No Surprises Act Enforcement Act

Issues related to funding for Medicaid and Medicare. Issues related to the No Surprises Act Enforcement Act (H.R.4710/S.2420).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2420/H.R. 4710, the No Surprises Enforcement Act: To increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements

Client expense: $35,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2420/H.R. 4710, the No Surprises Enforcement Act: To increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements

Client expense: $35,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Educated members on the importance of worker classification, project labor agreements, and Davis-Bacon prevailing wage protections on federal construction and infrastructure projects. H.R. 4615, Pay for Performance Act; equitable adjustments and payment for changes to federal construction contracts. Lobbied in support of the application of Davis-Bacon prevailing wage protections to federal funds administered through states, including related defense authorization provisions. Educated members on H.R. 4710 / S. 2420, No Surprises Act Enforcement Act; balance billing enforcement and independent dispute resolution provisions affecting employer health plans.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

ACA Healthcare tax credits; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Cyber Attack/ Cyber Security; Community Health + Maternal Health; Hospital Billing; Anti-tiering, Anti-steering; Artificial Intelligence; Individual Market Reforms and eAPTC Extension; Healthcare Affordability S.4027 - Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Sen. Husted, Jon [R-OH] H.R.6248 - Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Rep. Arrington, Jodey C. [R-TX-19] H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] S.2355 - Patients Deserve Price Tags Act To amend the Public Health Service Act to provide for hospital and insurer price transparency. Sponsor: Sen. Marshall, Roger [R-KS] H.R.8684 - Transparency in Billing Act of 2026 To amend the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices, and for other purposes. Sponsor: Rep. Foxx, Virginia [R-NC-5] H.R.9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector. Sponsor: Rep. Guthrie, Brett [R-KY-2] H.R.9397 - Premium Transparency Act 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, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information. Sponsor: Rep. Pfluger, August [R-TX-11] H.R.9396 - Prior Authorization Accountability Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require the displaying of claim denial rates. Sponsor: Rep. Goldman, Craig A. [R-TX-12] H.R. 8201 - Expanding Community Access to Health Services Act To amend Public Health Service Act to require community health centers to provide behavioral and mental health and substance use disorder services, and for other purposes. Sponsor: Rep. Lee, Susie [D-NV-3] S.380 - Rural Obstetrics Readiness Act To improve obstetric emergency care. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.1254 - Rural Obstetrics Readiness Act To improve obstetric emergency care. Sponsor: Rep. Kelly, Robin L. [D-IL-2] H.R.7973 - Momnibus Act To end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. Sponsor: Rep. Underwood, Lauren [D-IL-14] H.R.1521 - DOC Access Act of 2025 To amend title XXVII of the Public Health Service Act to improve health care coverage under vision and dental plans, and for other purposes. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] S.3097 - Health Information Privacy Reform Act To provide additional protections with respect to health information, and for other purposes. Sponsor: Sen. Cassidy, Bill [R-LA] S.1874 - Title VIII Nursing Workforce Reauthorization Act of 2026 To amend the Public Health Service Act to reauthorize certain nursing workforce development programs, and for other purposes. Sponsor: Sen. Merkley, Jeff [D-OR] S.2301 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Sen. Scott, Tim [R-SC]

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

ACA Healthcare tax credits; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Artificial Intelligence; Individual Market Reforms and eAPTC Extension; Healthcare Affordability H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. S.2355 - Patients Deserve Price Tags Act - To amend the Public Health Service Act to provide for hospital and insurer price transparency. H.R.9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector. H.R.9397 - Premium Transparency Act - 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, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information. H.R.9396 - Prior Authorization Accountability Act - To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require the displaying of claim denial rates.

Client expense: $820,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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. 90 - Health Coverage Choice Act - Rep. Biggs, Andy - Duration of STLDHI plans H.R. 114 - Responsible Path to Full Obamacare Repeal Act - Rep. Biggs, Andy - ACA repeal H.R. 247 - Health Care Affordability Act - Rep. Underwood, Lauren - ACA tax credit extension H.R. 267 - Health Care Price Transparency Act - Rep. Davidson, Warren - Hospital and insurer transparency requirements H.R. 639 - Doctor Knows Best Act - Rep. Van Drew, Jefferson - Commercial market prior authorization H.R. 957 - Parity Enforcement Act - Rep. Norcross, Donald - Penalties for mental health parity violations H.R. 1385 - DOC Access Act - Rep. Carter, Earl "Buddy" - Rate setting for dental and optometric services H.R. 1397 - Increasing Access to Dental Insurance Act - Rep. Miller-Meeks, Mariannette - Standalone dental plans H.R. 1776 - New Health Options Act - Rep. Palmer, Gary - ACA reinsurance H.R. 2079 - Insurance Fraud Accountability Act - Rep. Ross, Deborah - fraudulent ACA enrollments H.R. 2082 - WISH Act - Rep. Suozzi, Thomas - Long-term care insurance benefits H.R. 2199 - Restore Protections for Dialysis Patients Act - Rep. Kelly, Mike - ESRD coverage H.R. 2553 - Capping Prescription Costs Act - Rep. Horsford, Steven - Prescription cost-sharing H.R. 2554 - Lower Drug Costs for Families Act - Rep. Horsford, Steven - Commercial market drug rebates H.R. 2636 - Making Insulin Affordable for All Children Act - Rep. Landsman, Greg - Commercial market insulin cost-sharing H.R. 3020 - Addressing Anti-Competitive Health Care Contract Clauses Act - Rep. Spartz, Victoria - Study on anti-competitive contracting H.R. 3257 - Bridge to Medicaid Act - Rep. Sewell, Terri - ACA subsidies for non-Medicaid expansion states H.R. 3701 - Family Vaccine Protection Act - Rep. Pallone, Frank - ACIP codification and vaccine coverage H.R. 4406 - State-Based Universal Health Care Act - Rep. Khanna, Ro - State-based universal health care H.R. 4710 - No Surprises Act Enforcement Act - Rep. Murphy, Greg - Surprise billing penalties for noncompliance by health insurers H.R. 5145 - Bipartisan Premium Tax Credit Extension Act - Rep. Kiggans, Jennifer - Temporary extension of ACA enhanced premium tax credits H.R. 5509 - Safe Step Act - Rep. Allen, Rick - Step therapy requirements H.R. 5582 - Patients Deserve Price Tags Act - Rep. James, John - Hospital and insurer price transparency requirement H.R. 6171 - ACA Copay CAP Act of 2025 - Rep. Auchincloss, Jake - establish out of pocket limit on prescription drugs H.R. 6248 - Healthy Competition for Better Care Act - Rep. Arrington, Jodey - ban anticompetitive terms in contracts, promote higher quality, lower cost care H.R. 6703 - Lower Health Care Premiums for All Americans Act - Rep. Miller-Meeks, Mariannette - amend ERISA to lower premiums H.R. 7023 - Affordable CHOICE Act - Rep. Schakowsky, Janice - public option under ACA H.R. 7164 - Capping Costs for Consumers Act - Rep. Schrier, Kim - ACA cost-sharing reductions H.R. 8270 - Every Dollar Counts Act - Rep. Murphy, Greg - Requirements for deductibles and MOOP to include expenditures for DTC prescriptions H.R. 8684 - Transparency in Billing Act - Rep. Foxx, Virginia - Transparency enforcement H.R. 9393 - Lower Costs, More Transparency Act - Rep. Guthrie, Brett - Healthcare price transparency H.R. 9645 - Health Care Price Certainty for All Americans Act - Rep. Smith, Jason - Price transparency requirements H.R. 10024 - Health Insurance Transparency for Patients Act - Rep. Hinson, Ashley - Price transparency requirements S. 46 - Health Care Affordability Act - Sen. Shaheen, Jeanne - ACA tax credit extension S. 729 - Hospital Transparency Compliance Enforcement Act - Sen. Kennedy, John - Hospital price transparency requirements S. 864 - HELP Copays Act - Sen. Marshall, Roger - Cost-sharing requirements S. 976 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - fraudulent ACA enrollments S. 2355 - Patients Deserve Price Tags Act - Sen. Marshall, Roger - Hospital and insurer price transparency requirements S. 2420 - No Surprises Act Enforcement Act - Sen. Marshall, Roger - Surprise billing penalties for noncompliance by health insurers S. 2903 - Safe Step Act - Sen. Murkowski, Lisa - Step therapy requirement S. 3599 - Affordable CHOICE Act - Sen. Whitehouse, Sheldon - public option under ACA S. 4189 - INSULIN Act - Sen. Collins, Susan - Insulin cost-sharing caps S. 4512 - Affordable Insulin Now Act - Sen. Kennedy, John - Insulin cost-sharing caps Issues related to implementation rule implementing the No Surprises Act prohibiting surprise medical bills; transparency report requirements; parity in mental health benefits; ERISA preemption; paperless delivery for health plan disclosures; Unauthorized Enrollments/Unauthorized Plan Switching; ACA Tax Credits (Inflation Reduction Act); final rule on Section 1557 of the ACA and its impact on Medigap plans; ACA Marketplace Enrollment and Agents and Brokers; Waste Fraud and Abuse; Vaccine Coverage; Preventative Services Coverage; the Advanced Explanation of Benefits; coverage of weight loss drugs; Transparency in Coverage; No Surprises Act; ACA Marketplace Integrity; ACA Enhanced Tax Credits; Prior Authorization; affordability; and health savings accounts.

