicare and Medicaid, this act removes various barriers to practice for several RHC professionals, including NPs, certified nurse-midwives, and advanced practice registered nurses. Reducing Medically Unnecessary Delays in Care Act of 2025 (H.R.2433) Requires Medicare, Medicare Advantage, and Part D prior authorization decisions to be made by physicians in the same specialty as the requesting provider Medicare Audiology Access Improvement Act of 2025 (H.R.2757) This bill adds audiologists as Medicare-covered providers in RHCs. Improving Seniors Timely Access to Care Act of 2025 (S.1816) Streamlines the prior authorization process to reduce administrative burden on providers and improve access to care for seniors enrolled in Medicare Advantage (MA) plans. Registered Nurses (RNs) for Rural Health Act (H.R.3878) Allows RNs at RHCs to conduct Annual Wellness Visits (AWVs) and receive reimbursement from Medicare. Critical Access for Veterans Care Act (S.1868) Removes prior authorization and referral requirements for covered veterans seeking care under the Veterans Community Care Program at provider-based RHCs affiliated with CAHs. CONNECT for Health Act of 2025 (S.1261 and H.R. 4206) Includes the language necessary to achieve reimbursement parity for RHC telehealth visits. Save America's Rural Hospitals Act (H.R.3684) Includes the language necessary to achieve reimbursement parity for RHC telehealth visits. Prompt and Fair Pay Act (H.R.4559) Requires MA plans to provide reimbursement comparable to traditional Medicare. Telehealth Modernization Act (H.R.5081 and S.2709) Extends Medicare telehealth flexibilities through FY 27 and includes language necessary to achieve reimbursement parity for RHC telehealth visits. Helping Ensure Access to Local TeleHealth Act (H.R.5496) Allows RHCs to permanently receive Medicare reimbursement for telehealth services. Physical Therapist Workforce and Patient Access Act of 2025 (H.R.5621) Expands Medicare coverage for Physical Therapy services at RHCs.

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

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

H.R. 3514/S. 1816: Improving Seniors' Timely Access to Care Act of 2025 - requires Medicare Advantage plans to implement electronic prior authorization, increase transparency, protect enrollees, and adhere to new response timeframes to improve timely access to care. H.R. 2433: Reducing Medically Unnecessary Delays in Care Act - mandates that prior authorization decisions under Medicare be made by qualified physicians, based on medical necessity and evidence-based standards, with transparency and input from practicing physicians. H.R. 9693, Patients First Act of 2026 would finally make structural changes needed to prevent cuts and create a payment system that helps ensure physicians can keep their doors open and provide seniors with quality, value-based healthcare. S. 1640/H.R. 879: Medicare Patient Access and Practice Stabilization Act of 2025 - This bill increases certain payment adjustments under the Medicare physician fee schedule for services furnished between April 1, 2025, and January 1, 2026. H.R. 8163/S. 5180: Provider Reimbursement Stability Act, to amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program. H.R. 8622: Medicare Physician Data-driven Performance Payment System Act to amend title XVIII of the Social Security Act to transform the Merit-based Incentive Payment System into the Data-driven Performance Payment System under the Medicare physician fee schedule H.R. 6160: Strengthening Medicare for Patients and Providers Act to modify certain adjustments to payment amounts under the Medicare physician fee schedule S. 1460/H.R. 786: Preserving Patient Access to Accountable Care Act - extends Medicare incentive payments for alternative payment models to 2027, with a new rate of 3.53 percent, to promote continued participation and improve healthcare efficiency. H.R. 2120/S. 1031: ROCR Value Based Program Act - establishes a new payment program for radiation oncology services, focusing on stable payments, quality care, and patient access, while exempting it from budget neutrality adjustments. H.R. 4559: Prompt and Fair Pay Act - to establish payment parity between Medicare Advantage and fee-for-service Medicare, and to establish prompt payment requirements under Medicare Advantage. H.R. 2484: Seniors' Access to Critical Medications Act of 2025 - establishes an exception to the physician self-referral prohibition for certain outpatient drugs under Medicare, mandates a study on drug dispensing practices, and reduces the Medicare improvement fund by $18 million. H.R. 4299: Protecting Patient Access to Cancer and Complex Therapies Act - provide for a rebate by manufacturers for selected drugs and biological products subject to maximum fair price negotiation. H.R. 4206/S. 1261: CONNECT for Health Act - expands access to telehealth services under Medicare H.R. 5081/S. 2709: Telehealth Modernization Act - to extend certain telehealth flexibilities under the Medicare program. H.R. 4752/S. 2760: Reducing Hereditary Cancer Act - to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation. H.R. 8500: Timely Access to Coverage Decisions Act of 2026: To amend title XVIII of the Social Security Act to ensure timely review of local coverage determination requests under the Medicare program. H.R. 4331, Access to Claims Data Act: To require the Secretary of Health and Human Services to establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

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

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

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

HR 879 Medicare reimbursements for physicians Prior Authorization reform Medicare Advantage reforms to reduce administrative burdens HR 2433 H.R.1, the One Big Beautiful Bill Act S.1105 S.1816/H.R.3514 HR.4559 Provider Reimbursement Stability Act H.R. 7520 Medicare Provider Enrollment Issues Medicare HETS System Changes Medicare Program Integrity Initiatives

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

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

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

Client expense: $140,000 · Firm income: Not reported

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

Oppose Medicaid cuts. Oppose Medicare site neutral cuts. S. 1261 CONNECT for Health Act S. 1460/HR 786 Preserving Patient Access to Accountable Care Act (incentive payments for APMs) HR 1683 Protecting Rural Seniors Access to Care Act (SNF minimum staffing standards reg) S 1935 Expanding Access to Palliative Care Act S 1816 Improving Seniors' Timely Access to Care Act S. 1031 Radiation Oncology Case Rate (ROCR) Value Based Program Act S. 1087 Rebuild Americas Health Care Schools Act HR 3890 Resident Physician Shortage Reduction Act HR 538 Critical Access Hospital Relief Act of 2025 HR 3222 SMART Health Care Act HR 4559 Prompt and Fair Pay Act HR 6199 Medical Nutrition Therapy Act S 2834/HR 5439 Medically Tailored Home-Delivered Meals Program Pilot Act HR 9504 Tax Exempt Hospital Transparency Act Food is medicine

Client expense: $240,000 · Firm income: Not reported

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

H.R. 3514/S. 1816: Improving Seniors' Timely Access to Care Act of 2025 - requires Medicare Advantage plans to implement electronic prior authorization, increase transparency, protect enrollees, and adhere to new response timeframes to improve timely access to care. H.R. 2433: Reducing Medically Unnecessary Delays in Care Act - mandates that prior authorization decisions under Medicare be made by qualified physicians, based on medical necessity and evidence-based standards, with transparency and input from practicing physicians. S. 1640/H.R. 879: Medicare Patient Access and Practice Stabilization Act of 2025 - This bill increases certain payment adjustments under the Medicare physician fee schedule for services furnished between April 1, 2025, and January 1, 2026. H.R. 8163: Provider Reimbursement Stability Act, to amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program. H.R. 8622: Medicare Physician Data-driven Performance Payment System Act to amend title XVIII of the Social Security Act to transform the Merit-based Incentive Payment System into the Data-driven Performance Payment System under the Medicare physician fee schedule H.R. 6160: Strengthening Medicare for Patients and Providers Act to modify certain adjustments to payment amounts under the Medicare physician fee schedule S. 1460/H.R. 786: Preserving Patient Access to Accountable Care Act - extends Medicare incentive payments for alternative payment models to 2027, with a new rate of 3.53 percent, to promote continued participation and improve healthcare efficiency. H.R. 2120/S. 1031: ROCR Value Based Program Act - establishes a new payment program for radiation oncology services, focusing on stable payments, quality care, and patient access, while exempting it from budget neutrality adjustments. H.R. 4559: Prompt and Fair Pay Act - to establish payment parity between Medicare Advantage and fee-for-service Medicare, and to establish prompt payment requirements under Medicare Advantage. H.R. 2484: Seniors' Access to Critical Medications Act of 2025 - establishes an exception to the physician self-referral prohibition for certain outpatient drugs under Medicare, mandates a study on drug dispensing practices, and reduces the Medicare improvement fund by $18 million. H.R. 4299: Protecting Patient Access to Cancer and Complex Therapies Act - provide for a rebate by manufacturers for selected drugs and biological products subject to maximum fair price negotiation H.R. 4206/S. 1261: CONNECT for Health Act - expands access to telehealth services under Medicare H.R. 5081/S. 2709: Telehealth Modernization Act - to extend certain telehealth flexibilities under the Medicare program. H.R. 4752/S. 2760: Reducing Hereditary Cancer Act - to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation.

Client expense: $480,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to prior authorization requirements in Medicare, including H.R. 3514/S. 1816, the Improving Seniors Timely Access to Care Act of 2025 Issues related to Medicare coverage of audiology services and the Medicare Audiology Access Improvement Act (H.R. 2757/S. 1996) Issues related to the provision of audiology and speech-language pathology services through telepractice, including H.R. 1614, legislation to amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, H.R. 5801, H.R. 6296, the Advancing Access to Telehealth Act, the Telehealth Modernization Act (H.R. 5081/S. 2709), and S. 3834, the Expanded Telehealth Access Act. Issues related to Medicare Part B reimbursement of audiology and speech-language pathology services, including H.R. 8163, the Provider Reimbursement Stability Act of 2026 Issues related to the Multiple Procedure Payment Reduction, including the Removing Excessive Cuts to Outpatient and Vital Essential Rehabilitation (RECOVER) Act (H.R. 8386) H.R. 6160, Strengthening Medicare for Patients and Providers Act H.R. 7520, the Efficiency Adjustment Delay Act Prompt and Fair Pay Act (H.R. 4559) Medicare Patient Choice Act (H.R. 4204) Stopping Fraudulent Payments Act (H.R. 8464) Protecting Health Care and Lowering Costs Act (H.R. 4849/S. 2556) Various issues related to CMS Actions surrounding: Audits of medical records and claims for Part A and B services Procedure code development and valuation of audiology and speech-language pathology services Quality reporting under MIPS Implementation of the IMPACT Act Medicare physician fee schedule Prospective payments systems, including home health and skilled nursing facility policy and payment issues Accountable Care Organizations Federally-facilitated marketplace Medicare Advantage Various issues related to interoperable health information, including the post-acute care interoperability project (PACIO) Medicare telehealth coverage under Part A and B Provision and payment for Part A therapy Various issues related to implementation of ACA Issues related to Medicare beneficiaries accessing services provided by audiologists without a physician order Issues related to qualified Medicare providers Issues related to fraud, waste, and abuse Issues related to the Center for Medicare and Medicaid Innovation (CMMI) actions related to value-based care Issues related to proposals to block grant or institute work requirements and/or per capita caps in the Medicaid program.

Client expense: $280,000 · Firm income: Not reported

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

Connect for Health Act - S.1261 - Fixes telehealth reimbursement for RHCs Seeking to create a reimbursement benefit for RHCs vis a vis Medicare Advantage Informing Members of Congress of the impacts of Medicaid cut proposals on RHCs H.R. 1 - One Big Beautiful Bill Act - Opposing cuts to Medicaid Strengthening Pathways to Health Professions Act (H.R.593) Provides tax relief for certain health professional scholarships and loan payments intended to increase availability of health care services in underserved or health professional shortage areas. Rural Health Care Access Act of 2025 (H.R.771) Removes the requirement that prevents hospitals from pursuing a Critical Access Hospital (CAH) designation if it falls within 35-miles of another CAH. Improving Care and Access to Nurses Act (H.R.1317) Under Medicare and Medicaid, this act removes various barriers to practice for several RHC professionals, including NPs, certified nurse-midwives, and advanced practice registered nurses. Reducing Medically Unnecessary Delays in Care Act of 2025 (H.R.2433) Requires Medicare, Medicare Advantage, and Part D prior authorization decisions to be made by physicians in the same specialty as the requesting provider Medicare Audiology Access Improvement Act of 2025 (H.R.2757) This bill adds audiologists as Medicare-covered providers in RHCs. Improving Seniors Timely Access to Care Act of 2025 (S.1816) Streamlines the prior authorization process to reduce administrative burden on providers and improve access to care for seniors enrolled in Medicare Advantage (MA) plans. Registered Nurses (RNs) for Rural Health Act (H.R.3878) Allows RNs at RHCs to conduct Annual Wellness Visits (AWVs) and receive reimbursement from Medicare. Critical Access for Veterans Care Act (S.1868) Removes prior authorization and referral requirements for covered veterans seeking care under the Veterans Community Care Program at provider-based RHCs affiliated with CAHs. CONNECT for Health Act of 2025 (S.1261 and H.R. 4206) Includes the language necessary to achieve reimbursement parity for RHC telehealth visits. Save America's Rural Hospitals Act (H.R.3684) Includes the language necessary to achieve reimbursement parity for RHC telehealth visits. Prompt and Fair Pay Act (H.R.4559) Requires MA plans to provide reimbursement comparable to traditional Medicare. Telehealth Modernization Act (H.R.5081 and S.2709) Extends Medicare telehealth flexibilities through FY 27 and includes language necessary to achieve reimbursement parity for RHC telehealth visits. Helping Ensure Access to Local TeleHealth Act (H.R.5496) Allows RHCs to permanently receive Medicare reimbursement for telehealth services. Physical Therapist Workforce and Patient Access Act of 2025 (H.R.5621) Expands Medicare coverage for Physical Therapy services at RHCs.

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

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

H.R.879 Medicare Patient Access and Practice Stabilization Act - support passage No bill number - Support an annual inflationary update or an increase for 2025 and 2026 to the Medicare Physician Fee Schedule No bill number - Support introduction and passage of the Provider Reimbursement Stability Act No bill number - Support a resumption and extension of telehealth waivers under Medicare after the January 31, 2026 expiration. H.R.2013 Medicare Home Health Accessibility Act - support passage and introduction of similar bill in Senate H.R.1614, therapy telehealth act - support passage S.1261/H.R.4206 CONNECT for Health Act - advocate for provision to establish OTs as permanent Medicare telehealth providers No bill number - Asking for potential carve out of schools from Medicaid referral requirement S.2847/H.R.4037 Occupational Therapy Mental Health Parity Act - support passage H.R. 926 - Support inclusion of language similar to H.R.4037/S.2847, the Occupational Therapy Mental Health Parity Act in report language H.R.4204 Medicare Patient Choice Act - support passage S.2329/H.R.4475 Medicare Orthotics and Prosthetics Patient-Centered Care Act - support passage S.2830 WELL Seniors Act - support passage S.2709/H.R.5081 Telehealth Modernization Act - support passage H.R.4559 Prompt and Fair Pay Act - support passage H.R.1171/S.2612 Stopping Addiction and Falls for the Elderly (SAFE) Act - support passage H.R. 8386 Removing Excessive Cuts to Outpatient and Vital Essential Rehabilitation (RECOVER) Act - support passage No bill number - Support legislation to make occupational therapy, physical therapy and speech language pathology a mandatory Medicaid benefit.

Client expense: $189,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Oppose Medicaid cuts. Oppose Medicare site neutral cuts. S. 1261 CONNECT for Health Act S. 1460/HR 786 Preserving Patient Access to Accountable Care Act (incentive payments for APMs) HR 1683 Protecting Rural Seniors Access to Care Act (SNF minimum staffing standards reg) S 1935 Expanding Access to Palliative Care Act S 1816 Improving Seniors' Timely Access to Care Act S. 1031 Radiation Oncology Case Rate (ROCR) Value Based Program Act S. 1087 Rebuild Americas Health Care Schools Act HR 3890 Resident Physician Shortage Reduction Act HR 538 Critical Access Hospital Relief Act of 2025 HR 3222 SMART Health Care Act HR 4559 Prompt and Fair Pay Act HR 6199 Medical Nutrition Therapy Act S 2834/HR 5439 Medically Tailored Home-Delivered Meals Program Pilot Act

Client expense: $240,000 · Firm income: Not reported

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

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

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

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

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

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

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

HR 879 Medicare reimbursements for physicians Prior Authorization reform Medicare Advantage reforms to reduce administrative burdens HR 2433 H.R.1, the One Big Beautiful Bill Act S.1105 S.1816/H.R.3514 HR.4559 Provider Reimbursement Stability Act H.R. 7520 Medicare Provider Enrollment Issues Medicare HETS System Changes Medicare Program Integrity Initiatives

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

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

Connect for Health Act - S.1261 - Fixes telehealth reimbursement for RHCs Seeking to create a reimbursement benefit for RHCs vis a vis Medicare Advantage Informing Members of Congress of the impacts of Medicaid cut proposals on RHCs H.R. 1 - One Big Beautiful Bill Act - Opposing cuts to Medicaid Strengthening Pathways to Health Professions Act (H.R.593) Provides tax relief for certain health professional scholarships and loan payments intended to increase availability of health care services in underserved or health professional shortage areas. Rural Health Care Access Act of 2025 (H.R.771) Removes the requirement that prevents hospitals from pursuing a Critical Access Hospital (CAH) designation if it falls within 35-miles of another CAH. Improving Care and Access to Nurses Act (H.R.1317) Under Medicare and Medicaid, this act removes various barriers to practice for several RHC professionals, including NPs, certified nurse-midwives, and advanced practice registered nurses. Reducing Medically Unnecessary Delays in Care Act of 2025 (H.R.2433) Requires Medicare, Medicare Advantage, and Part D prior authorization decisions to be made by physicians in the same specialty as the requesting provider Medicare Audiology Access Improvement Act of 2025 (H.R.2757) This bill adds audiologists as Medicare-covered providers in RHCs. Improving Seniors Timely Access to Care Act of 2025 (S.1816) Streamlines the prior authorization process to reduce administrative burden on providers and improve access to care for seniors enrolled in Medicare Advantage (MA) plans. Registered Nurses (RNs) for Rural Health Act (H.R.3878) Allows RNs at RHCs to conduct Annual Wellness Visits (AWVs) and receive reimbursement from Medicare. Critical Access for Veterans Care Act (S.1868) Removes prior authorization and referral requirements for covered veterans seeking care under the Veterans Community Care Program at provider-based RHCs affiliated with CAHs. CONNECT for Health Act of 2025 (S.1261 and H.R. 4206) Includes the language necessary to achieve reimbursement parity for RHC telehealth visits. Save America's Rural Hospitals Act (H.R.3684) Includes the language necessary to achieve reimbursement parity for RHC telehealth visits. Prompt and Fair Pay Act (H.R.4559) Requires MA plans to provide reimbursement comparable to traditional Medicare. Telehealth Modernization Act (H.R.5081 and S.2709) Extends Medicare telehealth flexibilities through FY 27 and includes language necessary to achieve reimbursement parity for RHC telehealth visits. Helping Ensure Access to Local TeleHealth Act (H.R.5496) Allows RHCs to permanently receive Medicare reimbursement for telehealth services. Physical Therapist Workforce and Patient Access Act of 2025 (H.R.5621) Expands Medicare coverage for Physical Therapy services at RHCs.

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

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

Connect for Health Act - S.1261 - Fixes telehealth reimbursement for RHCs Seeking to create a reimbursement benefit for RHCs vis a vis Medicare Advantage Informing Members of Congress of the impacts of Medicaid cut proposals on RHCs H.R. 1 - One Big Beautiful Bill Act - Opposing cuts to Medicaid Strengthening Pathways to Health Professions Act (H.R.593) Provides tax relief for certain health professional scholarships and loan payments intended to increase availability of health care services in underserved or health professional shortage areas. Rural Health Care Access Act of 2025 (H.R.771) Removes the requirement that prevents hospitals from pursuing a Critical Access Hospital (CAH) designation if it falls within 35-miles of another CAH. Improving Care and Access to Nurses Act (H.R.1317) Under Medicare and Medicaid, this act removes various barriers to practice for several RHC professionals, including NPs, certified nurse-midwives, and advanced practice registered nurses. Reducing Medically Unnecessary Delays in Care Act of 2025 (H.R.2433) Requires Medicare, Medicare Advantage, and Part D prior authorization decisions to be made by physicians in the same specialty as the requesting provider Medicare Audiology Access Improvement Act of 2025 (H.R.2757) This bill adds audiologists as Medicare-covered providers in RHCs. Improving Seniors Timely Access to Care Act of 2025 (S.1816) Streamlines the prior authorization process to reduce administrative burden on providers and improve access to care for seniors enrolled in Medicare Advantage (MA) plans. Registered Nurses (RNs) for Rural Health Act (H.R.3878) Allows RNs at RHCs to conduct Annual Wellness Visits (AWVs) and receive reimbursement from Medicare. Critical Access for Veterans Care Act (S.1868) Removes prior authorization and referral requirements for covered veterans seeking care under the Veterans Community Care Program at provider-based RHCs affiliated with CAHs. CONNECT for Health Act of 2025 (S.1261 and H.R. 4206) Includes the language necessary to achieve reimbursement parity for RHC telehealth visits. Save America's Rural Hospitals Act (H.R.3684) Includes the language necessary to achieve reimbursement parity for RHC telehealth visits. Prompt and Fair Pay Act (H.R.4559) Requires MA plans to provide reimbursement comparable to traditional Medicare. Telehealth Modernization Act (H.R.5081 and S.2709) Extends Medicare telehealth flexibilities through FY 27 and includes language necessary to achieve reimbursement parity for RHC telehealth visits. Helping Ensure Access to Local TeleHealth Act (H.R.5496) Allows RHCs to permanently receive Medicare reimbursement for telehealth services. Physical Therapist Workforce and Patient Access Act of 2025 (H.R.5621) Expands Medicare coverage for Physical Therapy services at RHCs.

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

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

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

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

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

H.R. 3514/S. 1816, the Improving Seniors Timely Access to Care Act of 2025 Issues related to Medicare coverage of audiology services and the Medicare Audiology Access Improvement Act (H.R. 2757/S. 1996) Issues related to the provision of audiology and speech-language pathology services through telepractice, including H.R. 1614, legislation to amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, H.R. 5801, H.R. 6296, the Advancing Access to Telehealth Act, the Telehealth Modernization Act (H.R. 5081/S. 2709), and S. 3834, the Expanded Telehealth Access Act. Issues related to Medicare Part B reimbursement of audiology and speech-language pathology services, including H.R. 879, the Medicare Patient Access and Practice Stabilization Act of 2025 Issues related to the Multiple Procedure Payment Reduction H.R. 6160, Strengthening Medicare for Patients and Providers Act H.R. 7520, the Efficiency Adjustment Delay Act Prompt and Fair Pay Act (H.R. 4559) Medicare Patient Choice Act (H.R. 4204) Protecting Health Care and Lowering Costs Act (H.R. 4849/S. 2556) Various issues related to CMS Actions surrounding: oAudits of medical records and claims for Part A and B services oProcedure code development and valuation of audiology and speech-language pathology services oQuality reporting under MIPS oImplementation of the IMPACT Act oMedicare physician fee schedule oProspective payments systems, including home health and skilled nursing facility policy and payment issues oAccountable Care Organizations oFederally-facilitated marketplace oMedicare Advantage oVarious issues related to interoperable health information, including the post-acute care interoperability project (PACIO) oMedicare telehealth coverage under Part A and B oProvision and payment for Part A therapy oVarious issues related to implementation of ACA oIssues related to Medicare beneficiaries accessing services provided by audiologists without a physician order oIssues related to qualified Medicare providers oIssues related to fraud, waste, and abuse Issues related to the Center for Medicare and Medicaid Innovation (CMMI) actions related to value-based care Issues related to proposals to block grant or institute work requirements and/or per capita caps in the Medicaid program. H.R. 7148, the Consolidated Appropriations Act, 2026

Client expense: $360,000 · Firm income: Not reported

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

H.R.879 Medicare Patient Access and Practice Stabilization Act - support passage No bill number - Support an annual inflationary update or an increase for 2025 and 2026 to the Medicare Physician Fee Schedule No bill number - Support introduction and passage of the Provider Reimbursement Stability Act No bill number - Support a resumption and extension of telehealth waivers under Medicare after the January 31, 2026 expiration. H.R.2013 Medicare Home Health Accessibility Act - support passage and introduction of similar bill in Senate H.R.1614, therapy telehealth act - support passage S.1261/H.R.4206 CONNECT for Health Act - advocate for provision to establish OTs as permanent Medicare telehealth providers No bill number - Asking for potential carve out of schools from Medicaid referral requirement S.2847/H.R.4037 Occupational Therapy Mental Health Parity Act - support passage H.R.4204 Medicare Patient Choice Act - support passage S.2329/H.R.4475 Medicare Orthotics and Prosthetics Patient-Centered Care Act - support passage S.2830 WELL Seniors Act - support passage S.2709/H.R.5081 Telehealth Modernization Act - support passage H.R.4559 Prompt and Fair Pay Act - support passage H.R.1171/S.2612 Stopping Addiction and Falls for the Elderly (SAFE) Act - support passage No bill number - Support legislation to repeal the Medicare Multiple Procedure Payment Reduction applied to therapy services. No bill number - Support legislation to make occupational therapy, physical therapy and speech language pathology a mandatory Medicaid benefit.

Client expense: $189,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3514/S. 1816: Improving Seniors' Timely Access to Care Act of 2025 - requires Medicare Advantage plans to implement electronic prior authorization, increase transparency, protect enrollees, and adhere to new response timeframes to improve timely access to care. S. 1640/H.R. 879: Medicare Patient Access and Practice Stabilization Act of 2025 - This bill increases certain payment adjustments under the Medicare physician fee schedule for services furnished between April 1, 2025, and January 1, 2026. S. 1460/H.R. 786: Preserving Patient Access to Accountable Care Act - extends Medicare incentive payments for alternative payment models to 2027, with a new rate of 3.53 percent, to promote continued participation and improve healthcare efficiency. H.R. 4206/S. 1261: CONNECT for Health Act - expands access to telehealth services under Medicare H.R. 2433: Reducing Medically Unnecessary Delays in Care Act - mandates that prior authorization decisions under Medicare be made by qualified physicians, based on medical necessity and evidence-based standards, with transparency and input from practicing physicians. H.R. 1509/S. 752: Accelerating Kids Access to Care Act - To amend titles XIX and XXI of the Social Security Act to streamline the enrollment process for eligible out-of-state providers under Medicaid and CHIP. H.R. 2484: Seniors' Access to Critical Medications Act of 2025 - establishes an exception to the physician self-referral prohibition for certain outpatient drugs under Medicare, mandates a study on drug dispensing practices, and reduces the Medicare improvement fund by $18 million. H.R. 2120/S. 1031: ROCR Value Based Program Act - establishes a new payment program for radiation oncology services, focusing on stable payments, quality care, and patient access, while exempting it from budget neutrality adjustments. H.R. 4559: Prompt and Fair Pay Act - to establish payment parity between Medicare Advantage and fee-for-service Medicare, and to establish prompt payment requirements under Medicare Advantage. H.R. 4299: Protecting Patient Access to Cancer and Complex Therapies Act - provide for a rebate by manufacturers for selected drugs and biological products subject to maximum fair price negotiation. H.R. 5081/S. 2709: Telehealth Modernization Act - to extend certain telehealth flexibilities under the Medicare program. H.R. 4752/S. 2760: Reducing Hereditary Cancer Act - to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Healthcare issues related to clinical laboratories; H.R. 5269/S. 2761,the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act, and Section 6209 of the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extension Act, 2026, Pub. L. 119-37, provisions relating to reform of Medicare reimbursement for clinical laboratory services under Section 216 of the Protecting Access to Medicare Act, Pub. L. 113-93; Section 8001 of H.R. 5371, the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extension Act, 2026, Pub. L. 119-37, provisions relating to implementation of Medicare reimbursement cuts under the Statutory Pay-As-You-Go Act of 2010, Pub. L. 111-139; H.R. 6280, the Access to Genetic Counselor Services Act, provisions relating to Medicare coverage of genetic counselor services; H.R. 5582/S. 2355, the Patients Deserve Price Tags Act, provisions relating to lab test price transparency; H.R. 5454/S. 2879, the Medicare Advantage Prompt Pay Act, and H.R. 4559, the Prompt and Fair Pay Act, provisions relating to prompt payment of Medicare Advantage claims; Federal policy relating to access to mandatory code sets for administrative transactions; Federal policy relating to oversight of laboratory-developed tests; and Federal policy relating to supply chain issues affecting pre-clinical biomedical research for drug development.

Client expense: $310,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Connect for Health Act - S.1261 - Fixes telehealth reimbursement for RHCs Seeking to create a reimbursement benefit for RHCs vis a vis Medicare Advantage Informing Members of Congress of the impacts of Medicaid cut proposals on RHCs H.R. 1 - One Big Beautiful Bill Act - Opposing cuts to Medicaid Strengthening Pathways to Health Professions Act (H.R.593) Provides tax relief for certain health professional scholarships and loan payments intended to increase availability of health care services in underserved or health professional shortage areas. Rural Health Care Access Act of 2025 (H.R.771) Removes the requirement that prevents hospitals from pursuing a Critical Access Hospital (CAH) designation if it falls within 35-miles of another CAH. Improving Care and Access to Nurses Act (H.R.1317) Under Medicare and Medicaid, this act removes various barriers to practice for several RHC professionals, including NPs, certified nurse-midwives, and advanced practice registered nurses. Reducing Medically Unnecessary Delays in Care Act of 2025 (H.R.2433) Requires Medicare, Medicare Advantage, and Part D prior authorization decisions to be made by physicians in the same specialty as the requesting provider Medicare Audiology Access Improvement Act of 2025 (H.R.2757) This bill adds audiologists as Medicare-covered providers in RHCs. Improving Seniors Timely Access to Care Act of 2025 (S.1816) Streamlines the prior authorization process to reduce administrative burden on providers and improve access to care for seniors enrolled in Medicare Advantage (MA) plans. Registered Nurses (RNs) for Rural Health Act (H.R.3878) Allows RNs at RHCs to conduct Annual Wellness Visits (AWVs) and receive reimbursement from Medicare. Critical Access for Veterans Care Act (S.1868) Removes prior authorization and referral requirements for covered veterans seeking care under the Veterans Community Care Program at provider-based RHCs affiliated with CAHs. CONNECT for Health Act of 2025 (S.1261 and H.R. 4206) Includes the language necessary to achieve reimbursement parity for RHC telehealth visits. Save America's Rural Hospitals Act (H.R.3684) Includes the language necessary to achieve reimbursement parity for RHC telehealth visits. Prompt and Fair Pay Act (H.R.4559) Requires MA plans to provide reimbursement comparable to traditional Medicare. Telehealth Modernization Act (H.R.5081 and S.2709) Extends Medicare telehealth flexibilities through FY 27 and includes language necessary to achieve reimbursement parity for RHC telehealth visits. Helping Ensure Access to Local TeleHealth Act (H.R.5496) Allows RHCs to permanently receive Medicare reimbursement for telehealth services. Physical Therapist Workforce and Patient Access Act of 2025 (H.R.5621) Expands Medicare coverage for Physical Therapy services at RHCs.

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

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

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

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

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

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

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

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

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

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

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

H.R.5454/S.2879, Medicare Advantage Prompt Pay Act. H.R.4559 - Prompt and Fair Pay Act H.R.3514/S.1816, Improving Seniors Timely Access to Care Act. H.R.5142, Home Health Stabilization Act S.3300, ANCHOR Act. S.3299, DSH in Tennessee Act. Issues related to implementation of healthcare provisions in H.R.1. Issues related to reintroduction of the Access to Genetic Counselor Services Act Issues related to CMS telehealth policies. Issues related to hospital outpatient reimbursement. Issues related to the Medicare area wage index. Issues related to Medicare Advantage. Issues related to Medicare GME. Issues related to the PAYGO Scorecard.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3514/S. 1816: Improving Seniors' Timely Access to Care Act of 2025 - requires Medicare Advantage plans to implement electronic prior authorization, increase transparency, protect enrollees, and adhere to new response timeframes to improve timely access to care. S. 1640: Medicare Patient Access and Practice Stabilization Act of 2025 - The bill extends Medicare payment adjustment timelines to 2025 and introduces an 8.51 percent adjustment for services between June 1, 2025, and January 1, 2026, to support healthcare providers in adapting to payment changes. S. 1460: Preserving Patient Access to Accountable Care Act - extends Medicare incentive payments for alternative payment models to 2027, with a new rate of 3.53 percent, to promote continued participation and improve healthcare efficiency. H.R. 4206/S. 1261: CONNECT for Health Act - expands access to telehealth services under Medicare H. 879: Medicare Patient Access and Practice Stabilization Act - Providing automatic inflationary updates to Medicare physician payments. Eliminate budget neutrality requirements. Meaningful changes to the Merit-Based Incentive Payment System (MIPS). H.R. 786: Preserving Patient Access to Accountable Care Act. Incentivizing the transition to value-based care. H.R. 2433: Reducing Medically Unnecessary Delays in Care Act - mandates that prior authorization decisions under Medicare be made by qualified physicians, based on medical necessity and evidence-based standards, with transparency and input from practicing physicians. H.R. 1509/S. 752: Accelerating Kids Access to Care Act - To amend titles XIX and XXI of the Social Security Act to streamline the enrollment process for eligible out-of-state providers under Medicaid and CHIP. H.R. 2484: Seniors' Access to Critical Medications Act of 2025 - establishes an exception to the physician self-referral prohibition for certain outpatient drugs under Medicare, mandates a study on drug dispensing practices, and reduces the Medicare improvement fund by $18 million. H.R. 2120/S. 1031: ROCR Value Based Program Act - establishes a new payment program for radiation oncology services, focusing on stable payments, quality care, and patient access, while exempting it from budget neutrality adjustments. H.R. 4559: Prompt and Fair Pay Act - to establish payment parity between Medicare Advantage and fee-for-service Medicare, and to establish prompt payment requirements under Medicare Advantage. H.R. 4299: Protecting Patient Access to Cancer and Complex Therapies Act - provide for a rebate by manufacturers for selected drugs and biological products subject to maximum fair price negotiation. H.R. 5081/S. 2709: Telehealth Modernization Act - to extend certain telehealth flexibilities under the Medicare program. H.R. 4752/S. 2760: Reducing Hereditary Cancer Act - to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 879 Medicare reimbursements for physicians Prior Authorization reform Medicare Advantage reforms to reduce administrative burdens HR 2433 H.R.1, the One Big Beautiful Bill Act S.1105 S.1816/H.R.3514 HR.4559

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

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

H.R.879 Medicare Patient Access and Practice Stabilization Act - support passage No bill number - Support an annual inflationary update or an increase for 2025 and 2026 to the Medicare Physician Fee Schedule No bill number - Support introduction and passage of the Provider Reimbursement Stability Act No bill number - Support a resumption and extension of telehealth waivers under Medicare after the September 30, 2025 expiration. H.R.1171 Stopping Addiction and Falls for the Elderly Act (SAFE Act) - support passage H.R.2013 Medicare Home Health Accessibility Act - support passage and introduction of similar bill in Senate H.R.1614, therapy telehealth act - support passage S.1261/H.R.4206 CONNECT for Health Act - advocate for provision to establish OTs as permanent Medicare telehealth providers No bill number - Asking for potential carve out of schools from Medicaid referral requirement S.2847/H.R.4037 Occupational Therapy Mental Health Parity Act - support passage H.R.4204 Medicare Patient Choice Act - support passage S.2329/H.R.4475 Medicare Orthotics and Prosthetics Patient-Centered Care Act - support passage S.2830 WELL Seniors Act - support passage S.2709/H.R.5081 Telehealth Modernization Act - support passage H.R.4559 Prompt and Fair Pay Act - support passage H.R.1171/S.2612 Stopping Addiction and Falls for the Elderly (SAFE) Act - support passage No bill number - Support legislation to repeal the Medicare Multiple Procedure Payment Reduction applied to therapy services. No bill number - Support legislation to make occupational therapy, physical therapy and speech language pathology a mandatory Medicaid benefit.

Client expense: $189,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Oppose Medicaid cuts. Oppose Medicare site neutral cuts. S. 1261 CONNECT for Health Act S. 1460/HR 786 Preserving Patient Access to Accountable Care Act (incentive payments for APMs) HR 1683 Protecting Rural Seniors Access to Care Act (SNF minimum staffing standards reg) S 1935 Expanding Access to Palliative Care Act S 1816 Improving Seniors' Timely Access to Care Act S. 1031 Radiation Oncology Case Rate (ROCR) Value Based Program Act S. 1087 Rebuild Americas Health Care Schools Act HR 3890 Resident Physician Shortage Reduction Act HR 538 Critical Access Hospital Relief Act of 2025 HR 3222 SMART Health Care Act HR 4559 Prompt and Fair Pay Act HR 6199 Medical Nutrition Therapy Act

Client expense: $240,000 · Firm income: Not reported

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

H.R. 483: Health Care Efficiency Through Flexibility Act H.R. 5347: Health Care Efficiency Through Flexibility Act H.R. 786/ S. 1460: Preserving Patient Access to Accountable Care Act S.891: Bipartisan Health Care Act H.R. 1768: Lower Costs for Everyday Americans Act S. 1816/ 3514: Improving Seniors Timely Access to Care Act S. 1650: Medicare Patient Access and Practice Stabilization Act S. 1105: No UPCODE Act H.R. 4559: Prompt and Fair Pay Act H.R. 5454: Medicare Advantage Prompt Pay Act S. 2561/ H.R. 5768: Skin Substitute Access and Payment Reform Act H.R. 4773/ S. 3350: ACO Assignment Improvement Act H.R. 4313/ S.2237: Hospital Inpatient Services Modernization Act Issues related to Medicare payments, Medicare Shared Savings Program, ACO REACH, Medicare Advantage, alternative payment model incentives, telehealth, and fraud, waste, abuse.

Client expense: $134,639 · Firm income: Not reported

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

Healthcare issues related to clinical laboratories; H.R. 5269/S. 2761,the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act, and Section 6209 of the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extension Act, 2026, Pub. L. 119-37, provisions relating to reform of Medicare reimbursement for clinical laboratory services under Section 216 of the Protecting Access to Medicare Act, Pub. L. 113-93; Section 8001 of H.R. 5371, the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extension Act, 2026, Pub. L. 119-37, provisions relating to implementation of Medicare reimbursement cuts under the Statutory Pay-As-You-Go Act of 2010, Pub. L. 111-139; H.R. 6280, the Access to Genetic Counselor Services Act, provisions relating to Medicare coverage of genetic counselor services; H.R. 5582/S. 2355, the Patients Deserve Price Tags Act, provisions relating to lab test price transparency; H.R. 5454/S. 2879, the Medicare Advantage Prompt Pay Act, and H.R. 4559, the Prompt and Fair Pay Act, provisions relating to prompt payment of Medicare Advantage claims; Federal policy relating to access to mandatory code sets for administrative transactions; Federal policy relating to oversight of laboratory-developed tests; and Federal policy relating to supply chain issues affecting pre-clinical biomedical research for drug development.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3514/S. 1816, the Improving Seniors Timely Access to Care Act of 2025 Issues related to Medicare coverage of audiology services and the Medicare Audiology Access Improvement Act (H.R. 2757/S. 1996) Issues related to the provision of audiology and speech-language pathology services through telepractice, including H.R. 1614, legislation to amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, and H.R. 5801, the Telehealth Modernization Act. Issues related to Medicare Part B reimbursement of audiology and speech-language pathology services, including H.R. 879, the Medicare Patient Access and Practice Stabilization Act of 2025 H.R. 6160, Strengthening Medicare for Patients and Providers Act Prompt and Fair Pay Act (H.R. 4559) Medicare Patient Choice Act (H.R. 4204) Protecting Health Care and Lowering Costs Act (H.R. 4849/S. 2556) Various issues related to CMS Actions surrounding: oAudits of medical records and claims for Part A and B services oProcedure code development and valuation of audiology and speech-language pathology services oQuality reporting under MIPS oImplementation of the IMPACT Act oMedicare physician fee schedule oProspective payments systems, including home health and skilled nursing facility policy and payment issues oAccountable Care Organizations oFederally-facilitated marketplace oMedicare Advantage oVarious issues related to interoperable health information, including the post-acute care interoperability project (PACIO) oMedicare telehealth coverage under Part A and B oProvision and payment for Part A therapy oVarious issues related to implementation of ACA oIssues related to Medicare beneficiaries accessing services provided by audiologists without a physician order oIssues related to qualified Medicare providers Issues related to the Center for Medicare and Medicaid Innovation (CMMI) actions related to value-based care Issues related to proposals to block grant or institute work requirements and/or per capita caps in the Medicaid program. H.R.5371, the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act, 2026 H.R. 6296, the Advancing Access to Telehealth Act

Client expense: $400,000 · Firm income: Not reported

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

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

Client expense: $730,000 · Firm income: Not reported

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

Congressional outreach and monitoring regarding the following: -H.R. 1, One Big Beautiful Bill Act. -H.R. 4559, Prompt and Fair Pay Act. -Healthcare and hospital workforce budget and appropriations, generally. -Medicaid Disproportionate Share Hospital (DSH) Payments. -Managed Care Organizations (MCOs). -340B Drug Discount Program & HRSA/CMS policies. -Site Neutral Payment Proposals.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS Medicare compare website H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 497 - Medicaid Third Party Liability Act - Rep. Crenshaw, Dan - Medicaid liable third-party exceptions H.R. 538 - Critical Access Hospital Relief Act - Rep. Smith, Adrian - Medicare physician certification requirement H.R. 584 - No Medicaid for Illegal Immigrants Act - Rep. Kiley, Kevin - Medicaid eligibility requirements H.R. 608 - COVER Now Act - Rep. Doggett, Lloyd - Medicaid expansion demo H.R. 610 - Close the Medigap Act - Rep. Doggett, Lloyd - Medigap plan reform H.R. 879 - Medicare Patient Access and Practice Stabilization Act - Rep. Murphy, Gregory - Medicare physician reimbursement H.R. 936 - Medicaid Improvement and State Flexibility Act - Rep. Green, Mark - Medicaid demonstration programs H.R. 1019 - Medicaid Program Improvement Act - Rep. Miller-Meeks, Mariannette - Medicaid management care reporting H.R. 1059 - Jobs and Opportunities for Medicaid Act - Rep. Crenshaw, Dan - Medicaid eligibility requirements H.R. 1162 - Medicaid Primary Care Improvement Act - Rep. Crenshaw, Dan - Medicaid direct primary care arrangements H.R. 1191 - Supporting Access to Rural Community Hospitals Act - Rep. Flood, Mike - Medicare critical access hospitals definition H.R. 1195 - Protect Medicaid Act - Rep. Hudson, Richard - Medicaid eligibility requirements H.R. 1279 - To amend title XIX of the Social Security Act to establish a community engagement requirement for certain individuals under the Medicaid program. - Rep. Bean, Aaron - Medicaid eligibility requirements H.R. 1403 - LIVE Beneficiaries Act - Rep. Bilirakis, Gus - Medicaid registration audits H.R. 1598 - Ensuring Access to Medicaid Buy-in Programs Act - Rep. Ciscomani, Juan - Medicaid eligibility requirements H.R. 1683 - Protecting Rural Seniors Access to Care Act - Rep. Fischbach, Michelle - Minimum nursing home staffing H.R. 1775 - Second Chances for Rural Hospitals Act - Rep. Arrington, Jodey -Definition of rural emergency hospitals H.R. 1805 - ARCH Act - Rep. Miller, Carol - Extend Medicare-dependent and low-value hospitals payments H.R. 1924 - Securing Access to Care for Seniors in Critical Condition Act - Rep. Hern, Kevin - Medicare site-neutral payments for LTC hospitals H.R. 2045 - Medicare Dental, Vision, and Hearing Benefit Act - Rep. Doggett, Lloyd - Medicare dental, vision, and hearing coverage H.R. 2263 - Telehealth Coverage Act - Rep. Khanna, Ro - Telehealth flexibilities in Medicare H.R. 2309 - Medicare and Medicaid Fraud Prevention Act - Rep. Peters, Scott - provider screening for Federal programs H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act - Rep. Green, Mark - Medicare Advantage prior authorization H.R. 2533 - EASE Act - Rep. Arrington, Jodey - CMS model for virtual technology H.R. 2586 - Reentry Act - Rep. Tonko, Paul - Medicaid coverage for incarcerated population H.R. 2590 - Mental and Physical Health Care Comorbidities Act - Rep. Boyle, Brendan - CMS demonstration to treat comorbidities H.R. 2610 - Protecting Options for Seniors Act - Rep. Tenney, Claudia - MA wage index reclassification H.R. 3023 - Preventing Hospital Overbilling of Medicare Act - Rep. Spartz, Victoria - Site-neutral payment reform H.R. 3069 - Medicare for All Act - Rep. Jayapal, Pramila - New national health insurance program H.R. 3222 - SMART Health Care Act - Rep. Spartz, Victoria - MA risk adjustment H.R. 3263 - PATCH Act - Rep. Tokuda, Jill - Medicare geographic practice cost indices H.R. 3321 - Ending Medicaid Discrimination Against the Most Vulnerable Act - Rep. Roy, Chip - Enhance FMAP phase out H.R. 3415 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Rep. Schakowsky, Janice - Nurse staffing ratio requirements H.R. 3467 - To amend title XVIII to reform the Medicare Advantage program - Rep. Schweikert, David - MA reforms H.R. 3808 - Expanding Seniors Access to Mental Health Services Act - Rep. Fitzpatrick, Brian - Medicare mental health services H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4277 - Rural Emergency Hospital Financial Stability Act - Rep. Davis, Donald - Medicaid treatment of rural emergency hospitals H.R. 4313 - Hospital Inpatient Services Modernization Act - Rep. Buchanan, Vern - Acute hospital care at home waiver H.R. 4559 - Prompt and Fair Pay Act - Rep. Doggett, Lloyd - Payment parity for MA and FFS; MA reimbursement requirements H.R. 4641 - Keep Kids Covered Act - Rep. Castor, Kathy - Continuous eligibility for children in Medicaid/CHIP H.R. 4807 - Protect Our Hospitals Act - Rep. Landsman, Greg - Medicaid provider tax repeal H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. - Rep. McClellan, Jennifer - MA supplemental benefits data reporting H.R. 5281 - REAL Health Providers Act - Rep. Panetta, Jimmy - MA provider directory requirements H.R. 5454 - Medicare Advantage Prompt Pay Act - Rep. Arrington, Jodey - payment delivery requirements for MA plans H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - Impact of Third Party Liability on MCOs S. 523 - Protect Medicaid Act - Sen. Cassidy, Bill - Medicaid eligibility requirements S. 678 - LIVE Beneficiaries Act - Sen. Scott, Rick - Medicaid enrollment audits S. 717 - Increasing Access to Quality Cardiac Rehabilitation Care Act - Sen. Capito, Shelley Moore - Expanding cardiac care coverage in Medicare S. 750 - Protecting Rural Seniors Access to Care Act - Sen. Fischer, Deb - Medicaid nursing home staff requirements S. 752 - Accelerating Kids Access to Care Act - Sen. Grassley, Chuck - Out-of-state provider access for Medicaid S. 939 - Medicare Dental, Hearing, and Vision Expansion Act - Sen. Sanders, Bernard - Medicare coverage requirements S. 1082 - Safeguarding Medicaid Act - Sen. Barrasso, John - Medicaid enrollee asset verification S. 1105 - No UPCODE Act - Sen. Cassidy, Bill - MA risk adjustment S. 1264 - Mental and Physical Health Care Comorbidities Act - Sen. Bennet, Michael - CMS demonstration to treat comorbidities S. 1399 - Health Tech Investment Act - Sen. Rounds, Mike - Medicare coverage for algorithm-based services S. 1506 - Medicare for All Act - Sen. Sanders, Bernard - New national health insurance program S. 1624 - PATCH Act - Sen. Schatz, Brian - Medicare geographic practice cost indices S. 1629 - Same Care, Lower Cost Act - Sen. Kennedy, John - Medicare site-neutral payment reform S. 1637 - MVP Act - Sen. Mullin, Markwayne - Medicaid value-based purchasing agreements S. 1709 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Sen. Padilla, Alex - Nurse staffing ratio requirements S. 1816 - Improving Seniors Timely Access to Care Act - Sen. Marshall, Roger - MA prior authorization S. 1903 - A bill to prohibit changes to Medicare and Medicaid in reconciliation - Sen. Reed, Jack - Medicare and Medicaid safeguards against reconciliation cuts S. 2237 - Hospital Inpatient Services Modernization Act - Sen. Scott, Tim - Acute hospital care at home waiver S. 2279 - Protect Medicaid and Rural Hospitals Act - Sen. Hawley, Josh - Medicaid provider tax and State directed payments S. 2289 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - Medicaid/CHIP maternal health coverage improvements S. 2496 - Keep Kids Covered Act - Sen. Bennet, Michael - Continuous eligibility for children in Medicaid/CHIP S. 2497 - Fair Billing Act - Sen. Hassan, Maggie - Medicare site-neutral transparency and identification requirements S. 2793 - Ensuring Access to Essential Providers Act - Sen. Cassidy, Bill - Essential community provider coverage requirements for MA Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicare Transparency in Coverage; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; Medicare Advantage Health Risk Assessment and chart reviews; Medicare Advantage supplemental benefits and Social Determinants of health; CBO estimates of MA and FFS costs; coverage of weight loss drugs; Inflation Reduction Act implementation; Medicare Advantage Rate Notice; Part D Payment Issues; Part D VBID Issues; RADV; MA payment issues; Part D issues; prior authorization; MedPAC spending comparisons; and MA prompt pay.

Client expense: $4,230,000 · Firm income: Not reported

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

H.R. 879, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S. 1640, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S. 891, Bipartisan Health Care Act, provisions related to Medicare and Medicaid H.R. 786, Preserving Patient Access to Accountable Care Act, all provisions S. 1460, Preserving Patient Access to Accountable Care Act, all provisions H.R. 539, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S. 106, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R. 1317, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions S. 665, Fatal Overdose Reduction Act of 2025, all provisions H.R. 4977, Connected MOM Act, all provisions S. 141, Connected MOM Act, all provisions H.R. 3514, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1816, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1105, No Unreasonable Payments, Coding, Or Diagnoses for the Elderly (No UPCODE) Act, all provisions H.R. 5081, Telehealth Modernization Act, all provisions S. 2709, Telehealth Modernization Act, all provisions H.R. 1, One Big Beautiful Bill Act, provisions relating to Medicare and Medicaid physician payments, work requirements, per capita taxes, provider taxes, APMs, FMAP changes, PBM transparency H.R. 5347, Health Care Efficiency Through Flexibility Act, all provisions H.R. 2120, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions S. 1031, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions H.R. 2314, Fair Access In Residency (FAIR) Act, all provisions S. 2715, Fair Access In Residency (FAIR) Act of 2025, all provisions H.R. 1968, Full-Year Continuing Appropriations and Extensions Act, 2025, provisions relating to APMs H.R. 4206, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2025, all provisions S. 1261, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2025, all provisions H.R. 1614, To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R. 3108, Rural Patient Monitoring (RPM) Access Act, all provisions S. 1535, Rural Patient Monitoring (RPM) Access Act, all provisions H.R. 3164, Ensuring Community Access to Pharmacist Services (ECAPS) Act, all provisions S. 2426, Equitable Community Access to Pharmacist Services (ECAPS) Act, all provisions H.R. 2757, Medicare Audiology Access Improvement Act of 2025, all provisions S. 1996, Medicare Audiology Access Improvement Act of 2025, all provisions H.R. 3878, RNs for Rural Health Act of 2025, all provisions H.R. 5199, Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025, al provisions H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R. 5467, Patient Access to Autoimmune Treatments (PAAT) Act, all provisions H.R. 4002, Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R. 3022, Restoring Rights of Physicians to Own Hospitals Act, all provisions H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions S. 1390, Physician Led and Rural Access to Quality Care Act, all provisions S. 1399, Health Tech Investment Act, all provisions H.R. 4559, Prompt and Fair Pay Act, all provisions H.R. 5454, Medicare Advantage Prompt Pay Act, all provisions S. 2879, Medicare Advantage Prompt Pay Act, all provisions H.R. 4313, Hospital Inpatient Services Modernization Act, all provisions S. 2237, Hospital Inpatient Services Modernization Act, all provisions H.R. 4752, Reducing Hereditary Cancer Act, all provisions S. 2760, Reducing Hereditary Cancer Act, all provisions S. 2882, Continuing Appropriations and Extensions and Other Matters Act, 2026, provisions relating to Medicaid S.J.Res.8, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Market Integrity and Affordability," all provisions H.R. 5343, Ensuring Patient Access to Critical Breakthrough Products Act, all provisions S. 1717, Ensuring Patient Access to Critical Breakthrough Products Act of 2025, all provisions H.R. 842, Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act, all provisions S. 1692, Radiology Outpatient Ordering Transmission (ROOT) Act, all provisions H.R. 3890, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4731, Resident Physician Shortage Reduction Act of 2025, all provisions S. 2439, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4464, Preventive Health Savings Act, all provisions H.R. 2509, Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act, all provisions S. 931, Connecting Our Medical Providers with Links to Expand Tailored and Effective (COMPLETE) Care Act, all provisions Draft legislation to reform the MACRA/MIPS program Value in Health Care Act/draft GOLD CARD Act/drafts Medicare program: 21st Century Cures Act/implementation Medicare program: Medicare Economic Index (MEI) inflationary updates Medicare program: Merit-based Incentive Payment System (MIPS)/cost, quality, improvement activities, and interoperability Medicare program: MIPS Value Pathways (MVPs) reforms Medicare program: Medicare Physician Fee Schedule/efficiency adjustment, and indirect practice-expense Medicare program: Physician payment/budget neutrality Medicare program: Physician payment reform Medicare program: Kidney care models Medicare program: Coding Medicare program: G2211 Inherent Complexity Code Medicare program: Prior authorization Medicare program: Site neutral payment Medicare program: Accountable Care Organizations (ACOs)/Alternative Payment Model (APM) flexibilities Medicare program: APMs/Wasteful and Inappropriate Service Reduction (WISeR) Medicare program: APMs/Ambulatory Specialty Model (ASM) Medicare program: APM Bonus Extension Medicare program: Medicare acceptance rates, private practice issues/benchmark survey Medicare program: Relative Value Scale Update Committee (RUC) processes Medicare program: Wearables Medicare program: Local and National Coverage Determination processes Medicare program: Value-based care Medicare program: Postoperative visits Medicare program: Medicare Advantage (MA)/utilization management Medicare program: MA/prior authorization Medicare program: Promoting Interoperability (PI) Program Medicare program: Health IT/physician burdens Medicare program: Data privacy and cybersecurity Medicare program: HIPAA/electronic records Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Center for Medicare & Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: Telehealth flexibilities Medicaid: Access to care/advance premium tax credit

Client expense: $4,620,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Technology Policy (OTP), SENATE

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

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

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

H.R. 1 - One Big Beautiful Bill Act. Expressed opposition to the following items being considered for a budget reconciliation package: capped Medicaid funding, restrictions on provider taxes, restrictions on state directed payment programs, site-neutral payment policies. Expressed support for delaying cuts to Medicaid Disproportionate Share hospitals, extending telehealth flexibilities, extending Medicare-related programs that support rural hospitals, and repealing the nursing home minimum staffing rule. Endorse Prompt and Fair Pay Act (HR 4559), legislation to establish payment parity between Medicare Advantage and fee-for-service Medicare, and to establish prompt payment requirements under Medicare Advantage. Endorse Medicare Advantage Prompt Pay Act (HR 5454), legislation that establishes payment timelines and penalties for "clean claims" by Medicare Advantage plans. Provide comments to CMS on Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Ratings; and Hospital Price Transparency CMS-1834-P; specifically, the market basket factor update, payment of "inpatient only" services, reduction of payment for services furnished in excepted off-campus hospital outpatient departments (HOPD), and other provisions. Stated opposition to CMS about a new Aetna payment policy for its Medicare Advantage (MA) and Special Needs Plans. General appropriations package (FY 2026): Expressed support for delaying/repealing cuts to Medicaid Disproportionate Share Hospitals, extending telehealth flexibilities, extending Hospital at Home program, extending Medicare-related programs that support rural hospitals.

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

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

H.R. 483: Health Care Efficiency Through Flexibility Act H.R. 5347: Health Care Efficiency Through Flexibility Act H.R. 786/ S. 1460: Preserving Patient Access to Accountable Care Act S.891: Bipartisan Health Care Act H.R. 1768: Lower Costs for Everyday Americans Act S. 1816/ 3514: Improving Seniors Timely Access to Care Act S. 1650: Medicare Patient Access and Practice Stabilization Act S. 1105: No UPCODE Act H.R. 4559: Prompt and Fair Pay Act H.R. 5454: Medicare Advantage Prompt Pay Act S. 2561: Skin Substitute Access and Payment Reform Act H.R. 4773: ACO Assignment Improvement Act Issues related to Medicare payments, Medicare Shared Savings Program, ACO REACH, Medicare Advantage, alternative payment model incentives, telehealth, and fraud, waste, abuse.

Client expense: $167,316 · Firm income: Not reported

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

H.R. 1, the One Big Beautiful Bill Act H.R. 3514/S. 1816, the Improving Seniors Timely Access to Care Act of 2025 Issues related to Medicare coverage of audiology services and the Medicare Audiology Access Improvement Act (H.R. 2757/S. 1996) Issues related to the provision of audiology and speech-language pathology services through telepractice, including H.R. 1614, legislation to amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, and H.R. 5801, the Telehealth Modernization Act. Issues related to Medicare Part B reimbursement of audiology and speech-language pathology services, including H.R. 879, the Medicare Patient Access and Practice Stabilization Act of 2025 Prompt and Fair Pay Act (H.R. 4559) Medicare Patient Choice Act (H.R. 4204) Protecting Health Care and Lowering Costs Act (H.R. 4849/S. 2556) Various issues related to CMS Actions surrounding: oAudits of medical records and claims for Part A and B services oProcedure code development and valuation of audiology and speech-language pathology services oQuality reporting under MIPS oImplementation of the IMPACT Act oMedicare physician fee schedule oProspective payments systems, including home health and skilled nursing facility policy and payment issues oAccountable Care Organizations oFederally-facilitated marketplace oMedicare Advantage oVarious issues related to interoperable health information, including the post-acute care interoperability project (PACIO) oMedicare telehealth coverage under Part A and B oImplementation of CARES Act (P.L. 116-136) oProvision and payment for Part A therapy oVarious issues related to implementation of ACA oIssues related to Medicare beneficiaries accessing services provided by audiologists without a physician order oIssues related to qualified Medicare providers Issues related to the Center for Medicare and Medicaid Innovation (CMMI) actions related to value-based care Issues related to proposals to block grant or institute work requirements and/or per capita caps in the Medicaid program.

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

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

340B Drug Pricing Program Telehealth waivers Acute Hospital at Home program Prompt and Fair Pay Act (H.R. 4559) AHRQ Healthcare Extension Service Cooperatives grant program Bipartisan Premium Tax Credit Extension Act (H.R. 5145) Accelerating Kids' Access to Care Act (H.R. 1509/S. 752)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3514/S. 1816: Improving Seniors' Timely Access to Care Act of 2025 - requires Medicare Advantage plans to implement electronic prior authorization, increase transparency, protect enrollees, and adhere to new response timeframes to improve timely access to care. S. 1640: Medicare Patient Access and Practice Stabilization Act of 2025 - The bill extends Medicare payment adjustment timelines to 2025 and introduces an 8.51 percent adjustment for services between June 1, 2025, and January 1, 2026, to support healthcare providers in adapting to payment changes. S. 1460: Preserving Patient Access to Accountable Care Act - extends Medicare incentive payments for alternative payment models to 2027, with a new rate of 3.53 percent, to promote continued participation and improve healthcare efficiency. H.R. 4206/S. 1261: CONNECT for Health Act - expands access to telehealth services under Medicare H. 879: Medicare Patient Access and Practice Stabilization Act - Providing automatic inflationary updates to Medicare physician payments. Eliminate budget neutrality requirements. Meaningful changes to the Merit-Based Incentive Payment System (MIPS). H.R. 786: Preserving Patient Access to Accountable Care Act. Incentivizing the transition to value-based care. H.R. 2433: Reducing Medically Unnecessary Delays in Care Act - mandates that prior authorization decisions under Medicare be made by qualified physicians, based on medical necessity and evidence-based standards, with transparency and input from practicing physicians. H.R. 1509/S. 752: Accelerating Kids Access to Care Act - To amend titles XIX and XXI of the Social Security Act to streamline the enrollment process for eligible out-of-state providers under Medicaid and CHIP. H.R. 2484: Seniors' Access to Critical Medications Act of 2025 - establishes an exception to the physician self-referral prohibition for certain outpatient drugs under Medicare, mandates a study on drug dispensing practices, and reduces the Medicare improvement fund by $18 million. H.R. 2120/S. 1031: ROCR Value Based Program Act - establishes a new payment program for radiation oncology services, focusing on stable payments, quality care, and patient access, while exempting it from budget neutrality adjustments. H.R. 4559: Prompt and Fair Pay Act - to establish payment parity between Medicare Advantage and fee-for-service Medicare, and to establish prompt payment requirements under Medicare Advantage. H.R. 4299: Protecting Patient Access to Cancer and Complex Therapies Act - provide for a rebate by manufacturers for selected drugs and biological products subject to maximum fair price negotiation. H.R. 5081/S. 2709: Telehealth Modernization Act - to extend certain telehealth flexibilities under the Medicare program. H.R. 4752/S. 2760: Reducing Hereditary Cancer Act - to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation Preserving the Medicaid Program for cancer patients.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE