CHARGE Act

Issues related to the 340B Drug Pricing Program - regarding all bio-pharmaceutical related provisions H.R.7635, the 340B PATIENTS Act Issues related to the six protected classes of medicines under Medicare Part D, regarding all bio-pharmaceutical issues

Client expense: $3,180,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for proposals to provide direct financial support to safety net hospitals with Congressional staff. Oppose changes to Affordable Care Act in H.R.1: limitations on premium tax credit eligibility, reductions to special enrollment period. Urge legislative delay of premium tax credit eligibility restrictions included in H.R. 1. Discuss support for permanently extending expiring Affordable Care Act premium tax credits with Congressional staff. Discuss support for the 340B Drug Pricing Program with Congressional staff and discuss certain changes: oppose 340B ACCESS Act (H.R. 7635), comments on SUSTAIN 340B Act discussion draft, support PATIENTS Act (H.R. 7635); oppose back-end rebate proposals. Discuss with HHS staff and Congressional staff recommendations to address workforce shortages for nursing and ancillary health care workforce: faculty recruitment and retention, additional financial support for supervision and precepting students, Medicare payment for nursing and allied health, testing new workforce models, establishing incentives and early recruitment strategies, providing funding for clinical training sites, and immigration reforms that expedite entry for foreign health care workers. Support passage of the SAVE Healthcare Workers Act (H.R. 3178/S. 1600). Support revisions to Conrad 30 waiver program to increase the number of foreign physicians that may remain in the US after completing GME: S.665/H.R.4942, S.2719/H.R.6980, H.R. 4875. Discuss FEMA COVID-19 Public Assistance payouts with Congressional staff. Support Improving Seniors Timely Access to Care Act (S. 4532/H.R. 8702). Support SEPSIS Act (S.1929). Discuss New York State application for Section 1331 Basic Health Plan waiver with Congressional staff and CMS staff. Discuss Section 1332 State Innovation Waiver with Congressional staff. Discuss legislative proposals to regulate the use of artificial intelligence in health care settings with Congressional staff. Discuss non-profit tax-exempt status of hospitals with Congressional staff and discuss examples of community benefit for IRS purposes.

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

Advocate for proposals to provide direct financial support to safety net hospitals with Congressional staff. Discuss with Congressional staff opposition to Medicaid proposals in H.R.1: work requirements as a condition of coverage, changes to state-directed payments, reductions to Federal matching funds, reductions to the safe harbor threshold for provider taxes, rescission of Medicaid Eligibility rule and Medicaid/CHIP Access rule, cost-sharing for Medicaid beneficiaries, reductions to retroactive coverage, elimination of reasonable opportunity window, reductions in coverage for immigrants. Oppose changes to Affordable Care Act in H.R.1: limitations on premium tax credit eligibility, limitations on basic health program eligibility, reductions to special enrollment period. Discuss opposition to Medicare site-neutral payment policies with Congressional staff. Educate Congressional staff on hospital price transparency federal rule (84 FR 65602). Oppose changes to national provider identifier (NPI)s for hospital outpatient departments (118th: H.R. 7623, H.R. 4509, H.R. 7623 as amended, H.R. 4822). Discuss with Congressional staff S.891, Bipartisan Health Care Act, and comment on following provisions: support for delay of Medicaid DSH cut, codification and expansion of Federal price transparency rule, oppose NPI requirements for hospital outpatient departments, support reauthorization of Community Health Centers, support reauthorization of National Health Service Corps, support reauthorization of Teaching Health Center Graduate Medical Education funding, support PAHPA reauthorization, support SUPPORT Act reauthorization. Discuss support for the 340B Drug Pricing Program with Congressional staff and discuss certain changes: oppose 340B ACCESS Act (H.R. 7635), comments on SUSTAIN 340B Act discussion draft, support PATIENTS Act (H.R. 7635); oppose back-end rebate proposals. Discuss legislative proposals with Congressional staff to stabilize long-term care and post-acute care providers: establish a temporary per diem Medicare payment to ease capacity issues and address financial challenges from slow discharges (support); make permanent three-day hospital stay waiver (support) and other COVID-19 PHE regulatory flexibilities. Discuss Medicare Graduate Medical Education (GME) provisions in the Consolidated Appropriations Act (CAA), 2021 and CAA, 2023 with HHS staff. Discuss with Congressional staff support for Medicare GME expansion and changes to GME program: the Resident Physician Shortage Reduction Act, the Pathway to Practice Act of 2021, the Substance Use Disorder Workforce Act (H.R. 7050); additional GME slots in CAA, 2021 and CAA, 2023; Rural Residency Planning and Development Act (H.R. 7855); concerns on Rural Physician Workforce Preservation Act and opposition to modifications to ongoing slot distribution; Senate Finance Committee draft proposals to increase GME slots. Discuss with HHS staff and Congressional staff recommendations to address workforce shortages for nursing and ancillary health care workforce: faculty recruitment and retention, additional financial support for supervision and precepting students, Medicare payment for nursing and allied health, testing new workforce models, establishing incentives and early recruitment strategies, providing funding for clinical training sites, and immigration reforms that expedite entry for foreign health care workers. Support passage of the SAVE Healthcare Workers Act (H.R. 3178/S. 1600). Support revisions to Conrad 30 waiver program to increase the number of foreign physicians that may remain in the US after completing GME: S.665/H.R.4942, S.2719/H.R.6980, H.R. 4875. Support health extenders in H.R. 1968 (Full-Year Continuing Appropriations and Extensions Act, 2025): extend COVID-19 Medicare-covered telehealth flexibilities, Acute Hospital Care at Home waiver, Medicaid DSH cut delay; discuss with Congressional staff and HHS staff. Discuss FEMA COVID-19 Public Assistance payouts with Congressional staff. Support Improving Seniors Timely Access to Care Act (S. 4532/H.R. 8702). Discuss Congressional activity on antitrust exemptions for medical residencies with Congressional staff. Support SEPSIS Act (S.1929). Support Streamline Emergency Care Act (H.R. 3980). Provide health care deregulation suggestions to OMB, HHS: make CMMI models voluntary, repeal certain reporting mandates, ease telehealth restrictions, urge nonenforcement of laboratory developed tests final rule.

Issues related to the 340B Drug Pricing Program - regarding all bio-pharmaceutical related provisions H.R.7635, the 340B PATIENTS Act

Client expense: $870,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocate for proposals to provide direct financial support to safety net hospitals with Congressional staff. Discuss with Congressional staff opposition to proposals to reduce the Medicaid program: work requirements as a condition of coverage, changes to state-directed payments, block grants, per capita caps, reductions to federal matching funds, reductions to the safe harbor threshold for provider taxes, rescission of Medicaid Eligibility rule and Medicaid/CHIP Access rule. Discuss opposition to Medicare site-neutral payment policies with Congressional staff. Educate Congressional staff on hospital price transparency federal rule (84 FR 65602). Oppose changes to NPIs for hospital outpatient departments (118th: H.R. 7623, H.R. 4509, H.R. 7623 as amended, H.R. 4822). Discuss with Congressional staff S.891, Bipartisan Health Care Act, and comment on following provisions: support for delay of Medicaid DSH cut, codification and expansion of Federal price transparency rule, oppose National Provider Identifier (NPI) requirements for hospital outpatient departments, support reauthorization of Community Health Centers, support reauthorization of National Health Service Corps, support reauthorization of Teaching Health Center Graduate Medical Education funding, support PAHPA reauthorization, support SUPPORT Act reauthorization. Discuss support for the 340B Drug Pricing Program with Congressional staff and discuss certain changes: oppose 340B ACCESS Act (H.R. 7635), comments on SUSTAIN 340B Act discussion draft, support PATIENTS Act (H.R. 7635); oppose back-end rebate proposals. Discuss legislative proposals with Congressional staff to stabilize long-term care and post-acute care providers: establish a temporary per diem Medicare payment to ease capacity issues and address financial challenges from slow discharges (support); make permanent three-day hospital stay waiver (support) and other COVID-19 PHE regulatory flexibilities. Discuss Medicare Graduate Medical Education (GME) provisions in the Consolidated Appropriations Act (CAA), 2021 and CAA, 2023 with HHS staff. Discuss with Congressional staff support for Medicare GME expansion and changes to GME program: the Resident Physician Shortage Reduction Act, the Pathway to Practice Act of 2021, the Substance Use Disorder Workforce Act (H.R. 7050); additional GME slots in CAA, 2021 and CAA, 2023; Rural Residency Planning and Development Act (H.R. 7855); concerns on Rural Physician Workforce Preservation Act and opposition to modifications to ongoing slot distribution; Senate Finance Committee draft proposals to increase GME slots. Discuss with HHS staff and Congressional staff recommendations to address workforce shortages for nursing and ancillary health care workforce: faculty recruitment and retention, additional financial support for supervision and precepting students, Medicare payment for nursing and allied health, testing new workforce models, establishing incentives and early recruitment strategies, providing funding for clinical training site, and immigration reforms that expedite entry for foreign health care workers. Support passage of the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S.2768). Support revisions to Conrad 30 waiver program to increase the number of foreign physicians that may remain in the US after completing GME: S.665/H.R.4942, S.2719/H.R.6980, H.R. 4875. Support health extenders in H.R. 1968 (Full-Year Continuing Appropriations and Extensions Act, 2025): extend COVID-19 Medicare-covered telehealth flexibilities, Acute Hospital Care at Home waiver, Medicaid DSH cut delay; discuss with Congressional staff and HHS staff. Discuss legislative proposals to regulate the use of artificial intelligence in health care delivery with Congressional staff and National Science Foundation. Discuss FEMA COVID-19 Public Assistance payouts with Congressional staff. Support Improving Seniors Timely Access to Care Act (S. 4532/H.R. 8702).