Save our Safety-Net Hospitals Act of 2025

Support Medicare graduate medical education (GME) expansion and legislative proposals to expand Medicare GME program: the Resident Physician Shortage Reduction Act, the Pathway to Practice Act of 2021, the Substance Use Disorder Workforce Act, additional GME slots in CAA, 2021 and CAA, 2023; Rural Residency Planning and Development Act. Discuss technical amendment to CAA, 2021, Sec. 131 to address artificially low GME caps with Congressional staff. Discuss with Congressional staff distribution methodology for Medicare GME slots created in the CAA, 2021. Discuss rural reclassification for Medicare wage index and Medicare GME purposes with Congressional staff. Discuss COVID-19 Public Health Emergency (PHE) Medicare flexibilities with Congressional staff and HHS staff and support legislative proposals to permanently extend PHE telehealth flexibilities and two-year extension of Acute Hospital Care at Home Waiver. Oppose Medicare site-neutral payment policies. Oppose unique national provider identifier (NPI) requirement for hospital outpatient departments and discuss implementation - H.R. 7148-Sec. 6225. Discuss CY 2026 OPPS final rule with Congressional staff: 340B drug acquisition survey, opposition to site-neutral cuts for drug administration services. Support Medicare Advantage reforms - Improving Seniors Timely Access to Care Act (H.R. 3514/S. 1816), MA Prompt Pay Act (H.R. 5454/S.2879). Discuss Medicare wage index issues with CMS. Discuss proposals that stabilize long-term care and post-acute care providers: establish a temporary per diem Medicare payment to ease capacity issues and address financial challenges from slow discharges (support), make permanent three-day hospital stay waiver (support) and other COVID-19 PHE regulatory flexibilities. Oppose Medicaid program and financing in H.R.1: work requirements as a condition of coverage, changes to state-directed payments, reductions to Federal matching funds, reductions to the safe harbor threshold for provider taxes, sunset of broad-based and uniform provider tax waivers, rescission of Medicaid Eligibility rule and Medicaid/CHIP Access rule, reductions to retroactive coverage. Discuss H.R. 1 phase-out of non-broad-based and uniform Medicaid provider tax waivers and support maximum phase-out period. Support certain changes to Medicaid DSH payments: support two-year elimination of Medicaid DSH cut; support Save Our Safety Net Hospitals Act (H.R. 5064) to restore pre-CAA, 2021 DSH cap calculation methodology and include dual-eligible patients in state DSH cap calculation. Discuss Medicaid Section 1115 waiver with Congressional staff and HHS. Oppose proposed rule - Medicare and Medicaid Conditions of Participation: Limiting Participation Based on the Performance of Sex Trait Modification Procedures on Children with Congressional staff. Discuss nursing and allied health cost report issues. Discuss uncompensated care.

Client expense: $560,000 · 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), Medicare Payment Advisory Commission (MedPAC), SENATE, White House Office

Issues related to the Medicare/Medicaid dual eligible population Issues related to Medicare uncompensated care payments Issues related to Medicare Advantage Issues related to Medicaid DSH Cuts Issues related to Medicaid financing Issues related to Medicaid eligibility Issues related to Medicaid state directed payments Issues related to Medicaid provider taxes Issues related to essential hospital designation Issues related to Maternal health equity S.1261 - CONNECT for Health Act of 2025 HR 4150 - Advancing Maternal Health Equity Under Medicaid Act of 2025 S2879/HR5454 - Medicare Advantage Prompt Pay Act Issues related to Medicare Issues related to Medicare Prior Authorization Issues related to Medicare Payment Cuts Issues related to telehealth services under the Medicare program HR 7444- amend title XVIII of the Social Security Act to protect access to telehealth services under the Medicare program HR 5064- the Save Our Safety Net Hospitals Act HR 7145 - the Reinforcing Essential Health Systems for Communities Act

Client expense: $660,000 · Firm income: Not reported

H.R, 5371, FY 2026 Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extension Act (P.L. 119-37); funding for the NIH; Facilities and Administrative cost reimbursement related issues; NIH grant related issues; Medicare telehealth waivers; issues related to Medicaid DSH (Disproportionate Share Hospital) rates H.R. 5064, Save Our Safety-Net Hospitals Act of 2025 H.R. 4731, Resident Physician Shortage Reduction Act of 2025

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R, 5371, FY 2026 Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extension Act (P.L. 119-37); funding for the NIH; Facilities and Administrative cost reimbursement related issues; NIH grant related issues; Medicare telehealth waivers; issues related to Medicaid DSH (Disproportionate Share Hospital) rates H.R. 5064, Save Our Safety-Net Hospitals Act of 2025 H.R. 4731, Resident Physician Shortage Reduction Act of 2025

Client expense: $350,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5064/S.2743 - Save Our Safety Net Hospitals Act; H.R. 1 - One Big Beautiful Bill Act; FY26 LHHS Appropriations; Administration Changes to H-1B / J-1B visa programs; Administration Changes to Medicaid and Medicare reimbursement; Advanced Premium Tax Credit extension; COVID-19 telehealth extension; Medical Research Funding, including NIH, CDC and HRSA; and Medicare Graduate Medical Education (GME)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE