Chiropractic Medicare Coverage Modernization Act of 2025

H.R. 4093 - Apples to Apples Comparison Act of 2025, all provisions H.R. 483 - Health Care Efficiency Through Flexibility Act, all provisions H.R. 6728 - Linking Seniors to Needed Legal Services Act of 2025, all provisions H.R. 9393 - Lower Costs, More Transparency Act, all provisions H.R. 9397 - Premium Transparency Act, all provisions H.R. 9468 - Saving Today's Ascute-Care Resouces (STAR) act, all provisions H.R. 9693 - The Patients First Act of 2026 - all provisions H.R.1 - An act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (PL 119-21), provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R.1317 - I CAN Act, all provisions H.R.1614 - To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015 (PL 114-10) H.R.2120 - ROCR Value Based Program Act, all provisions H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2902 - SOAR Act of 2025, all provisions H.R.3069 - Medicare for All Act, all provisions H.R.3108 - RPM Access Act, all provisions, all provisions H.R.3514 - Improving Seniors Timely Access to Care Act of 2025, all provisions H.R.3878 - RNs for Rural Health Act of 2025, all provisions H.R.4002 - Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R.4206 - CONNECT for Health Act of 2025, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.4977 - Connected MOM Act, all provisions H.R.5081 - Telehealth Modernization Act, all provisions H.R.5178 - Sickle Cell Disease Comprehensive Care Act, all provisions H.R.5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. H.R.5347 - Health Care Efficiency Through Flexibility Act, all provisions H.R.539 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R.5467 - PAAT Act, all provisions H.R.5940 - Seniors Deserve SMARTER Care Act of 2025, all provisions H.R.6160 - Strengthening Medicare for Patients and Providers Act, all provisions H.R.6280 - Access to Genetic Counselor Services Act of 2025, all provisions H.R.7520 - Efficiency Adjustment Delay Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.7905 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions H.R.8129 - To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R.8163 - Provider Reimbursement Stability Act of 2026, all provisions H.R.8261 - Chronic Care Management Improvement Act of 2026, all provisions H.R.8375 - Medicare Advantage Improvement Act of 2026, all provisions H.R.8500 - Timely Access to Coverage Decisions Act of 2026, all provisions H.R.8622 - Medicare Physician Data-driven Performance Payment System Act of 2026, all provisions H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions H.R.9392 - Medicare Advantage Cost Transparency Act, all provisions H.R.9644 - Medicare Advantage MLR Transparency Act, all provisions S.1031 - ROCR Value Based Program Act, all provisions S.106 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S.1105 - No UPCODE Act, all provisions S.1261 - CONNECT for Health Act of 2025, all provisions S.1399 - Health Tech Investment Act, all provisions S.141 - Connected MOM Act, all provisions S.1460 - Preserving Patient Access to Accountable Care Act, all provisions S.1535 - Rural Patient Monitoring (RPM) Access Act, all provisions S.1640 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1816 - Improving Seniors Timely Access to Care Act of 2025, all provisions S.1996 - Medicare Audiology Access Improvement Act of 2025, all provisions S.2709 - Telehealth Modernization Act, all provisions S.3480 - Seniors Deserve SMARTER Care Act of 2025, all provisions S.3607 - Access to Genetic Counselor Services Act of 2026, all provisions S.5168 - Provider Reimbursement Stability Act of 2026, all provisions S.5180 - Provider Reimbursement Stability Act, all provisions S.665 - Fatal Overdose Reduction Act of 2025, all provisions S.721 - Sickle Cell Disease Comprehensive Care Act, all provisions S.891 - Bipartisan Health Care Act, all provisions Comment Letter: [CMS 0057 F] 2024 CMS Interoperability and Prior Authorization final rule Comment Letter: [CMS-0062-P] 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, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges Comment Letter: [CMS-1844-P] CY 2027 Home Health Prospective Payment System proposed rule Comment Letter: [CMS-1848-P] Medicare Physician Fee Schedule, including conversion factors, Modifier -25 payment reduction, efficiency adjustment, RPM/RTM, Maternity Care Services codes, CPT request for information, MIPS/MVP transition, Medicare Shared Savings Program, and Qualifying APM Participant determinations Comment Letter: [CMS-1850-P] Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; Including the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Program; Request for Information on Strengthening the Standardization and Comparability of Hospital Price Transparency (HPT) Data; Prior Authorization; Accrediting Organization (AO) Deeming for Emergency Medical Treatment and Labor Act (EMTALA); and Notices of Closure of Teaching Hospitals and Opportunities To Apply for Available Slots Comment Letter: [CMS-2452-P] Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes Comment Letter: [CMS-2454-IFC] Medicaid Program; Community Engagement Requirement for Certain Individuals Comment Letter: [CMS-3847-NC] Regulatory Alignment for Predictable and Immediate Device (RAPID) coverage pathway Comment Letter: [CMS-9874-NC] Request for Information; Comprehensive Review of the Essential Health Benefits Framework and Typical Employer Plan Standard Comment Letter: [HHS-OS-2026-0332] Request for Information: Categories Used in Federal Vaccine Recommendations and the Role of Shared Clinical Decision-Making Comment Letter: Request for Information (RFI) Strengthening the Medicare Physician Payment System Statement for the Record: Examining Legislative Proposals to Reform Medicare Provider Payment and Bolster Health Care Cybersecurity Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: ACO/APM flexibilities Medicare program: Advanced APM reporting Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: AI services/payment Medicare program: Aligned Networks and interoperability Medicare program: Alternative Payment Models (APMs) Medicare program: Certified electronic health record and PI Medicare program: Coding Medicare program: Data privacy/cybersecurity Medicare program: Data-Driven Performance Payment System Medicare program: Digital quality measures Medicare program: G2211 Inherent Complexity Code Medicare program: Health Information Technology/physician burdens Medicare program: Indirect practice expense Medicare program: Informed decision-making among beneficiaries Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Medicare Diabetes Prevention Program Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare Part D issues Medicare program: Medicare physician payment/budget neutrality Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS Promoting Interoperability Medicare program: MIPS quality and cost measures Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Promoting Interoperability (PI) Program Medicare program: Provider directories Medicare program: Public Health Reporting and Data Exchange Medicare program: Quality Payment Program Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: RVS Update Committee (RUC) and Current Procedural Terminology (CPT) issues Medicare program: Shared Savings Program Medicare program: Site Neutral Payment Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model Medicaid program: Changes in Children's Health Insurance Program (CHIP) and Affordable Care Act insurance marketplaces Medicaid program: Community engagement/medical frailty exemption Medicaid program: Practice of Medicine Medicaid program: State directed payments Medicaid program: Work requirements, per capita caps, provider taxes, Federal Medical Assistance Percentage (FMAP) changes Medicare and Medicaid programs: ACO REACH (Realizing Equity, Access, and Community Health) Model Reform Medicare and Medicaid programs: Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model reform. Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: Evaluation and Management (E/M) codes Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicare and Medicaid programs: Indirect Practice Expense Relative Value Updates (RVU) changes Medicare and Medicaid programs: Interoperability Medicare and Medicaid programs: LEAD (Long-term Enhanced ACO Design) Model Reform Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: Prior authorization Medicare and Medicaid programs: TEAM (Transforming Episode Accountability Model) changes Medicare and Medicaid programs: Telehealth and Digital Health Draft: Artificial intelligence in prior authorization denials by Medicare Advantage organizations Draft: GOLD CARD Act Draft: MACRA/MIPS program reform Draft: Transparency in Downcoding Model Act Draft: Value in Health Care Act Matters related to downcoding by Insurace plans Matters related to drug price negotiations Matters related to expiring Medicare Physician payment rates Matters related to Modifier-25/Multiple Procedure Payment Reductions

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

Issues related to Medicare physician payment, specifically proposed changes by CMS to reimbursement for services provided on the same day using Modifier 25. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. H.R.7520, Efficiency Adjustment Delay Act. H.R.8163/S.5180, Provider Reimbursement Stability Act of 2026. H.R.9260, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027. H.R.9693, Patients First Act of 2026. S.1105, No UPCODE Act. Commented to Centers for Medicare & Medicaid Services Administrator Mehmet Oz on August 21, 2026, regarding CY 2027 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the Extended HH Value-Based Purchasing Model; Medicare Provider Enrollment, Durable Medical Equipment (DME), and DME, Prosthetics, Orthotics, and Supplies (DMEPOS) Policies [CMS-1844-P]. Commented to Centers for Medicare & Medicaid Services Administrator Mehmet Oz on September 11, 2026, regarding CY 2027 Medicare Physician Fee Schedule and Quality Payment Program proposed rule [CMS-1848-P]. Submitted statement for the record supporting H.R. 4331, the Access to Claims Data Act, on September 15, 2026, at the House Energy and Commerce Health Subcommittee hearing: Examining Legislative Proposals to Reform Medicare Provider Payment and Bolster Health Care Cybersecurity.

Client expense: $388,538 · Firm income: Not reported

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

Issues related to Medicare physician payment, specifically proposed changes by CMS to reimbursement for services provided on the same day using Modifier 25. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.929/S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. H.R.2028/S.942, Resident Education Deferred Interest (REDI) Act. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3164/S.2426, Ensuring Community Access to Pharmacist Services (ECAPS) Act. H.R.3170/S.3296, Improving Access to Workers' Compensation for Injured Federal Workers Act. H.R.3277/S.1677, Ensuring Lasting Smiles Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4606/S.3400, Allys Act. H.R.4681/S.1380, Specialty Physicians Advancing Rural Care (SPARC) Act. H.R.4710/S.2420, No Surprises Act Enforcement Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5435/S.2842, Stop CMV Act of 2025. H.R.5509/S.2903, Safe Step Act. H.R. 5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. H.R. 7520, Efficiency Adjustment Delay Act. H.R.8163/S.5180, Provider Reimbursement Stability Act of 2026. H.R.9237, Take Care of Americas Veterans Act. H.R.9260, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027. H.R.9693, Patients First Act of 2026. S.1105, No UPCODE Act. Commented to Office of Management and Budget Director Russell Vought on July 13, 2026, regarding regulation for Federal Financial Assistance [OMB-2026-0034]. Commented to Centers for Medicare & Medicaid Services Administrator Mehmet Oz on August 21, 2026, regarding CY 2027 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the Extended HH Value-Based Purchasing Model; Medicare Provider Enrollment, Durable Medical Equipment (DME), and DME, Prosthetics, Orthotics, and Supplies (DMEPOS) Policies [CMS-1844-P]. Commented to Centers for Medicare & Medicaid Services Administrator Mehmet Oz on September 11, 2026, regarding CY 2027 Medicare Physician Fee Schedule and Quality Payment Program proposed rule [CMS-1848-P]. Submitted statement for the record supporting H.R. 4331, the "Access to Claims Data Act," on September 15, 2026, at the House Energy and Commerce Health Subcommittee hearing: "Examining Legislative Proposals to Reform Medicare Provider Payment and Bolster Health Care Cybersecurity."

Client expense: $388,538 · Firm income: Not reported

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

HR 539 Chiropractic Medicare Coverage Modernization Act: Bill would allow Medicare beneficiaries to access all Medicare-covered services allowed under a chiropractor's state licensure. S 106 Chiropractic Medicare Coverage Modernization Act: Bill would allow Medicare beneficiaries to access all Medicare-covered services allowed under a chiropractor's state licensure. HR 879 Medicare Patient Access and Practice Stabilization Act: Bill stops the entirety of the current reimbursement reduction and helps account for rising inflationary costs with a two percent payment increase. HR 1968 Full-Year Continuing Appropriations and Extensions Act, 2025. Lobbied to have HR 539 (above) included in bill. HR 4204 Medicare Patient Choice Act: Allows Medicare beneficiaries to choose their physical and occupational therapists, speech-language pathologists, audiologists, and chiropractors. HR 8163 Provider Reimbursement Stability Act: modernizes and updates the underlying mechanics of the Medicare Physician Fee Schedule (MPFS) to improve stability for physicians and their patients. HR 9693 Patients First Act: Allows for larger annual adjustments to the Medicare physician fee schedule and bases these adjustments on inflation. It also requires certain corrections to compensate for expenditures under the fee schedule that exceed a certain amount in a given year, and it limits how much certain adjustment factors may vary each year.

Client expense: $63,650 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment reform Counting observation stays as satisfying Medicare three-day inpatient stay prerequisite for skilled nursing facility (SNF) coverage H.R. 1-One Big Beautiful Bill Act, to provide for reconciliation pursuant to title II of H. Con. Res. 14 H.R. 539-Chiropractic Medicare Coverage Modernization Act of 2025, to amend title XVIII of the Social Security Act to provide Medicare coverage for all physicians services furnished by doctors of chiropractic within the scope of their license, and for other purposes. H.R. 771-Rural Health Care Access Act of 2025, to eliminate the 35-mile requirement to qualify as a critical access hospital H.R. 772-Rural ER Access Act, to require the Centers for Medicare and Medicaid Services to repeal the 35-mile requirement for off-campus facilities H.R. 879- Medicare Patient Access and Practice Stabilization Act of 2025, to address the 2025 Medicare Physician Fee Schedule cuts and increaser support for physicians and other practitioners in adjusting to Medicare payment changes H.R.1968-Full-Year Continuing Appropriations and Extensions Act, to provide appropriations for federal departments and agencies and to provide an increase for the calendar year 2024 physician fee schedule conversion factor H.R. 2433-Reducing Unnecessary Medical Delays in Care Act of 2025, to ensure that prior authorization medical decisions under Medicare are determined by physicians. H.R. 3164-Ensuring Community Access to Pharmacist Services Act (ECAPS) Act, to amend title XVIII of the Social Security Act to provide pharmacy payment of certain services H.R. 4206-CONNECT for Health Act, to expand access to telehealth services H.R. 6160-Strengthening Medicare for Patients and Providers Act, provide for an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index H.R. 6721-Medicare Advance Planning for Care Act, to encourage Medicare beneficiaries to voluntarily adopt advance directives guiding the medical care they receive H.R. 7520-Efficiency Adjustment Delay Act, to delay the implementation of an efficiency adjustment to work relative value units under the Medicare physician fee schedule H.R. 8163-Provider Reimbursement Stability Act, ensure stability for provider payments under the Medicare program H.R. 8622-Medicare Data-driven Performance Payment System Act of 2026, to transform the Merit-based Incentive Payment System into the Data-driven Performance Payment System under the Medicare physician fee schedule S. 106-Chiropractic Medicare Coverage Modernization Act of 2025, to amend title XVIII of the Social Security Act to provide Medicare coverage for all physicians services furnished by doctors of chiropractic within the scope of their license, and for other purposes. S.1261-CONNECT for Health Act, to expand access to telehealth services S. 1640- Medicare Patient Access and Practice Stabilization Act of 2025, to address the 2025 Medicare Physician Fee Schedule cuts and increaser support for physicians and other practitioners in adjusting to Medicare payment changes S. 2426-Ensuring Community Access to Pharmacist Services Act (ECAPS) Act, to amend title XVIII of the Social Security Act to provide pharmacy payment of certain services S. 3473-Medicare Advance Planning for Care Act, to encourage Medicare beneficiaries to voluntarily adopt advance directives guiding the medical care they receive S. 4927-Rural Hospital Emergency Room Guarantee Act, to establish a guaranteed funding stream to keep existing emergency rooms at America's rural hospitals open.

Client expense: $498,299 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare reimbursement and coverage of chiropractic services, including H.R.539 and S.106. Issues related to expanding access through telehealth. Issues related to physician reimbursement.

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

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

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. 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

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)

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. 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

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)

H.R.1 - An act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (PL 119-21), provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R.1317 - I CAN Act, all provisions H.R.1614 - To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015 (PL 114-10) H.R.2120 - ROCR Value Based Program Act, all provisions H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2902 - SOAR Act of 2025, all provisions H.R.3069 - Medicare for All Act, all provisions H.R.3108 - RPM Access Act, all provisions, all provisions H.R.3514 - Improving Seniors Timely Access to Care Act of 2025, all provisions H.R.3878 - RNs for Rural Health Act of 2025, all provisions H.R.4002 - Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R.4074 - Optimizing Postpartum Outcomes Act of 2025, all provisions H.R.4206 - CONNECT for Health Act of 2025, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.4977 - Connected MOM Act, all provisions H.R.5081 - Telehealth Modernization Act, all provisions H.R.5178 - Sickle Cell Disease Comprehensive Care Act, all provisions H.R.5281 - REAL Health Providers Act, all provisions H.R.5347 - Health Care Efficiency Through Flexibility Act, all provisions H.R.539 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R.5467 - PAAT Act, all provisions H.R.5940 - Seniors Deserve SMARTER Care Act of 2025, all provisions H.R.6160 - Strengthening Medicare for Patients and Providers Act, all provisions H.R.6280 - Access to Genetic Counselor Services Act of 2025, all provisions H.R.7520 - Efficiency Adjustment Delay Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.7905 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions H.R.8129 - To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R.8163 - Provider Reimbursement Stability Act of 2026, all provisions H.R.8261 - Chronic Care Management Improvement Act of 2026, all provisions H.R.8375 - Medicare Advantage Improvement Act of 2026, all provisions H.R.8487 - Ensuring Excellence in Mental Health Act, all provisions H.R.8500 - Timely Access to Coverage Decisions Act of 2026, all provisions H.R.8622 - Medicare Physician Data-driven Performance Payment System Act of 2026, all provisions H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1031 - ROCR Value Based Program Act, all provisions S.106 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S.1105 - No UPCODE Act, all provisions S.1261 - CONNECT for Health Act of 2025, all provisions S.1399 - Health Tech Investment Act, all provisions S.141 - Connected MOM Act, all provisions S.1460 - Preserving Patient Access to Accountable Care Act, all provisions S.1535 - Rural Patient Monitoring (RPM) Access Act, all provisions S.1640 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1816 - Improving Seniors Timely Access to Care Act of 2025, all provisions S.1996 - Medicare Audiology Access Improvement Act of 202, all provisions S.1996 - Medicare Audiology Access Improvement Act of 2025, all provisions S.2709 - Telehealth Modernization Act, all provisions S.3480 - Seniors Deserve SMARTER Care Act of 2025, all provisions S.3607 - Access to Genetic Counselor Services Act of 2026, all provisions S.3750 - REAL Health Providers Act, all provisions S.3762 - Prior Authorization Relief Act, all provisions S.4070 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions S.4384 - Medicare Advantage Improvement Act of 2026, all provisions S.665 - Fatal Overdose Reduction Act of 2025, all provisions S.721 - Sickle Cell Disease Comprehensive Care Act, all provisions S.891 - Bipartisan Health Care Act, all provisions Comment Letter: [CMS 0057 F] 2024 CMS Interoperability and Prior Authorization final rule Comment Letter: [CMS-0062-P] 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, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges Comment Letter: [CMS-1849-P] Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates; Requirements for Quality Programs; and Other Policy Changes Comment Letter: [CMS-9874-NC] Request for Information; Comprehensive Review of the Essential Health Benefits Framework and Typical Employer Plan Standard Statement for the Record: Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms Draft: Artificial intelligence in prior authorization denials by Medicare Advantage organizations Draft: GOLD CARD Act Draft: MACRA/MIPS program reform Draft: Medicare bonus payment for alternative payment model (APM) participation Draft: Medicare Budget Neutrality and MIPS reform Medicaid program: Changes in Children's Health Insurance Program (CHIP) and Affordable Care Act insurance marketplaces Medicaid program: Community engagement/medical frailty exemption Medicaid program: Practice of Medicine Medicaid program: Work requirements, per capita caps, provider taxes, Federal Medical Assistance Percentage (FMAP) changes Medicare and Medicaid programs: LEAD (Long-term Enhanced ACO Design) Model Reform Medicare and Medicaid programs: ACO REACH (Realizing Equity, Access, and Community Health) Model Reform Medicare and Medicaid programs: Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model reform. Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: Evaluation and Management (E/M) codes Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicare and Medicaid programs: Indirect Practice Expense Relative Value Updates (RVU) changes Medicare and Medicaid programs: Interoperability Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: Prior authorization Medicare and Medicaid programs: TEAM (Transforming Episode Accountability Model) changes Medicare and Medicaid programs: Telehealth Medicare and Medicaid programs: Telehealth and Digital Health Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: ACO/APM flexibilities Medicare program: Advanced APM reporting Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: AI services/payment Medicare program: Aligned Networks and interoperability Medicare program: Alternative Payment Models (APMs) Medicare program: Certified electronic health record and PI Medicare program: CJR-X (Comprehensive Care for Joint Replacement Expanded) Model Medicare program: Coding Medicare program: Data privacy/cybersecurity Medicare program: Data-Driven Performance Payment System Medicare program: Digital quality measures Medicare program: G2211 Inherent Complexity Code Medicare program: Health Information Technology/physician burdens Medicare program: Indirect practice expense Medicare program: Long-term Enhanced ACO Design (LEAD) Model Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Medicare Diabetes Prevention Program Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare Part D issues Medicare program: Medicare physician payment/budget neutrality Medicare program: MEI Update Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS quality and cost measures Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Promoting Interoperability (PI) Program Medicare program: Provider directories Medicare program: Public Health Reporting and Data Exchange Medicare program: Quality Payment Program Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: RVS Update Committee (RUC) and Current Procedural Terminology (CPT) issues Medicare program: Shared Savings Program Medicare program: Site Neutral Payment Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model

Client expense: $5,130,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

H.R.1 - An act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (PL 119-21), provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R.1317 - I CAN Act, all provisions H.R.1614 - To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015 (PL 114-10) H.R.2120 - ROCR Value Based Program Act, all provisions H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2757 - Medicare Audiology Access Improvement Act of 2025, all provisions H.R.2902 - SOAR Act of 2025, all provisions H.R.3069 - Medicare for All Act, all provisions H.R.3108 - RPM Access Act, all provisions, all provisions H.R.3514 - Improving Seniors Timely Access to Care Act of 2025, all provisions H.R.3878 - RNs for Rural Health Act of 2025, all provisions H.R.4002 - Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R.4074 - Optimizing Postpartum Outcomes Act of 2025, all provisions H.R.4206 - CONNECT for Health Act of 2025, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.483 - Health Care Efficiency Through Flexibility Act, all provisions H.R.4977 - Connected MOM Act, all provisions H.R.5081 - Telehealth Modernization Act, all provisions H.R.5178 - Sickle Cell Disease Comprehensive Care Act, all provisions H.R.5281 - REAL Health Providers Act, all provisions H.R.5347 - Health Care Efficiency Through Flexibility Act, all provisions H.R.539 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R.5467 - PAAT Act, all provisions H.R.5940 - Seniors Deserve SMARTER Care Act of 2025, all provisions H.R.6160 - Strengthening Medicare for Patients and Providers Act, all provisions H.R.6280 - Access to Genetic Counselor Services Act of 2025, all provisions H.R.7520 - Efficiency Adjustment Delay Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.786 - Preserving Patient Access to Accountable Care Act, all provisions H.R.7905 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions H.R.8129 - To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R.8163 - Provider Reimbursement Stability Act of 2026, all provisions H.R.8261 - Chronic Care Management Improvement Act of 2026, all provisions H.R.8375 - Medicare Advantage Improvement Act of 2026, all provisions H.R.8487 - Ensuring Excellence in Mental Health Act, all provisions H.R.8500 - Timely Access to Coverage Decisions Act of 2026, all provisions H.R.8622 - Medicare Physician Data-driven Performance Payment System Act of 2026, all provisions H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1031 - ROCR Value Based Program Act, all provisions S.106 - Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S.1105 - No UPCODE Act, all provisions S.1261 - CONNECT for Health Act of 2025, all provisions S.1399 - Health Tech Investment Act, all provisions S.141 - Connected MOM Act, all provisions S.1460 - Preserving Patient Access to Accountable Care Act, all provisions S.1535 - Rural Patient Monitoring (RPM) Access Act, all provisions S.1640 - Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S.1816 - Improving Seniors Timely Access to Care Act of 2025, all provisions S.1996 - Medicare Audiology Access Improvement Act of 202, all provisions S.1996 - Medicare Audiology Access Improvement Act of 2025, all provisions S.2709 - Telehealth Modernization Act, all provisions S.3480 - Seniors Deserve SMARTER Care Act of 2025, all provisions S.3607 - Access to Genetic Counselor Services Act of 2026, all provisions S.3750 - REAL Health Providers Act, all provisions S.3762 - Prior Authorization Relief Act, all provisions S.4070 - Diabetes Foot Health Access and Modernization Act of 2026, all provisions S.4384 - Medicare Advantage Improvement Act of 2026, all provisions S.665 - Fatal Overdose Reduction Act of 2025, all provisions S.721 - Sickle Cell Disease Comprehensive Care Act, all provisions S.891 - Bipartisan Health Care Act, all provisions Comment Letter: [CMS 0057 F] 2024 CMS Interoperability and Prior Authorization final rule Comment Letter: [CMS-0062-P] 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, State Medicaid Agencies, Children's Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-Facilitated Exchanges Comment Letter: [CMS-1849-P] Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals (IPPS) and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year (FY) 2027 Rates; Requirements for Quality Programs; and Other Policy Changes Comment Letter: [CMS-9874-NC] Request for Information; Comprehensive Review of the Essential Health Benefits Framework and Typical Employer Plan Standard Statement for the Record: Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms Draft: Artificial intelligence in prior authorization denials by Medicare Advantage organizations Draft: GOLD CARD Act Draft: MACRA/MIPS program reform Draft: Medicare bonus payment for alternative payment model (APM) participation Draft: Medicare Budget Neutrality and MIPS reform Medicaid program: Changes in Children's Health Insurance Program (CHIP) and Affordable Care Act insurance marketplaces Medicaid program: Community engagement/medical frailty exemption Medicaid program: Practice of Medicine Medicaid program: Work requirements, per capita caps, provider taxes, Federal Medical Assistance Percentage (FMAP) changes Medicare and Medicaid programs: LEAD (Long-term Enhanced ACO Design) Model Reform Medicare and Medicaid programs: ACO REACH (Realizing Equity, Access, and Community Health) Model Reform Medicare and Medicaid programs: Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model reform. Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: Evaluation and Management (E/M) codes Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicare and Medicaid programs: Indirect Practice Expense Relative Value Updates (RVU) changes Medicare and Medicaid programs: Interoperability Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: Prior authorization Medicare and Medicaid programs: TEAM (Transforming Episode Accountability Model) changes Medicare and Medicaid programs: Telehealth Medicare and Medicaid programs: Telehealth and Digital Health Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: ACO/APM flexibilities Medicare program: Advanced APM reporting Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: AI services/payment Medicare program: Aligned Networks and interoperability Medicare program: Alternative Payment Models (APMs) Medicare program: Certified electronic health record and PI Medicare program: CJR-X (Comprehensive Care for Joint Replacement Expanded) Model Medicare program: Coding Medicare program: Data privacy/cybersecurity Medicare program: Data-Driven Performance Payment System Medicare program: Digital quality measures Medicare program: G2211 Inherent Complexity Code Medicare program: Health Information Technology/physician burdens Medicare program: Indirect practice expense Medicare program: Long-term Enhanced ACO Design (LEAD) Model Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Medicare Diabetes Prevention Program Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare Part D issues Medicare program: Medicare physician payment/budget neutrality Medicare program: MEI Update Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS quality and cost measures Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Promoting Interoperability (PI) Program Medicare program: Provider directories Medicare program: Public Health Reporting and Data Exchange Medicare program: Quality Payment Program Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: RVS Update Committee (RUC) and Current Procedural Terminology (CPT) issues Medicare program: Shared Savings Program Medicare program: Site Neutral Payment Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model

Client expense: $513,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE

Issues related to Medicare physician payment. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.929/S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. H.R.2028/S.942, Resident Education Deferred Interest (REDI) Act. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3164, Ensuring Community Access to Pharmacist Services (ECAPS) Act. H.R.3170, Improving Access to Workers' Compensation for Injured Federal Workers Act. H.R.3277/S.1677, Ensuring Lasting Smiles Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4606/S.3400, Ally's Act. H.R.4681/S.1380, Specialty Physicians Advancing Rural Care (SPARC) Act. H.R.4710/S.2420, No Surprises Act Enforcement Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5435/S.2842, Stop CMV Act of 2025. H.R.5509/S.2903, Safe Step Act. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. H.R.7520, Efficiency Adjustment Delay Act. H.R.8163, Provider Reimbursement Stability Act of 2026. H.R.9237, Take Care of America's Veterans Act. H.R.9260, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027. S.1105, No UPCODE Act. Commented on May 20, 2026, House Energy and Commerce Health Subcommittee hearing regarding Medicare Physician Fee Schedule, MACRA, and opportunities for payment reforms. Provided comments to Representatives Greg Murphy, MD; John Joyce, MD; and Kim Schrier, MD; regarding their April 23 discussion draft of legislation to modernize the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Provided comments to Representatives Greg Murphy, MD; John Joyce, MD; and Kim Schrier, MD; urging them to include provisions in their physician payment reform legislation that would address the impending cut to the Medicare Physician Fee Schedule scheduled to take effect in 2027 and address the efficiency adjustment cuts expected to continue on an indefinite three-year cycle.

Client expense: $286,331 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare physician payment. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. H.R.7520, Efficiency Adjustment Delay Act. H.R.8163, Provider Reimbursement Stability Act of 2026. H.R.9260, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027. S.1105, No UPCODE Act. Commented on May 20, 2026, House Energy and Commerce Health Subcommittee hearing regarding Medicare Physician Fee Schedule, MACRA, and opportunities for payment reforms. Provided comments to Representatives Greg Murphy, MD; John Joyce, MD; and Kim Schrier, MD; regarding their April 23 discussion draft of legislation to modernize the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Provided comments to Representatives Greg Murphy, MD; John Joyce, MD; and Kim Schrier, MD; urging them to include provisions in their physician payment reform legislation that would address the impending cut to the Medicare Physician Fee Schedule scheduled to take effect in 2027 and address the efficiency adjustment cuts expected to continue on an indefinite three-year cycle.

Client expense: $286,331 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act S. 4582/H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act H.R. 5509/S. 2903 - Safe Step Act H.R. 8358/S. 4318 - Breast Cancer Stamp Reauthorization Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) RMOCC development Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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

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

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act S. 4582/H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act H.R. 5509/S. 2903 - Safe Step Act H.R. 8358/S. 4318 - Breast Cancer Stamp Reauthorization Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) RMOCC development Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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

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

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act S. 4582/H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act H.R. 5509/S. 2903 - Safe Step Act H.R. 8358/S. 4318 - Breast Cancer Stamp Reauthorization Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) RMOCC development Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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

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

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act S. 4582/H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act H.R. 5509/S. 2903 - Safe Step Act H.R. 8358/S. 4318 - Breast Cancer Stamp Reauthorization Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) RMOCC development Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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

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

Medicare Physician Payment Reform; in general; Mitigating cuts for Medicare Part B cuts; in general; Concerns regarding Expansion of Prior Authorization in Medicare FFS; H.R. 879/S. 1640, the Medicare Patient Access and Practice Stabilization Act; H.R. 2433, the Reducing Medically Unnecessary Delays in Care Act; H.R. 3514/S.1816, the Improving Seniors Timely Access to Care Act; H.R. 539/S. 106, the Chiropractic Medicare Coverage Modernization Act; H.R. 4731/S. 2439, Resident Physician Shortage Reduction Act; H.R. 4681/S. 1380, the Specialty Physicians Advancing Rural Care (SPARC) Act; H.R. 7520, the Efficiency Adjustment Delay Act; H.R. 1616/S. 1805, the Promoting Access to Diabetic Shoes Act; H.R. 8163, the Provider Reimbursement Stability Act of 2026 Expansion of Physician Workforce/surgical workforce shortages; in general

Client expense: $70,000 · Firm income: Not reported

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

HR 539 Chiropractic Medicare Coverage Modernization Act: Bill would allow Medicare beneficiaries to access all Medicare-covered services allowed under a chiropractor's state licensure. S 106 Chiropractic Medicare Coverage Modernization Act: Bill would allow Medicare beneficiaries to access all Medicare-covered services allowed under a chiropractor's state licensure. HR 879 Medicare Patient Access and Practice Stabilization Act: Bill stops the entirety of the current reimbursement reduction and helps account for rising inflationary costs with a two percent payment increase. HR 1968 Full-Year Continuing Appropriations and Extensions Act, 2025. Lobbied to have HR 539 (above) included in bill. HR 4204 Medicare Patient Choice Act: Allows Medicare beneficiaries to choose their physical and occupational therapists, speech-language pathologists, audiologists, and chiropractors. HR 8163 Provider Reimbursement Stability Act: modernizes and updates the underlying mechanics of the Medicare Physician Fee Schedule (MPFS) to improve stability for physicians and their patients.

Client expense: $63,025 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment reform Counting observation stays as satisfying Medicare three-day inpatient stay prerequisite for skilled nursing facility (SNF) coverage H.R. 1-One Big Beautiful Bill Act, to provide for reconciliation pursuant to title II of H. Con. Res. 14 H.R. 539-Chiropractic Medicare Coverage Modernization Act of 2025, to amend title XVIII of the Social Security Act to provide Medicare coverage for all physicians services furnished by doctors of chiropractic within the scope of their license, and for other purposes. H.R. 771-Rural Health Care Access Act of 2025, to eliminate the 35-mile requirement to qualify as a critical access hospital H.R. 772-Rural ER Access Act, to require the Centers for Medicare and Medicaid Services to repeal the 35-mile requirement for off-campus facilities H.R. 879- Medicare Patient Access and Practice Stabilization Act of 2025, to address the 2025 Medicare Physician Fee Schedule cuts and increaser support for physicians and other practitioners in adjusting to Medicare payment changes H.R.1968-Full-Year Continuing Appropriations and Extensions Act, to provide appropriations for federal departments and agencies and to provide an increase for the calendar year 2024 physician fee schedule conversion factor H.R. 2433-Reducing Unnecessary Medical Delays in Care Act of 2025, to ensure that prior authorization medical decisions under Medicare are determined by physicians. H.R. 3164-Ensuring Community Access to Pharmacist Services Act (ECAPS) Act, to amend title XVIII of the Social Security Act to provide pharmacy payment of certain services H.R. 4206-CONNECT for Health Act, to expand access to telehealth services H.R. 6160-Strengthening Medicare for Patients and Providers Act, provide for an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index H.R. 6721-Medicare Advance Planning for Care Act, to encourage Medicare beneficiaries to voluntarily adopt advance directives guiding the medical care they receive H.R. 7520-Efficiency Adjustment Delay Act, to delay the implementation of an efficiency adjustment to work relative value units under the Medicare physician fee schedule H.R. 8163-Provider Reimbursement Stability Act, ensure stability for provider payments under the Medicare program S. 106-Chiropractic Medicare Coverage Modernization Act of 2025, to amend title XVIII of the Social Security Act to provide Medicare coverage for all physicians services furnished by doctors of chiropractic within the scope of their license, and for other purposes. S.1261-CONNECT for Health Act, to expand access to telehealth services S. 1640- Medicare Patient Access and Practice Stabilization Act of 2025, to address the 2025 Medicare Physician Fee Schedule cuts and increaser support for physicians and other practitioners in adjusting to Medicare payment changes S. 2426-Ensuring Community Access to Pharmacist Services Act (ECAPS) Act, to amend title XVIII of the Social Security Act to provide pharmacy payment of certain services S. 3473-Medicare Advance Planning for Care Act, to encourage Medicare beneficiaries to voluntarily adopt advance directives guiding the medical care they receive

Client expense: $468,727 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare reimbursement and coverage of chiropractic services, including H.R.539 and S.106. Issues related to expanding access through telehealth. Issues related to physician reimbursement.

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

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

H.R. 879, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S. 1640, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S, 891, Bipartisan Health Care Act, all provisions H.R. 786, Preserving Patient Access to Accountable Care Act, all provisions S. 1460, Preserving Patient Access to Accountable Care Act, all provisions H.R. 539, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S. 106, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R. 1317, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions S. 1390, Physician Led and Rural Access to Quality Care Act, all provisions S. 665, Fatal Overdose Reduction Act of 2025, all provisions H.R, 4977, Connected MOM Act, all provisions S. 141, Connected MOM Act, all provisions H.R. 3514, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1816, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1105, No UPCODE Act, all provisions H.R. 5081, Telehealth Modernization Act, all provisions S. 2709, Telehealth Modernization Act, all provisions H.R. 2483, SUPPORT for Patients and Communities Reauthorization Act of 2025, all provisions H.R. 1, One Big Beautiful Bill Act, provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R. 6160, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 7520, Efficiency Adjustment Delay Act, all provisions H.R. 7148, Consolidated Appropriations Act, 2026, provisions related to APM bonus extension/incentive payments/qualifying provider revenue thresholds freeze H.R. 1968, Full-Year Continuing Appropriations and Extensions Act, 2025, provisions related to APMs H.R. 8163, To amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program, all provisions H.R. 2120, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions S. 1031, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions H.R. 483, Health Care Efficiency Through Flexibility Act, all provisions H.R. 5347, Health Care Efficiency Through Flexibility Act, all provisions H.R. 8129, To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R. 1614, To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R. 3108, Rural Patient Monitoring (RPM) Access Act, all provisions S. 1535, Rural Patient Monitoring (RPM) Access Act, all provisions H.R. 3164, Ensuring Community Access to Pharmacist Services Act, all provisions H.R. 2725, Affordable Housing Credit Improvement Act of 2025, all provisions H.R. 2757, Medicare Audiology Access Improvement Act of 2025, all provisions S. 1996, Medicare Audiology Access Improvement Act of 2025, all provisions H.R. 3878, RNs for Rural Health Act of 2025, all provisions H.R. 5199, Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025, all provisions H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R. 5467, Patient Access to Autoimmune Treatments (PAAT) Act, all provisions H.R. 5940, Seniors Deserve Streamlined Medical Approvals for Timely, Efficient Recovery (SMARTER) Care Act of 2025, all provisions S. 3480, Seniors Deserve Streamlined Medical Approvals for Timely, Efficient Recovery (SMARTER) Care Act of 2025, all provisions H.R. 4002, Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R. 3022, Restoring Rights of Physicians to Own Hospitals Act, all provisions S. 1399, Health Tech Investment Act, all provisions S. 3386, Health Care Freedom for Patients Act of 2025, provisions related to the ACA H.R. 498, Do No Harm in Medicaid Act, all provisions H.R. 4710, No Surprises Act Enforcement Act, all provisions S. 2420, No Surprises Act Enforcement Act, all provisions S. 1692, Radiology Outpatient Ordering Transmission (ROOT) Act, provisions related to imaging appropriate use criteria H.R. 5737, Radiology Outpatient Ordering Transmission (ROOT) Act, provisions related to imaging appropriate use criteria H.R. 3164, Equitable Community Access to Pharmacist Services Act, all provisions S. 2426, Equitable Community Access to Pharmacist Services Act, all provisions S. 3934, Medical Nutrition Therapy Act of 2026, all provisions H.R. 4206, CONNECT for Health Act of 2025, all provisions No Fees for EFTs Act, all provisions Drafts/Chronic Care Management Improvement Act Drafts/Access to Genetic Counselor Services Act Drafts/GOLD CARD Act Drafts/Medicare Advantage Improvement Act Draft/Value in Health Care Act Draft/Medicare Budget Neutrality and MIPS reform Draft/MACRA/MIPS program reform Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare physician payment/budget neutrality Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: MIPS quality and cost measures Medicare program: G2211 Inherent Complexity Code Medicare program: Alternative Payment Models (APMs) Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: Long-term Enhanced ACO Design (LEAD) Model Medicare program: ACO/APM flexibilities Medicare program: Prior authorization Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model Medicare program: Site Neutral Payment Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: Coding Medicare program: MEI Update Medicare program: AI services/payment Medicare program: Indirect practice expense Medicare program: Telehealth and Digital Health Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Shared Savings Program Medicare program: Medicare Diabetes Prevention Program Medicare program: Data-Driven Performance Payment System Medicare program: Promoting Interoperability (PI) Program Medicare program: Quality Payment Program Medicare program: Certified electronic health record and PI Medicare program: Advanced APM reporting Medicare program: Public Health Reporting and Data Exchange Medicare program: Provider directories Medicare program: Digital quality measures Medicare program: Aligned Networks and interoperability Medicare program: Health Information Technology/physician burdens Medicare program: Data privacy/cybersecurity Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Telehealth Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicaid program: Gender affirming care Medicaid program: Work requirements, per capita caps, provider taxes, FMAP changes Medicaid program: Community engagement/medical frailty exemption

Client expense: $7,970,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Medicare Payment Advisory Commission (MedPAC), SENATE

H.R. 879, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S. 1640, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S, 891, Bipartisan Health Care Act, all provisions H.R. 786, Preserving Patient Access to Accountable Care Act, all provisions S. 1460, Preserving Patient Access to Accountable Care Act, all provisions H.R. 539, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S. 106, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R. 1317, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions S. 1390, Physician Led and Rural Access to Quality Care Act, all provisions S. 665, Fatal Overdose Reduction Act of 2025, all provisions H.R, 4977, Connected MOM Act, all provisions S. 141, Connected MOM Act, all provisions H.R. 3514, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1816, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1105, No UPCODE Act, all provisions H.R. 5081, Telehealth Modernization Act, all provisions S. 2709, Telehealth Modernization Act, all provisions H.R. 2483, SUPPORT for Patients and Communities Reauthorization Act of 2025, all provisions H.R. 1, One Big Beautiful Bill Act, provisions related to Medicare payment reform, Medicaid reforms, Alternative Payment Models (APMs) H.R. 6160, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 7520, Efficiency Adjustment Delay Act, all provisions H.R. 7148, Consolidated Appropriations Act, 2026, provisions related to APM bonus extension/incentive payments/qualifying provider revenue thresholds freeze H.R. 1968, Full-Year Continuing Appropriations and Extensions Act, 2025, provisions related to APMs H.R. 8163, To amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program, all provisions H.R. 2120, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions S. 1031, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions H.R. 483, Health Care Efficiency Through Flexibility Act, all provisions H.R. 5347, Health Care Efficiency Through Flexibility Act, all provisions H.R. 8129, To amend title XVIII of the Social Security Act to establish a full risk ACO program, all provisions H.R. 1614, To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R. 3108, Rural Patient Monitoring (RPM) Access Act, all provisions S. 1535, Rural Patient Monitoring (RPM) Access Act, all provisions H.R. 3164, Ensuring Community Access to Pharmacist Services Act, all provisions H.R. 2725, Affordable Housing Credit Improvement Act of 2025, all provisions H.R. 2757, Medicare Audiology Access Improvement Act of 2025, all provisions S. 1996, Medicare Audiology Access Improvement Act of 2025, all provisions H.R. 3878, RNs for Rural Health Act of 2025, all provisions H.R. 5199, Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025, all provisions H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R. 5467, Patient Access to Autoimmune Treatments (PAAT) Act, all provisions H.R. 5940, Seniors Deserve Streamlined Medical Approvals for Timely, Efficient Recovery (SMARTER) Care Act of 2025, all provisions S. 3480, Seniors Deserve Streamlined Medical Approvals for Timely, Efficient Recovery (SMARTER) Care Act of 2025, all provisions H.R. 4002, Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R. 3022, Restoring Rights of Physicians to Own Hospitals Act, all provisions S. 1399, Health Tech Investment Act, all provisions S. 3386, Health Care Freedom for Patients Act of 2025, provisions related to the ACA H.R. 498, Do No Harm in Medicaid Act, all provisions H.R. 4710, No Surprises Act Enforcement Act, all provisions S. 2420, No Surprises Act Enforcement Act, all provisions S. 1692, Radiology Outpatient Ordering Transmission (ROOT) Act, provisions related to imaging appropriate use criteria H.R. 5737, Radiology Outpatient Ordering Transmission (ROOT) Act, provisions related to imaging appropriate use criteria H.R. 3164, Equitable Community Access to Pharmacist Services Act, all provisions S. 2426, Equitable Community Access to Pharmacist Services Act, all provisions S. 3934, Medical Nutrition Therapy Act of 2026, all provisions H.R. 4206, CONNECT for Health Act of 2025, all provisions No Fees for EFTs Act, all provisions Drafts/Chronic Care Management Improvement Act Drafts/Access to Genetic Counselor Services Act Drafts/GOLD CARD Act Drafts/Medicare Advantage Improvement Act Draft/Value in Health Care Act Draft/Medicare Budget Neutrality and MIPS reform Draft/MACRA/MIPS program reform Medicare program: Medicare Economic Index (MEI)/inflationary updates Medicare program: Medicare physician payment/budget neutrality Medicare program: Merit-based Incentive Payment System (MIPS)/reforms and penalties Medicare program: MIPS Value Pathways (MVPs) reform Medicare program: MIPS quality and cost measures Medicare program: G2211 Inherent Complexity Code Medicare program: Alternative Payment Models (APMs) Medicare program: ACO (Accountable Care Organization) REACH Model Medicare program: Long-term Enhanced ACO Design (LEAD) Model Medicare program: ACO/APM flexibilities Medicare program: Prior authorization Medicare program: Wasteful and Inappropriate Service Reduction (WISeR) and Ambulatory Specialty Model Medicare program: Site Neutral Payment Medicare program: AI chatbots/Medicare Advantage preventive screens Medicare program: Coding Medicare program: MEI Update Medicare program: AI services/payment Medicare program: Indirect practice expense Medicare program: Telehealth and Digital Health Medicare program: Medicare Advantage provider networks/physician experience Medicare program: Shared Savings Program Medicare program: Medicare Diabetes Prevention Program Medicare program: Data-Driven Performance Payment System Medicare program: Promoting Interoperability (PI) Program Medicare program: Quality Payment Program Medicare program: Certified electronic health record and PI Medicare program: Advanced APM reporting Medicare program: Public Health Reporting and Data Exchange Medicare program: Provider directories Medicare program: Digital quality measures Medicare program: Aligned Networks and interoperability Medicare program: Health Information Technology/physician burdens Medicare program: Data privacy/cybersecurity Medicare program: Review Choice Demonstration (RCD)/Inpatient Rehabilitation Facility (IRF) Medicare program: Organ transplantation access Medicare program: Prior authorization/Medical billing transition Medicare program: Traditional Medicare/Medicare Advantage enrollment difficulties Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Telehealth Medicare and Medicaid programs: Center for Medicare and Medicaid Innovation (CMMI) reforms Medicare and Medicaid programs: CMMI reform/Physician AI use Medicare and Medicaid programs: High-cost disposable supplies/billing codes Medicaid program: Gender affirming care Medicaid program: Work requirements, per capita caps, provider taxes, FMAP changes Medicaid program: Community engagement/medical frailty exemption

Client expense: $7,970,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Medicare Payment Advisory Commission (MedPAC), SENATE

Medicare Physician Payment Reform; in general; Mitigating cuts for Medicare Part B cuts; in general; Concerns regarding Expansion of Prior Authorization in Medicare FFS; H.R. 879/S. 1640, the Medicare Patient Access and Practice Stabilization Act; H.R. 2433, the Reducing Medically Unnecessary Delays in Care Act of 2025; H.R. 3514/S.1816, the Improving Seniors Timely Access to Care Act of 2025; H.R. 539/S. 106, the Chiropractic Medicare Coverage Modernization Act; H.R. 4731/S. 2439, Resident Physician Shortage Reduction Act of 2025; H.R. 4681/S. 1380, the Specialty Physicians Advancing Rural Care (SPARC) Act; H.R. 7520, the Efficiency Adjustment Delay Act; H.R. 1616/S. 1805, the Promoting Access to Diabetic Shoes Act; H.R. 8163, the Provider Reimbursement Stability Act of 2026

Client expense: $90,000 · Firm income: Not reported

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

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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

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

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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

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

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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

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

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act H.R. 7198 - Reintroduction of Ensuring Access to General Surgery Act H.R. 7520 - Efficiency Adjustment Delay Act Merit based Incentive Payment System (MIPS) Reform Value-Based Care (VBC) healthcare model CMS TEAM Model National Trauma and Emergency Preparedness System (NTEPS) Pre-hospital blood Medicare Economic Index (MEI) Indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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

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

Issues related to Medicare physician payment. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5304/S.2587, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. H.R. 7520, Efficiency Adjustment Delay Act S.1105, No UPCODE Act. Commented on policies to modernize the Medicare Access and CHIP Reauthorization Act of 2015. Submitted comments to CMS on CY 2027 Medicare Advantage and Part D Advance Notice Submitted response to CMS RFI on Comprehensive Regulations to Uncover Suspicious Healthcare Activity (CRUSH) Regulation RFI

Client expense: $319,200 · Firm income: Not reported

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

Issues related to Medicare physician payment. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.929/S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. H.R.2028/S.942, Resident Education Deferred Interest (REDI) Act. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3164, Ensuring Community Access to Pharmacist Services (ECAPS) Act. H.R.3170, Improving Access to Workers' Compensation for Injured Federal Workers Act. H.R.3277/S.1677, Ensuring Lasting Smiles Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4606/S.3400, Ally's Act. H.R.4681/S.1380, Specialty Physicians Advancing Rural Care (SPARC) Act. H.R.4710/S.2420, No Surprises Act Enforcement Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5304/S.2587, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026. H.R.5435/S.2842, Stop CMV Act of 2025. H.R.5509/S.2903, Safe Step Act. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. H.R. 7520, Efficiency Adjustment Delay Act. S.1105, No UPCODE Act. Commented on policies to modernize the Medicare Access and CHIP Reauthorization Act of 2015. Commented on the Department of Homeland Security proclamation Restriction on Entry of Certain Nonimmigrant Workers. Submitted an Appropriations request of $310 million for smoking cessation programs in the Centers for Disease Control Submitted comments to CMS on CY 2027 Medicare Advantage and Part D Advance Notice Submitted response to CMS RFI on Comprehensive Regulations to Uncover Suspicious Healthcare Activity (CRUSH) Regulation RFI

Client expense: $319,200 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), 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 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. 8163, the Provider Reimbursement Stability Act S. 1816/H.R. 3514, Improving Seniors Timely Access to Care Act of 2025 Cigna Modifier 25 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 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 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 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 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

Client expense: $60,000 · 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)

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. 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 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 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 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

Client expense: $60,000 · 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 Science & Technology Policy (OSTP), SENATE, Veterans Affairs, Dept of (VA)

HR 539 Chiropractic Medicare Coverage Modernization Act: Bill would allow Medicare beneficiaries to access all Medicare-covered services allowed under a chiropractor's state licensure. S 106 Chiropractic Medicare Coverage Modernization Act: Bill would allow Medicare beneficiaries to access all Medicare-covered services allowed under a chiropractor's state licensure. HR 879 Medicare Patient Access and Practice Stabilization Act: Bill stops the entirety of the current reimbursement reduction and helps account for rising inflationary costs with a two percent payment increase. HR 1968 Full-Year Continuing Appropriations and Extensions Act, 2025. Lobbied to have HR 539 (above) included in bill. HR 4204 Medicare Patient Choice Act: Allows Medicare beneficiaries to choose their physical and occupational therapists, speech-language pathologists, audiologists, and chiropractors.

Client expense: $63,025 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment reform Counting observation stays as satisfying Medicare three-day inpatient stay prerequisite for skilled nursing facility (SNF) coverage H.R. 1-One Big Beautiful Bill Act, to provide for reconciliation pursuant to title II of H. Con. Res. 14 H.R. 539-Chiropractic Medicare Coverage Modernization Act of 2025, to amend title XVIII of the Social Security Act to provide Medicare coverage for all physicians services furnished by doctors of chiropractic within the scope of their license, and for other purposes. H.R. 771-Rural Health Care Access Act of 2025, to eliminate the 35-mile requirement to qualify as a critical access hospital H.R. 772-Rural ER Access Act, to require the Centers for Medicare and Medicaid Services to repeal the 35-mile requirement for off-campus facilities H.R. 879- Medicare Patient Access and Practice Stabilization Act of 2025, to address the 2025 Medicare Physician Fee Schedule cuts and increaser support for physicians and other practitioners in adjusting to Medicare payment changes H.R.1968-Full-Year Continuing Appropriations and Extensions Act, to provide appropriations for federal departments and agencies and to provide an increase for the calendar year 2024 physician fee schedule conversion factor H.R. 2433-Reducing Unnecessary Medical Delays in Care Act of 2025, to ensure that prior authorization medical decisions under Medicare are determined by physicians. H.R. 3164-Ensuring Community Access to Pharmacist Services Act (ECAPS) Act, to amend title XVIII of the Social Security Act to provide pharmacy payment of certain services H.R. 4206-CONNECT for Health Act, to expand access to telehealth services H.R. 6721-Medicare Choices Empowerment and Protection Act, to encourage Medicare beneficiaries to voluntarily adopt advance directives guiding the medical care they receive S. 106-Chiropractic Medicare Coverage Modernization Act of 2025, to amend title XVIII of the Social Security Act to provide Medicare coverage for all physicians services furnished by doctors of chiropractic within the scope of their license, and for other purposes. S.1261-CONNECT for Health Act, to expand access to telehealth services S. 1640- Medicare Patient Access and Practice Stabilization Act of 2025, to address the 2025 Medicare Physician Fee Schedule cuts and increaser support for physicians and other practitioners in adjusting to Medicare payment changes S. 2426-Ensuring Community Access to Pharmacist Services Act (ECAPS) Act, to amend title XVIII of the Social Security Act to provide pharmacy payment of certain services S. 3473- Medicare Choices Empowerment and Protection Act, to encourage Medicare beneficiaries to voluntarily adopt advance directives guiding the medical care they receive

Client expense: $501,071 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Medicare physician payment. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.929/S.266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act. H.R.2028/S.942, Resident Education Deferred Interest (REDI) Act. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3164, Ensuring Community Access to Pharmacist Services (ECAPS) Act. H.R.3170, Improving Access to Workers' Compensation for Injured Federal Workers Act. H.R.3277/S.1677, Ensuring Lasting Smiles Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4606/S.3400, Ally's Act. H.R.4681/S.1380, Specialty Physicians Advancing Rural Care (SPARC) Act. H.R.4710/S.2420, No Surprises Act Enforcement Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5304/S.2587, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026. H.R.5435/S.2842, Stop CMV Act of 2025. H.R.5509/S.2903, Safe Step Act. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. S.1105, No UPCODE Act. Commented to House and Senate leadership opposing provision in CY2026 Medicare Physician Fee Schedule final rule that reduces the work Relative Value Units (RVUs) and intra-service time for all non-time-based codes by 2.5 percent in 2026, with additional reductions expected every three years indefinitely. Commented to House Appropriations Committee commending them for adopting an amendment to the FY2026 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act that would halt funding to implement the Medicare Wasteful and Inappropriate Service Reduction (WISeR) Model.

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

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

Issues related to Medicare physician payment. H.R.539/S.106, Chiropractic Medicare Coverage Modernization Act of 2025. H.R.879/S.1640, Medicare Patient Access and Practice Stabilization Act of 2025. H.R.2191/S.1390, Physician Led and Rural Access to Quality Care Act. H.R.2433, Reducing Medically Unnecessary Delays in Care Act of 2025. H.R.2757/S.1996, Medicare Audiology Access Improvement Act of 2025. H.R.3006/S.1776, Medicare Beneficiary Co-Pay Fairness Act. H.R.3514/S.1816, Improving Seniors' Timely Access to Care Act of 2025. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025. H.R.4206/S.1261, CONNECT for Health Act of 2025. H.R.4331, Access to Claims Data Act. H.R.4731/S.2439, Resident Physician Shortage Reduction Act of 2025. H.R.5304/S.2587, Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026. H.R.5736, Penicillin Allergy Verification and Evaluation (PAVE) Act. H.R.6160, Strengthening Medicare for Patients and Providers Act. S.1105, No UPCODE Act. Commented to House and Senate leadership opposing provision in CY2026 Medicare Physician Fee Schedule final rule that reduces the work Relative Value Units (RVUs) and intra-service time for all non-time-based codes by 2.5 percent in 2026, with additional reductions expected every three years indefinitely. Commented to House Appropriations Committee commending them for adopting an amendment to the FY2026 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act that would halt funding to implement the Medicare Wasteful and Inappropriate Service Reduction (WISeR) Model.

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

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

H.R. 539, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions S. 106, Chiropractic Medicare Coverage Modernization Act of 2025, all provisions H.R. 1317, Improving Care and Access to Nurses (I CAN) Act, all provisions H.R. 1521, Dental and Optometric Care (DOC) Access Act of 2025, all provisions H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions S. 1390, Physician Led and Rural Access to Quality Care Act, all provisions S. 665, Fatal Overdose Reduction Act of 2025, all provisions H.R. 4977, Connected MOM Act, all provisions H.R. 1, One Big Beautiful Bill Act (PL 119-21), provisions relating to Graduate Medical Education, Medicare Physician Payment Reform, Medicaid Reform (work requirements, per capita caps, provider taxes, and FMAP changes), Alternative Payment Models (APMs), Artificial Intelligence (AI), and Medicaid biannual redetermination requirements S. 141, Connected MOM Act, all provisions H.R. 3514, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1816, Improving Seniors Timely Access to Care Act of 2025, all provisions S. 1105, No Unreasonable Payments, Coding, Or Diagnoses for the Elderly (No UPCODE) Act, all provisions H.R. 5081, Telehealth Modernization Act, all provisions S. 2709, Telehealth Modernization Act, all provisions H.R. 879, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions S. 1640, Medicare Patient Access and Practice Stabilization Act of 2025, all provisions H.R. 6160, Strengthening Medicare for Patients and Providers Act, all provisions H.R. 786, Preserving Patient Access to Accountable Care Act, all provisions S. 1460, Preserving Patient Access to Accountable Care Act, all provisions H.R. 2120, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions S. 1031, Radiation Oncology Case Rate (ROCR) Value Based Program Act of 2025, all provisions H.R. 1968, Full-Year Continuing Appropriations and Extensions Act, 2025, provisions relating to APMs H.R. 483, Health Care Efficiency Through Flexibility Act, provisions relating to APMs H.R. 3890, Resident Physician Shortage Reduction Act of 2025, all provisions S. 2439, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4731, Resident Physician Shortage Reduction Act of 2025, all provisions H.R. 4206, CONNECT for Health Act of 2025, all provisions S. 1261, CONNECT for Health Act of 2025, all provisions H.R. 1614, To amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, all provisions H.R. 3108, Rural Patient Monitoring (RPM) Access Act, all provisions S. 1535, Rural Patient Monitoring (RPM) Access Act, all provisions H.R. 3164, Ensuring Community Access to Pharmacist Services (ECAPS) Act, all provisions S. 2426, Equitable Community Access to Pharmacist Services (ECAPS) Act, all provisions H.R. 2757, Medicare Audiology Access Improvement Act of 2025, all provisions S. 1996, Medicare Audiology Access Improvement Act of 2025, all provisions H.R. 3878, RNs for Rural Health Act of 2025, all provisions H.R. 5199, Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025, all provisions H.R. 2433, Reducing Medically Unnecessary Delays in Care Act of 2025, all provisions H.R. 5467, Patient Access to Autoimmune Treatments (PAAT) Act, all provisions H.R. 5940, Seniors Deserve SMARTER Care Act of 2025, all provisions S. 3480, Seniors Deserve SMARTER Care Act of 2025, all provisions H.R. 4002, Patient Access to Higher Quality Health Care Act of 2025, all provisions H.R. 3022, Restoring Rights of Physicians to Own Hospitals Act, all provisions S. 1399, Health Tech Investment Act, all provisions H.R. 4710, No Surprises Act Enforcement Act, all provisions S. 2420, No Surprises Act Enforcement Act, all provisions S. 2882, Continuing Appropriations and Extensions and Other Matters Act, 2026, provisions relating to ACA premium tax credit S.J.Res.84, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Market Integrity and Affordability,/Congressional Review Act repeal effort S. 3386, Health Care Freedom for Patients Act of 2025, provisions related to ACA premium tax credit H.R. 6575, CommonGround for Affordable Health Care Act, provisions related to ACA premium tax credit H.R. 6501, Bipartisan Health Insurance Affordability Act, provisions related to ACA premium tax credit H.R. 5737, Radiology Outpatient Ordering Transmission (ROOT) Act, all provisions S. 1692, Radiology Outpatient Ordering Transmission (ROOT) Act, all provisions H.R. 5813, Womens Health and Cancer Rights Modernization Act of 2025, all provisions H.R. 5347, Health Care Efficiency Through Flexibility Act, all provisions H.R. 5269, Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act of 2025, all provisions S. 2761, Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act of 2025, all provisions Access to Genetic Counselor Services Act/draft GOLD CARD Act/drafts Medicare Access to Radiology Care (MARCA) Act/drafts Data-Driven Payment Performance System (DPPS) Act/draft Value in Health Care Act/draft Legislation to reform the MACRA and MIPS Programs/draft Medicare program: Medicare Economic Index (MEI)/Physician inflationary updates Medicare program: Medicare Physician Payment System/Budget Neutrality reforms Medicare program: MEDPAC/physician practice 2027 payment update/full MEI update recommendation Medicare program: Merit-Based Incentive Payment System (MIPS)/reforms/penalties/replacement proposal Medicare program: CY 2026 Medicare Physician Fee Schedule/implementation phase-in/indirect practice expense Medicare program: APMs/bonuses/incentive payments Medicare program: G2211 Inherent Complexity Code Medicare program: Private practice physician issues/benchmark survey Medicare program: Center for Medicare & Medicaid Innovation (CMMI) reforms Medicare program: Payer and EHR developers/proprietary technology and electronic prior authorizations Medicare program: Prior Authorization/AI Medicare program: Medicare Advantage/prior authorization Medicare program: Site neutral payment Medicare program: Coding Medicare program: Medicare Advantage/preventive screens/AI Chatbots Medicare program: AI services/payment Medicare program: Diabetes Prevention Program Medicare program: Promoting Interoperability (PI) Program Medicare program: Quality Payment Program Medicare program: HIPAA/Electronic health records Medicare program: Certified electronic health record technology and PI Medicare program: Medicare Shared Savings Program/Advanced APM reporting Medicare program: Public Health Reporting and Data Exchange Medicare program: Value-based care delivery Medicare program: Telehealth/digital health/budget neutrality Medicare program: Medicare Telehealth waiver extension Medicare program: Wasteful and Inappropriate Service Reduction (WISER) payment model Medicare program: Modifier 25/appropriate use Medicare program: Provider directories Medicare program: ACO/MIPS/skin substitutes/clinicians increased spending Medicare program: ACO/APM flexibilities Medicare program: Local Coverage Determination/peripheral nerve blocks/chronic pain procedures Medicare program: Data privacy/cybersecurity Medicare program: ACA/Enhanced tax credit extension Medicare program: Digital health and wearables Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA)/broad reform Medicare and Medicaid programs: MACRA/physician burdens Medicare and Medicaid programs: Health IT/physician burdens

Client expense: $5,480,000 · Firm income: Not reported

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

H.R. 21/S. 6 - Born-Alive Abortion Survivors Protection Act H.R.1096 - HOPE and Mental Wellbeing Act of 2025 H.R. 929/S. 266 - Lorna Breen Health Care Provider Protection Reauthorization H.R. 593 - Strengthening Pathways to Health Professions Act H.R. 879/S. 1640 - Medicare Patient Access and Practice Stabilization Act H.R. 1153 - Rural America Health Corps Act H.R. 1227/S. 475 - Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 1735/S. 779 - EARLY Minds Act H.R. 1448 - PEER for Mental Health Act H.R. 1585/S. 709 - Conrad State 30 and Physician Access Reauthorization Act H.R. 1909/S. 2621 - Preventing Maternal Deaths Reauthorization Act of 2025 H.R. 957 - Parity Enforcement Act H.R. 2509/S. 931 - COMPLETE Care Act H.R. 4206/S. 1261 - CONNECT for Health Act H.R. 1305 - Improving Measurements for Loneliness and Isolation Act H.R. 1902 - Helping Emergency Responders Overcome (HERO) Act H.R. 2223 - Building Capacity for Care Act H.R. 2586 - Reentry Act of 2025 H.R. 3884/S.2011 - Telemental Health Care Access Act of 2025 H.R. 3266/S.1673 - Mental Health Infrastructure Improvement Act of 2025 Mental Health Matters Act H.R. 4619 - Medicare Mental Health Inpatient Equity Act Letter to Congress in support of the Prevention and Public Health Fund Letter to Congress to extend telehealth flexibilities Letter to Congress for funding for public health research into firearm morbidity and mortality prevention at CDC, NIH and NIJ. Letter to Congress on Agency for Healthcare Research and Quality (AHRQ) funding Letter to Congress on funding for FDAs Neurology Drug Program in FY26 Letter to Congress on funding for the BRAIN Initiative in FY26 Letter to Congress regarding school-based Medicaid programs Letters to Congress in support of Medicaid Letter to NIH regarding indirect cost caps for NIH grants Letter to HHS in response to the draft Make American Healthy Again Commission Assessment. S. 1062 - Suicide Prevention Act H.R. 912 - 9-8-8 Lifeline Cybersecurity Act H.R. 2587 - Youth Mental Health Research Act H.R. 2483/S. 2121 - SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 539/S. 106 - Chiropractic Medicare Coverage Modernization Act of 2025 H.R. 2630 - Youth Suicide Prevention Research Act H.R. 3655 - STAR Plus Scholarship Act Letter to Congress in support of NIH neuroscience research Letter to Congress to protect federal funding of maternal health programs Letter to Congress supporting the Pediatric Mental Health Care Access (PMHCA) program Letter to Congress in support of funding for the Children's Hospital Graduate Medical Education (CHGME) program Letter to Congress in support of school mental health workforce grants Communication with Congressional offices on CCBHC funding Letter to Congress to include report language in FY26 appropriations for the 988 Suicide and Crisis Lifeline and Garrett Lee Smith Youth Suicide Prevention Campus Grants Letter to Congress concerning funding for 988 lifeline LGBTQ+ youth specialized services H.R. 3890/S. 2439 - Resident Physician Shortage Reduction Act of 2025 H.R. 3885 - Community TEAMS Act H.R. 3658 - 911 Community Crisis Responders Act H.R. 4745/S. 2410 - Medicaid Bump Act H.R. 3758 - Workers' Disability Benefits Parity Act H.R. 4744/S. 2445 - Community Mental Wellness and Resilience Act H.R. 1867 - To amend title XVIII of the Social Security Act to remove in-person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology H.R 4641 - Keep Kids Covered Act Letter opposing H.R. 3164 - Ensuring Community Access to Pharmacist Services (ECAPS) Act Letter to Congress to support the integrity of the United States Preventive Services Task Force (USPSTF) Letter in response to FDA panel review of SSRIs and pregnancy Letter to HHS in response to proposed change to its interpretation of federal public benefit to include 13 additional programs as restricted Federal public benefits Letter to SAMHSA regarding reports on the redirection of FY25 funds H.R. 4681/S. 1379 - Specialty Physicians Advancing Rural Care (SPARC) Act H.R. 4723/S. 2446 - Mental Health for Latinos Act Conversations with Congressional offices on Teaching Health Center Graduate Medical Education (THCGME) H.R.3505 - Barriers to Suicide Act H.R. 5454/S.2879 - Medicare Advantage Prompt Pay Act Letters to Congress to extend the enhanced premium tax credits H.R.6249 - Addressing Addiction After Disasters Act Mental Health Emergency Needs in Disasters (MEND) Act Mental Health Career Promotion Act H.R. 5074 - Protecting Young Minds Online Act H.R. 5434/S. 2826 - 988 LGBTQ+ Youth Access Act H.R.5509 /S.2903 - Safe Step Act H.R.5553 - CTE Student Mental Health and Wellness Act H.R. 5557 - Mental Health Services for Students Act H.R.1197 - PREEMIE Reauthorization Act of 2025 H.R. 3514/S.1816 - Improving Seniors Timely Access to Care Act Draft legislation on expedited FDA approval pathways for addiction therapeutics Mental Health Emergency Package: Youth Mental Health Day and Suicide Prevention Day Resolution, Mental Health Crisis Response Act, and Mental Health Emergency Responder Act S. 3064 - Relief of Chronic Pain Act H.R. 6226 - Latino Youth Mental Health Empowerment Act H.R. 5482 - Prevent Youth Suicide Act H.R.6672 - Mental Health Professionals Workforce Shortage Loan Repayment Act Letter to Letter to Department of Labor, Department of Health and Human Services, and Department of Treasury regarding mental health parity enforcement. H.R. 3492 - Protect Children's Innocence Act H.R. 498 - Do No Harm in Medicaid Act H.R. 6817/ S. 1056 - Home-Based Telemental Health Care Act Letters and a presentation to the FDA digital health advisory panel regarding generative AI enabled mental health medical devices

Client expense: $391,974 · Firm income: Not reported

Government targets: Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of

Medicare reimbursement and coverage of chiropractic services, including H.R.539 and S.106. Issues related to expanding access through telehealth. Issues related to physician reimbursement.

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

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

Mitigating cuts for Medicare Part B cuts; in general. H.R. 879/S. 1640, the Medicare Patient Access and Practice Stabilization Act. Inclusion of physician payment provisions in the Full-Year Continuing Appropriations and Extensions Act, 2025 H.R. 2433, the Reducing Medically Unnecessary Delays in Care Act of 2025 H.R. 3514/S.1816, the Improving Seniors Timely Access to Care Act of 2025 H.R. 1, One Big Beautiful Bill, Medicare payment provisions, reduction in Medicaid benefits H.R. 539/S. 106, the Chiropractic Medicare Coverage Modernization Act Concerns regarding Expansion of Prior Authorization in Medicare FFS Comments relating to File Code CMS-1832-P; Medicare Program; 2026 Payment Policies under the Physician Payment Schedule and Other Changes to Part B Payment and Coverage Policies; (July 16, 2025) H.R. 4331, the Access to Claims Data Act H.R. 4731/S. 2439, Resident Physician Shortage Reduction Act of 2025 H.R. 4681/S. 1380, the Specialty Physicians Advancing Rural Care (SPARC) Act Medicare Physician Payment Reform; in general. Extending ACA subsidies; in general Issues relating to the "efficiency adjustment" policy re: CY26 MPFS

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

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

Client expense: $40,000 · 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 Science & Technology Policy (OSTP), SENATE, Veterans Affairs, Dept of (VA)

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 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 S. 1816/H.R. 3514, Improving Seniors Timely Access to Care Act of 2025 Cigna Modifier 25 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 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 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 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 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

Client expense: $40,000 · 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)

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act National Trauma and Emergency Preparedness System (NTEPS) Reintroduction of Ensuring Access to General Surgery Act Pre-hospital blood Efficiency Adjustment Medicare Economic Index (MEI) indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare CMS TEAM Model Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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

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

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act National Trauma and Emergency Preparedness System (NTEPS) Reintroduction of Ensuring Access to General Surgery Act Pre-hospital blood Efficiency Adjustment Medicare Economic Index (MEI) indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare CMS TEAM Model Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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

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

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act National Trauma and Emergency Preparedness System (NTEPS) Reintroduction of Ensuring Access to General Surgery Act Pre-hospital blood Efficiency Adjustment Medicare Economic Index (MEI) indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare CMS TEAM Model Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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

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

H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 S. 266/H.R. 929 - Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act S. 942/H.R. 2028 - Resident Education Deferred Interest (REDI) Act S. 1380 - Specialty Physicians Advancing Rural Care (SPARC) Act S. 2031 - Workforce Mobility Act S. 1595 - Improving Police Critical Aid for Responding to Emergencies (CARE) Act S. 1410 - Find it Early Act S. 1935 - Expanding Access to Palliative Care Act H.R. 2191 - Physician Led and Rural Access to Quality Care Act S. 106/H.R. 539 - Chiropractic Medicare Coverage Modernization Act of 2025 S.1816/H.R.3514 - Improving Seniors Timely Access to Care Act National Trauma and Emergency Preparedness System (NTEPS) Reintroduction of Ensuring Access to General Surgery Act Pre-hospital blood Efficiency Adjustment Medicare Economic Index (MEI) indirect practice expense Medicare physician fee schedule CPT/Work Relative Value Units (RVUs) Tariffs on medical supplies Congressionally Directed Medical Research Programs Outpatient Prospective Payment System (OPPS) Ambulatory Surgical Center (ASC) Rule CollaboRATE Quality Measure WISeR Model Pandemic and All-Hazards Preparedness and Response Act (PAHPA) reauthorization National Institutes of Health Funding Global health funding Access to care issues One Big Beautiful Bill Act (Reconciliation) Congressionally Directed Medical Research Program (CDMRP) Veteran Healthcare CMS TEAM Model Administration Confirmations Physician consolidation Medicare coding/payment for lower extremity revascularization services Medicare Physician Payment Cuts Neglected Surgical Conditions Administrative Burden/Prior Authorization Legislation MISSION Zero Reauthorization Bilateral Exchange Visa Issues/J-1 Visas for physician educational and cultural exchange Cancer Research Advocacy Agenda Trauma Advocacy Agenda Workforce Advocacy Agenda

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

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