Provider Reimbursement Stability Act of 2026

S. 1390/H.R.2191, Physician-Led and Rural Access to Quality Care Act: To revise certain physician self-referral exemptions relating to physician-owned hospitals. S. 1640, the Medicare Patient Access and Practice Stabilization Act: Io increase support for physicians and other practitioners in adjusting to Medicare payment changes S. 1816/H.R.3514, Improving Seniors Timely Access to Care Act of 2025: Prior authorization reform in Medicare Advantage S. 2439/H.R.3890, Resident Physician Shortage Reduction Act: Medicare funding for medical residency training. S.5180/H.R. 8163, Provider Reimbursement Stability Act: Modifying Medicare's budget neutrality rules under the Medicare physician fee schedule. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. H.R. 4331, Access to Claims Data Act: To establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement. H.R.6160, Strengthening Medicare for Patients and Providers Act: To 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. 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. 8622. Medicare Physician Data-Driven Performance Payment System Act: To reform the Merit-based Incentive Payment System into the Data-driven Performance Payment System under the Medicare physician fee schedule. H.R.9693, Patients First Act: To modify MACRA to reform the Medicare physician payment system, including positive payment updates and improvements to the quality payment program. No Bill: Urging Congress to prevent funding for the proposed CMMI Wasteful and Inappropriate Service Reduction (WISeR) Model in the Medicare Fee-for-Service (FFS) program, which expandsprior authorization to traditional Medicare.

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

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

S. 1390/H.R.2191, Physician-Led and Rural Access to Quality Care Act: To revise certain physician self-referral exemptions relating to physician-owned hospitals. S. 1640, the Medicare Patient Access and Practice Stabilization Act: Io increase support for physicians and other practitioners in adjusting to Medicare payment changes S. 1816/H.R.3514, Improving Seniors Timely Access to Care Act of 2025: Prior authorization reform in Medicare Advantage S. 2439/H.R.3890, Resident Physician Shortage Reduction Act: Medicare funding for medical residency training. S.5180/H.R. 8163, Provider Reimbursement Stability Act: Modifying Medicare's budget neutrality rules under the Medicare physician fee schedule. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. H.R. 4331, Access to Claims Data Act: To establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement. H.R.6160, Strengthening Medicare for Patients and Providers Act: To 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. 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. 8622. Medicare Physician Data-Driven Performance Payment System Act: To reform the Merit-based Incentive Payment System into the Data-driven Performance Payment System under the Medicare physician fee schedule. H.R.9693, Patients First Act: To modify MACRA to reform the Medicare physician payment system, including positive payment updates and improvements to the quality payment program. No Bill: Urging Congress to prevent funding for the proposed CMMI Wasteful and Inappropriate Service Reduction (WISeR) Model in the Medicare Fee-for-Service (FFS) program, which expands prior authorization to traditional Medicare.

Client expense: $35,000 · 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. 1805, Assistance for Rural Community Hospitals (ARCH) Act, all provisions; S. 1261 / H.R. 4206, CONNECT for Health Act of 2025, all provisions; H.R. 2191, Physician Led and Rural Access to Quality Care Act, all provisions; S. 335, Rural Hospital Support Act, all provisions; S.1816 / H.R.3514, Improving Seniors Timely Access to Care Act, all provisions; S. 502, Rural Hospital Closure Relief Act, all provisions; S. 2439 / H.R. 4731, Resident Physician Shortage Reduction Act of 2025, all provisions; H.R. 4002, Patient Access to Higher Quality Health Care Act, all provisions; H.R. 5454/S. 2879, the Medicare Advantage Prompt Pay Act, all provisions; H.R. 6240, Rural Hospital Closure Relief Act of 2025, all provisions; H.R. 8375/ S. 4384, Medicare Advantage Improvement Act, all provisions; H.R. 8967 / S. 4460, Rural Community Hospital Demonstration Program Reauthorization, all provisions; H.R. 9468, Saving Today's Acute Care Resources (STAR) Act, all provisions; H.R. 8891, Rural Maternity Options for Medial Support (Rural MOMS) Act, all provisions; H.R. 3108 / S. 1535, Rural Patient Monitoring Access Act (RPM Access Act), all provisions; S. 2761 / H.R. 5269, the Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act , all provisions; H.R. 5142, The Home Health Stabilization Act, all provisions; H.R. 8261, Chronic Care Management Improvement Act, all provisions; DRAFT, HCA Mission Act, all provisions; H.R. 9642, Medicare Access to Rural Anesthesiology Act, all provisions; H.R. 9644, Medicare Advantage MLR Transparency Act, all provisions; H.R. 9693, Patients First Act of 2026, all provisions; H.R. 8163, Provider Reimbursement Stability Act of 2026, all provisions; H.R. 8622, Medicare Physician Data-driven Performance Payment system, all provisions; DRAFT, Medicare Provider Reimbursement Step to Stabilization Act of 2026, Issues pertaining to physician fee schedule reforms; H.R.10666, Frontier Community Health Integration Project Extension Act, all provisions; H.R. 1775, Second Chances for Rural Hospitals Act, all provisions; Centers for Medicare & Medicaid Services (CMS), Issues regarding proposed rule on Medicaid managed care state-directed payments and Medicaid fee-for-service targeted practitioner payments; Centers for Medicare & Medicaid Services (CMS), Issues pertaining to funding from the Rural Health Transformation Program and how it is distributed to hospitals; Centers for Medicare & Medicaid Services (CMS), Issues pertaining to the physician fee schedule and updates for the CY2027; Centers for Medicare & Medicaid Services (CMS), "Comments pertaining to the proposed rule regarding the indirect hold harmless threshold of healthcare-related taxes. "; Centers for Medicare & Medicaid Services (CMS), Issues pertaining to interim final rule on community engagement requirements for certain Medicaid beneficiaries; Centers for Medicare & Medicaid Services (CMS), Issues pertaining to the hospital outpatient prospective payment system and ambulatory surgical center payment system proposed rule for calendar year 2027; Centers for Medicare & Medicaid Services (CMS), Issues pertaining to the calendar year 2027 home health prospective payment system proposed rule; Centers for Medicare & Medicaid Services (CMS), Issues pertaining to the CMS proposed rule implementing and codifying the Medicare Drug Benefit Program under the Inflation Reduction Act of 2022; Centers for Medicare & Medicaid Services (CMS), Issues pertaining to Essential Health Benefits framework and Affordable Care Act requirements; Medicaid Program, Issues pertaining to Medicaid program and how states finance programs, reimburse providers, and determine beneficiary eligibility, and implementation and mitigation of H.R. 1 provisions related to state directed payments, provider taxes and community engagement requirements; Site Neutral Payments, Issues related to site neutral payment cuts and facility fees; Rural Hospitals, Issues pertaining to the sustainability of MDHS, CAHs, SCHs, REH's, implementation of Rural Health Transformation Program, rural reclassification policy; Physician Payments, Issues pertaining to alternative payment models, mental health of workforce, physician reimbursement cuts, Medicare Access & CHIP Reauthorization (MACRA) Reforms; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay and cost-based reimbursement for critical access hospitals under Medicare Advantage, Wasteful and Inappropriate Services Reduction (WISeR) model, transparency in plan denial signatures, inappropriate downcoding, reducing administrative burdens; Provider Reimbursements, Issues related to provider reimbursement, site neutral payment cuts, Medicare/Medicaid program funding, facility fees; Post Acute Care, Issues pertaining to expanding patients' access to crucial services provided by long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities, hospital at home, and home health agencies; Expiring Health Care Programs, Issues pertaining to expiring health care programs such as GPCI, Physician reimbursement, Medicare Dependent Hospital Program, and Low-Volume Adjustment program.

Client expense: $3,840,000 · Firm income: Not reported

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

H.R. 8163: Provider Reimbursement Stability Act of 2026; provisions related to Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) budget neutrality H.R. 9693: Patients First Act of 2026; all provisions S. 5180: Provider Reimbursement Stability Act of 2026 ; all provisions CMS-1848-P: Medicare Physician Payment Rule; all provisions CMS-2449-P: Medicaid Program; Medicaid Managed Care State Directed Payments and Medicaid Fee-For-Service Targeted Medicaid Practitioner Payments; all provisions CMS-2452-P: Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes; all provisions

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

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

H.R. 2484, Seniors Access to Critical Medications Act; Issues related to the extension of telehealth services; Issues related to site neutral payments; Issues related to 2024 Physician Fee Schedule and physician payment reform; H.R. 4299, Protecting Patient Access to Cancer and Complex Therapies Act; Issues related to in-office dispensing of medication regulations; H.R. 8163/S. 5180, Provider Reimbursement Stability Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2120--Older Americans Act Reauthorization Act of 2025--Reauthorizes through FY2030, modifies, and establishes programs under the Older Americans Act, which supports social services and activities for individuals aged 60 years or older. S.1105--No Unreasonable Payments, Coding, or Diagnoses for the Elderly (No UPCODE) Act--An act to improve the way Medicare Advantage plans assess patients health risks and reduce overpayments for care. H.R 4093--Apples to Apples--An act to require the Secretary of Health and Human Services to publish information on expenditures under the Medicare program, and for other purposes. S. 2625--Independent BROKERS TIME Act of 2025--An Act to carry out certain activities relating to the regulation of independent agents and brokers and third-party marketing organizations under parts C and D of the Medicare program, and for other purposes. H.R 5243--Increase data transparency for supplemental benefits under Medicare Advantage--An Act to increase data transparency around Medicare Advantage supplemental benefits for seniors. S. 2793--Require Medicare Advantage plans to cover items and services furnished by certain essential community providers within a service area--An act to add an Essential Community Provider (ECP) requirement to Medicare Advantage networks. H.R. 5454--Medicare Advantage Prompt Pay Act--An act to improve Medicare Advantages (MA) billing practices, offer certainty health care providers who contract with MA plans, and ensure that seniors arent stuck with unfair, confusing, or delayed bills after receiving critical care. HR 5746--Addressing Whole Health in Medicare Advantage Act--Supplemental Benefits for chronically Ill enrollees S. 3573--Medicare Advantage Supplemental Benefits Transparency Act--Improving Supplemental Benefits for MA beneficiaries HR 3514--To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans--Prior Authorization in Medicare Advantage S 1816--A bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans-Prior Authorization in Medicare Advantage H.R. 9393--Lower Costs, More Transparency Act of 2026--Promotes price transparency across hospitals, Ambulatory Surgical Centers (ASCs), and the broader health care sector H.R. 9392--Medicare Advantage Cost Transparency Act--An act to require MA plans and commercial plans to publicly post PA approval/denial rates, appeal outcomes, and average determination timelines H.R. 9395--Transparency in Medicare Advantage Steering Act--Statutory caps on compensation paid by MA organizations to agents and brokers H.R. 9544--Saving MEDICARE Act of 2026--To amend title XVIII of the Social Security Act to ensure appropriate payments under Medicare Advantage, and for other purposes. H.R.8163--Provider Reimbursement Stability Act of 2026--Medicare physician payment reform and Alternative Payment Model (APM) incentives H.R. 8375--Medicare Advantage Improvement Act--Prior authorization reform, plan transparency, prompt pay, and coverage standards alignment H.R. 9397--Premium Transparency Act--Requires MA plans to publish overhead costs, claims payment data, and MLR revenue detail H.R. 9396-Prior Authorization Accountability Act--Public posting of PA approval/denial rates, appeal outcomes, and processing times H.R. 9693--Patients First Act--Physician Fee Schedule reform H.R. 9645--Health Care Price Certainty for All Americans Act--Price transparency reform Health CARE Act of 2026--Reverse health care provisions from H.R. 1

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to Physician Fee Schedule and physician payment reform; H.R. 879, Medicare Patient Access and Practice Stabilization Act; H.R. 3164/S. 2426, Equitable Community Access to Pharmacist Services Act; H.R. 8163/S. 5180, Provider Reimbursement Stability Act; Issues related to Provider Reimbursement Stability Act and Merit Based Incentive Payments System (MIPS) reform; Issues related to Senate Finance Dear Colleague process

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment under Medicare (general); Medicare Physician Fee Schedule Efficiency Adjustment (general); Graduate medical education (general); S.1816/H.R. 3514, Improving Seniors Timely Access to Care Act of 2025; Prior authorization in Medicare (general); Medicaid (general); Physician payment under Medicaid (general); Medicaid work requirements (general); CMS billing and coding procedures (general); preserving postpartum Medicaid extension (general); implementation of P.L. 119-21, One Big, Beautiful Bill Act; telehealth (general); H.R. 7520, Efficiency Adjustment Delay Act; H.R. 8163, Provider Reimbursement Stability Act; FMAP for Puerto Rico; unbundling of obstetric codes in Medicare; H.R. 4731/S. 2439, Resident Physician Shortage Reduction Act; H.R. 9693, Patients First Act; S. 5037, MediKids Act

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

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549 Chronic Care Management Act of 2026ﾠHR 8261 Prior Authorization Reform for Autoimmune & Blood Disorders ActﾠHR 9192 Patient Access to Autoimmune Treatments ActﾠHR 5467 Patients First Act H.R. 9693 Expedited Access to Biosimilars Act H.R. 9661/ S. 1414 Protecting Approved Care Act H.R. 10394 Doctors Not AI Act of 2026 H.R. 10210 Protecting Patients from Automatic Denials Act H.R. 9734

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

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549 Chronic Care Management Act of 2026ﾠHR 8261 Prior Authorization Reform for Autoimmune & Blood Disorders ActﾠHR 9192 Patient Access to Autoimmune Treatments ActﾠHR 5467 Patients First Act H.R. 9693 Expedited Access to Biosimilars Act H.R. 9661/ S. 1414 Protecting Approved Care Act H.R. 10394 Doctors Not AI Act of 2026 H.R. 10210 Protecting Patients from Automatic Denials Act H.R. 9734

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

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

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549 Chronic Care Management Act of 2026ﾠHR 8261 Prior Authorization Reform for Autoimmune & Blood Disorders ActﾠHR 9192 Patient Access to Autoimmune Treatments ActﾠHR 5467 Patients First Act H.R. 9693 Expedited Access to Biosimilars Act H.R. 9661/ S. 1414 Protecting Approved Care Act H.R. 10394 Doctors Not AI Act of 2026 H.R. 10210 Protecting Patients from Automatic Denials Act H.R. 9734

Client expense: $50,000 · 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. 5347: Health Care Efficiency Through Flexibility Act H.R. 786/ S. 1460: Preserving Patient Access to Accountable Care Act S. 1816/ 3514: Improving Seniors Timely Access to Care Act S. 1105: No UPCODE Act S. 2561/ H.R. 5768: Skin Substitute Access and Payment Reform Act H.R. 4773/ S.3350: ACO Assignment Improvement Act H.R. 8129: To amend title XVIII of the Social Security Act to establish a full risk ACO program H.R. 6852: Advanced Wound Care and Regenerative Medicine Access and Reform Act H.R. 8163: Provider Reimbursement Stability Act H.R. 8622: Medicare Physician Data Driven Performance Payment System H.R. 9693: Patients First Act S.5269: Pay PCPs Act Issues related to Medicare payments, Medicare Shared Savings Program, ACO REACH, Medicare Advantage, alternative payment model incentives, telehealth, and fraud, waste, abuse.

Client expense: $177,310 · 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. 5199 - Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025 H.R. 5217 - Rural Behavioral Health Improvement Act of 2025 H.R. 3684 - Save Americas Rural Hospitals Act S. 1941 - Cure Hepatitis C Act of 2025 H.R. 5081/S. 2709 - Telehealth Modernization Act H.R. 3108/S. 1535 - Rural Patient Monitoring Access Act H.R. 1616/S. 1805 - Promoting Access to Diabetic Shoes Act S. 717/H.R. 6894 - Increasing Access to Quality Cardiac Rehabilitation Care Act H.R. 1317/S. 575 - Improving Care and Access to Nurses (ICAN) Act H.R. 4773/S. 3350 - ACO Assignment Improvement Act of 2025 H.R. 6199/S. 3934 - Medical Nutrition Therapy Act of 2025 H.R. 2509/S. 931 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care (COMPLETE Care) Act H.R. 2586 - Reentry Act of 2025 H.R. 842/S. 339 - the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act S. 683/H.R. 7324 - More Behavioral Health Providers Act S. 1261/H.R. 4206 - CONNECT for Health Act of 2025 H.R. 2172/S. 1058 - Preserving Patient Access to Home Infusion Act H.R. 1 - One Big Beautiful Bill Act [P.L. No. 119-21] H.R. 1227/S. 475 - the Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 2531/S. 1232 - Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 7787 - Mental Health Workforce Act H.R. 7106 - Enhancing Skilled Nursing Facilities Act H.R. 7973/S. 5283 - Momnibus Act H.R. 8163 - the Provider Reimbursement Stability Act H.R. 9693/S. 5672 - Patients First Act of 2026 Hospice certification and recertification Skilled nursing facility admitting examination and assessment requirements Reducing regulatory burdens, including those relating to Medicare Conditions of Participation Medicare provider reimbursement Inclusion of NPs in the HPSA bonus program for clinicians practicing in primary care HPSAs Medicaid reform Issues related to Medicare Part B reform Issues related to enhancing access to care at home in rural and underserved communities Public health and nursing workforce infrastructure Telehealth, remote patient monitoring and other forms of health technology Primary care payment reform Documentation of medical records Medication-Assisted Treatment (MATs) Issues relating to the mental and substance use disorder workforce Opioid epidemic

Client expense: $390,000 · Firm income: Not reported

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

H.R. 5199 - Modernizing Rural Physician Assistant and Nurse Practitioner Utilization Act of 2025 H.R. 5217 - Rural Behavioral Health Improvement Act of 2025 H.R. 3684 - Save Americas Rural Hospitals Act S. 1941 - Cure Hepatitis C Act of 2025 H.R. 5081/S. 2709 - Telehealth Modernization Act S. 1599/H.R. 6394 - Midwives for Maximizing Optimal Maternity Services (MOMS) Act S. 131/H.R. 392 - Providing Real-world Education and Clinical Experience by Precepting Tomorrows (PRECEPT) Nurses Act H.R. 4564 - Dillons Law H.R. 3108/S. 1535 - Rural Patient Monitoring Access Act H.R. 1616/S. 1805 - Promoting Access to Diabetic Shoes Act S. 717/H.R. 6894 - Increasing Access to Quality Cardiac Rehabilitation Care Act H.R. 1317/S. 575 - Improving Care and Access to Nurses (ICAN) Act H.R. 4773/S. 3350 - ACO Assignment Improvement Act of 2025 H.R. 6199/S. 3934 - Medical Nutrition Therapy Act of 2025 H.R. 2509/S. 931 - Connecting Our Medical Providers with Links to Expand Tailored and Effective Care (COMPLETE Care) Act H.R. 2586 - Reentry Act of 2025 H.R. 929/S. 266 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act H.R. 842/S. 339 - the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act S. 683/H.R. 7324 - More Behavioral Health Providers Act S. 3435/H.R. 6607 - Future Advancement of Academic Nursing (FAAN) Act H.R. 1627 - Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act H.R. 2319/S. 1157 - the Women and Lung Cancer Research and Preventive Services Act of 2025 S. 1261/H.R. 4206 - CONNECT for Health Act for 2025 H.R. 2172/S. 1058 - Preserving Patient Access to Home Infusion Act S. 1874/H.R. 3593 - Title VIII Nursing Workforce Reauthorization Act of 2025 H.R. 1 - One Big Beautiful Bill Act [P.L. No. 119-21] H.R. 1227/S. 475 - the Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 2199/S. 1173 - Restore Protections for Dialysis Patients Act (Restore Act) H.Res. 389/S.Res. 206 - Supporting the goals and ideals of National Nurses Week, to be observed from May 6 through May 12, 2025. S. 1482/H.R. 4407 - National Nursing Workforce Center Act of 2025 H.R. 2531/S. 1232 - Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 1300 - Prostate-Specific Antigen (PSA) Screening for High-risk Insured Men (HIM) Act H.R. 7106 - Enhancing Skilled Nursing Facilities Act H.R. 5629 - To provide that the final rule of the Department of Health and Human Services titled "Medications for the Treatment of Opioid Use Disorder", except for the portion of the final rule relating to accreditation of opioid treatment programs, shall have no force or effect. H.R. 7787 - Mental Health Workforce Act S. 4186/H.R. 8089 - Perinatal Workforce Act H.R. 7973/S. 5283 - Momnibus Act S. 3707/H.R. 7279 - Nurse Faculty Shortage Reduction Act. H.R. 7602 - State of Men's Health Act H.Res. 1264/S.Res. 709 - Supporting the goals and ideals of National Nurses Week, to be observed from May 6 through May 12, 2026. H.R. 8163 - the Provider Reimbursement Stability Act H.R. 8261 - Chronic Care Management Improvement Act S. 5269 - Pay PCPs Act of 2026 H.R. 10410 - Educating Future Nurses Act H.R. 4464 - Preventive Health Savings Act Affordability of health insurance coverage Tobacco prevention Hospice certification and recertification Immunization policies H.R. 9257/S. 4754 - Primary and Behavioral Health Care Access Act Skilled nursing facility admitting examination and assessment requirements Reducing regulatory burdens, including those relating to Medicare Conditions of Participation Medicare provider reimbursement Health plan coverage and program requirements, including provider non-discrimination, network adequacy and prior authorization Nursing faculty and workforce shortage Nursing education Include nurses, APRNs, and nursing students in all national public health plans Rural health care issues, including rural workforce and reimbursement Inclusion of NPs in the HPSA bonus program for clinicians practicing in primary care HPSAs Medicaid reform Issues related to Medicare Part B reform Issues related to enhancing access to care at home in rural and underserved communities Public health and nursing workforce infrastructure Medication-Assisted Treatment (MATs) Issues relating to the mental and substance use disorder workforce Opioid epidemic Use of telehealth to prescribe controlled substances under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 [Public Law No: 110-425] Site specific restrictions on providers under DEA controlled substances policy Telehealth, remote patient monitoring and other forms of health technology Primary care payment reform Documentation of medical records

Client expense: $390,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

Issues related to access and physician reimbursement under Medicare Part B, including H.R. 879 - Medicare Patient Access and Practice Stabilization Act; H.R. 2474 - Strengthening Medicare for Patients and Providers Act; S. 1640 - Medicare Patient Access and Practice Stabilization Act of 2025 Implementation of provisions included in Subtitle B of PL.117-169-Inflation Reduction Act of 2022. H.R. 2484- Seniors' Access to Critical Medications Act of 2025. Issues related to prior authorization. H.R. 4299, Protecting Patient Access to Cancer and Complex Therapies Act Issues related to stark regulation of in office dispensing of Part D drugs. Issues related to the Provider Reimbursement Stability Act of 2026 (H.R.8163). Issues related to the Patients First Act of 2026 (H.R.9693)

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

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

Issues surrounding Medicare reimbursement and coverage denials Issues surrounding 2025 conversion factor and Medicare reimbursement reform (H.R. 3514/S.1816) Improving Seniors' Timely Access to Care Act (H.R. 1) One Big Beautiful Bill Act [P.L. No. 119-21] (H.R.4204) Medicare Patient Choice Act (H.R.4475/S.2329) Medicare Orthotics and Prosthetics Patient-Centered Care Act (H.R. 8163) Provider Reimbursement Stability Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

2027 Medicare Physician Fee Schedule Proposed Rule: Submitted comments in response to the 2027 Medicare Physician Fee Schedule Proposed Rule that included recommendations on proposals related to Medicare physician payment, value-based care, MIPS, remote patient monitoring, and more. Joined coalition letter urging CMS to withdraw proposed changes to remote patient monitoring. Joined coalition of physician specialty organizations in urging CMS and the Administration (OMB and DPC) to withdraw its proposed policy to reduce payment by 50 percent when a separately identifiable office/outpatient (O/O) evaluation and management (E/M) service reported with modifier -25 is furnished on the same day as a procedure with a 0-, 10-, or 90-day global period. Medicare Physician Payment: Submitted Statement for the Record supporting the Patients First Act (H.R. 9693), the Provider Reimbursement Stability Act (H.R. 8163), and the Medicare Physician Data-driven Performance Payment System Act (H.R. 8622), three pieces of Medicare payment legislation that were discussed in the House Energy and Commerce Subcommittee on Health legislative hearing. Supported the introduction of the Patients First Act (H.R. 9693) that would make structural reforms to Medicare reimbursement. Medicare Enrollment: Submitted comments in response to the 2027 Home Health Prospective Payment System Proposed Rule urging CMS to withdraw Medicare enrollment proposals. Joined a coalition letter of provider organizations urging CMS to reconsider its proposed Medicare enrollment changes. H-1B: Submitted comments urging the Department of Homeland Security to exempt all healthcare workers from proposed $103,265 H-1B visa fees. Value-Based Care: Joined a coalition of provider groups in a letter to CMS urging the agency to support accountable care in Medicare. Prior Authorization: Supported the passage of the Improving Seniors Timely Access to Care Act (H.R. 3514), legislation that would reform prior authorization in Medicare Advantage, through both the Ways and Means and Energy and Commerce Committee. Medicare Advantage: Supported the introduction of the Protecting Approved Care Act (H.R. 10394) that would prohibit Medicare Advantage organizations from reversing payment decisions or downcoding after the plan approves prior authorization for an item or service.

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

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

2027 Medicare Physician Fee Schedule Proposed Rule: Submitted comments in response to the 2027 Medicare Physician Fee Schedule Proposed Rule that included recommendations on proposals related to Medicare physician payment, value-based care, MIPS, remote patient monitoring, and more. Joined coalition letter urging CMS to withdraw proposed changes to remote patient monitoring. Joined coalition of physician specialty organizations in urging CMS and the Administration (OMB and DPC) to withdraw its proposed policy to reduce payment by 50 percent when a separately identifiable office/outpatient (O/O) evaluation and management (E/M) service reported with modifier -25 is furnished on the same day as a procedure with a 0-, 10-, or 90-day global period. Medicare Physician Payment: Submitted Statement for the Record supporting the Patients First Act (H.R. 9693), the Provider Reimbursement Stability Act (H.R. 8163), and the Medicare Physician Data-driven Performance Payment System Act (H.R. 8622), three pieces of Medicare payment legislation that were discussed in the House Energy and Commerce Subcommittee on Health legislative hearing. Supported the introduction of the Patients First Act (H.R. 9693) that would make structural reforms to Medicare reimbursement. Medicare Enrollment: Submitted comments in response to the 2027 Home Health Prospective Payment System Proposed Rule urging CMS to withdraw Medicare enrollment proposals. Joined a coalition letter of provider organizations urging CMS to reconsider its proposed Medicare enrollment changes. H-1B: Submitted comments urging the Department of Homeland Security to exempt all healthcare workers from proposed $103,265 H-1B visa fees. Value-Based Care: Joined a coalition of provider groups in a letter to CMS urging the agency to support accountable care in Medicare. Prior Authorization: Supported the passage of the Improving Seniors Timely Access to Care Act (H.R. 3514), legislation that would reform prior authorization in Medicare Advantage, through both the Ways and Means and Energy and Commerce Committee. Medicare Advantage: Supported the introduction of the Protecting Approved Care Act (H.R. 10394) that would prohibit Medicare Advantage organizations from reversing payment decisions or downcoding after the plan approves prior authorization for an item or service.

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

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

Issues related to Skilled Nursing and Assisted Living Facility Industry. Issues related to Medicare, including the Provider Reimbursement Stability Act of 2026, H.R.8163. Issues related to Patient-Driven Payment Model (PDPM).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 929/S.266 - Lorna Breen Health Care Provider Protection Reauthorization H.R. 593 - Strengthening Pathways to Health Professions 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. 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. 2586 - Reentry Act of 2025 H.R. 3884/S.2011 - Telemental Health Care Access Act of 2025 H.R. 4619 - Medicare Mental Health Inpatient Equity Act S. 1062 - Suicide Prevention Act H.R. 912 - 9-8-8 Lifeline Cybersecurity Act H.R. 2483/S.2121 - SUPPORT for Patients and Communities Reauthorization Act of 2025 H.R. 3655 - STAR Plus Scholarship Act H.R. 3885/S.3989 - Community TEAMS Act H.R. 3164 - Ensuring Community Access to Pharmacist Services (ECAPS) Act H.R. 4681/S. 1379 - Specialty Physicians Advancing Rural Care (SPARC) Act Conversations with Congressional offices on Teaching Health Center Graduate Medical Education (THCGME) H.R.3505/S.5558 - Barriers to Suicide Act H.R. 5434/S. 2826 - 988 LGBTQ+ Youth Access Act H.R.5509 /S.2903 - Safe Step Act H.R. 5557 - Mental Health Services for Students Act H.R. 3514/S.1816 - Improving Seniors Timely Access to Care Act S. 3064 - Relief of Chronic Pain Act H.R.6672 - Mental Health Professionals Workforce Shortage Loan Repayment Act Conversations regarding mental health parity enforcement Communication with Congressional offices on SAMHSA grant terminations Input on Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) modernization Communication with Congressional offices on ghost networks H.R.7092 - RAYS Act Support of funding for gun violence prevention research at CDC, NIH and NIJ. S.4076 - Removing Medicare Mental Health Inpatient Limitations Act of 2026 Letter supporting funding for Maternal Mental Health and Substance Use Disorder Programs (MMHSUD) and National Maternal Mental Health Hotline. H.R. 5629 - To provide that the final rule of the Department of Health and Human Services titled Medications for the Treatment of Opioid Use Disorder except for the portion of the final rule relating to accreditation of opioid treatment programs, shall have no force or effect H.R. 7994 - The HERO Act H.R. 8124 - STOP Suicide Act H.R. 8201 - Expanding Community Access to Health Services Act Letter expressing concerns over H.R. 5629 and H.R. 5630 H.R. 9044 - Minority Fellowship Program Reauthorization Act of 2026 H.R. 8163 - Provider Reimbursement Stability Act H.R.8961 - Student Suicide Prevention Awareness Act H.Res.1329 - Expressing support for the designation of May 2026 as Mental Health Awareness Month H.R.8989 - Evidence-Based Youth Suicide Prevention Act of 2026 H.R.8122/ S.4640 - 9-8-8 Connect Act H.R.8811/S.4552 - Moms Matter Act H.R.9257 - Primary and Behavioral Health Care Access Act H.R.8487/S.3401 - Ensuring Excellence in Mental Health Act H.R. 9948 - Addictive Design Act H.R. 9551 - Mental Health Parity Enforcement and Funding Act H.R. 9693 - Patients First Act S.4916 - Aging with Artificial Intelligence Act of 2026 H.R.9538 - Residential Recovery for Seniors Act H.R.10216 - Public Transit Mental Health Awareness Act H.R. 8657 - Campus Lifeline Act H.R. 10349 - Emergency Responders Mental Health Training (EMT) Act H.R. 10210 - Doctors Not AI Act H.R. 8693/S.3062 - GUARD Act H.R.10280 - 9-8-8 Implementation Act of 2026 Letter supporting Project AWARE funding Letter urging prior authorization and step therapy reform National Health Service Corps extension Community Health Center funding extension H.R. 1 implementation impacts on Medicaid Conversation regarding vaccine recommendations and public health Response to HRSA RFI on the Safe Administration of Psychedelic Therapies

Client expense: $144,050 · Firm income: Not reported

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

Physician and payment issues. H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025. H.R. 8163, The Provider Reimbursement Stability Act. H.R. 3164, the Ensuring Community Access to Pharmacist Services Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.879, Medicare Patient Access and Practice Stabilization Act of 2025. General provisions to address Medicare physician fee schedule payment policies and access to physician services. In general, policies impacting physician burden and sustaining the private practice physician model. H.R.3514/S.1816, Improving Seniors Timely Access to Care Act of 2025. Pub. L. No. 119-21, One Big Beautiful Bill Act, provisions regarding Medicare physicians payment increase, reform. H.R.9693, Patients First Act. H.R.8163/S.5180, Provider Reimbursement Stability Act. H.R.8375/S.4384, Medicare Advantage Improvement Act.

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

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

Adequacy of Medicare physician payments for physicians and implementation of the Medicare Access and CHIP Reauthorization Act, including related provisions in H.R. 879 Medicare Patient and Practice Stabilization Act of 2025, S. 891 the Bipartisan Health Care Act of 2025 and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21, and related to physician payment adjustment of 2.5%. Issues related to adequate network coverage for ophthalmology care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans, Medicare reimbursement for telemedicine, and extending Medicare Telehealth Flexibilities. Use of step therapy in Medicare and health insurance coverage. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including monitor CMMI Medicare Part B drug-related demonstrations. H.R.8163 - Provider Reimbursement Stability Act of 2026. Issues related to modifier 25 in the 2027 physician fee schedule.

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

Government targets: HOUSE OF REPRESENTATIVES, 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 H.R. 9963, the Patients First Act H.R. 8500/S. 5475, the Timely Access to Coverage Decisions Act Issues relating to the CY2027 Medicare Physician Fee Schedule Proposed Rule

Client expense: $50,000 · 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

Update and reforms to Medicare payments for physicians and implementation of related provisions of the Medicare Access and CHIP Reauthorization Act (MACRA), including regulatory relief for physicians in the MACRA Quality Payment Program, evaluation and management (E/M) codes and related legislative issues related to payment for E/M codes, and qualified clinical data registries, including related provisions in H.R. 879 - Medicare Patient and Practice Stabilization Act of 2025, S. 891 - Bipartisan Health Care Act, and H.R. 1, the One Big Beautiful Bill Act (OBBB) P.L. 119-21. Issues related to adequate network coverage for dermatologic care within Medicare Advantage plans and advocate for relief from prior authorization requirements under Medicare Advantage and Medicare Part D plans. H.R.8163 - Provider Reimbursement Stability Act of 2026. Issues related to modifier 25 in the 2027 physician fee schedule.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Discussions with House and Senate Offices regarding the future of Medicare physician payment and the Medicare physician payment fee schedule for CY 2026 and the finalized work efficiency adjuster and the need to delay. H.R.7520 - Efficiency Adjustment Delay Act. Legislation to support Medicare reimbursement for the office site of service, H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026. Legislation to support changes in budget neutrality methodology in the Medicare Physician Fee Schedule, H.R.8163 - Provider Reimbursement Stability Act of 2026. Discussions for House and Senate Office staffers regarding reform of the MACRA law and Medicare Quality Payment Program. Discussions with House and Senate Offices on legislative language and committee action on HR 9693/S. 5672 - Patients First Act of 2026.

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

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

Policies in the 2027 Medicare Physician Fee Schedule Proposed Rule including Modifier 25 and orthopedic surgery cuts, Medicare physician payment reform including changes to budget neutrality and indexing the conversion factor to inflation, Provider Reimbursement Stability Act (H.R. 8163/S. 5180), Patients First Act (H.R. 9693), policies related to value-based care.

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

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

Policies in the 2027 Medicare Physician Fee Schedule Proposed Rule including Modifier 25 and orthopedic surgery cuts, Medicare physician payment reform including changes to budget neutrality and indexing the conversion factor to inflation, Provider Reimbursement Stability Act (H.R. 8163/S. 5180), and value-based care reform.

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

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

H.R. 879/S. 1640, the Medicare Patient Access and Practice Stabilization Act of 2025; H.R. 1, the One Big Beautiful Bill Act; H.R. 3164/S. 2426, the Ensuring Community Access to Pharmacist Services Act; Draft legislation to amend title XVIII of the Social Security Act to modify the conversion factor updates applicable to physicians' services under the Medicare program; Implementation of Centers for Medicare & Medicaid Services. (2025). Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program. Federal Register, 88, 90 FR 49266-50481; H.R. 6160, the Strengthening Medicare for Patients and Providers Act; H.R. 8163, the Provider Reimbursement Stability Act; H.R. 7520, the Efficiency Adjustment Delay Act; H.R. 8622, the Medicare Physician Data-driven Performance Payment System Act of 2026 H.R.9693, Patients First Act of 2026 H.R.4331, Access to Claims Data Act Proposed CY 2027 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program

Client expense: $2,047,000 · Firm income: Not reported

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

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

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

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

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

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

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

Issues related to prior authorization requirements in Medicare, including H.R. 3514/S. 1816, the Improving Seniors Timely Access to Care Act of 2025 Issues related to Medicare coverage of audiology services and the Medicare Audiology Access Improvement Act (H.R. 2757/S. 1996) Issues related to the provision of audiology and speech-language pathology services through telepractice, including H.R. 1614, legislation to amend title XVIII of the Social Security Act to expand practitioners eligible to furnish telehealth services under the Medicare program, H.R. 5801, H.R. 6296, the Advancing Access to Telehealth Act, the Telehealth Modernization Act (H.R. 5081/S. 2709), and S. 3834, the Expanded Telehealth Access Act. Issues related to Medicare Part B reimbursement of audiology and speech-language pathology services, including H.R. 8163, the Provider Reimbursement Stability Act of 2026 Issues related to the Multiple Procedure Payment Reduction, including the Removing Excessive Cuts to Outpatient and Vital Essential Rehabilitation (RECOVER) Act (H.R. 8386) H.R. 6160, Strengthening Medicare for Patients and Providers Act H.R. 7520, the Efficiency Adjustment Delay Act Provider Reimbursement Stability Act (H.R. 8163) Patients First Act (H.R. 9693) Prompt and Fair Pay Act (H.R. 4559) Medicare Patient Choice Act (H.R. 4204) Stopping Fraudulent Payments Act (H.R. 8464) Protecting Health Care and Lowering Costs Act (H.R. 4849/S. 2556) Health Care Fraud Prevention and Enforcement Act (S. 5326) H.R.6500, the Continuing Appropriations and Extensions Act, 2027 Various issues related to CMS Actions surrounding: o Audits of medical records and claims for Part A and B services o Procedure code development and valuation of audiology and speech-language pathology services o Quality reporting under MIPS o Implementation of the IMPACT Act o Medicare physician fee schedule o Prospective payments systems, including home health and skilled nursing facility policy and payment issues o Accountable Care Organizations o Federally-facilitated marketplace o Medicare Advantage o Various issues related to interoperable health information, including the post-acute care interoperability project (PACIO) o Medicare telehealth coverage under Part A and B o Provision and payment for Part A therapy o Various issues related to implementation of ACA o Issues related to Medicare beneficiaries accessing services provided by audiologists without a physician order o Issues related to qualified Medicare providers o Issues related to fraud, waste, and abuse Issues related to the Center for Medicare and Medicaid Innovation (CMMI) actions related to value-based care Issues related to proposals to block grant or institute work requirements and/or per capita caps in the Medicaid program.

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

Government targets: Administration on Aging, Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE

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

P.L.119-21 - One Big Beautiful Bill Act H.R.1 and Senate-Passed Amendment to H.R.1 Fiscal Year 2025 Budget Reconciliation H.Con.Res.14 Fiscal Year 2026 Budget Reconciliation Fiscal Year 2027 Budget Reconciliation Issue: Educate Congress on potential financial implications of Medicare and Medicaid cuts and entitlement reform on academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. Support preservation of non-profit tax status of AAMC member institutions. Oppose reduction in Medicare hospital outpatient department reimbursement and site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital and provider cuts, including Medicare graduate medical education (GME) reforms, reduction or elimination of bad debt reimbursement, reforming Medicare disproportionate share hospital payments and uncompensated care, prevention of rural reclassification, and reductions in wage index. Oppose cuts to federal Medicaid funding, including reductions to the federal medical assistance percentage (FMAP), changes to provider taxes and state-directed payments, and the implementation of per-capita caps or block grants. Oppose policies that restrict access to coverage and care for the Medicaid population, such as work/community engagement requirements, more frequent eligibility redeterminations, and additional cost-sharing. Oppose limits on Affordable Care Act (ACA) premium tax credit eligibility and restrictions on eligibility for and enrollment in ACA Marketplace plans. Oppose reducing Medicare reimbursement for 340B-acquired drugs. Issue: Oppose restrictions on federal Medicaid funding for certain disfavored services Issue: Educate lawmakers on the need to delay, undo, or revise pending new restrictions on to provider taxes and state-directed payments, along with implement strategies to mitigate coverage losses due to the One Big Beautiful Bill Acts (OBBBA) work requirements and more frequent eligibility redeterminations for the Affordable Care Act (ACA) expansion population. Issue: Educate lawmakers on the importance of academic health systems, teaching hospitals, and physician practice eligibility for Rural Health Transformation Program (RHTP), support increased funding for RHTP. Issue: Educate Congress and policymakers on the financial challenges facing academic health systems and teaching hospitals, medical schools, and faculty practices and the impact on patients access to care and the nations health. H.R.7409 - Defend Rural Health Act Issue: Oppose efforts to repeal or curtail the ability of urban hospitals to become rural referral centers or reclassify for the purposes of their wage index. Issue: Educate Congress and policymakers on the role academic health systems, teaching hospitals, medical schools, and faculty practices play in caring for rural patients and communities, training providers to practice in rural communities, and ensuring access to critical health care services not otherwise available. Issue: Educate Congress on impact of Statutory Pay-As-You-Go Act Medicare sequester H.R.1835 - Breaking the Gridlock Act S.3385 - Lower Health Care Costs Act S.3386 - Health Care Freedom for Patients Act of 2025 Issue: Support clean extension of Affordable Care Act (ACA) enhanced premium tax credits (EPTCs) set to expire at the end of 2025 H.R.4371/S.2439 - Resident Physician Shortage Reduction Act of 2025 Issue: Support increased Medicare funding for graduate medical education (GME). Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). Oppose duplicative teaching health system and hospital reporting and policies that increase regulatory burden. H.R.2314/S.2715 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.1153 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare graduate medical education (GME) payment formulas that reduce current Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments to teaching hospitals. Issue: Educate Congress on teaching health system and hospital graduate medical education (GME) data collection practices and concerns related to duplicative reporting requirements. H.R.3178/S.2600 - Save Healthcare Workers Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. Issue: Oppose legislation that pays for workforce investments and mitigation of Medicaid Disproportionate Share Hospital (DSH) program cuts paid for by cuts to hospital outpatient departments. Issue: Support legislation that ensures the move to value-based care. Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported graduate medical education (GME) slots from the Consolidated Appropriations Act (CAA), 2021 and 2023. Issue: Educate Congress on status of Centers for Medicare and Medicaid Services (CMS) distribution of the 1,000 new graduate medical education (GME) slots authorized by the Consolidated Appropriations Act (CAA), 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: CAA, 2021 Sec. 131 extension and RTP thresholds Issue: Support Medicare graduate medical education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose the redesign of Medicare Indirect Medical Education (IME) financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Issue: Support creation of new Medicare outpatient Indirect Medical Education (IME) payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. Issue: Support efforts to reform the Medicare physician fee schedule. H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025 H.R.9693 - Patients First Act of 2026 H.R.8163 - Provider Reimbursement Stability Act of 2026 Issue: Support Medicare Physician Fee Schedule (PFS) reform. P.L.119-4 - Full-Year Continuing Appropriations and Extensions Act, 2025 P.L.118-158 - American Relief Act 2025 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule (PFS) cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. Support allowing hospitals to count costs and reimbursements for Medicaid patients with third-party coverage towards their DSH cap. Support extensions of Acute Hospital at Home program waiver of 24/7 nursing requirement and Medicare telehealth waivers and efforts to expand patient access to telehealth. H.R.5582/S.2355 - Patients Deserve Price Tags Act H.R.9393 - Lower Costs, More Transparency Act of 2026 H.R.9390 - Prices on the Wall Act of 2026 Issue: Oppose efforts to increase administrative burden on hospitals through expanded reporting measures. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. H.R.9504 - Tax Exempt Hospital Transparency Act Issue: Oppose efforts that increase duplicative and burdensome reporting requirements on tax exempt hospitals through expanded IRS reporting measures. H.R.3514/ S.1816 - Improving Seniors' Timely Access to Care Act of 2025 Issue: Support efforts to decrease the burden of prior authorization in Medicare Advantage plans Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support elimination of scheduled reductions to the Medicaid disproportionate share hospital (DSH) program. H.R.8163 - Provider Reimbursement Stability Act of 2026 Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. H.R.4313 - Hospital Inpatient Services Modernization Act Issue: Support extension of the Acute Hospital Care at Home program. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove the requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. Issue: Support legislation to eliminate the 190-day Lifetime Limit policy in the Medicare program. Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). S.2761/H.R.5269 - Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare. Issue: Oppose Department Homeland Security (DHS) proposed rule to expand public charge definition and educate Congress on potential impacts to health care providers.

Client expense: $431,446 · 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. 1517/S.2225 - Prevent Interruptions in Physical Therapy Act Implementation/Expansion of CDC Falls Program Physician self-referral/Stark Law 21st Century Cures Act Health Information Technology Medicaid Expansion MACRA/MIPS APMS IMPACT/PAC reform Network adequacy Opioid Epidemic/Pain Management DOL/OSHA Nominations to NQF committees Primary Care Administrative Burden/Prior Authorizations 1332 Empowerment Waivers Affordable Care Act Protecting Student Athletes from Concussions Act 1115 Waivers Student and Student Athlete Opioid Misuse Prevention Act Personal Health Investment Today Act Promoting Physical Activity for Americans Act Establishment of an Office of Falls Prevention in the Administration on Aging H.R. 2332/S.1101 - States Handling Access to Reciprocity for Employment (SHARE) Act H.R. 4074 - Optimizing Postpartum Outcomes Act Expanded Telehealth Access Act - reintroduction H.R. 5621 - Physical Therapist Workforce and Patient Access Act Strengthening Medicare for Patients and Providers Act - reintroduction IDEA Act Medicare Payment Reform H.R. 1711/S. 2612 - Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 5081/S. 2709 - Telehealth Modernization Act H.R. 935 - Health Care Workforce Innovation Act H.R. 1614 - to expand eligible practitioners to furnish telehealth services S. 668/H.R. 3183 - SAFE Steps for Veterans Act H.R. 879 - Medicare Patient Access and Practice Stabilization Act H.R. 1 - One Big Beautiful Bill Act (Medicare provider payment section) H.R. 4204 - Medicare Patient Choice Act S.1816/H.R. 3514 - Improving Seniors' Timely Access to Care Act H.R. 8386 - the RECOVER Act (Repeal of Multiple Procedure Payment Reduction Policy) H.R. 6160 - Strengthening Medicare for Patients and Providers Act H.R. 8163/S. 5180 - Provider Reimbursement Stability Act H.R. 9693/S. 5672 - Patients First Act

Client expense: $312,662 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE, Social Security Administration (SSA), White House Office

Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Medicare Orthotics and Prosthetics Patient-Centered Care Act Medicare Private Contracting Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act S.1816/H.R. 3514 - Improving Seniors Timely Access to Care Act Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule Support Medicare Providers Act H.R. 4074 - Optimizing Postpartum Outcomes Act H.R. 1517/S.2225 - Prevent Interruptions in Physical Therapy Act Expanded Telehealth Access Act - reintroduction H.R. 5621 - Physical Therapist Workforce and Patient Access Act Strengthening Medicare for Patients and Providers Act - reintroduction IDEA Act H.R. 1711/S. 2612 - Stopping Addiction and Falls for the Elderly (SAFE) Act H.R. 5081/S.2709 - Telehealth Modernization Act H.R. 1614 - to expand eligible practitioners to furnish telehealth services H.R. 879 - Medicare Patient Access and Practice Stabilization Act Medicare Payment Reform H.R. 4202 - Medicare Patient Choice Act H.R. 8386 - the RECOVER Act (Repeal of Multiple Procedure Payment Reduction Policy) H.R. 1 - One Big Beautiful Bill Act H.R. 6160 Strengthening Medicare for Patients and Providers Act H.R. 8163/S. 5180 - Provider Reimbursement Stability Act H.R. 9693/S. 5672 - Patients First Act

Client expense: $312,662 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

- (S.1797/H.R.3808) Expanding Seniors Access to Mental Health Services Act. - (H.R.1096) HOPE and Mental Wellbeing Act of 2025 - (S.683) More Behavioral Health Providers Act of 2025 - Issues surrounding Medicaid reforms - (H.R. 1) One Big Beautiful Bill Act [P.L. No. 119-21] - Issues surrounding LCSW Medicare reimbursement - (S. 2011/H.R. 3884) Telemental Health Care Access Act - (S.4202/H.R.8081) Mental Health Access and Provider Support Act - (H.R. 8163) Provider Reimbursement Stability Act of 2026

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

Government targets: 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.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

Oppose provisions in the proposed 2027 Medicare Physician Fee Schedule: 1) a -2.5% efficiency adjustment to Work RVUs for non-time-based services; 2) a new methodology for calculating indirect practice expenses in facility settings that unfairly penalizes facility-based surgical services. Support for H.R. 6160, the Strengthening Medicare for Patients and Providers Act, which would provide an annual inflationary update for Medicare physician payment tied to the Medicare Economic Index (MEI). Support for The Efficiency Adjustment Delay Act (HR 7520), which would would delay the efficiency adjustment provision in the 2026 Medicare Physician Fee Schedule until January of 2030 and require CMS to submit a report to Congress within 2 years containing an assessment of whether it is necessary to apply a one-time, across-the-board adjustment to work relative value units, and to make corresponding updates to the intraservice portion of physician time inputs for non-time-based services, with respect to services that have not been revalued or reviewed within the 10-year period preceding the calendar year in which such one-time adjustment would be applied. Support for the Improving Seniors Timely Access to Care Act of 2025 (H.R. 3514/S. 1816) that would would streamline and standardize prior authorization requirements within the Medicare Advantage (MA) program. Support for H.R. 8163, the Provider Reimbursement Stability Act, urging Congress to take immediate steps to stabilize Medicare physician reimbursement and to modernize the Medicare payment system. Support for S. 5180, the Provider Reimbursement Stability Act that seeks to modernize and update the budget neutrality mechanism of the Medicare Physician Fee Schedule (MPFS) to improve stability for physician reimbursement and patient access.

Client expense: $78,800 · Firm income: Not reported

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

H.R. 3514/S. 1816: Improving Seniors' Timely Access to Care Act of 2025 - requires Medicare Advantage plans to implement electronic prior authorization, increase transparency, protect enrollees, and adhere to new response timeframes to improve timely access to care. H.R. 2433: Reducing Medically Unnecessary Delays in Care Act - mandates that prior authorization decisions under Medicare be made by qualified physicians, based on medical necessity and evidence-based standards, with transparency and input from practicing physicians. H.R. 9693, Patients First Act of 2026 would finally make structural changes needed to prevent cuts and create a payment system that helps ensure physicians can keep their doors open and provide seniors with quality, value-based healthcare. S. 1640/H.R. 879: Medicare Patient Access and Practice Stabilization Act of 2025 - This bill increases certain payment adjustments under the Medicare physician fee schedule for services furnished between April 1, 2025, and January 1, 2026. H.R. 8163/S. 5180: Provider Reimbursement Stability Act, to amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program. H.R. 8622: Medicare Physician Data-driven Performance Payment System Act to amend title XVIII of the Social Security Act to transform the Merit-based Incentive Payment System into the Data-driven Performance Payment System under the Medicare physician fee schedule H.R. 6160: Strengthening Medicare for Patients and Providers Act to modify certain adjustments to payment amounts under the Medicare physician fee schedule S. 1460/H.R. 786: Preserving Patient Access to Accountable Care Act - extends Medicare incentive payments for alternative payment models to 2027, with a new rate of 3.53 percent, to promote continued participation and improve healthcare efficiency. H.R. 2120/S. 1031: ROCR Value Based Program Act - establishes a new payment program for radiation oncology services, focusing on stable payments, quality care, and patient access, while exempting it from budget neutrality adjustments. H.R. 4559: Prompt and Fair Pay Act - to establish payment parity between Medicare Advantage and fee-for-service Medicare, and to establish prompt payment requirements under Medicare Advantage. H.R. 2484: Seniors' Access to Critical Medications Act of 2025 - establishes an exception to the physician self-referral prohibition for certain outpatient drugs under Medicare, mandates a study on drug dispensing practices, and reduces the Medicare improvement fund by $18 million. H.R. 4299: Protecting Patient Access to Cancer and Complex Therapies Act - provide for a rebate by manufacturers for selected drugs and biological products subject to maximum fair price negotiation. H.R. 4206/S. 1261: CONNECT for Health Act - expands access to telehealth services under Medicare H.R. 5081/S. 2709: Telehealth Modernization Act - to extend certain telehealth flexibilities under the Medicare program. H.R. 4752/S. 2760: Reducing Hereditary Cancer Act - to provide hereditary cancer genetic testing for individuals with a history of a hereditary cancer gene mutation. H.R. 8500: Timely Access to Coverage Decisions Act of 2026: To amend title XVIII of the Social Security Act to ensure timely review of local coverage determination requests under the Medicare program. H.R. 4331, Access to Claims Data Act: To require the Secretary of Health and Human Services to establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

ACPs 2026 Third Quarter Lobbying Disclosure Report Medicare Payments to Physicians: Sent letter and met with legislators in support of the Patients First Act of 2026, (H.R. 9693) for a Medicare Economic Index inflationary updated to the physician fee schedule for physician practices, support for independent practices and replacement of MIPS with POINTS for quality measures. Supported and urged Congress to pass (H.R. 8163, S.5180), the Provider Reimbursement Stability Act, to enhance Medicare reimbursement stability for physicians by modernizing the Medicare Physician Fee Schedule. The Provider Reimbursement Stability Act of 2026. H.R. 8163 would raise the budget neutrality threshold from $20 million to $57.64 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every 5 years. ACP supported the Medicare Physician Data-Drive Performance Payment System Act of 2026, H.R. 8622. This critical legislation seeks to modernize Medicare payments by reducing administrative burdens, improving patient care, and supporting small/rural practices through a more practical, data-driven approach. Dr. William Fox, Chair Emeritus of ACPs Board of Regents, testified before the House Energy and Commerce Committees Health Subcommittee on policy reforms to improve the Medicare Physician Fee Schedule and the Medicare Access and CHIP Reauthorization Act (MACRA) on behalf of ACP. Dr. Rebecca Andrews, Past Chair of ACPs Board of Regents, testified before the House E&C Health Subcommittee in favor of each of the bills mentioned above. ACP supported Pay PCPs Act of 2026 (S. 5269), to inject $10 billion federal investment from fiscal year 2027 through 2031 to provide for the establishment of hybrid primary care payments under Medicare. Support Value-Based Care: Urged reintroduction and support of the Value in Health Care Act of 2024. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that expired at the end of 2024. ACP supported the Preserving Patient Access to Accountable Care Act which aligns with Colleges policy to support the transition to value-based payments through alternative payment models (APMs) that can accommodate a wide range of specialties, practice sizes, and unique patient populations. ACP supported this legislation as it would extend the incentive payments for qualifying physicians and other clinicians to participate in Medicare advanced APMs through payment year 2027 at an increased amount of 3.53 percent and would freeze the scheduled increase in qualifying thresholds. Pricing Transparency/Consolidation: Provided comments to the House Energy and Commerce Committees markup, which includes the Lower Cost, More Transparency Act, H.R. 9393, and the Improving Seniors Timely Access to Care Act, H.R. 3514. The two bills would enhance price transparency across health care entities and streamline unnecessary administrative burden, respectively. ACP also supported several policies included in bills slated for markup that would reform Medicare Advantage practices to ensure accountability and safeguard market competition. ACP strongly supports pricing transparency in health care. ACP supported the passage of the Lower Costs, More Transparency Act, which passed the House in the 118th Congress, and we continue to support its reintroduction and passage in this Congress under H.R. 9393. ACP supported provisions within the Medicare Advantage Cost Transparency Act, H.R. 9392, led by Ranking Member DeGette and Dr. Joyce, which would provide greater oversight by requiring that Medicare Advantage (MA) plans report to the Centers for Medicare & Medicaid Services (CMS) on encounter data, including the allowed amount that a plan agreed to pay for a service in total and the total out-of-pocket costs the patient pays for a service. The College has repeatedly voiced support for the Improving Seniors' Timely Access to Care Act, led by Reps. Kelly and DelBene, which would protect patients from unnecessary delays in care and reduce administrative burden on physicians by streamlining MAs prior authorization approval processes. We urge Congress to pass H.R. 3514 to ensure that our patients will get the care they need, when they need it most. FY2026 Appropriations/Agency Restructuring: For FY2027, ACP is urged appropriations committees that funding be either maintained or increased for the following proven programs: 1) Health Resources Services Administration (HRSA), $10.5 billion, including: 2) Health Workforce, National Health Service Corps (NHSC), $915.6 million in total program funding; 3) Primary Care Training and Enhancement (PCTE), $71 million; 4) Title X Family Planning Program, $390 million; 5) Agency for Healthcare Research and Quality (AHRQ), $500 million; 6) Centers for Disease Control and Prevention (CDC) Injury Prevention and Control, $11.6 billion, including: 7) Firearm Injury and Mortality Prevention Research, $35 million; 8) Chronic Disease Prevention and Health Promotion, Social Determinants of Health, $100 million; 9) National Institutes of Health (NIH), $51.3 billion, including: 10) Office of the Director, Firearms Research, $25 million; 11) Centers for Medicare and Medicaid Services (CMS) and Government Accountability Office (GAO); and 12) Report language to ensure primary care physicians are receiving Medicare physician revaluations. We urged Congress to include report language in the FY2026 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usage. While the House and Senate bills included language, we prefer the stronger House version language and hope Congress will pass the FY26 Labor HHS bills. Also urged Congress to include report language in the FY2027 Labor HHS appropriations bill directing a study on extent G2211 add on codes and increases in fee schedule for primary care are being retained by hiring entities (hospitals, ACOs, private equity) versus the physicians. ACP urged appropriators to provide $35 million for the U.S. Centers for Disease Control and Prevention (CDC), $25 million for the National Institutes of Health (NIH), and $1 million for the National Institute of Justice (NIJ) to conduct public health research into firearm morbidity and mortality prevention. Primary Care and the Physician Workforce: ACP urged Congress to support the Resident Physician Shortage Reduction Act of 2025 (S. 2439/ H.R. 4731), which would increase the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years. ACP supported the Conrad State 30 and Physician Access Reauthorization Act, S. 709 and H.R. 1585, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement. We supported the Resident Education Deferred Interest (REDI) Act (S 942/HR 2028) that, if passed, will allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program. ACP supported legislation for the H-1Bs for Physicians and Healthcare Workforce Act, H.R. 7961. The bill's primary goal is to exempt healthcare professionals from a $100,000 H-1B visa filing fee. ACP supported H.R. 8765, the Prioritizing Primary Care Act. This legislation would mandate an annual report on federal spending on primary care as well as establish a working group to study and make recommendations on how each federal agency addresses the issue. Scope of Practice: ACP provided comments urging the House Ways and Means Committee during markup to oppose the Equitable Community Access to Pharmacist Services Act, which would expand Medicare coverage to permanently include select services provided by a pharmacist. ACP advocated before Senate offices against the marked-up bill coming out of House Ways and Means and renamed the Main Street Pharmacy Access Act enabling pharmacists to bill certain Medicare codes and to diagnose and treat flu, strep throat and other respiratory infections. Expand Patient Access: We urged Congress to reintroduce and pass the Chronic Care Management Improvement Act. This legislation would have removed the cost sharing requirement for patients to access chronic care management services. We also support allowing the physician that performs chronic care management services to waive the requirement that the patient pay the 20 percent coinsurance fee associated with this service. We urged Congress to protect the public health infrastructure, recognize evidence-based science and preserve healthcare agency staffing to inform and protect the public from infectious disease and other health emergencies. Incidences of previously well-controlled, vaccine-preventable diseases, such as pertussis (whooping cough) and measles, are increasing in the United States. Vaccines are vital to our ability to prevent diseases that threaten public health, including novel diseases and future pandemics. We urged Congress to utilize the best possible scientific evidence to guide public health legislation. It is critical that public health leaders support evidence-based medicine, including the use of vaccines and other effective public health strategies that protect the public. ACP conducted a Hill Briefing on using scientifically driven, evidenced-based vaccines. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries. Prescription Drug Reform: Supported the Capping Prescription Costs Act, introduced by Senator Raphael Warnock. The legislation would lower prescription drug costs for millions of Americans by placing annual caps on out-of-pocket costs for prescription drugs at $2,000 for individuals and $4,000 for families with private insurance. Supported bipartisan Drug-price Transparency for Consumers (DTC) Act, a bill that would require price disclosures on advertisements for prescription drugs in order to empower patients and reduce Americans colossal spending on medications. The bill was introduced by Senators Dick Durbin and Chuck Grassley. ACP also supported the Saving Seniors Money on Prescriptions Act, H.R. 950, which aims to drive down the rising costs of prescription drugs for patients on Medicare by improving price transparency in Pharmacy Benefit Managers (PBMs) business practices. Urged Congress to reintroduce and pass: 1) the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029; 2) the Medicare PBM Accountability Act, legislation aimed at lowering the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans; 3) the Increasing Access to Biosimilars Act of 2023, legislation which would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B; 4) the Cutting Copays Act, legislation which would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs; and the Drug Shortage Prevention Act of 2023, which would require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. ACP supported legislation, Drug-Price Transparency for Consumers (DTC) Act, by Senators. Durbin and Grassley that requires Direct-to-Consumer advertisements for prescription drugs and biological products paid for by Medicare and Medicaid to include the list price or Wholesale Acquisition Cost (WAC) for a 30-month supply-which is the price set by manufacturers (and which is paid by uninsured patients, as well as the 50 percent of patients with high-deductible plans).

Client expense: $86,880 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

ACPSs 2026 Third Quarter Lobbying Disclosure Report Medicare Payments to Physicians: Sent letter and met with legislators in support of the Patients First Act of 2026, (H.R. 9693) for a Medicare Economic Index inflationary updated to the physician fee schedule for physician practices, support for independent practices and replacement of MIPS with POINTS for quality measures. Supported and urged Congress to pass (H.R. 8163, S.5180), the Provider Reimbursement Stability Act, to enhance Medicare reimbursement stability for physicians by modernizing the Medicare Physician Fee Schedule. The Provider Reimbursement Stability Act of 2026. H.R. 8163 would raise the budget neutrality threshold from $20 million to $57.64 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every 5 years. ACP supported the Medicare Physician Data-Drive Performance Payment System Act of 2026, H.R. 8622. This critical legislation seeks to modernize Medicare payments by reducing administrative burdens, improving patient care, and supporting small/rural practices through a more practical, data-driven approach. Dr. William Fox, Chair Emeritus of ACPs Board of Regents, testified before the House Energy and Commerce Committees Health Subcommittee on policy reforms to improve the Medicare Physician Fee Schedule and the Medicare Access and CHIP Reauthorization Act (MACRA) on behalf of ACP. Dr. Rebecca Andrews, Past Chair of ACPs Board of Regents, testified before the House E&C Health Subcommittee in favor of each of the bills mentioned above. ACP supported Pay PCPs Act of 2026 (S. 5269), to inject $10 billion federal investment from fiscal year 2027 through 2031 to provide for the establishment of hybrid primary care payments under Medicare. Support Value-Based Care: Urged reintroduction and support of the Value in Health Care Act of 2024. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that expired at the end of 2024. ACP supported the Preserving Patient Access to Accountable Care Act which aligns with Colleges policy to support the transition to value-based payments through alternative payment models (APMs) that can accommodate a wide range of specialties, practice sizes, and unique patient populations. ACP supported this legislation as it would extend the incentive payments for qualifying physicians and other clinicians to participate in Medicare advanced APMs through payment year 2027 at an increased amount of 3.53 percent and would freeze the scheduled increase in qualifying thresholds. Pricing Transparency/Consolidation: Provided comments to the House Energy and Commerce Committees markup, which includes the Lower Cost, More Transparency Act, H.R. 9393, and the Improving Seniors Timely Access to Care Act, H.R. 3514. The two bills would enhance price transparency across health care entities and streamline unnecessary administrative burden, respectively. ACP also supported several policies included in bills slated for markup that would reform Medicare Advantage practices to ensure accountability and safeguard market competition. ACP strongly supports pricing transparency in health care. ACP supported the passage of the Lower Costs, More Transparency Act, which passed the House in the 118th Congress, and we continue to support its reintroduction and passage in this Congress under H.R. 9393. ACP supported provisions within the Medicare Advantage Cost Transparency Act, H.R. 9392, led by Ranking Member DeGette and Dr. Joyce, which would provide greater oversight by requiring that Medicare Advantage (MA) plans report to the Centers for Medicare & Medicaid Services (CMS) on encounter data, including the allowed amount that a plan agreed to pay for a service in total and the total out-of-pocket costs the patient pays for a service. The College has repeatedly voiced support for the Improving Seniors' Timely Access to Care Act, led by Reps. Kelly and DelBene, which would protect patients from unnecessary delays in care and reduce administrative burden on physicians by streamlining MAs prior authorization approval processes. We urge Congress to pass H.R. 3514 to ensure that our patients will get the care they need, when they need it most. FY2026 Appropriations/Agency Restructuring: For FY2027, ACP is urged appropriations committees that funding be either maintained or increased for the following proven programs: 1) Health Resources Services Administration (HRSA), $10.5 billion, including: 2) Health Workforce, National Health Service Corps (NHSC), $915.6 million in total program funding; 3) Primary Care Training and Enhancement (PCTE), $71 million; 4) Title X Family Planning Program, $390 million; 5) Agency for Healthcare Research and Quality (AHRQ), $500 million; 6) Centers for Disease Control and Prevention (CDC) Injury Prevention and Control, $11.6 billion, including: 7) Firearm Injury and Mortality Prevention Research, $35 million; 8) Chronic Disease Prevention and Health Promotion, Social Determinants of Health, $100 million; 9) National Institutes of Health (NIH), $51.3 billion, including: 10) Office of the Director, Firearms Research, $25 million; 11) Centers for Medicare and Medicaid Services (CMS) and Government Accountability Office (GAO); and 12) Report language to ensure primary care physicians are receiving Medicare physician revaluations. We urged Congress to include report language in the FY2026 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usage. While the House and Senate bills included language, we prefer the stronger House version language and hope Congress will pass the FY26 Labor HHS bills. Also urged Congress to include report language in the FY2027 Labor HHS appropriations bill directing a study on extent G2211 add on codes and increases in fee schedule for primary care are being retained by hiring entities (hospitals, ACOs, private equity) versus the physicians. ACP urged appropriators to provide $35 million for the U.S. Centers for Disease Control and Prevention (CDC), $25 million for the National Institutes of Health (NIH), and $1 million for the National Institute of Justice (NIJ) to conduct public health research into firearm morbidity and mortality prevention. Primary Care and the Physician Workforce: ACP urged Congress to support the Resident Physician Shortage Reduction Act of 2025 (S. 2439/ H.R. 4731), which would increase the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years. ACP supported the Conrad State 30 and Physician Access Reauthorization Act, S. 709 and H.R. 1585, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement. We supported the Resident Education Deferred Interest (REDI) Act (S 942/HR 2028) that, if passed, will allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program. ACP supported legislation for the H-1Bs for Physicians and Healthcare Workforce Act, H.R. 7961. The bill's primary goal is to exempt healthcare professionals from a $100,000 H-1B visa filing fee. ACP supported H.R. 8765, the Prioritizing Primary Care Act. This legislation would mandate an annual report on federal spending on primary care as well as establish a working group to study and make recommendations on how each federal agency addresses the issue. Scope of Practice: ACP provided comments urging the House Ways and Means Committee during markup to oppose the Equitable Community Access to Pharmacist Services Act, which would expand Medicare coverage to permanently include select services provided by a pharmacist. ACP advocated before Senate offices against the marked-up bill coming out of House Ways and Means and renamed the Main Street Pharmacy Access Act enabling pharmacists to bill certain Medicare codes and to diagnose and treat flu, strep throat and other respiratory infections. Expand Patient Access: We urged Congress to reintroduce and pass the Chronic Care Management Improvement Act. This legislation would have removed the cost sharing requirement for patients to access chronic care management services. We also support allowing the physician that performs chronic care management services to waive the requirement that the patient pay the 20 percent coinsurance fee associated with this service. We urged Congress to protect the public health infrastructure, recognize evidence-based science and preserve healthcare agency staffing to inform and protect the public from infectious disease and other health emergencies. Incidences of previously well-controlled, vaccine-preventable diseases, such as pertussis (whooping cough) and measles, are increasing in the United States. Vaccines are vital to our ability to prevent diseases that threaten public health, including novel diseases and future pandemics. We urged Congress to utilize the best possible scientific evidence to guide public health legislation. It is critical that public health leaders support evidence-based medicine, including the use of vaccines and other effective public health strategies that protect the public. ACP conducted a Hill Briefing on using scientifically driven, evidenced-based vaccines. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries. Prescription Drug Reform: Supported the Capping Prescription Costs Act, introduced by Senator Raphael Warnock. The legislation would lower prescription drug costs for millions of Americans by placing annual caps on out-of-pocket costs for prescription drugs at $2,000 for individuals and $4,000 for families with private insurance. Supported bipartisan Drug-price Transparency for Consumers (DTC) Act, a bill that would require price disclosures on advertisements for prescription drugs in order to empower patients and reduce Americans colossal spending on medications. The bill was introduced by Senators Dick Durbin and Chuck Grassley. ACP also supported the Saving Seniors Money on Prescriptions Act, H.R. 950, which aims to drive down the rising costs of prescription drugs for patients on Medicare by improving price transparency in Pharmacy Benefit Managers (PBMs) business practices. Urged Congress to reintroduce and pass: 1) the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029; 2) the Medicare PBM Accountability Act, legislation aimed at lowering the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans; 3) the Increasing Access to Biosimilars Act of 2023, legislation which would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B; 4) the Cutting Copays Act, legislation which would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs; and the Drug Shortage Prevention Act of 2023, which would require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. ACP supported legislation, Drug-Price Transparency for Consumers (DTC) Act, by Senators. Durbin and Grassley that requires Direct-to-Consumer advertisements for prescription drugs and biological products paid for by Medicare and Medicaid to include the list price or Wholesale Acquisition Cost (WAC) for a 30-month supply-which is the price set by manufacturers (and which is paid by uninsured patients, as well as the 50 percent of patients with high-deductible plans).

Client expense: $119,057 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

H.R. 879, Medicare Patient Access and Practice Stabilization Act; H.R. 3164/S. 2426, Equitable Community Access to Pharmacist Services Act H.R. 8163, Provider Reimbursement Stability Act of 2026 H.R. 9693, Patients First Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

The One Big Beautiful Bill Act, H.R. 1; Medicare physician payment including, the Medicare Patient Access and Practice Stabilization Act (H.R. 879); the Strengthening Medicare for Patients and Providers Act (H.R. 6160), the Provider Reimbursement Stability Act (S. 4935); the Provider Reimbursement Stability Act (H.R. 8163/S. 5180); and the Efficiency Adjustment Delay Act (H.R. 7520); new/alternative payment models; Medicare coverage, hospital payment of cardiovascular services; access to Medicare claims data; physician and hospital quality; Quality Payment Program; clinical data registries; health care quality; medical imaging and prior authorization; the Stark Law and the in-office ancillary services exception; Medicare Access and CHIP Reauthorization Act implementation and oversight; Bipartisan Budget Act of 2015 and Medicare site of service policy; graduate medical education policy including the Resident Physician Shortage Reduction Act (H.R. 3890/S. 2439); provide a specialty physician loan repayment program with the SPARC Act (H.R 4681/S. 1380); provide deferred interest payments for residents on student loans with the Resident Education Deferred Interest (REDI) Act (H.R. 2028/S. 942); oversight and implementation of the Protecting Access to Medicare Act of 2014, including Appropriate Use Criteria; physician-owned hospital policy including the Physician Led Rural Access to Quality Care Act (H.R. 2191/S. 1390) and the Patient Access to Higher Quality Health Care Act (H.R. 4002); COVID-19 public health emergency and the implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security Act; implementation of the Protecting Medicare and American Farmers from Sequester Cuts Act; Increasing Access to Quality Cardiac Rehabilitation Care Act; the expansion of telehealth services, including the CONNECT for Health Act (H.R. 41894206/S. 1261), the Sustainable Cardiopulmonary Rehabilitation Services in the Home At (H.R. 783/S. 248), and the Telehealth Modernization Act (H.R. 5081/S. 2709); Improving maternal health, including Connected Maternal Online Monitoring Act (Connected MOM Act) (H.R. 4977/S. 141), Preventing Maternal Deaths Reauthorization Act of 2025 (H.R. 1909), and Rural Obstetrics Readiness Act (H.R. 1254/S. 380), and the Womens Heart Health Expansion Act (H.R. 7417/S. 3944) ; prior authorization reform, including the Improving Seniors Timely Access to Care Act (H.R. 3514/S. 1816), the Reducing Medically Unnecessary Delays in Care Act (H.R. 2433), and the Safe Step Act (H.R. 5509/S. 2903); clinician-led registry access to federal claims data, including the Access to Claims Data Act (H.R. 4331); and expanding in home prescribing coverage provided in the Increasing Access to Quality Cardiac Rehabilitation Care Act of 2025 (H.R. 6894/S. 717), Centers for Medicare and Medicaid Innovation payment models, including the Ambulatory Specialty Model for Heart Failure.

Client expense: $600,000 · Firm income: Not reported

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