Client expense: $3,010,000 · 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), Labor, Dept of (DOL), Office of the Vice President of the United States, SENATE, White House Office

S. 2355, Patients Deserve Price Tags Act; H.R. 9645, Health Care Price Certainty for All Americans Act; H.R. 9393, Lower Costs More Transparency Act re: Health Care Price Transparency H.R. 4710/ S. 2420, No Surprises Act Enforcement Act; H.R. 10788, Lower Premiums Faster Payments Act re: No Surprises Act reform Rural Health Transformation Fund re: implementation S.709/HR1585, Conrad State 30 and Physician Access Reauthorization Act re: physician workforce S. 3315, Health Care Cybersecurity and Resiliency Act of 2025 re: cybersecurity requirements

Client expense: $760,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3164: Ensuring Community Access to Pharmacist Services Act; all provisions H.R. 3514: Improving Seniors' Timely Access to Care Act of 2025; all provisions H.R. 4710: No Surprises Act Enforcement Act; all provisions H.R. 6160: Strengthening Medicare for Patients and Providers Act; provisions related to Medicare physician payments S. 1816: Improving Seniors Timely Access to Care Act of 2025; all provisions S. 2420: No Surprise Act Enforcement Act; all provisions HHS-OS-2026-0332-0001: Categories Used in Federal Vaccine Recommendations and the Roles of Shared Clinical Decision-Making; all provisions

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

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

S 2420/HR 4710 - No Surprises Act Enforcement Act including issues related to independent dispute resolution abuse; S (not yet introduced)/HR 10788 - Lower Premiums, Faster Payments Act including issues related to the appeals process

Client expense: $4,090,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support and endorse an extension of The Terrorism Risk Insurance Act of 2026 - H.R. 7128 The No Surprises Act. Opposed section which would require that the multiemployer health plans and the administration of benefits are taxed for IDR/IDRE claims before the larger process of claims can be resolved. - H.R. 4710

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Urge support for Amendment #8 and opposition to Amendment #72 to the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2027, highlighting the need to strengthen IAQ/HVAC standards and avoid restrictions on design services. Supported the bills $157 billion funding level and advocated for full VA construction funding (~$3.9 billion) to maintain project timelines and facility quality - H.R. 8469 The No Surprises Act. Opposed section which would require that the multiemployer health plans and the administration of benefits are taxed for IDR/IDRE claims before the larger process of claims can be resolved. - H.R. 4710 Support the Federal Facilities Indoor Air Quality Assessment Act - H.R. 9866 Support Military Occupancy Living Defense (MOLD) Act - H.R. 7188, S. 3654

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support the American Energy Independence and Affordability Act - H.R. 5862 Support resolution to terminate national emergency declared to justify tariffs on imports from Canada under the International Emergency Economic Powers Act (IEEPA) - H.J. Res. 72 Support the AIRBORNE Act which would incentivize non-residential building owners to conduct indoor air quality assessments (IAQ) and upgrade their ventilation and air filtration systems. - H.R. 7460 Support the American Energy Dominance Act which would restore the highly impactful energy efficiency tax incentive provisions of the Inflation Reduction Act. - H.R. 8477 Oppose No Surprises Act Enforcement Act which would Ensure multiemployer health and welfare plans and the administration of benefits are not taxed for IDR/IDRE claims until the larger process of claims can be addressed. - H.R. 4710

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support resolution to terminate national emergency declared to justify tariffs on imports from Canada under the International Emergency Economic Powers Act (IEEPA) - H.J. Res. 72 Request robust funding for FY27 for Onsite Energy Technical Assistance Partnerships (TAPs) program within the DoE's Office of Innovation, Affordability, and Consumer Choice Support the American Energy Dominance Act which would restore the highly impactful energy efficiency tax incentive provisions of the Inflation Reduction Act. - H.R. 8477 Urge support for Amendment #8 and opposition to Amendment #72 to the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2027, highlighting the need to strengthen IAQ/HVAC standards and avoid restrictions on design services. Supported the bills $157 billion funding level and advocated for full VA construction funding (~$3.9 billion) to maintain project timelines and facility quality - H.R. 8469 Support several FY27 NDAA amendments related to geothermal energy, workforce development, and contractor relief, while endorsing the bills significant military construction, housing, and energy resilience investments. The association also backed oversight and workforce provisions aimed at strengthening defense infrastructure and the skilled labor pipeline. - H.R. 8800 Oppose the Davis-Bacon Repeal Act before the Senate HELP Committee, citing concerns that repealing prevailing wage requirements would depress construction wages, undermine local labor standards, and disadvantage responsible signatory contractors on federal projects. - H.R. 8602 / S. 4477 The No Surprises Act. Opposed section which would require that the multiemployer health plans and the administration of benefits are taxed for IDR/IDRE claims before the larger process of claims can be resolved. - H.R. 4710 Oppose portions of OMB's proposed federal financial assistance rule that would increase administrative burdens, create funding uncertainty, and negatively impact registered apprenticeship programs, project labor agreements, and federally funded construction projects (Docket No. OMB-2026-0034). Support House passage of Senate-passed CR, Including Ban of OMB's Proposed Regulation for Federal Financial Assistance (Docket No. OMB-2026-0034)

Client expense: Not reported · Firm income: Not reported

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

Affordability of Coverage, Site-Neutral Payments, Hospital Billing, Artificial Intelligence, Prior Authorization, Surprise Billing, Vertical Integration, Transparency, Anti-Steering/Tiering S.3822 - Break Up Big Medicine Act - A bill to prohibit pharmacy benefit managers, insurers, and prescription drug or medical device wholesalers from being under common ownership with certain medical service providers, and for other purposes. H.R. 5582/S.2355 - Patients Deserve Price Tags Act - A bill to provide for hospital and insurer price transparency. H.R. 6248/S.4027 - Healthy Competition for Better Care Act - A bill to ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. H.R.4710 - No Surprises Act Enforcement Act - A bill to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. H.R. 9393, Lower Costs, More Transparency Act - A bill to require group health plans, individual market issuers, PBMs, hospitals, clinical laboratories, imaging service providers, and ambulatory surgical centers, to publicly disclose pricing and other specified information. H.R.9396 - Prior Authorization Accountability Act - A bill to require the displaying of claim denial rates. H.R.9397 - Premium Transparency Act - A bill to ensure health insurer accountability through publishing of overhead costs and claim payments, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information. H.R.9645 - Health Care Price Certainty for All Americans Act - A bill To promote health care price transparency, and for other purposes.

Client expense: $300,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 2420/HR 4710 No Surprises Act Enforcement Act, provisions related to employee health plans

Client expense: $2,640,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues: ACA Healthcare tax credits; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Cyber Attack/ Cyber Security; Community Health + Maternal Health; Hospital Billing; Anti-tiering, Anti-steering; Artificial Intelligence; Individual Market Reforms and eAPTC Extension; Healthcare Affordability Bills: S.4027 - Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Sen. Husted, Jon [R-OH] H.R.6248 - Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Rep. Arrington, Jodey C. [R-TX-19] H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] S.2355 - Patients Deserve Price Tags Act To amend the Public Health Service Act to provide for hospital and insurer price transparency. Sponsor: Sen. Marshall, Roger [R-KS] H.R.8684 - Transparency in Billing Act of 2026 To amend the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices, and for other purposes. Sponsor: Rep. Foxx, Virginia [R-NC-5] H.R.9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector. Sponsor: Rep. Guthrie, Brett [R-KY-2] H.R.9397 - Premium Transparency Act 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, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information. Sponsor: Rep. Pfluger, August [R-TX-11] H.R.9117 - Clear Healthcare Expense Cost Knowledge Act (CHECK Act) To promote the availability of certain healthcare information, and for other purposes. Sponsor: Rep. Langworthy, Nicholas A. [R-NY-23] H.R.9390 - Prices on the Wall Act of 2026 To amend title XXVII of the Public Health Service Act to require certain facilities to post prices on the walls. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] H.R.9396 - Prior Authorization Accountability Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require the displaying of claim denial rates. Sponsor: Rep. Goldman, Craig A. [R-TX-12] H.R. 8209 - School Based-Health Centers Reauthorization Act To amend the Public Health Service Act to reauthorize the school-based health centers grant program. Sponsor: Rep. Tonko, Paul [D-NY-20] H.R.9389 - Nutrition Education and Chronic Disease Prevention in Community Health Centers Act of 2026 To amend the Public Health Service Act to authorize funding for nutrition education and chronic disease prevention at federally qualified health centers, and for other purposes. Sponsor: Rep. Harshbarger, Diana [R-TN-1] H.R. 8201 - Expanding Community Access to Health Services Act To amend Public Health Service Act to require community health centers to provide behavioral and mental health and substance use disorder services, and for other purposes. Sponsor: Rep. Lee, Susie [D-NV-3] S.380 - Rural Obstetrics Readiness Act To improve obstetric emergency care. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.1254 - Rural Obstetrics Readiness Act To improve obstetric emergency care. Sponsor: Rep. Kelly, Robin L. [D-IL-2] H.R.7973 - Momnibus Act To end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. Sponsor: Rep. Underwood, Lauren [D-IL-14] H.R.1521 - DOC Access Act of 2025 To amend title XXVII of the Public Health Service Act to improve health care coverage under vision and dental plans, and for other purposes. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] S.3097 - Health Information Privacy Reform Act To provide additional protections with respect to health information, and for other purposes. Sponsor: Sen. Cassidy, Bill [R-LA] S.1874 - Title VIII Nursing Workforce Reauthorization Act of 2026 To amend the Public Health Service Act to reauthorize certain nursing workforce development programs, and for other purposes. Sponsor: Sen. Merkley, Jeff [D-OR] S.2301 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Sen. Scott, Tim [R-SC]

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

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

ACA Healthcare tax credits; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Cyber Attack/ Cyber Security; Community Health + Maternal Health; Hospital Billing; Anti-tiering, Anti-steering; Artificial Intelligence; Individual Market Reforms and eAPTC Extension; Healthcare Affordability S.4027 - Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Sen. Husted, Jon [R-OH] H.R.6248 - Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sponsor: Rep. Arrington, Jodey C. [R-TX-19] H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] S.2355 - Patients Deserve Price Tags Act To amend the Public Health Service Act to provide for hospital and insurer price transparency. Sponsor: Sen. Marshall, Roger [R-KS] H.R.8684 - Transparency in Billing Act of 2026 To amend the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices, and for other purposes. Sponsor: Rep. Foxx, Virginia [R-NC-5] H.R.9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector. Sponsor: Rep. Guthrie, Brett [R-KY-2] H.R.9397 - Premium Transparency Act 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, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information. Sponsor: Rep. Pfluger, August [R-TX-11] H.R.9117 - Clear Healthcare Expense Cost Knowledge Act (CHECK Act) To promote the availability of certain healthcare information, and for other purposes. Sponsor: Rep. Langworthy, Nicholas A. [R-NY-23] H.R.9390 - Prices on the Wall Act of 2026 To amend title XXVII of the Public Health Service Act to require certain facilities to post prices on the walls. Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] H.R.9396 - Prior Authorization Accountability Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require the displaying of claim denial rates. Sponsor: Rep. Goldman, Craig A. [R-TX-12] H.R. 8209 - School Based-Health Centers Reauthorization Act To amend the Public Health Service Act to reauthorize the school-based health centers grant program. Sponsor: Rep. Tonko, Paul [D-NY-20] H.R.9389 - Nutrition Education and Chronic Disease Prevention in Community Health Centers Act of 2026 To amend the Public Health Service Act to authorize funding for nutrition education and chronic disease prevention at federally qualified health centers, and for other purposes. Sponsor: Rep. Harshbarger, Diana [R-TN-1] H.R. 8201 - Expanding Community Access to Health Services Act To amend Public Health Service Act to require community health centers to provide behavioral and mental health and substance use disorder services, and for other purposes. Sponsor: Rep. Lee, Susie [D-NV-3] S.380 - Rural Obstetrics Readiness Act To improve obstetric emergency care. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.1254 - Rural Obstetrics Readiness Act To improve obstetric emergency care. Sponsor: Rep. Kelly, Robin L. [D-IL-2] H.R.7973 - Momnibus Act To end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. Sponsor: Rep. Underwood, Lauren [D-IL-14] H.R.1521 - DOC Access Act of 2025 To amend title XXVII of the Public Health Service Act to improve health care coverage under vision and dental plans, and for other purposes. Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] S.3097 - Health Information Privacy Reform Act To provide additional protections with respect to health information, and for other purposes. Sponsor: Sen. Cassidy, Bill [R-LA] S.1874 - Title VIII Nursing Workforce Reauthorization Act of 2026 To amend the Public Health Service Act to reauthorize certain nursing workforce development programs, and for other purposes. Sponsor: Sen. Merkley, Jeff [D-OR] S.2301 - Improving Care in Rural America Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care. Sponsor: Sen. Scott, Tim [R-SC]

Client expense: $1,240,000 · Firm income: Not reported

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

Issues: ACA Healthcare tax credits; Transparency in coverage; Surprise Billing; 2025 Proposed NBPP/Individual Market/ACA exchanges; Prior Authorization; Hospital Consolidation; Employer-provided health coverage; Cyber Attack/ Cyber Security; Community Health + Maternal Health; Hospital Billing; Anti-tiering, Anti-steering; Artificial Intelligence; Individual Market Reforms and eAPTC Extension; Healthcare Affordability Bills: H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] S.2355 - Patients Deserve Price Tags Act To amend the Public Health Service Act to provide for hospital and insurer price transparency. Sponsor: Sen. Marshall, Roger [R-KS] H.R.8684 - Transparency in Billing Act of 2026 To amend the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices, and for other purposes. Sponsor: Rep. Foxx, Virginia [R-NC-5] H.R.9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector. Sponsor: Rep. Guthrie, Brett [R-KY-2] H.R.9397 - Premium Transparency Act 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, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information. Sponsor: Rep. Pfluger, August [R-TX-11] H.R.9396 - Prior Authorization Accountability Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require the displaying of claim denial rates. Sponsor: Rep. Goldman, Craig A. [R-TX-12] H.R. 8209 - School Based-Health Centers Reauthorization Act To amend the Public Health Service Act to reauthorize the school-based health centers grant program. Sponsor: Rep. Tonko, Paul [D-NY-20] H.R.9389 - Nutrition Education and Chronic Disease Prevention in Community Health Centers Act of 2026 To amend the Public Health Service Act to authorize funding for nutrition education and chronic disease prevention at federally qualified health centers, and for other purposes. Sponsor: Rep. Harshbarger, Diana [R-TN-1] H.R. 8201 - Expanding Community Access to Health Services Act To amend Public Health Service Act to require community health centers to provide behavioral and mental health and substance use disorder services, and for other purposes. Sponsor: Rep. Lee, Susie [D-NV-3]

Client expense: $276,347 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General business issues; Pharmacy benefit manager issues; Medicare advantage; Issues relating to health insurance; General healthcare competition issues; H.R.4710/S.2420 - No Surprises Enforcement Act; Budget reconciliation.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HJRes 197 / SJRes 197, CRA related to the 2027 NBPP; HR 247 / S 46, Health Care Affordability Act; HR 6867 / S 3562, the NIH Clinical Trial Integrity Act; HR 3521 / S 4440, the Clinical Trial Modernization Act; HR 4710 / S 2420, No Surprises Act Enforcement Act; HR 5526 / S 1954, Biosimilar Red Tape Elimination Act; HR 5582 / S 2355, the Patients Deserve Price Tags Act; HR 6248 / S 4027, Healthy Competition for Better Care Act HR 6485 / S 43, Skinny Labels, Big Savings Act; HR 6867 / S 3562, NIH Clinical Trial Integrity Act; HR 7895, the PBM Kickback Prohibition Act; HR 8879 / S 4509, Patients Before Monopolies Act; HR 8908, the STOP GAMES Act; HR 9393, Lower Costs, More Transparency Act; HR 9396, the Prior Authorization Accountability Act; HR 9397, the Premium Transparency Act; HR 9645, the Health Care Price Certainty for All Americans Act; HR 9661 / S 1414, the Expedited Access to Biosimilars Act; HR 10370, the AIM to Cure Kids with Cancer Act; HR 10788, the Lower Premiums, Faster Payments Act; S 976, the Insurance Fraud Accountability Act; S 1041, Affordable Prescriptions for Patients Act; S 1095, Stop STALLING Act; S 1096, Preserve Access to Affordable Generics & Biosimilars Act S 1097, Interagency Patent Coordination & Improvements Act; S 2658, Medication Affordability & Patent Integrity Act; S 3014, Ensuring Timely Access to Generics Act; S 3822, the Break Up Big Medicine Act Policies to address the expiration of the enhanced Advanced Premium Tax Credits; Policies to improve transparency in hospital and insurer costs and finances; Policies to streamline pediatric patient access to subspecialist care via telemedicine; Policies to protect patients and consumers from junk insurance, including short-term limited duration insurance; Policies related to modernization of clinical trials; Policies related to the 2027 FDA user fee agreements; Implementation of the No Surprises Act; Policies related to oversight of insurance agents and brokers; Oversight and patient impact of the 340B program; Policies related to consolidation within the healthcare sector;

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

Government targets: Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), SENATE

Issues related to commercial insurance and pharmacy benefits. H.R.4710: No Surprises Act. H.R.7895: PBM Kickback Prohibition Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

H.R. 2102 Major Richard Star Act H.R. 2199 - Restore Protections for Dialysis Patients Act H.R. 4710 No Surprises Act Enforcement Act H.R. 8347, the Reinforcing Underserved, Rural, and Local (RURAL) Healthcare Act H.R. 9237 Take Care of Americas Veterans Act Hearing: Less Red Tape, More Opportunity: Unleashing American Workers and Job Creators Rep. Dingell heat safety letter and legislation S. 1032 Major Richard Star Act S. 2355 - Patients Deserve Price Tags Act S. 2420 - No Surprises Act Enforcement Act S. 4378 - Protecting American Taxpayers Act S. 4744 Take Care of Americas Veterans Act S.2420 No Surprises Act Enforcement Act S.4189 - INSULIN Act S.4742 - AI DATA Act S.J.Res. 198 to end WISeR demonstration program in Medicare S.J.Res.197 - CRA resolution to halt HHS ACA rule S.J.Res.198 - CRA resolution to halt the Wasteful and Inappropriate Service Reduction program Toxic Substance Control Act- Draft bills

Client expense: $920,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 4710, No Surprises Act Enforcement Act, including provisions related to the current No Surprises Act enforcement processes. S. 2355, Patients Deserve Price Tags Act, including provisions related to the hold-harmless of insurers. Issues and data related to marketplace enrollment.

Client expense: $1,120,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

- Draft legislation regarding ERISA Preemption, telemedicine, rural health, group health plan, PBMs and flexible spending accounts - issues relating to H.R. 4710

Client expense: $1,289,734 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to the implementation of provisions included in Subtitle BB of PL.116-260- No Surprises Act, including the No Surprises Act Enforcement Act (H.R. 4710/S. 2420). Issues relating to the Federal Independent Dispute Resolution Operations proposed rule

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The IBEW lobbied on provider payment and surprise medical bills issues raised by the No Surprises Enforcement Act (S. 2420 and H.R. 4710) The IBEW lobbied on ERISA preemption issues and other issues raised in the Patients Deserve Price Tags Act (S. 2355), the Health Care Price Certainty for All Act (H.R. 9645), as well as DOC Access Act (H.R. 1521), dealing with payment structures for optometrists and dentists.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to employer sponsored insurance; H.R.4710/S.2420 - No Surprises Act Enforcement Act.

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

Government targets: HOUSE OF REPRESENTATIVES

Affordable Care Act (ACA), ACA subsidies and tax credits; Transparency in Coverage, Rural healthcare; Surprise Billing; Prior Authorization; Managed Care Organizations; Maternal Health; Artificial Intelligence; Hospital billing; Individual Market Reforms and eAPTC Extension; Healthcare Affordability. H.R.4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep. Murphy, Gregory F. [R-NC-3] S.2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans, health insurance issuers, and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS] H.R. 9117- Clear Healthcare Expense Cost Knowledge Act (CHECK Act) To promote the availability of certain healthcare information, and for other purposes. Sponsor: Rep. Langworthy, Nicholas A. [R-IA-1] H.R.8684 - Transparency in Billing Act of 2026 To amend the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices, and for other purposes. Sponsor: Rep. Foxx, Virginia [R-NC-5] H.R.9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector. Sponsor: Rep. Guthrie, Brett [R-KY-2] H.R.9396 - Prior Authorization Accountability Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require the displaying of claim denial rates. Sponsor: Rep. Goldman, Craig A. [R-TX-12] H.R.7973 - Momnibus Act To end preventable maternal mortality, severe maternal morbidity, and maternal health disparities in the United States, and for other purposes. Sponsor: Rep. Underwood, Lauren [D-IL-14]

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support for the National Institutes of Health: Discussions on the impact of forward funding procedures, facilities and administration costs; the importance of the merit review system; Concerns about the proposed "Regulation for Federal Financial Assistance" (H.R. 4710/S. 2420) "No Surprises Enforcement Act" - concerns about unintended abuses of the dispute resolution process

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

-Support for the Improving Dental Administration Act (HR 7931), which would apply state dental insurance laws to ERISA dental plans operating in that state. -Support for the Ensuring Lasting Smiles Act (S 1677/HR 3277), which would require health insurers to cover treatment, including dental, for patients with congenital craniofacial anomalies. -Support for the No Surprises Act Enforcement Act (HR 4710), which would increase penalties for health plans and issuers that violate the laws balance billing requirements and establish consequences for failing to make required payments following an IDR determination in a timely manner. -Comments in response to the introduction of the Patients Deserve Price Tags Act (S 2355), which would increase healthcare price transparency requirements among hospitals, insurers and certain healthcare providers.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

7/10 - Letter in opposition to the No Surprises Act Enforcement Act (H.R. 4710/S. 2420)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Behavioral Health Issues related to behavioral health - no specific bill Childcare Issues related to childcare - no specific bill Gun Safety Issues related to gun safety - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care - no specific bill Issues related to Private Equity/Healthcare - no specific bill H.R. 2191, Physician Led and Rural Access to Quality Care Act Support of community water fluoridation - no specific bill Extend Premium Tax Credits - no specific bill Health Care Workforce Issues related to health care workforce shortages - no specific bill Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project - no specific bill Demographic data collection - no specific bill H.R. 929/S.266 the Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 3890/S. 2439, the Resident Physician Shortage Reduction Act H.R. 5283/S. 2759, the Healthcare Workforce Resilience Act H.R. 3164, the Ensuring Community Access to Pharmacist Services (ECAPS) Act H.R. 4002, the Patient Access to Higher Quality Health Care Act of 2025 HIV/AIDS Presidents Emergency Plan for AIDS Relief (PEPFAR) Immigration Issues related to Immigration - no specific bill H.R.1585/S.709 the Conrad State 30 and Physician Access Reauthorization Act Protecting Immigrant Families (PIF) Campaign H.R.1061/S.455 Protecting Sensitive Locations Act Infrastructure Issues related to broadband access - no specific bill Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Maternal Health and Reproductive Health H.R. 3480 Health Coverage for IVF Act S. 2035 Protect IVF Act S.3743 - Supporting Healthy Moms and Infants Act Issues related to maternal health - no specific bill S. 141, The Connected Maternal Online Monitoring (MOM) Act Medical Education Issues related to the affordability of medical education - no specific bill Issues related to student loan forgiveness - no specific bill Support for physicians, residents and medical students - no specific bill Medicare/Medicaid H.R. 9693, the Patients First Act. H.R. 8163, the Provider Reimbursement Stability Act S. 1816/H.R. 3514, Improving Seniors Timely Access to Care Act of 2025 Budget neutrality rules in the Medicare Physician Fee Schedule - no specific bill H.R. 2757 Medicare Audiology Access Improvement Act of 2025 S. 575 the Improving Care and Access to Nurses Act H.R. 879 the Medicare Patient Access and Practice Stabilization Act H.R. 8163, the Provider Reimbursement Stability Act Issues related to Medicare physician payment - no specific bill Issues related to Medicare/Medicaid - no specific bill H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025 Issues related to Medicare Advantage - no specific bill H.R. 1, One Big Beautiful Bill Act H.R. 2757, Medicare Audiology Access Improvement Act S. 106/H.R. 539, the Chiropractic Medicare Coverage Modernization Act of 2025 Nutrition Issues related to nutrition and food security - no specific bill Issues related to SNAP funding - - no specific bill (including H.R.1) Opioids/ Substance Use Disorder MATE ACT Adds New Education Mandate for 8 Hours of Continuing Education on Opioid Treatment H.R. 2483 SUPPORT for Patients and Communities Reauthorization Act S.4941 Modernizing Opioid Treatment Access Act 2.0 of 2026 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill HR 4002, The Patient Access to Higher Quality Health Care Act Publications Open access to information based on publicly funded research - no specific bill Request for Information for NIH Plan to Enhance Public Access to the Results of NIH-Supported Research Issues related to scholarly and scientific publishing and public access - no specific bill Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Health disparities and protecting vulnerable populations - no specific bill Issues related to equitable policies around blood, tissue donations - no specific bill Surprise Billing H.R. 4710/S. 2420, the No Surprises Act Enforcement Act Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act - no specific bill Telehealth S. 1261, the CONNECT for Health Act of 2025 H.R. 5081/S. 2709, the Telehealth Modernization Act of 2025 H.R. 1650, the Telehealth Expansion Act of 2025 Issues related to telehealth - no specific bill Issues related to telebehavioral health access - no specific bill Issues related to physician licensing - no specific bill Issues related to telehealth PHE flexibilities/waivers - no specific bill Tobacco Issues related to prohibiting sale of menthol cigarettes and flavored cigars - no specific bill Issues related to increasing awareness about lung cancer screening on cigarette packages - no specific bill Vaccines H.R.5448/S.2857 Protecting Free Vaccines Act of 2025 H.R.3701/S.3323 Family Vaccine Protection Act Issues related to vaccines - no specific bill Regulatory FDA's proposed rule to eliminate menthol cigarettes Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to Medicare Advantage Star Rating Health Equity Index calculation HIPAA-related Reporting Requirements Involving the Change Healthcare Cyber Incident Marketplace Integrity and Affordability Proposed Rule (CMS-9884-P) Medicaid Program; Preserving Medicaid Funding for Vulnerable Populations-Closing a Health Care-Related Tax Loophole Proposed Rule (CMS-2448-P) Notice: Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA); Interpretation of Federal Public Benefit NIH RFI on Maximizing Research Funds by Limiting Allowable Publishing Costs File Code CMS-3481-P. Medicare and Medicaid Programs; Hospital Condition of Participation: Prohibiting Sex-Rejecting Procedures for Children File Code CMS-2451-P Medicaid Program; Prohibition on Federal Medicaid and Children's Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children OMB-2026-0034, Proposed Revisions to the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards File Code CMS-2454-IFC. Medicaid Program; Community Engagement Requirement for Certain Individuals Docket No. HHS-OS-2026-0332; RIN 0991-ZA62 - Request for Information: Categories Used in Federal Vaccine Recommendations and the Role of Shared Clinical Decision-Making (91 Fed. Reg. 54724, Aug. 24, 2026) File Code CMS-1848-P. Medicare and Medicaid Programs; CY 2027 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program Notice of Proposed Rulemaking, Fee for Certain H-1B Petitions, 91 Fed. Reg. 54817 (Aug. 25, 2026); DHS Docket No. USCIS-2026-0298; CIS No. 2861-26; RIN 1615-AD20 Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes, File Code: CMS-2452-P, RIN 0938-AV93, 91 Fed. Reg. 46562 (published July 23, 2026) File Code CMS-1848-P; Medicare Program; CY 2027 Payment Policies Under the Physician Payment Schedule and Other Changes to Part B Payment and Coverage Policies; (July 16, 2026). Accounting for E/M Resource Overlap Between Stand-Alone Visits and Global Periods File Code ACF-2026-0595-0001; Reducing Federal Burden for Head Start Programs

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA)

Behavioral Health Issues related to behavioral health - no specific bill Childcare Issues related to childcare - no specific bill Health Care Issues related to health care/universal access to quality, equitable, affordable coverage - no specific bill Issues related to mental and behavioral health care - no specific bill Issues related to Private Equity/Healthcare - no specific bill H.R. 2191, Physician Led and Rural Access to Quality Care Act Support of community water fluoridation - no specific bill Extend Premium Tax Credits - no specific bill Health Care Workforce Issues related to health care workforce shortages - no specific bill Issues related to the affordability of medical education and federal loan programs - no specific bill Issues related to scope of practice - no specific bill Issues related to the Department of Veterans Affairs Federal Supremacy Project - no specific bill Demographic data collection - no specific bill H.R. 929/S.266 the Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 3890/S. 2439, the Resident Physician Shortage Reduction Act H.R. 5283/S. 2759, the Healthcare Workforce Resilience Act H.R. 3164, the Ensuring Community Access to Pharmacist Services (ECAPS) Act H.R. 4002, the Patient Access to Higher Quality Health Care Act of 2025 HIV/AIDS Presidents Emergency Plan for AIDS Relief (PEPFAR) Immigration Issues related to Immigration - no specific bill H.R.1585/S.709 the Conrad State 30 and Physician Access Reauthorization Act Protecting Immigrant Families (PIF) Campaign H.R.1061/S.455 Protecting Sensitive Locations Act Infrastructure Issues related to broadband access - no specific bill Interoperability/ONC Issues related to interoperability and information blocking - no specific bill Maternal Health and Reproductive Health H.R. 3480 Health Coverage for IVF Act S. 2035 Protect IVF Act S.3743 - Supporting Healthy Moms and Infants Act Issues related to maternal health - no specific bill S. 141, The Connected Maternal Online Monitoring (MOM) Act Medicare/Medicaid H.R. 9693, the Patients First Act. H.R. 8163, the Provider Reimbursement Stability Act S. 1816/H.R. 3514, Improving Seniors Timely Access to Care Act of 2025 Budget neutrality rules in the Medicare Physician Fee Schedule - no specific bill H.R. 2757 Medicare Audiology Access Improvement Act of 2025 S. 575 the Improving Care and Access to Nurses Act H.R. 879 the Medicare Patient Access and Practice Stabilization Act H.R. 8163, the Provider Reimbursement Stability Act Issues related to Medicare physician payment - no specific bill Issues related to Medicare/Medicaid - no specific bill H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025 Issues related to Medicare Advantage - no specific bill H.R. 1, One Big Beautiful Bill Act H.R. 2757, Medicare Audiology Access Improvement Act S. 106/H.R. 539, the Chiropractic Medicare Coverage Modernization Act of 2025 Nutrition Issues related to nutrition and food security - no specific bill Issues related to SNAP funding - - no specific bill (including H.R.1) Opioids/ Substance Use Disorder MATE ACT Adds New Education Mandate for 8 Hours of Continuing Education on Opioid Treatment H.R. 2483 SUPPORT for Patients and Communities Reauthorization Act S.4941 Modernizing Opioid Treatment Access Act 2.0 of 2026 Issues related to opioids and substance use disorder - no specific bill Prescription Drug Pricing Issues related to prescription drug pricing - no specific bill HR 4002, The Patient Access to Higher Quality Health Care Act Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Health disparities and protecting vulnerable populations - no specific bill Issues related to equitable policies around blood, tissue donations - no specific bill Surprise Billing H.R. 4710/S. 2420, the No Surprises Act Enforcement Act Issues related to surprise billing - no specific bill Issues related to the implementation of the No Surprises Act - no specific bill Telehealth S. 1261, the CONNECT for Health Act of 2025 H.R. 5081/S. 2709, the Telehealth Modernization Act of 2025 H.R. 1650, the Telehealth Expansion Act of 2025 Issues related to telehealth - no specific bill Issues related to telebehavioral health access - no specific bill Issues related to physician licensing - no specific bill Issues related to telehealth PHE flexibilities/waivers - no specific bill Tobacco Issues related to prohibiting sale of menthol cigarettes and flavored cigars - no specific bill Issues related to increasing awareness about lung cancer screening on cigarette packages - no specific bill Vaccines H.R.5448/S.2857 Protecting Free Vaccines Act of 2025 H.R.3701/S.3323 Family Vaccine Protection Act Issues related to vaccines - no specific bill Regulatory FDA's proposed rule to eliminate menthol cigarettes Issues related to Medicare physician payment Issues related to implementation of the No Surprises Act Issues related to telehealth Issues related to Medicare Advantage Star Rating Health Equity Index calculation HIPAA-related Reporting Requirements Involving the Change Healthcare Cyber Incident Marketplace Integrity and Affordability Proposed Rule (CMS-9884-P) Medicaid Program; Preserving Medicaid Funding for Vulnerable Populations-Closing a Health Care-Related Tax Loophole Proposed Rule (CMS-2448-P) Notice: Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA); Interpretation of Federal Public Benefit NIH RFI on Maximizing Research Funds by Limiting Allowable Publishing Costs File Code CMS-3481-P. Medicare and Medicaid Programs; Hospital Condition of Participation: Prohibiting Sex-Rejecting Procedures for Children File Code CMS-2451-P Medicaid Program; Prohibition on Federal Medicaid and Children's Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children File Code CMS-2454-IFC. Medicaid Program; Community Engagement Requirement for Certain Individuals Docket No. HHS-OS-2026-0332; RIN 0991-ZA62 - Request for Information: Categories Used in Federal Vaccine Recommendations and the Role of Shared Clinical Decision-Making (91 Fed. Reg. 54724, Aug. 24, 2026) File Code CMS-1848-P. Medicare and Medicaid Programs; CY 2027 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program Notice of Proposed Rulemaking, Fee for Certain H-1B Petitions, 91 Fed. Reg. 54817 (Aug. 25, 2026); DHS Docket No. USCIS-2026-0298; CIS No. 2861-26; RIN 1615-AD20 Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes, File Code: CMS-2452-P, RIN 0938-AV93, 91 Fed. Reg. 46562 (published July 23, 2026) File Code CMS-1848-P; Medicare Program; CY 2027 Payment Policies Under the Physician Payment Schedule and Other Changes to Part B Payment and Coverage Policies; (July 16, 2026). Accounting for E/M Resource Overlap Between Stand-Alone Visits and Global Periods File Code ACF-2026-0595-0001; Reducing Federal Burden for Head Start Programs

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

Air medical services H.R. 4710 / S. 2420 - No Surprises Enforcement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Air medical services H.R. 4710 / S. 2420 - No Surprises Enforcement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Increased radar funding Policies that ensure air ambulance care providers get adequate reimbursements Air medical services H.R. 4710 / S. 2420 - No Surprises Enforcement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

ERISA Preemption Tax treatment of employer-sponsored health benefit plans Site-neutral payment policies, anti-competitive practices, hospital consolidation, and reforms No Surprises Act reforms and HR 4710 Patients Deserve Price Tags Act (HR 5582/ S 2355) Excepted fertility benefits DOL NPRM Pharmacy Benefit Fee Disclosure (sec. 408(b)(2)) Electronic disclosure for health and welfare benefit plans Employer Innovations in Health Care Sec. 340B pharmacy drug pricing program End-Stage Renal Disease, Restore Protections for Dialysis Patients Act (HR 2199) Lower Costs More Transparency Act (HR 9393) Chronic disease coverage, on-site clinics, direct primary care Mental Health Parity and Addiction Equity Act (MHPAEA) Health care price transparency, prescription drug price transparency, PBM price transparency, hospital price transparency ERISA fiduciary duties for health care plans (S. 3345 / S. 526) Prescription Drug Data Collection reporting Medicare Operations Rule

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

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

Affordable Care Act (ACA), ACA subsidies and tax credits; Telehealth/telehealth flexibilities, ACA Fraud; Transparency in Coverage; Exchanges; Rural Healthcare; Prior Authorization (PA); Managed Care Organizations; Hospital Billing/Consolidation; Maternal Health; Employer Provided Health Coverage; Individual Marketplace Program Integrity; EAPTC Extension; HealthCare Affordability; Suprise Billing; Artificial Intelligence S.2355 - Patients Deserve Price Tags Act To amend the Public Health Service Act to provide for hospital and insurer price transparency. Sponsor: Sen. Roger Marshall H.R. 4710 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Cide if 1986 to increase penalties for group health plans, health insurance issuers and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Rep Gergory Murphy S. 2420 - No Surprises Act Enforcement Act To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Cide if 1986 to increase penalties for group health plans, health insurance issuers and nonparticipating providers or facilities for practices that violate balance billing requirements, and for other purposes. Sponsor: Sen. Roger Marshall S. 4027- Health Competition For Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care Sponsor: Sen Jon Justed H.R. 6248 Healthy Competition for Better Care Act To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care Sponsor: Rep Jodey Arrington H.R. 2079 - Insurance Fraud Accountability Act To amend the Patient Protection and Affordable Care Act to reduce fraudulent enrollments in qualified health plans, and for other purposes. H.R. 8684 - Transparency in Billing Act of 2026 To amend the Employee Retirement Income Security Act of 1974 to require group health plans and health insurance issuers offering group health insurance coverage to only pay claims submitted by hospitals that have in place policies and procedures to ensure accurate billing practices, and for other purposes. H.R. 9393 - Lower Costs, More Transparency Act of 2026 To promote price transparency in the health care sector S. 2301 - Improving Care in Rural Camerica Reauthorization Act of 2025 To reauthorize certain programs regarding rural health care.

Client expense: $420,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H. Res 1519 - Supporting the Designation of September 17, 2026 as National Physician Suicide Awareness Day to Raise Awareness of, and promote a national discussion about, physician suicide and to reduce the stigma of mental health conditions, and for other purposes. H. Res. 1528 - Recognizing Suicide as a serious public health problem and expressing support for the designation of September 2026 as National Physician Suicide Prevention Month, as well as September 10, 2026 as World Suicide Prevention Day. H.R. 1 - One Big Beautiful Bill Act, provisions relating to artificial intelligence (AI), provisions related to changes in medicaid regarding "Release the Pressure" hypertension control campaign H.R. 1254 - Rural Obstetrics Readiness Act, all provisions H.R. 2314 - Fair Access In Residency (FAIR) Act, all provisions H.R. 3492 - Protect Children's Innocence Act, all provisions H.R. 9390 - Prices on the Wall Act, all provisions H.R. 9395 - Transparency in Medicare Advantage Steering Act, all provisions H.R. 9645 - Health Care Price Certainty for All Americans Act, all provisions H.R. 9693 - The Patients First Act of 2026 - all provisions H.R.10444 - The Stop Corporate Takeovers of Physicians Act, all provisions H.R.1520 - Charlotte Woodward Organ Transplant Discrimination Prevention Act, all provisions H.R.2191 - Physician Led and Rural Access to Quality Care Act, all provisions H.R.2332 - SHARE Act of 2025, all provisions H.R.2483 - SUPPORT for Patients and Communities Reauthorization Act of 2025, all provisions H.R.2850 - Youth Sports Facilities Act of 2025, all provisions H.R.3022 - Restoring Rights of Physicians to Own Hospitals Act, all provisions H.R.3164 - Ensuring Community Access to Pharmacist Services Act, all provisions H.R.3170 - Improving Access to Workers Compensation for Injured Federal Workers Act of 2025, all provisions H.R.4583 - Living Donor Protection Act of 2025, all provisions H.R.4710 - No Surprises Act Enforcement Act, all provisions H.R.5199 - Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025, all provisions H.R.5861 - Legacy Act of 2025, all provisions H.R.628 - Honor Our Living Donors Act, all provisions H.R.7023 - Affordable CHOICE Act, all provisions H.R.7868 - Expanding Support for Living Donors Act of 2026, all provisions H.R.7884 - Healthcare is Human Act of 2026, all provisions H.R.8794 - FED UP with Bleeding Disorders Act of 2026, all provisions H.R.9192 - Prior Authorization Reform for Autoimmune and Blood Disorders Act, all provisions H.R.929 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions H.R.9393 - Lower Costs, More Transparency Act of 2026, all provisions H.R.9396 - Prior Authorization Accountability Act, all provisions S. 380 - Rural Obstetrics Readiness Act, all provisions S.1390 - Physician Led and Rural Access to Quality Care Act, all provisions S.1419 - Youth Sports Facilities Act of 2025, all provisions S.1552 - Living Donor Protection Act of 2025, all provisions S.1782 - Charlotte Woodward Organ Transplant Discrimination Prevention Act, all provisions S.2355 - Patients Deserve Price Tags Act, all provisions S.2420 - No Surprises Act Enforcement Act, all provisions S.2426 - Equitable Community Access to Pharmacist Services , all provisions S.266 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions S.3097 - Health Information Privacy Reform Act, all provisions S.3315 - Health Care Cybersecurity and Resiliency Act of 2026, all provisions S.3599 - Affordable CHOICE Act, all provisions S.3907 - Health Information Privacy Reform Act, all provisions S.5419 - The Stop Corporate Takeovers of Physicians Act, all provisions S.5496 - Health for the Commonwealth through Affordability Reform and Expansion Health Care (CARE) Act, all provisions "Legitimate Medical Purpose" definition under the Controlled Substance Act "Still at Risk" wristband initiative Jeanette Acosta Invest in Women's Health Act Comment Letter: [ACF-2026-0595] Reducing Federal Burden for Head Start Programs Comment Letter: [CMS-2026-1255-0001] Medicare and Medicaid Programs: Patient Protection and Affordable Care Act; Interoperability Standards and Prior Authorization for Drugs for Medicare Advantage Organizations, Medicaid Managed Care Plans, etc. Comment Letter: [REG-118484-25; CMS-9879-P; RIN 0938-AV94; RIN 1210-AC40; RIN 1545-BS02] Excepted Fertility Benefits Comment Letter: Request for Information (RFI) on Health Coverage that Works for Everyone Comment Letter: [2120-AM18] Improving Emergency Medical Kit Efficacy and Flexibility in Commercial Airline Operations Draft: Health Infrastructure Security and Accountability Act Draft: Noncompete clauses in physician contracts Matters related to AI use in prior authorization Matters related to Alternative Payment Model bonuses/incentive payments and freezing the qualifying provider revenue thresholds Matters related to Data privacy, cybersecurity, and AI Matters related to Health care consolidation Matters related to the Health Insurance Portability and Accountability Act (HIPAA) and electronic records Matters related to Maternal health and hypertensive disorder during pregnancy Matters related to Medical devices Matters related to Nutrition Matters related to the Office of the National Coordinator for Health Information Technology (ONC) improving electronic health record certification; implementation of 21st Century Cures Act provisions; digital health policies, and reduction of technology burden on physicians entering into the Quality Payment Program Matters related to Payment for AI services within health care Matters related to the Public Health effects of opioid medications Matters related to Unbundling of Maternity Care of Current Procedural Terminology (CPT) Codes Matters related to the United States Preventive Services Task Force (USPSTF) Matters related to Vaccines/ACIP Matters related to ACA benefits and payments Matters related to high-resolution anoscopy services Matters related to peptides Matters related to physician prescribing of antibiotics Matters related to reproductive health Matters related to the Authorization of ENDS Products Age Verification

Client expense: $4,540,000 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Treasury, Dept of

No Surprises Act implementation; H.R. 4710, No Surprises Act Enforcement Act; H.R. 4792, Protecting Air Ambulance Services for Americans Act of 2025; S. 2518, Protection Air Ambulance Services for Americans Act of 2025

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

No Surprises Act implementation; H.R. 4710, No Surprises Act Enforcement Act; H.R. 4792, Protecting Air Ambulance Services for Americans Act of 2025; S. 2518, Protection Air Ambulance Services for Americans Act of 2025

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to No Surprises Act implementation; H.R.4710 No Surprises Act Enforcement Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislative and regulatory issues related to preventing surprise medical bills and lowering health care costs, including implementation of H.R.133, Consolidated Appropriations Act, 2021 (P.L.116-260); S.2420/H.R.4710, the No Surprises Act Enforcement Act.

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

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

General legislative and regulatory issues including health care reform; Legislative and regulatory policy proposals to protect employer-sponsored health care coverage; Legislative and regulatory issues related to preventing surprise medical bills and lowering health care costs; H.R.919, Chronic Disease Flexible Coverage Act; H.R.133, Consolidated Appropriations Act, 2021 (P.L.116-260) implementation; S.2420/H.R.4710, the No Surprises Act Enforcement Act; H.R.1, One Big Beautiful Bill Act (P.L.119-21) implementation; H.R.6248/S.4027, the Healthy Competition for Better Care Act; S.2355, Patients Deserve Price Tags Act.

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE