340B PATIENTS Act of 2025

Discretionary funding for the Health Center Program, the National Health Service Corps, and the Teaching Health Centers Graduate Medical Education Program that is funded via the Appropriations measure covering the Departments of Labor, Health and Human Services, Education, and Related Agencies Appropriations for FY 2027 in both the House and the Senate. The Community Health Center Fund reauthorization; this "extender" must be reauthorized by December 31, 2026. Lobbying related to ACH's proposed CHC Value and Innovation Fund; H.R.1 One Big Beautiful Bill Act implementation, specifically state-based operations to implement the Rural Health Transformation Program and Community Engagement Requirements Issues related to CMS Interim Final Rule implementing Community Engagement Requirements & Notice of Proposed Rulemaking for Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments. H.R. 10398, the Community Health Center Reforms Enabling Better Access for Seniors and Elders (CHC REBASE) Act. Medicare/Duals issues including Medicare PPS payments, the PACE program, and telehealth flexibilities in the Medicare program. 340B Drug Pricing Program legislation, including HR 10770, the 340B Rebate Model Delay Act; HR 5244, the SUSTAIN 340B Act; HR 9599, the SECURE 340B Act; the 340B Patients Act (S 2372 & HR 4581); the Community Health Center Drug Pricing Protection Act (HR 7391). Comments and legislative efforts to block 340B Rebate Model Pilot Program efforts and manufacturers efforts to compel claims data Issues and legislation related to the primary care workforce, including the Developing the Community Health Workforce Act (HR8629), the Health Workforce Innovation Act (HR935), H-1Bs for Physicians and the Healthcare Workforce Act (HR7961), the Community TEAMS Act of 2025 (HR3885), funding for Title 7 & Title 8 workforce programs and activities related to a new workforce coalition, The Alliance to Strengthen Americas Health Workforce for the Underserved Issues related to CMMI models and health center participation in value-based care payment arrangements, including MAHA Elevate, ACCESS, and LEAD Issues related to the Health Center Community Transformation Hub Act (Has not been reintroduced in 119th Congress) Issues related to the Trump Administrations stance on community health centers and primary care workforce funding, including the Make America Healthy Again agenda (nutrition and chronic disease management). Legislation being developed by Senator Warnock to establish an HRSA grant program to help Section 330 grantees maintain and modernize mobile units.

Client expense: $65,000 · Firm income: Not reported

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

H.R. 9599 SECURE 340B Act, all pharmaceutical related provisions H.R. 5256 340B ACCESS Act, all pharmaceutical related provisions S. 2372 H.R. 4581 340B Patients Act of 2025, all pharmaceutical related provisions H.R. 8269 CLEAR LABELS Act, all pharmaceutical related provisions S. 2658 Medication Affordability and Patient Integrity Act, all pharmaceutical related provisions S. 1096 Preserve Access to Affordable Generics and Biosimilars Act, all pharmaceutical related provisions S. 1040 Drug Competition Enhancement Act, all pharmaceutical related provisions S.1095 Stop STALLING Act, all pharmaceutical related provisions S. 1954 Biosimilar Red Tape Elimination Act, all pharmaceutical related provisions Drug Pricing: Policies pertaining to drug pricing not yet introduced Plasma: Policies or advocacy in the promotion of protecting access PBM Reform: Policies related to PBM not yet introduced (e.g., coverage, transparency, accumulators, etc) (Note: RFIs do not count) 340B: Policies related to 340B not specific to a piece of legislation PDUFA: Perscription Drug User Fee Act Global pharmaceutical supply chain operations and manufacturing locations Bayh-Dole march in rights policy issues

Client expense: $1,450,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Expressed support for Section 340B of the Public Health Service Act. Urged Congress to revise Section 2 in line with concerns expressed over discussion draft on rebate conditions; that the current HRSA standard of additional definitions in Section 4 remain in place; that Section 8 recognize that child sites operated through other appropriate affiliated structures, in addition to wholly owned facilities, align compliance requirements with existing Medicare provider-based standards, and reconsider the proposed charity-care and Medicaid/CHIP revenue benchmarks to account for state and community variation. (H.R. 9393) - The Lower Costs, More Transparency Act of 2026 and (H.R. 9390) - The Prices on the Wall Act of 2026 - Urged Congress to ensure that any new transparency requirements are aligned with existing federal rules, avoid duplication, recognize the complexity of health care pricing, and provide sufficient flexibility for hospitals serving diverse communities and patient populations. (H.R. 9645) - The Health Care Price Certainty for All Americans Act - Urged Congress to ensure that any new transparency requirements are aligned with existing federal rules, avoid duplication, recognize the complexity of health care pricing, and provide sufficient flexibility for hospitals serving diverse communities and patient populations. (S.2372/H.R.4581) - 340B PATIENTS Act of 2025-Expressed support for the 340B Patients Act. This legislation would codify 340B providers' ability to use contract pharmacies to dispense 340B discounted drugs, ensure that 340B patients can pick up their prescriptions at any local pharmacy, and allow safety-net providers to continue providing expanded medical and social services to their communities using their 340B discount savings. (S. 2287/H.R. 4425) - Palliative Care and Hospice Education and Training Act (PCHETA) - Expressed support for the Palliative Care and Hospice Education and Training Act (PCHETA). This legislation would increase the number of permanent faculty in palliative care in medical schools, nursing schools, and other programs, promote education and research in palliative care and hospice, and support the development of faculty careers in academic palliative and hospice (S. 380) - Rural Obstetrics Readiness Act - Expressed support for the Rural Obstetrics Readiness Act. This bipartisan legislation would ensure that rural health care facilities are equipped with targeted resources to provide high-quality obstetric care to women within their own communities.

Client expense: $116,445 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), President of the U.S., SENATE

Issues pertaining to the 340B Drug Discount Program - H.R. 5256, the 340B ACCESS Act; H.R.4581 & S. 2372, 340B PATIENTS Act of 2025; H.R. 9504, Tax Exempt Hospital Transparency Act; S.5244, SUSTAIN 340B Act; H.R.9599, SECURE 340B Act Step therapy reform - H.R. 5509 & S. 2903, Safe Step Act Neuroscience Drug Program - FY 2026 and FY2027 AgFDA Appropriations BRAIN Initiative - FY 2026 and FY2027 Labor-HHS Appropriations Issues related to DTC advertising regulations Headache disorders treatment and research - H.R. 5536, HEADACHE Act of 2025 Research and services for epilepsy - H.R. 1189 & S. 494, National Plan for Epilepsy Act Issues pertaining to prior authorization - HR 9396, Prior Authorization Accountability Act Issues pertaining to transparency - HR 9393, Lower Costs, More Transparency Act Issues pertaining to Pediatric Priority Review Voucher program at the FDA - H.R.10359, Priority for Pediatric Cures Act

Client expense: $130,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The SECURE 340B Act (H.R. 9599); The Tax-Exempt Hospital Transparency Act (H.R.9504); 340B PATIENTS Act (H.R. 4581/S.2372); The SUSTAIN 340B Act (S.5244); Senator Bill Cassidys 340B Discussion Draft bill 2027 OPPS Proposed Rule; Information Collection Request Title: 340B Rebate Model Pilot Program Application, Implementation, and Evaluation, OMB Number 0906-NEW; Manufacturer Demand for Access to in-House Pharmacy Claims Data; Lilly 340B Drug Pricing Denial; Notice Regarding 340B Rebate Model Pilot Program; Pending introduction of Reps. Bresnahan and Dingells two-year rebate model pilot ban legislation; FY27 Appropriations legislation.

Client expense: $330,000 · Firm income: Not reported

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

Issues related to the Departments of Labor, Health and Human Services, Education, and Related Agencies Appropriations for FY 2027, including written testimony to the U.S. House Appropriations Committee and U.S. Senate Appropriations Committee subcommittees on Labor, Health and Human Services, Education, and Related Agencies on CHC Funding H.R.1 One Big Beautiful Bill Act implementation, specifically state-based operations to implement the Rural Health Transformation Program Issues related to CMS Interim Final Rule implementing Community Engagement Requirements & Notice of Proposed Rulemaking for Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments 340B Drug Pricing Program legislation, including the SUSTAIN Act, 340B Patients Act (HR 4581), the Community Health Center Drug Pricing Protection Act (HR 7391), and proposed 340C legislation Comments and legislative efforts to block 340B Rebate Model Pilot Program efforts and manufacturers efforts to compel claims data Statement submitted to the House Committee on Budgets hearing, Reverse the Curse: Skyrocketing Health Care Costs and Americas Fiscal Future Issues and legislation related to the primary care workforce, including introduction of the Developing the Community Health Workforce Act (HR8629), the Health Workforce Innovation Act (HR935), H-1Bs for Physicians and the Healthcare Workforce Act (HR7961), the Community TEAMS Act of 2025 (HR3885), funding for Title 7 & Title 8 workforce programs and activities related to a new workforce coalition, The Alliance to Strengthen Americas Health Workforce for the Underserved Issues related to CMMI models and health center participation in value-based care payment arrangements, including MAHA Elevate, ACCESS, and LEAD Issues related to the Health Center Community Transformation Hub Act (Has not been reintroduced in 119th Congress) Issues related to the Trump Administrations stance on community health centers and primary care workforce funding, including the Make America Healthy Again agenda (nutrition and chronic disease management) and the Presidents proposed budget

Client expense: $85,000 · Firm income: Not reported

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

H.R. 4581, 340B PATIENTS Act of 2025; health related issues FY 2027 Departments of Labor, Health and Human Services (HHS), and Education, and Related Appropriations Act; funding for National Institutes of Health (NIH)

Client expense: $1,140,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Congressional outreach and monitoring regarding the following: -H.R. 1, One Big Beautiful Bill Act (P.L. 119-21). -H.R. 3178, Save Healthcare Workers Act. -H.R. 9504, Tax Exempt Hospital Transparency Act. -340B policy issues. -H.R. 4581 / S. 2372 - 340B PATIENTS Act of 2025 -H-1B Visa restrictions. -2027 federal budget. -Prior authorization reform and insurer prompt-pay legislation. -Centers for Medicare & Medicaid Services Regulatory Proposals. -Site Neutral Payment Proposals. -Healthcare and hospital workforce budget and appropriations, generally.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Congressional outreach and monitoring regarding the following: -H.R. 1, One Big Beautiful Bill Act (P.L. 119-21). -H.R. 3178, Save Healthcare Workers Act. -H.R. 9504, Tax Exempt Hospital Transparency Act. -340B policy issues. -H.R. 4581 / S. 2372 - 340B PATIENTS Act of 2025 -2027 federal budget. -Prior authorization reform and insurer prompt-pay legislation. -Centers for Medicare & Medicaid Services Regulatory Proposals. -Site Neutral Payment Proposals. -Healthcare and hospital workforce budget and appropriations, generally.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4581 / S.2372, 340B PATIENTS Act, all provisions; H.R. 3178 / S. 1600, The Save Healthcare Workers Act, all provisions; H.R. 929 / S. 266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions; H.R. 1585 / S. 709, Conrad State 30 and Physician Access Reauthorization Act, all provisions; S. 1874, Title VIII Nursing Workforce Reauthorization Act, all provisions; S. 2169, Rural Hospital Cybersecurity Enhancement Act, all provisions; H.R. 5283 / S. 2759, Healthcare Workforce Resilience Act, all provisions; S. 3315, Health Care Cybersecurity and Resiliency Act of 2025, all provisions; H.R. 5256, 340B Access Act, all provisions; S. 2355 / H.R. 5582, Patients Deserve Price Tags Act, all provisions; H.R. 7961, Physicians and the Healthcare Workforce Act, all provisions; S. 3435 / H.R. 6607, The Future Advancement of Academic Nursing, all provisions; S. 4637, Physician Workforce Optimization Act, all provisions; S.3788 / H.R. 8269, Consumer Labeling for Enhanced API Reporting and Legitimate Accountability for Base Entity Listings Act, all provisions; DRAFT, Issues pertaining to post-market surveillance of devices; S.Res.230, A resolution supporting the goals and ideals of National Hospital Week, to be observed from May 11 through May 17, 2025, all provisions; DRAFT, Issues pertaining to medical debt; S. 4568 / H.R. 8691, Nursing is a Professional Degree Act, all provisions; S.J. Res 196, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Education relating to "Reimagining and Improving Student Education-Federal Student Loan Program Final Regulations", all provisions; H.R. 6718, Professional Student Degree Act, all provisions; DRAFT, Lower Costs More Transparency Act of 2026, all provisions; DRAFT, To amend title XXVII of the Public Health Service Act to require hospitals to post prices on the walls, all provisions; DRAFT, To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to ensure health insurer accountability through publishing of overhead costs and claim payments, all provisions; DRAFT, To amend title XVIII of the Social Security Act and title XXVII of the Public Health Service Act to require the displaying of claim denial rates, all provisions; DRAFT, To amend title XI of the Social Security Act to require mandatory reporting with respect to certain health-related ownership information, all provisions; S. 1482, National Nursing Workforce Center, all provisions; S. 4027, Healthy Competition for Better Care Act, all provisions; H.R. 5629, To provide that the final rule of the Department of Health and Human Services titled Medications for the Treatment of Opioid Use Disorder, except for the portion of the final rule relating to accreditation of opioid treatment programs, shall have no force or effect; all provisions; H.R. 8726, the Protecting Authority and Restoring Tools Necessary for Enforcement by Regulatory States Act of 2026 PARTNERS Act, all provisions; S.3364, Fast Track Healthcare Apprenticeships Act, all provisions; S.4252, WIPP Economic Assistance Assurance Act of 2026, all provisions; H.R. 4470, Removing Burdens From Organ Donation Act, all provisions; U.S. Department of Health & Human Services / Office of the National Coordinator for Health Information Technology, Issue pertaining to standardized set of data elements intended to support nationwide, interoperable electronic data exchange to help ensure consistent health information exchange throughout a patient's health care journey; Health Resources & Services Administration (HRSA), Issue pertaining a revised version of a 340B rebate model pilot program; Health Resources & Services Administration (HRSA), Issue pertaining to Eli Lilly 340B program decisions; Federal Trade Commission & Department of Justice, Issues pertaining to the effectiveness of the Hart-Scott-Rodino (HSR) premerger notification form and implications for hospital field; Enhanced Premium Tax Credits, Extension of Enhanced Premium Tax Credits; Rural Health Care Access, Issues to protect access to rural health care; 340B Program, Issues pertaining to protecting 340B Program, including 340B Rebate Model Pilot Program; Maternal and Child Health, Access to maternal and child health care and addressing related workforce shortages, conditions of participation (COP); Behavioral Health, Issues related to expanding access to care and reducing regulatory barriers; Workforce, Issues pertaining to workforce development programs, supporting health care workforce and physician shortages, loan repayment programs for providers in rural and underserved areas, Graduate Medical Education program; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay, white-bagging and brown-bagging policies; Health Care Resiliency & Preparedness, Issues pertaining to natural disasters, strengthen health care cybersecurity, cybersecurity workforce, and securing drug supply chains, hospital preparedness program, PAHPA reauthorization; Healthcare Price Transparency, Issues related to health care price transparency; Affordability, Issues and policy solutions pertaining to health care affordability and rising costs of health care; Tax-exempt status, Issues pertaining to not-for-profit hospitals' tax exempt status and tax-exempt private activity bonds; Immigration, Proposed H1-B Visa Program changes and impact to health care workforce; AI in Healthcare, Issues pertaining to the use of AI in healthcare; Professional Degree Program Changes, Issues pertaining to new student loan borrowing limits and professional degree programs changes; Drug Prices, Issues pertaining to lowering drug prices, securing drug supply chain, and transparency; Rural Health Transformation Fund, Issues pertaining to implementation of the Rural Health Transformation program.

Client expense: $4,470,000 · Firm income: Not reported

Government targets: Education, Dept of, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Justice, Dept of (DOJ), SENATE

H.R. 2484 Seniors Access to Critical Medications Act H.R. 2853 Combating Organized Retail Crime Act H.R. 3164 Ensuring Community Access to Pharmacist Services Act H.R. 4317 PBM Reform Act S. 526 Pharmacy Benefit Manager (PBM) Transparency Act S. 527 Prescription Pricing for the People Act S. 882 Patients Before Middlemen (PBM) Act S. 927 Protecting Pharmacies in Medicaid Act S. 1404 Combating Organized Retail Crime Act S. 2426 Equitable Community Access to Pharmacist Services Act S. 3345 PBM Price Transparency and Accountability Act H.R. 6609 Pharmacists Fight Back in Medicare and Medicaid Act H.R. 6575 CommonGround for Affordable Health Care Act H.R. 6501 Bipartisan Health Insurance Affordability Act H.R. 5256 340B ACCESS Act H.R. 4581 340B PATIENTS Act S. 2372 340B PATIENTS Act H.R. 6400 Rx ACCESS Act S. 4106 Rx ACCESS Act S. 3788 CLEAR LABELS Act S. 4509 Patients Before Monopolies Act H.R. 8779 Patients Before Monopolies Act S. 3822 Break Up Big Medicine Act H.R. 8800 National Defense Authorization Act S. 4784 National Defense Authorization Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Rebuild Americas Health Care Schools Act (H.R. 1708/S. 1087), issues related to pharmacy residency funding. Issues related to FDA authority to manage drug shortages, regulation of pharmacy compounding, and implementation of the Drug Quality and Security Act. The Biosimilar Red Tape Elimination Act (H.R. 5526/S. 1954) and Expedited Access to Biosimilars Act (H.R. 9661), issues related to increased patient access to essential biosimilar medications. Issues related to pharmacy benefit manager (PBM) abuses and transparency (generally, no specific legislation). The 340B PATIENTS Act (H.R. 4581/S. 2372), issues related to 340B program nondiscrimination and contract pharmacy arrangements. Issues related to manufacturer attempts to undercut the 340B program, including conversion of the program to a rebate model (generally, no specific legislation). Issues related to drug price negotiations and patient out-of-pocket costs (generally, no specific legislation). Issues related to patient access to antipsychotic medication in long-term care settings (generally, no specific legislation). The Stop Pills That Kill Act (H.R. 8005), PRESS Act (H.R. 7184), and Fight Illicit Pill Presses Act (H.R. 5880), issues related to halting the unlawful production and availability of fentanyl, fentanyl analogues, and fentanyl-related substances. The States Handling Access to Reciprocity for Employment (SHARE) Act of 2025 (H.R. 4122), issues related to the Federal Bureau of Investigation (FBI) providing criminal history records to state licensing agencies under interstate compacts, which would help pharmacists and other healthcare professionals to more easily work across state lines.

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

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

The SECURE 340B Act (H.R. 9599); The Tax-Exempt Hospital Transparency Act (H.R.9504); 340B PATIENTS Act (H.R. 4581/S.2372); Community Health Center Drug Pricing Protection Act (H.R. 7391); 2027 OPPS Proposed Rule; Information Collection Request Title: 340B Rebate Model Pilot Program Application, Implementation, and Evaluation, OMB Number 0906-NEW; Manufacturer Demand for Access to in-House Pharmacy Claims Data; Lilly 340B Drug Pricing Denial; HRSA Rebate Model Pilot pending regulation; Pending Senate "Gang of Six" draft 340B legislation; FY27 Appropriations legislation; Pending introduction of updated and expanded Community Health Center Drug Pricing Protection Act.

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

Government targets: HOUSE OF REPRESENTATIVES, Office of Management & Budget (OMB), SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES

Oppose 340B cuts HR 4581 340B Patients Act Oppose 340B rebates Oppose Eli Lilly claims reporting

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

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

Issues pertaining to the 340B Drug Discount Program - H.R. 5256, the 340B ACCESS Act; H.R.4581 & S. 2372, 340B PATIENTS Act of 2025; H.R. 9504, Tax Exempt Hospital Transparency Act Step therapy reform - H.R. 5509 & S. 2903, Safe Step Act Neuroscience Drug Program - FY 2026 and FY2027 AgFDA Appropriations BRAIN Initiative - FY 2026 and FY2027 Labor-HHS Appropriations Issues related to DTC advertising regulations Headache disorders treatment and research - H.R. 5536, HEADACHE Act of 2025 Research and services for epilepsy - H.R. 1189 & S. 494, National Plan for Epilepsy Act Issues pertaining to prior authorization - HR 9396, Prior Authorization Accountability Act Issues pertaining to transparency - HR 9393, Lower Costs, More Transparency Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Oppose 340B cuts. HR 4581 340B Patients Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 7148, the Consolidated Appropriations Act, 2026 Issues related to the Departments of Labor, Health and Human Services, Education, and Related Agencies Appropriations for FY 2027, especially funding for the Community Health Center Program and the National Health Service Corps H.R.1 One Big Beautiful Bill Act implementation, specifically state-based operations to implement the Rural Health Transformation Program and Medicaid changes, like community engagement requirements and new limits to funding mechanisms 340B Drug Pricing Program legislation, including the SUSTAIN Act, 340B Patients Act (HR 4581), the Community Health Center Drug Pricing Protection Act (HR 7391), and proposed 340C legislation Comments and legislative efforts to block 340B Rebate Model efforts and manufacturers efforts to compel claims data, including meetings with CMS and OMB Statement submitted to the House Committee on Budgets hearing, Reverse the Curse: Skyrocketing Health Care Costs and Americas Fiscal Future RFI Response to Congressional Doctors Caucuses on Proposed Payment Reforms Submitted comments to the Department of Education Re: Reimagining and Improving Student Education Proposed Rule, 34 CFR Parts 674, 682, and 685 [Docket ID ED-2025-OPE-0944] RIN 1840-AD98 Issues and legislation related to the primary care workforce, including advancing the Developing the Community Health Workforce Act, the Health Workforce Innovation Act (HR935), H-1Bs for Physicians and the Healthcare Workforce Act (HR7961), the Community TEAMS Act of 2025 (HR3885), funding for Title 7 & Title 8 workforce programs and activities related to a new workforce coalition, The Alliance to Strengthen Americas Health Workforce for the Underserved Issues related to CMMI models and health center participation in value-based care payment arrangements, including MAHA Elevate, ACCESS, and LEAD Issues related to the Health Center Community Transformation Hub Act (Has not been reintroduced in 119th Congress) Issues related to the Trump Administrations stance on community health centers and primary care workforce funding, including the Make America Healthy Again agenda (nutrition and chronic disease management)

Client expense: $85,000 · Firm income: Not reported

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

H.R. 4581 / S.2372, 340B PATIENTS Act, all provisions; H.R. 3178 / S. 1600, The Save Healthcare Workers Act, all provisions; H.R. 929 / S. 266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions; H.R. 1585 / S. 709, Conrad State 30 and Physician Access Reauthorization Act, all provisions; S. 1874, Title VIII Nursing Workforce Reauthorization Act, all provisions; S. 2169, Rural, Hospital Cybersecurity Enhancement Act, all provisions; H.R. 5283 / S. 2759, Healthcare Workforce Resilience Act, all provisions; S. 3315, Health Care Cybersecurity and Resiliency Act of 2025, all provisions; H.R. 5256, 340B Access Act, all provisions; S. 1929, SEPSIS Act, all provisions; S. 2355 / H.R. 5582, Patients Deserve Price Tags Act, all provisions; H.R. 7961, Physicians and the Healthcare Workforce Act, all provisions; S. 3435 / H.R. 6607, The Future Advancement of Academic Nursing, all provisions; H.R. 5428, Medical Student Education Authorization Act of 2025, all provisions; H.R. 7920 / S. 4085, Take Back Our Hospitals Act, all provisions; S. 4208, A bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program, all provisions; DRAFT, Conrad 30 Enhancement Bill, all provisions; DRAFT, Rural Maternity Bill, all provisions; S.3788, Consumer Labeling for Enhanced API Reporting and Legitimate Accountability for Base Entity Listings Act, all provisions; S.3822, Break Up Big Medicine Act, all provisions; H.R.7727, Sustaining Rural Healthcare Act, all provisions; DRAFT, Preserving Patient Access Act, all provisions; H.R. 5629, Medications for the Treatment of Opioid Use Disorder (OUD), all provisions; S. 4141, Rural Hospital Revitalization Act of 2026, all provisions; H.R. 7478, Patient Debt Relief Act, all provisions; Federal Trade Commission, Issue pertaining to the remarks at the forge Mason Law Review 29th Annual Antitrust Symposium; Department of Health & Human Services / Office of the National Coordinator for Health IT, Issues pertaining to Health Data, Technology and Interoperability; Health Resources and Services Administration (HRSA), Comments pertaining to Eli Lilly and Company policy and impact to 340B hospitals; Health Resources and Services Administration (HRSA), Comments pertaining to Novo Nordisk policy and impact to 340B hospitals; Health Resources and Services Administration (HRSA), Comments pertaining to the request for information on a new 340B rebate model program; Department of Health & Human Services / Office of the National Coordinator for Health IT, Issues pertaining to diagnostic imaging interoperability; U.S. Department of Education, Issues pertaining to proposed rule implementing borrowing limits for federal student loans and impact on health care workforce; U.S. Department of Health & Human Services (HHS), Issues pertaining to accelerating the adoption and use of AI as part of clinical care; Enhanced Premium Tax Credits, Extension of Enhanced Premium Tax Credits; Rural Health Care Access, Issues to protect access to rural health care; 340B Program, Issues pertaining to protecting 340B Program, including 340B Rebate Model Pilot Program; Maternal and Child Health, Access to maternal and child health care and addressing related workforce shortages, conditions of participation (COP); Behavioral Health, Issues related to expanding access to care and reducing regulatory barriers; Workforce, Issues pertaining to workforce development programs, supporting health care workforce and physician shortages, definitions of professional degree programs and borrowing limits, loan repayment programs for providers in rural and underserved areas, Graduate Medical Education program; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay, white-bagging and brown-bagging policies; Health Care Resiliency & Preparedness, Issues pertaining to natural disasters, strengthen health care cybersecurity, cybersecurity workforce, and securing drug supply chains, hospital preparedness program, PAHPA reauthorization, outstanding FEMA COVID payments to hospitals; Price Transparency, Issues related to hospital price transparency; Affordability, Issues pertaining to the cost of health care; Tax-exempt status, Issues pertaining to not-for-profit hospitals' tax exempt status and tax-exempt private activity bonds; Immigration, Proposed H1-B Visa Program changes and impact to health care workforce; AI in Healthcare, Issues pertaining to the use of AI in healthcare.

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

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

H.R. 7148 Consolidated Appropriations Act, 2026 H.R. 2484 Seniors Access to Critical Medications Act H.R. 2853 Combating Organized Retail Crime Act H.R. 3164 Ensuring Community Access to Pharmacist Services Act H.R. 4317 PBM Reform Act S. 526 Pharmacy Benefit Manager (PBM) Transparency Act S. 527 Prescription Pricing for the People Act S. 882 Patients Before Middlemen (PBM) Act S. 927 Protecting Pharmacies in Medicaid Act S. 1404 Combating Organized Retail Crime Act S. 2426 Equitable Community Access to Pharmacist Services Act S. 3345 PBM Price Transparency and Accountability Act H.R. 6609 Pharmacists Fight Back in Medicare and Medicaid Act H.R. 6575 CommonGround for Affordable Health Care Act H.R. 6501 Bipartisan Health Insurance Affordability Act H.R. 5256 340B ACCESS Act H.R. 4581 340B PATIENTS Act S. 2372 340B PATIENTS Act H.R. 6400 Rx ACCESS Act S. 4106 Rx ACCESS Act S. 3788 CLEAR LABELS Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4581, 340B PATIENTS Act of 2025; health related issues FY 2027 Departments of Labor, Health and Human Services (HHS), and Education, and Related Appropriations Act; funding for National Institutes of Health (NIH)

Client expense: $740,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The Rebuild Americas Health Care Schools Act (H.R. 1708/S. 1087), issues related to pharmacy residency funding. Issues related to FDA authority to manage drug shortages, regulation of pharmacy compounding, and implementation of the Drug Quality and Security Act. The Biosimilar Red Tape Elimination Act (S. 1954), issues related to increased patient access to essential biosimilar medications. Issues related to pharmacy benefit manager (PBM) abuses and transparency (generally, no specific legislation). The 340B PATIENTS Act (H.R. 4581/S. 2372), issues related to 340B program nondiscrimination and contract pharmacy arrangements. Issues related to manufacturer attempts to undercut the 340B program, including conversion of the program to a rebate model (generally, no specific legislation). Issues related to drug price negotiations and patient out-of-pocket costs (generally, no specific legislation). Issues related to patient access to antipsychotic medication in long-term care settings (generally, no specific legislation).

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

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

Reconciliation Bill - Medicare, Medicaid, Physician Payments, 340(b) Discount Drug Program, ACA Premium Tax Credits; HHS, CMS H.R. 9351, Save Our Safety-Net Hospitals Act of 2024 H.R. 4581, 340B PATIENTS Act of 2025 H.R. 4731, Resident Physician Shortage Reduction Act of 2025 EDUCATE Act (House/Senate) Lower Costs, More Transparency Act (House/Senate) Reinforcing Essential Health Systems for Communities Act (House/Senate) Supplemental Guidance to the 2024 NIH (National Institutes of Health) Grants Policy Statement: Indirect Cost Rates (NOT-OD-25-068, February 7, 2025); Facilities and Administrative costs (F&A) related issues 340B Drug Discount Program; Application Process for the 340B Rebate Model Pilot Program and Request for Public Comment (HRSA-2025-14619, (90 FR 36163)); issues related to proposed 340B rebate model Medicaid Disproportionate Share Hospital (DSH) funding related issues Medicare telehealth waiver related issues mRNA Vaccine Clinical Trials

Client expense: $170,000 · Firm income: Not reported

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

Issues pertaining to the 340B Drug Discount Program - H.R. 5256, 340B ACCESS Act; H.R.4581 & S. 2372, 340B PATIENTS Act of 2025 Issues pertaining to the implementation of the Inflation Reduction Act of 2022 - H.R. 6166, Lowering Drug Costs for American Families Act Issues pertaining to Pharmacy Benefit Managers - S.3345, PBM Price Transparency and Accountability Act; H.R.4317, PBM Reform Act of 2025 Issues pertaining to CMS Coverage of APS in LTC Issues pertaining to Medicares Six Protected Classes policy Medicare Part D Smoothing Benefit - FY 2026 and FY2027 Labor-HHS Appropriations Orphan drug exclusion in the Inflation Reduction Act - H.R. 946 & S. 1862, ORPHAN Cures Act Small molecule discrepancy in the Inflation Reduction Act - H.R. 1492 & S. 832, The EPIC Act Issues pertaining to the Most Favored Nation drug price setting policy - H.R. 7837, Most Favored Patient Act of 2026 Issues pertaining to migraine screening for women in Medicare - FY 2026 and FY2027 Labor-HHS Appropriations

Client expense: $130,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to the 340B Drug Discount Program - H.R. 5256, the 340B ACCESS Act; H.R.4581 & S. 2372, 340B PATIENTS Act of 2025 Issues pertaining to Pharmacy Benefit Managers - H.R.4317, PBM Reform Act of 2025; H.R.6703, Lower Health Care Premiums for All Americans Act Step therapy reform - H.R. 5509 & S. 2903, Safe Step Act Neuroscience Drug Program - FY 2026 and FY2027 AgFDA Appropriations BRAIN Initiative - FY 2026 and FY2027 Labor-HHS Appropriations Reauthorization of the Pediatric Priority Review Voucher program at the FDA Issues related to DTC advertising regulations Pediatric rare diseases - H.R. 1262 & S. 932, Give Kids a Chance Act of 2025 Headache disorders treatment and research - H.R. 5536, HEADACHE Act of 2025 Research and services for epilepsy - H.R. 1189 & S. 494, National Plan for Epilepsy Act

Client expense: $130,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Congressional outreach and monitoring regarding the following: -H.R. 1, One Big Beautiful Bill Act (P.L. 119-21). -Healthcare and hospital workforce budget and appropriations, generally. -House and Senate Drafts - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027. -2027 federal budget. -Extending Enhanced Premium Tax Credits. -Healthcare extenders. -340B policy issues. -H.R. 4581 / S. 2372 - 340B PATIENTS Act of 2025. -H-1B Visa restrictions.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid payment issues and alternative payment models; Health care workforce and H-1B visas; Health care pricing transparency; Site Neutral; 340B Program and Drug Pricing; MA prior authorization; Telehealth and digital health; Home health / Hospice; Rural health and Rural Hospital Support Act (S. 335); Lorna Breen Health Care Worker Safety Reauthorization Act (S. 266 / H.R. 929); Graduate medical education; Artificial intelligence; The Affordable Care Act; RESULTS Act (H.R.5269 / S.2761); Equitable Community Access to Pharmacist Services (ECAPS) Act (H.R. 3164 / S. 2426); 340B PATIENTS Act (H.R.4581 / S.2372); CONNECT for Health Act (H.R.4206 / S.1261)

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

Government targets: HOUSE OF REPRESENTATIVES

Vaccine Policy, Coverage and Access Executive Order 14297 - Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients H.R. 5256 - 340B Access ACT Inflation Reduction Act (IRA): Maximum Fair Price (MFP) Effectuation, Biosimilars Special Rule Drug Pricing PBM Reform H.R. 4581 - 340B PATIENTS Act of 2025 H.R. 5509 - Safe Step Act S. 2903 - Safe Step Act S. 2296 - National Defense Authorization Act (NDAA) for Fiscal Year 2026 S. 1053 - FIGHT China Act Cancer Research Centers for Disease Control and Prevention (CDC) Policies

Client expense: $1,790,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

Executive Order 14297 - Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients H.R. 5256 - 340B Access ACT Inflation Reduction Act (IRA): Maximum Fair Price (MFP) Effectuation, Biosimilars Special Rule H.R. 4581 - 340B PATIENTS Act of 2025 340B Reform 340B HHS Pilot Program Model Insurance Coverage of Prescription Drugs Direct-to-Patient Prescription Drug Purchase Platforms and insurance coverage PBM Reform P.L. 117-169 - Inflation Reduction Act (IRA) of 2022 Drug Pricing Medicare/Medicaid

Client expense: $1,790,000 · Firm income: Not reported

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

Vaccine Policy, Coverage and Access Executive Order 14297 - Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients H.R. 5256 - 340B Access ACT Inflation Reduction Act (IRA): Maximum Fair Price (MFP) Effectuation, Biosimilars Special Rule Drug Pricing PBM Reform H.R. 4581 - 340B PATIENTS Act of 2025 H.R. 5509 - Safe Step Act S. 2903 - Safe Step Act S. 2296 - National Defense Authorization Act (NDAA) for Fiscal Year 2026 S. 1053 - FIGHT China Act Cancer Research Centers for Disease Control and Prevention (CDC) Policies

Client expense: $1,780,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

Executive Order 14297 - Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients H.R. 5256 - 340B Access ACT Inflation Reduction Act (IRA): Maximum Fair Price (MFP) Effectuation, Biosimilars Special Rule H.R. 4581 - 340B PATIENTS Act of 2025 340B Reform 340B HHS Pilot Program Model Insurance Coverage of Prescription Drugs Direct-to-Patient Prescription Drug Purchase Platforms and insurance coverage PBM Reform P.L. 117-169 - Inflation Reduction Act (IRA) of 2022 Drug Pricing Medicare/Medicaid

Client expense: $1,780,000 · Firm income: Not reported

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

Reconciliation Bill - Medicare, Medicaid, Physician Payments, 340(b) Discount Drug Program, ACA Premium Tax Credits; HHS, CMS H.R. 9351, Save Our Safety-Net Hospitals Act of 2024 H.R. 4581, 340B PATIENTS Act of 2025 H.R. 4731, Resident Physician Shortage Reduction Act of 2025 EDUCATE Act (House/Senate) Lower Costs, More Transparency Act (House/Senate) Reinforcing Essential Health Systems for Communities Act (House/Senate) Supplemental Guidance to the 2024 NIH (National Institutes of Health) Grants Policy Statement: Indirect Cost Rates (NOT-OD-25-068, February 7, 2025); Facilities and Administrative costs (F&A) related issues 340B Drug Discount Program; Application Process for the 340B Rebate Model Pilot Program and Request for Public Comment (HRSA-2025-14619, (90 FR 36163)); issues related to proposed 340B rebate model Medicaid Disproportionate Share Hospital (DSH) funding related issues Medicare telehealth waiver related issues Mental Health Impact of Cannabis Usage

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

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

Reconciliation Bill - Medicare, Medicaid, Physician Payments, 340(b) Discount Drug Program, ACA Premium Tax Credits; HHS, CMS H.R. 9351, Save Our Safety-Net Hospitals Act of 2024 H.R. 4581, 340B PATIENTS Act of 2025 H.R. 4731, Resident Physician Shortage Reduction Act of 2025 EDUCATE Act (House/Senate) Lower Costs, More Transparency Act (House/Senate) Reinforcing Essential Health Systems for Communities Act (House/Senate) Supplemental Guidance to the 2024 NIH (National Institutes of Health) Grants Policy Statement: Indirect Cost Rates (NOT-OD-25-068, February 7, 2025); Facilities and Administrative costs (F&A) related issues 340B Drug Discount Program; Application Process for the 340B Rebate Model Pilot Program and Request for Public Comment (HRSA-2025-14619, (90 FR 36163)); issues related to proposed 340B rebate model Medicaid Disproportionate Share Hospital (DSH) funding related issues Medicare telehealth waiver related issues

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

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

H.R. 4581 / S.2372, 340B PATIENTS Act, all provisions; H.R. 3178 / S. 1600, The Save Healthcare Workers Act, all provisions; H.R. 929 / S. 266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions; H.R. 1585 / S. 709, Conrad State 30 and Physician Access Reauthorization Act, all provisions; S. 1874, Title VIII Nursing Workforce Reauthorization Act, all provisions; S. 1784 / H.R. 4191, The Mapping America's Pharmaceutical Supply (MAPS) Act, all provisions; H.R. 5283 / S. 2759, Healthcare Workforce Resilience Act, all provisions; S. 2062, The Rolling Active Pharmaceutical Ingredient and Drug Reserve (RAPID Reserve) Act, all provisions; H.R. 5256, 340B Access Act, all provisions; S. 1929, SEPSIS Act, all provisions; S. 2355 / H.R. 5582, Patients Deserve Price Tags Act, all provisions; S. 1868, the Critical Access for Veterans Care Act, all provisions; S. 3435 / H.R. 6607, The Future Advancement of Academic Nursing, all provisions; DRAFT, Right to Re-Enroll Act of 2026, Issues related to the right of patients to use a special enrollment period if their providers are no longer in-network during the plan year; DRAFT, Issues related to how the Rural Health Transformation Fund allocates funding; S. 3097, Health Information Privacy Reform Act, all provisions; S. 2834 / H.R. 5439, Medically Tailored Home-Delivered Meals Program Pilot Act, all provisions; DRAFT, Issues pertaining to nursing school faculty workforce development; DRAFT, WELLS Act, Issues pertaining to maternal health; S. 3033, Improving Access to Care for Rural Veterans Act , all provisions; H.R. 6445/S. 3364, Fast Track Healthcare Apprenticeships Act, all provisions; H.R. 6010, The Fix it Act, all provisions; H.R. 6538 / S. 3264, The More Affordable Care Act, all provisions; Federal Trade Commission, Employer noncompete agreements- RFI, Comments on employer noncompete agreements; Office of Science and Technology Policy (OSTP) [White House], RFI regarding regulatory reform on artificial intelligence, Comments on regulatory reform on artificial intelligence; U.S Food & Drug Administration (FDA), RFI on artificial intelligence-enabled medical devices, Comments on artificial intelligence - enabled medical devices; U.S. Department of Education, Forthcoming Implementation of the One Big Beautiful Bill Acts (OBBBA) Definition of Professional Degree Programs, Comments pertaining to the changing definition of professional degree programs and impact to health care workforce; U.S. Department of Commerce, Section 232, Investigation on Medical Devices, Comments on impact of future tariffs on medical devices, PPE and other medical goods and impact to hospitals and health systems; Enhanced Premium Tax Credits, Extension of Enhanced Premium Tax Credits; Rural Health Care Access, Issues to protect access to rural health care; 340B Program, Issues pertaining to protecting 340B Program, including 340B Rebate Model Pilot Program; Maternal and Child Health, Access to maternal and child health care and addressing related workforce shortages, conditions of participation (COP), funding priorities; Behavioral Health, Issues related to expanding access to care and reducing regulatory barriers; Workforce, Issues pertaining to workforce development grants, supporting health care workforce, changing definitions of professional degree programs; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay, No Surprises Act Independent Dispute Resolution process; Health Care Resiliency & Preparedness, Issues pertaining to natural disasters, cyberattacks, cybersecurity workforce, and securing supply chains; Price Transparency, Issues related to hospital price transparency; Tax-exempt status, Issues pertaining to not-for-profit hospitals' tax exempt status and tax-exempt private activity bonds; Immigration, Proposed H1-B Visa Program changes and impact to health care workforce; AI in Healthcare, Issues pertaining to the use of AI in healthcare; Organ procurement and transplantation, Issues pertaining to organ procurement hearings; Veterans affairs issues, Issue pertaining to sterile processing in VA clinics.

Client expense: $6,570,000 · Firm income: Not reported

Government targets: Education, Dept of, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Office of Science & Technology Policy (OSTP), SENATE

Issues pertaining to the 340B Drug Discount Program - H.R. 5256, the 340B ACCESS Act; H.R.4581 & S. 2372, 340B PATIENTS Act of 2025 Issues pertaining to Pharmacy Benefit Managers - H.R.4317, PBM Reform Act of 2025; H.R.6703, Lower Health Care Premiums for All Americans Act Step therapy reform - H.R. 5509 & S. 2903, Safe Step Act Neuroscience Drug Program - FY 2026 AgFDA Appropriations BRAIN Initiative - FY 2026 Labor-HHS Appropriations Migraine care - FY 2026 MilCon Appropriations Reauthorization of the Pediatric Priority Review Voucher program at the FDA Issues related to DTC advertising regulations Pediatric rare diseases - H.R. 1262 & S. 932, Give Kids a Chance Act of 2025 Headache disorders treatment and research - H.R. 5536, HEADACHE Act of 2025 Research and services for epilepsy - H.R. 1189 & S. 494, National Plan for Epilepsy Act

Client expense: $170,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues pertaining to the 340B Drug Discount Program - H.R. 5256, 340B ACCESS Act; H.R.4581 & S. 2372, 340B PATIENTS Act of 2025 Issues pertaining to the implementation of the Inflation Reduction Act of 2022 Issues pertaining to Pharmacy Benefit Managers - S.3345, PBM Price Transparency and Accountability Act; H.R.4317, PBM Reform Act of 2025 Issues pertaining to CMS Coverage of APS in LTC Issues pertaining to Medicares Six Protected Classes policy Medicare Part D Smoothing Benefit - FY 2026 Labor-HHS Appropriations Orphan drug exclusion in the Inflation Reduction Act - H.R. 946 & S. 1862, ORPHAN Cures Act Small molecule discrepancy in the Inflation Reduction Act - H.R. 1492 & S. 832, The EPIC Act Issues pertaining to the Most Favored Nation drug price setting policy Issues pertaining to migraine screening for women in Medicare - FY 2026 Labor-HHS Appropriations

Client expense: $170,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Vaccine Policy, Coverage and Access Executive Order 14297 - Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients H.R. 5256 - 340B Access ACT Inflation Reduction Act (IRA): Maximum Fair Price (MFP) Effectuation, Biosimilars Special Rule Drug Pricing PBM Reform H.R. 4581 - 340B PATIENTS Act of 2025 H.R. 5509 - Safe Step Act S. 2903 - Safe Step Act S. 2296 - National Defense Authorization Act (NDAA) for Fiscal Year 2026 S. 1053 - FIGHT China Act Cancer Research Centers for Disease Control and Prevention (CDC) Policies

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

Government targets: Centers For Disease Control & Prevention (CDC), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

Executive Order 14297 - Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients H.R. 5256 - 340B Access ACT Inflation Reduction Act (IRA): Maximum Fair Price (MFP) Effectuation, Biosimilars Special Rule H.R. 4581 - 340B PATIENTS Act of 2025 340B Reform 340B HHS Pilot Program Model Insurance Coverage of Prescription Drugs Direct-to-Patient Prescription Drug Purchase Platforms and insurance coverage PBM Reform P.L. 117-169 - Inflation Reduction Act (IRA) of 2022 Drug Pricing Medicare/Medicaid

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

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

The Rebuild Americas Health Care Schools Act (H.R. 1708/S. 1087), issues related to pharmacy residency funding. Issues related to FDA authority to manage drug shortages, regulation of pharmacy compounding, and implementation of the Drug Quality and Security Act. The Biosimilar Red Tape Elimination Act (S. 1954), issues related to increased patient access to essential biosimilar medications. Issues related to pharmacy benefit manager (PBM) abuses and transparency (generally, no specific legislation). The 340B PATIENTS Act (H.R. 4581/S. 2372), issues related to 340B program nondiscrimination and contract pharmacy arrangements. Issues related to manufacturer attempts to undercut the 340B program, including conversion of the program to a rebate model (generally, no specific legislation). Issues related to drug price negotiations and patient out-of-pocket costs (generally, no specific legislation).

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

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

Oppose 340B cuts. HR 4581 340B Patients Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid payment issues and alternative payment models; Health care workforce and H-1B visas; Health care pricing transparency; Site Neutral; 340B Program and Drug Pricing; MA prior authorization; Telehealth and digital health; Home health / Hospice; Rural health and Rural Hospital Support Act (S. 335); Lorna Breen Health Care Worker Safety Reauthorization Act (S. 266 / H.R. 929); Mobile stroke unit funding and Medicare reimbursement; Graduate medical education; Artificial intelligence; The Affordable Care Act; RESULTS Act (H.R.5269 / S.2761); Equitable Community Access to Pharmacist Services (ECAPS) Act (H.R. 3164 / S. 2426); 340B PATIENTS Act (H.R.4581 / S.2372); CONNECT for Health Act (H.R.4206 / S.1261)

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

Government targets: HOUSE OF REPRESENTATIVES

Reconciliation Bill - Medicare, Medicaid, Physician Payments, 340(b), ACA Premium Tax Credits; HHS, CMS H.R. 9351, Save Our Safety-Net Hospitals Act of 2024 H.R. 4581, 340B PATIENTS Act of 2025 H.R. 4731, Resident Physician Shortage Reduction Act of 2025 EDUCATE Act (House/Senate) Lower Costs, More Transparency Act (House/Senate) Reinforcing Essential Health Systems for Communities Act (House/Senate) Supplemental Guidance to the 2024 NIH (National Institutes of Health) Grants Policy Statement: Indirect Cost Rates (NOT-OD-25-068, February 7, 2025); Facilities and Administrative costs (F&A) related issues 340B Drug Discount Program; Application Process for the 340B Rebate Model Pilot Program and Request for Public Comment (HRSA-2025-14619, (90 FR 36163)); issues related to proposed 340B rebate model Medicaid Disproportionate Share Hospital (DSH) funding related issues Medicare telehealth waiver related issues

Client expense: $389,000 · Firm income: Not reported

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

H.R. 4581 / S.2372, 340B PATIENTS Act, all provisions; H.R. 3178 / S. 1600, The Save Healthcare Workers Act, all provisions; H.R. 929 / S. 266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions; H.R. 1585 / S. 709, Conrad State 30 and Physician Access Reauthorization Act, all provisions; S. 1874Title VIII Nursing Workforce Reauthorization Act, all provisions; S. 1784 / H.R. 4191, The Mapping America's Pharmaceutical Supply (MAPS) Act, all provisions; H.R. 5283 / S. 2759, Healthcare Workforce Resilience Act, all provisions; H.R. 5428, Medical Student Education Authorization Act, all provisions; S. 1929, SEPSIS Act, all provisions; H.R. 2483, SUPPORT for Patients and Communities Reauthorization Act of 2025, all provisions; S. 2062, Rolling Active Pharmaceutical Ingredient and Drug Reserve (RAPID) Reserve Act, all provisions; S. 921, Tyler's Law, all provisions; H.R. 3482, Veterans Community Care Scheduling Improvement Act, all provisions; HR 3483, Forcing Real Accountability for Unlawful Distributions Act (FRAUD) Act of 2025, all provisions; HR 3494, VA Hospital Inventory Management System Authorization Act, all provisions; H.R. 3413, Physician and Patient Safety Act, all provisions; H.R. 2936, Addressing Boarding and Crowding in the Emergency Department, all provisions; Department of Health & Human Services (HHS), AHRQ 2025-001 Request for Information; Ensuring Lawful Regulation and Unleashing Innovation to Make America Healthy Again, Comments on easing administrative burdens and encouraging innovation in health care; Health Resources & Services Administration (HRSA); Health Resources and Services Administration (HRSA), 340B Rebate Model Pilot Program, Comments pertaining to 340B Rebate Model Pilot Program; Enhanced Premium Tax Credits, Extension of Enhanced Premium Tax Credits; Rural Health Care Access, Issues to protect access to rural health care; 340B Program, Issues pertaining to protecting 340B Program, including 340B Rebate Model Pilot Program; Maternal and Child Health, Access to maternal and child health care and addressing related workforce shortages, conditions of participation (COP), funding priorities; Behavioral Health, Issues related to expanding access to care and reducing regulatory barriers; Workforce, Issues pertaining to workforce development grants and supporting health care workforce; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay; Health Care Resiliency & Preparedness, Issues pertaining to natural disasters, cyberattacks, cybersecurity workforce, and securing supply chains; Price Transparency, Issues related to hospital price transparency; Post Acute Care, Issues pertaining to expanding patients' access and easy regulatory burdens to crucial services provided by Long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities, and home health agencies; Tax-exempt status, Issues pertaining to not-for-profit hospitals' tax exempt status and tax-exempt private activity bonds; Immigration, Proposed H1-B Visa Program changes and impact to health care workforce; Organ Procurement, Issues pertaining to organ procurement and transplantation.

Client expense: $5,720,000 · Firm income: Not reported

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

H.R. 1, The One Big Beautiful Bill Act (P.L. 119-21); Medicaid related issues; healthcare related provisions H.R. 9351, Save Our Safety-Net Hospitals Act of 2024 H.R. 4581, 340B PATIENTS Act of 2025 H.R. 4731, Resident Physician Shortage Reduction Act of 2025 Supplemental Guidance to the 2024 NIH (National Institutes of Health) Grants Policy Statement: Indirect Cost Rates (NOT-OD-25-068, February 7, 2025); Facilities and Administrative costs (F&A) related issues 340B Program Notice: Application Process for the 340B Rebate Model Pilot Program; Announcement of Application Process for the 340B Rebate Model Pilot Program and Request for Public Comment (HRSA-2025-14619, (90 FR 36163)); issues related to proposed 340B rebate model Medicaid Disproportionate Share Hospital (DSH) funding related issues Medicare telehealth waiver related issues

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE