Medicare Patient Access and Practice Stabilization Act of 2025

Draft, Medicare Compare Website (no bill number) - Rep. Guthrie, Brett - improvements to CMS' Medicare compare website Draft, HELP STATES Act (no bill number) - Rep. Kean, Tom - Medicaid fraud and program integrity H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 497 - Medicaid Third Party Liability Act - Rep. Crenshaw, Dan - Medicaid liable third-party exceptions H.R. 584 - No Medicaid for Illegal Immigrants Act - Rep. Kiley, Kevin - Medicaid eligibility requirements H.R. 610 - Close the Medigap Act - Rep. Doggett, Lloyd - Medigap plan reform H.R. 879 - Medicare Patient Access and Practice Stabilization Act - Rep. Murphy, Gregory - Medicare physician reimbursement H.R. 1019 - Medicaid Program Improvement Act - Rep. Miller-Meeks, Mariannette - Medicaid management care reporting H.R. 1059 - Jobs and Opportunities for Medicaid Act - Rep. Crenshaw, Dan - Medicaid eligibility requirements H.R. 1162 - Medicaid Primary Care Improvement Act - Rep. Crenshaw, Dan - Medicaid direct primary care arrangements H.R. 1195 - Protect Medicaid Act - Rep. Hudson, Richard - Medicaid eligibility requirements H.R. 1279 - To amend title XIX of the Social Security Act to establish a community engagement requirement for certain individuals under the Medicaid program. - Rep. Bean, Aaron - Medicaid eligibility requirements H.R. 1403 - LIVE Beneficiaries Act - Rep. Bilirakis, Gus - Medicaid registration audits H.R. 1598 - Ensuring Access to Medicaid Buy-in Programs Act - Rep. Ciscomani, Juan - Medicaid eligibility requirements H.R. 1924 - Securing Access to Care for Seniors in Critical Condition Act - Rep. Hern, Kevin - Medicare site-neutral payments for LTC hospitals H.R. 2045 - Medicare Dental, Vision, and Hearing Benefit Act - Rep. Doggett, Lloyd - Medicare dental, vision, and hearing coverage H.R. 2263 - Telehealth Coverage Act - Rep. Khanna, Ro - Telehealth flexibilities in Medicare H.R. 2309 - Medicare and Medicaid Fraud Prevention Act - Rep. Peters, Scott - provider screening for Federal programs H.R. 2433 - Reducing Medically Unnecessary Delays in Care Act - Rep. Green, Mark - Medicare Advantage prior authorization H.R. 2586 - Reentry Act - Rep. Tonko, Paul - Medicaid coverage for incarcerated population H.R. 2610 - Protecting Options for Seniors Act - Rep. Tenney, Claudia - MA wage index reclassification H.R. 3023 - Preventing Hospital Overbilling of Medicare Act - Rep. Spartz, Victoria - Site-neutral payment reform H.R. 3069 - Medicare for All Act - Rep. Jayapal, Pramila - New national health insurance program H.R. 3222 - SMART Health Care Act - Rep. Spartz, Victoria - MA risk adjustment H.R. 3321 - Ending Medicaid Discrimination Against the Most Vulnerable Act - Rep. Roy, Chip - Enhance FMAP phase out H.R. 3415 - Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - Rep. Schakowsky, Janice - Nurse staffing ratio requirements H.R. 3467 - To amend title XVIII to reform the Medicare Advantage program - Rep. Schweikert, David - MA reforms H.R. 3808 - Expanding Seniors Access to Mental Health Services Act - Rep. Fitzpatrick, Brian - Medicare mental health services H.R. 4093 - Apples to Apples Comparison Act - Rep. Bean, Aaron - Medicare and Medicare Advantage spending reports H.R. 4139 - Cutting Copays Act - Rep. McGarvey, Morgan - Medicare cost-sharing for generic drugs H.R. 4313 - Hospital Inpatient Services Modernization Act - Rep. Buchanan, Vern - Acute hospital care at home waiver H.R. 4559 - Prompt and Fair Pay Act - Rep. Doggett, Lloyd - Payment parity for MA and FFS; MA reimbursement requirements H.R. 4641 - Keep Kids Covered Act - Rep. Castor, Kathy - Continuous eligibility for children in Medicaid/CHIP H.R. 4807 - Protect Our Hospitals Act - Rep. Landsman, Greg - Medicaid provider tax repeal H.R. 5243 - To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. - Rep. McClellan, Jennifer - MA supplemental benefits data reporting H.R. 5281 - REAL Health Providers Act - Rep. Panetta, Jimmy - MA provider directory requirements H.R. 5584 - Medicaid Third Party Liability Act - Rep. Burgess, Michael - Impact of Third Party Liability on MCOs H.R. 6109 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to rates of reversed prior authorization coverage determinations under Medicare Advantage plans. - Rep. Pocan, Mark - prior authorization under Medicare Advantage H.R. 6110 - To amend title XVIII of the Social Security Act to require Medicare Advantage plans to automatically reconsider determinations denying coverage. - Rep. Pocan, Mark - reconsider denials under Medicare Advantage H.R. 6111 - To amend title XVIII of the Social Security Act to require any advertisement of a Medicare Advantage plan to include information related to the rates of prior authorization denials under such plan. - Rep. Pocan, Mark - advertise rates of prior authorization denials under Medicare Advantage H.R. 6112 - To amend title XVIII of the Social Security Act to establish certain requirements with respect to the average monthly cost to provide coverage to an enrollee under Medicare Advantage plans. - Rep. Pocan, Mark - require monthly coverage cost to enrollees under Medicare Advantage H.R. 6113 - To amend title XVIII of the Social Security Act to impose limitations on contracts with Medicare Advantage organizations offering multiple Medicare Advantage plans under the Medicare program. - Rep. Pocan, Mark - limit multiple Medicare Advantage plans H.R. 6114 - To prohibit funds made available to the Department of Health and Human Services by previous Appropriations Acts from being used for any activity that makes Medicare Advantage the default under the Medicare program. - Rep. Pocan, Mark - prohibit Medicare Advantage from becoming the default H.R. 6254 - Medicaid Staffing Flexibility and Protection Act of 2025 - Rep. Carter, Earl - extend eligibility determinations and redeterminations for Medicaid H.R. 6361 - Ban AI Denials in Medicare Act - Rep. Landsman, Greg - limit WISeR model H.R. 6951 - Stop Unfair Medicaid Recoveries Act - Rep. Schakowsky, Janice - State Medicaid cost recoupment H.R. 6974 - Improving MA SNP Act of 2026 - Rep. Arrington, Jodey - MA SNP beneficiary approval H.R. 7803 - Save Medicare Act - Rep. Pocan, Mark - Renames Medicare Advantage H.R. 7871 - MVP Act - Rep. Guthrie, Brett - Value-based purchasing arrangements in Medicaid H.R. 8375 - Medicare Advantage Improvement Act - Rep. Joyce, John - MA programmatic reforms H.R. 8377 - Stop Deadly Denials Act - Rep. Khanna, Ro - MA prior authorization prohibition H.R. 8875 - Improving Home Dialysis Act - Rep. Miller, Carol - Home dialysis coverage under Medicare H.R. 9542 - Protecting Health Care and Lowering Costs Act - Rep. Boyle, Brendan - Medicaid reforms H.R. 9544 - Save MEDICARE Act - Rep. Doggett, Lloyd - MA risk adjustment and requirements H.R. 9644 - Medicare Advantage MLR Transparency Act - Rep. Moran, Nathaniel - MA plan revenue and benefits reporting H.R. 9693 - Patients First Act - Rep. Joyce, John - Medicare physician fee schedule reform H.R. 10374 - Affordable Premiums for Seniors Act - Rep. Sewell, Terri - Part D premium stabilization demo H.R. 10521 - MA STARS Act - Rep. Kelly, Mike - MA star ratings reform S. 523 - Protect Medicaid Act - Sen. Cassidy, Bill - Medicaid eligibility requirements S. 678 - LIVE Beneficiaries Act - Sen. Scott, Rick - Medicaid enrollment audits S. 717 - Increasing Access to Quality Cardiac Rehabilitation Care Act - Sen. Capito, Shelley Moore - Expanding cardiac care coverage in Medicare S. 752 - Accelerating Kids' Access to Care Act - Sen. Grassley, Chuck - Out-of-state provider access for Medicaid S. 939 - Medicare Dental, Hearing, and Vision Expansion Act - Sen. Sanders, Bernard - Medicare coverage requirements S. 1082 - Safeguarding Medicaid Act - Sen. Barrasso, John - Medicaid enrollee asset verification S. 1105 - No UPCODE Act - Sen. Cassidy, Bill - MA risk adjustment S. 1399 - Health Tech Investment Act - Sen. Rounds, Mike - Medicare coverage for algorithm-based services S. 1506 - Medicare for All Act - Sen. Sanders, Bernard - New national health insurance program S. 1629 - Same Care, Lower Cost Act - Sen. Kennedy, John - Medicare site-neutral payment reform S. 1637 - MVP Act - Sen. Mullin, Markwayne - Medicaid value-based purchasing agreements S. 1816 - Improving Seniors' Timely Access to Care Act - Sen. Marshall, Roger - MA prior authorization S. 1903 - A bill to prohibit changes to Medicare and Medicaid in reconciliation - Sen. Reed, Jack - Medicare and Medicaid safeguards against reconciliation cuts S. 2237 - Hospital Inpatient Services Modernization Act - Sen. Scott, Tim - Acute hospital care at home waiver S. 2279 - Protect Medicaid and Rural Hospitals Act - Sen. Hawley, Josh - Medicaid provider tax and State directed payments S. 2289 - Healthy Moms and Babies Act - Sen. Grassley, Chuck - Medicaid/CHIP maternal health coverage improvements S. 2496 - Keep Kids Covered Act - Sen. Bennet, Michael - Continuous eligibility for children in Medicaid/CHIP S. 2497 - Fair Billing Act - Sen. Hassan, Maggie - Medicare site-neutral transparency and identification requirements S. 2556 - Protecting Healthcare and Lowering Costs Act - Sen. Schumer, Charles - repeal of Medicaid provisions in the One Big Beautiful Bill Act S. 2793 - Ensuring Access to Essential Providers Act - Sen. Cassidy, Bill - Essential community provider coverage requirements for MA S. 3642 - WALZ Act - Sen. Marshall, Roger - Medicaid payment investigation and audits S. 3690 - Ensuring Access to Medicaid Buy-in Programs - Sen. Blackburn, Marsha - Medicaid eligibility parameters S. 3729 - PBM Reporting Transparency Act - Sen. Warner, Mark - MedPAC reports on PBMs S. 3750 - REAL Health Providers Act - Sen. Bennet, Michael - MA provider directory accuracy S. 3762 - Prior Authorization Relief Act - Sen. Whitehouse, Sheldon - MA prior authorization restrictions S. 3848 - Apples to Apples Comparison Act - Sen. Scott, Tim - Medicare and Medicare Advantage spending reports S. 3886 - Nurses Belong in Nursing Homes Act - Sen. Wyden, Ron - Nursing home staffing hours S. 4384 - Medicare Advantage Improvement Act - Sen. Marshall, Roger - MA programmatic reforms S. 5034 - Medicare Advantage Supplemental Benefits Transparency Act - Sen. Warner, Mark - MA supplemental benefits reporting requirements S. 5037 - MediKids Act - Sen. Kim, Andy - Universal Medicaid eligibility for youth Issues related to mental health and Medicare; Medicare and Medicaid funding; Medicaid expansion; State innovation waivers; Medicaid and CHIP; Medicaid FMAP; Medicare Supplement Coverage; Medicare Transparency in Coverage; Waste Fraud and Abuse; Medicaid Access Final Rule; Medicaid Redeterminations; Medicaid rate actuarial soundness; value of Medicaid Managed Care; value of Medicare Advantage; Affordability; public option; Dental, Hearing, Vision benchmarks; HCBS; Home Health FFS Coverage; Medicare Advantage Health Risk Assessment and chart reviews; Medicare Advantage supplemental benefits and Social Determinants of health; CBO estimates of MA and FFS costs; coverage of weight loss drugs; Inflation Reduction Act implementation; Medicare Advantage Rate Notice; Part D Payment Issues; Part D VBID Issues; RADV; MA payment issues; Part D issues; prior authorization; MA prompt pay; agent/broker issues; MA reporting requirements; MA provider networks and network adequacy; nursing home staffing requirements; implementation of the One Big Beautiful Bill Act; Medicaid provider taxes; MA Star Ratings; Medicaid community engagement requirements; and VA's community care program.

Client expense: $3,010,000 · Firm income: Not reported

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

Issues related to 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

Coverage of blood transfusions under Medicare hospice benefit Medicare physician reimbursement issues CMS national coverage determinations for autologous stem cell transplantation for multiple myeloma Medicaid coverage for sickle cell disease Issues related to telehealth and extension of telehealth flexibilities Sickle cell disease/trait issues, including coverage for cell and gene therapies Prior authorization Implementation of the Inflation Reduction Act of 2022 (P.L. 117-169) Dental coverage for Medicare beneficiaries Sickle cell disease quality measures Issues impacting drug shortages Access to safe and effective vaccines Issues related to CAR-T/cellular and gene therapies Local Coverage Decisions for hematopoietic stem cell transplantation (HSCT) for lymphoma Local Coverage Decisions for next generation sequencing Medicare Patient Access and Practice Stabilization Act of 2025 (H.R. 879) Issues related to Social Security Administration disability evaluations for sickle cell disease Impact of Medicaid funding cuts on hematology Medicare codes for Chronic Care Management (CCM) and Principal Care Management (PCM) Implementation of One Big Beautiful Bill Act (Public Law No. 119-21) Community engagement requirements of One Big Beautiful Bill Act (Public Law No. 119-21) Sickle Cell Disease Comprehensive Care Act (S. 721 / H.R. 5178) Improving Access to Transfusion Care for Hospice Patients Act (S. 1936 / H.R. 9703) Improving Seniors Timely Access to Care Act (H.R. 3514 / S. 1816) CONNECT for Health Act (H.R. 4206 / S. 1261)

Client expense: $100,000 · 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), SENATE, Social Security Administration (SSA)

AI Diabetic Retinopathy Screening H.R.3277/S. 1677- Ensuring Lasting Smiles Act Medicare Access and CHIP Reauthorization Act (P.L.114-10) Improvement Issues Medicare Physician Payment Issues Drug Pricing and Shortages Issues Medicare Part B Drug Price Issues Expansion of Telehealth Services Vision Research Funding and proposed policy changes for federal research programs Step therapy requirements reforms Medicare Coverage for Low Vision Devices Modifications for federal student loan programs Modifications to the Medicaid Program H.R. 879, the Medicare Patient Access and Practice Stabilization Act of 2025 Healthcare Workforce Issues S. 864, the Help Ensure Lower Patient Copays Act (HELP Copays Act) S. 1105, the No Upcode Act Funding for the Pediatric Specialty Loan Repayment Program H.R. 2527, the Early Detection of Vision Impairments for Children Act of 2024 (EDVI Act) H.R.2433 - Reducing Medically Unnecessary Delays in Care Act of 2025 H.R. 3514/S. 1816- The Improving Seniors Timely Access to Care Act H.R. 7520, the Efficiency Adjustment Delay Act H.R. 3277/S. 1677, the Ensuring Lasting Smiles Act H.R. 10476, The Glaucoma Vision Act of 2026 H.R. 9693/S. 5672, the Patients First Act

Client expense: $254,772 · Firm income: Not reported

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

Medicaid State-Directed Payments. 340B Modernization. Funding for Disproportionate Share Hospitals (Medicaid DSH). Support for protecting front line multimission hospitals. Support of telehealth policies, including for audio-only telehealth services. Acute hospital care at home waiver flexibility. In general, support provisions to reform Medicare physician fee schedule payment policies and access to physician services. H.R.879, Medicare Patient Access and Practice Stabilization Act of 2025. Support for policies protecting access to Medicaid. Pub. L. No. 119-21, One Big Beautiful Bill Act, provisions regarding Medicaid provider taxes, state directed payments and other policies. H.R.5371, Continuing Appropriations and Extensions Act, 2026, provisions related to Medicaid DSH, telehealth, Hospital at Home program. H.R.4392, Uterine Fibroid Intervention and Gynecological Health Treatment Act of 2025. Medicare graduate medical education programs/funding; Medicare funding of trauma centers.

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

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

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

Oppose CMS's "efficiency adjustment" Support for structural changes that lead to delivering high quality care for patients while increasing efficiencies and promoting Medicare sustainability; oppose radiation oncology benefit managers Support for reforming the way Medicare pays for radiation oncology services by tying payments to quality and value Support for protecting access to care for Medicare patients Oppose physician fee schedule cuts due to clinical labor price updates Support for H.R. 2120 and S. 1031, a bill to modernize radiation oncology reimbursement - The Radiation Oncology Case Rate Value Based Program Act of 2025 Support for H.R. 879, to fix Medicare Physician Fee Schedule's physician payment reimbursement cuts Support H.R.3514, S.1816, the Improving Seniors' Timely Access to Care Act Support for H.R. 6160, Strengthening Medicare for Patients and Providers Act Support for H.R. 9693, Patients First Act

Client expense: $213,718 · Firm income: Not reported

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

Physician and payment issues. Issues related to Medicare payments and Medicare payment reform. Medicaid policies. H.R.879 - Medicare Patient Access and Practice Stabilization Act of 2025. Medicare Advantage H.R. 9693 - The Patients First Act of 2026.

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

Government targets: HOUSE OF REPRESENTATIVES, 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

H.R. 2484, Seniors Access to Critical Medications Act of 2025 (Support: Allows medically integrated physician dispensing flexibilities); H.R. 879, Medicare Patient Access and Practice Stabilization Act of 2025 (Support: Increases provider reimbursement in the Physician Fee Schedule); H.R. 2120, ROCR Value Based Program Act (Support: Modifies Medicare payment system for radiation oncology services); S. 1816 H.R. 3514, Improving Seniors' Timely Access to Care Act of 2025 (Support: Streamlines prior authorization process); Medicare Physician Payment; Site Neutral Payment Reform; CY2026 Medicare Physician Fee Schedule Proposed Rule; H.R. 4299, Protecting Patient Access to Cancer and Complex Therapies Act of 2025 (Support: Provide for a rebate by manufacturers for selected drugs and biological products subject to maximum fair price negotiation); PBM Transparency; Emergency Preparedness.

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

Government targets: 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

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)

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

Issues pertaining to physician payment and patient access to hospital care in PL 119-21, the One Big Beautiful Bill Act; various Presidential executive orders affecting health care providers; S. 1640/HR 879, the Medicare Patient Access and Practice Stabilization Act; S. 1816/HR 3514, the Improving Seniors' Timely Access to Care Act; S. 4641/HR 3954, the Improving Access to Medicare Coverage Act; HR 538, the Critical Access Hospitals Relief Act of 2025; provisions in CMS-1832-F, the CY 2026 Medicare Physician Fee Schedule Final Rule; health policy extensions in PL 119-75, FY2026 Consolidated Defense, LHHSED, Nat. Sec.-State, THUD, FSGG Approps. Act; HR 9693, Patients First Act of 2026

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

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

Issues related to Medicare and Medicaid payments to physicians; Issues related to medical imaging; Issues related to Appropriate Use Criteria (AUC); Issues related to prior authorization in Medicare and Medicaid; Issues related to H.R. 639 - Doctor Knows Best Act of 2025; Issues related to H.R. 879/S. 1640 - Medicare Patient Access and Practice Stabilization Act of 2025; Issues related to S. 891 - Bipartisan Health Care Act; Issues related to H.R. 5737/S. 1692 - Radiology Outpatient Ordering Transmission (ROOT) Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the CY 2025 Medicare Physician Fee Schedule proposed rule; Issues related to H.R. 879/S. 1640 - Medicare Patient Access and Practice Stabilization Act of 2025; Issues related to Consolidated Appropriations Act, 2026 (PL 119-75); Issues related to SUPPORT for Patients and Communities Reauthorization Act of 2025 (PL 119-44).

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

Government targets: HOUSE OF REPRESENTATIVES, 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

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

H.R.8163 - To amend title XVIII of the Social Security Act to ensure stability for provider payments under the Medicare program S.4254 - A bill to amend the Public Health Service Act to provide for a health care workforce innovation program. S.4109 - A bill to reauthorize the Stem Cell Therapeutic and Research Act of 2005, and for other purposes S.4110 - A bill to revise and extend health workforce programs under title VII of the Public Health Service Act H.R.7961 - Physicians and the Healthcare Workforce Act S.4086 - A bill to establish protections for health care providers who raise concerns about the quality of health care services, and for other purposes S.4039 - Professional Degree Access Restoration Act H.R.7884 - To amend the Internal Revenue Code of 1986 to provide a tax credit to health care professionals that provide health care services in qualifying facilities, and for other purposes; S.3908 - SOS: Sustaining Outpatient Services Act H.R.7686 - To recognize the importance of clinical roles of locum tenens physicians, and for other purposes H.R.7520 - Efficiency Adjustment Delay Act S.3762 - Prior Authorization Relief Act H.R.7118 - Genomic Answers for Childrens Health Act H.R. 1, the One Big, Beautiful Bill Act Improving seniors' timely access to care act (S. 1816 / H.R. 3514) Genomic Data Protection Act Tariffs PAMA reform S 1399, the Health Tech Investment Act H.R. 3580, the Oversight of Medicare Billing Code Cost Act S. 1916 - Protect Genetic information after bankruptcy S 1830 - HHS has no authority to regulate the practice of medicine LCD legislation HR2389/S1302 - Resident Physician Shortage Reduction Act S2333 - Public Health Workforce Loan Repayment Act S665/HR 4942 Conrad 30 and Physician Access Reauthorization Act CLIA Waiver CURES 2.0 To prevent across-the-board direct spending cuts HR 5392, the Timely Access to Coverage Decisions Act of 2023 Remote digital telepathology HR 4527 - HEALTH DATA Act Primary Care and Health Workforce Expansion Act Gene Therapy HR 6371 - budget neutrality bill S. 1546/H.R. 3152 The Patent Eligibility Restoration Act Cures 2.1 S. 4935, Physician Fee Stabilization Act Medical Lab Personnel Shortage Relief Act S. 1380 - SPARC Act S. 942/H.R. 2028 - REDI Act H.R. 879 - Medicare Patient Access and Practice Stabilization Act of 2025 Issues relating to regulation of laboratory diagnostics CDC Division of Cancer Prevention and Control and cancer registries appropriations S. 2439 and H.R. 4731, Resident Physician Shortage Reduction Act H.R.5371 - Continuing Appropriations and Extensions Act, 2026 S 2420 / H.R. 4710 - No Surprises Act Enforcement Act S 2793 - Ensuring Access to Essential Providers Act of 2025 H.R. 5582 / S 2355 - Patients Deserve Price Tags Act Issues related to public health Conrad 30 Physician Workforce Optimization Act (S. 4637) H.R.9645 - Health Care Price Certainty for All Americans Act H.R. 9693 - The Patients First Act S 5180 Provider Reimbursement Stability Act S 5062 - FAIR DME Appeals Act H.R. 8500 / S. 5745 - Timely Access to Coverage Decisions Act ROOT Act HR 8890 the Enhancing CLIA Act

Client expense: $203,130 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

No Bill No. - Physician payment reform No Bill No. - Value based care No Bill No. - Kids Access to Primary Care Act No Bill No. - Medicaid Primary Care Improvement Act No Bill No. - Alleviating Barriers for Caregivers (ABC) Act No Bill No. - MA Prompt Pay No Bill No. - CY2027 Medicare Physician Fee Schedule (H.R. 879) - Medicare Patient Access and Practice Stabilization Act (H.R. 1510) - Due Process Continuity of Care Act (S. 891) - Bipartisan Health Care Act (H.R. 1735/S. 779) - EARLY Minds Act (H.R. 786) - Reserving Patient Access to Accountable Care Act (S.2671/H.R. 5269) - RESULTS Act (2. 2749) - Medicare Sequester Exemption Bill (H.R. 483) - Health Care Efficiency Through Flexibility Act (H.R. 6160) - Strengthening Medicare for Patients and Providers Act (H.R. 6210) - Senior Savings Protection Act (S. 3300) - Access to New Community Health Opportunities and Recovery (ANCHOR) Act (S. 3522) - No Red Tape for Addiction Treatment Act (H.R. 8735/ S. 4384) - Medicare Advantage Improvements Act (H.R. 8390) - National Food as Medicine Program Act of 2026 (H.R. 8425) - Strengthening the Vaccines for Children Program Act of 2026 (H.R. 9693) - Patients First Act (S. 5296) - Pay PCPs Act

Client expense: $499,510 · 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. 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

H.R. 879, Medicare Patient Access and Practice Stabilization Act; H.R. 3164/S. 2426, Equitable Community Access to Pharmacist Services Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

H.R. 879 Medicare Patient Access and Practice Stabilization Act: To amend title XVIII of the Social Security Act to increase support for physicians and other practitioners in adjusting to Medicare payment changes. H.R. 2433 Reducing Medically Unnecessary Delays in Care Act: To amend title XVIII of the Social Security Act to extend incentive payments for participation in eligible alternative payment models under the Medicare program. H.R. 2191 Physician Led and Rural Access to Care Act: To amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals. S. 1390 Physician Led and Rural Access to Care Act: To amend title XVIII of the Social Security Act to revise certain physician self-referral exemptions relating to physician-owned hospitals. H.R. 751 HEALTH Panel Act: To amend the Congressional Budget and Impoundment Control Act of 1974 to codify the Panel of Health Advisors within the Congressional Budget Office, and for other purposes H.R. 1407 Permanent Telehealth from Home Act: To amend title XVIII of the Social Security Act to remove geographic requirements and expand originating sites for telehealth services under the Medicare program. H.R. 2028 REDI Act: To amend the Higher Education Act of 1965 to provide for interest-free deferment on student loans for borrowers serving in a medical or dental internship or residency program. S. 942 REDI Act: To amend the Higher Education Act of 1965 to provide for interest-free deferment on student loans for borrowers serving in a medical or dental internship or residency program. H.R. 3514 Improving Seniors' Access to Timely Care Act of 2025: To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. S. 1816: Improving Seniors' Access to Timely Care Act of 2025: To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans. CY2027 Medicare Physician Fee Schedule Proposed Rule - cuts to RVUs for total hip, knee and shoulder arthroplasty and shoulder hemiarthrolasty, Modifier-25, PE RVU formula changes.

Client expense: $400,000 · Firm income: Not reported

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

Support for Medicare physician payment reform, including H.R.879, the Medicare Patient Access and Practice Stabilization Act of 2025 and H.R. 8163, Provider Reimbursement Stability Act (H.R. 8163); Support for amendments to S. 1799/HR 3501, "Concentrating on High-Value Alzheimers Needs to Get to an End" to provide for shared decision-making, care planning and services, and primary care quality measures in connection with cognitive screening for Medicare beneficiaries; and monitoring of H.R. 6130, the Alzheimers Screening and Prevention (ASAP) Act of 2025.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 879, Medicare Patient Access and Practice Stabilization Act of 2025: payment rates H.R. 1317 (2025-2026), I CAN Act: provision of service under Medicare Medicare sequester, PAYGO Medicare Advantage Upcoding Medicare for All/Public Option Historical Medicare payment undervaluation for anesthesiology services (33% problem) Anesthesia Conversion Factor Medicare Physician Fee Schedule Rule Budget neutrality Medicare Economic Index: Medicare inflationary increase Medicaid Bundled payments H.R. 5454/S. 2879 Medicare Advantage Prompt Pay Act WISeR Model Medicare Administrative Contractor (MAC) Local Coverage Determinations (LCD) Practice Expense (PE) Opioid sparing Labor, Health and Human Services (LHHS) Appropriation S.586 - NOPAIN Act: Non-Opioids Prevent Addiction In the Nation Act or the NOPAIN Act Medicare Supervision Rule H.R. 9693: Patients First Act of 2026 H.R. 8163: Medicare Reimbursement Stabilization Act ((Provider Reimbursement Stability Act of 2026)

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

IPC supports S. 526 Pharmacy Benefit Manager Transparency Act of 2025 IPC supports S. 527 "Prescription Pricing for People Act of 2025 IPC supports H.R. 4317/S.3345 PBM Reform Act of 2025 IPC supports H.R. 3164/S. 2426 - "Main Street Pharmacy Access Act" IPC supports H.R. 6609 & H.R. 6610 - Pharmacists Fights Back Act IPC supports H.R. 5256 340B Affording Care for Communities and Ensuring a Strong Safety-Net Act (340B ACCESS Act) IPC monitors Trump Administration 340B Rebate Pilot Program adoption and implementation IPC supports OBBBA - Rural Health Transformation Program - grant implementation IPC monitors Senate BI-Partisan 340B working group - draft legislation IPC monitors Trump Administration overseas manufactured drug Section 232 tariffs investigation IPC monitors Trump Administration Drug Pricing Most Favored Nations status/Direct to Consumer (DTC) prescription drug distribution proposals IPC monitors HR 879/S.3794 Safe Drug Act of 2026 IPC is opposed to the HRSA 340B proposed rebate model IPC opposes HR 6509/S. 3794 Safe Drug Act of 2026. IPC opposes HR 5316 the "Drug Shortage Compounding Patient Access Act of 2025" IPC supports the Breakup Big Medicine Act S. 3822 IPC supports Protecting Pharmacies in Medicaid Act S. 927 IPC supports the US Department of Labor proposed rule on PBM transparency [RIN 1210-AB37]

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), SENATE, White House Office

H.R. 879, Medicare Patient Access and Practice Stabilization Act of 2025; Medicare coverage of physician telehealth in the post acute and long term care setting - H.R.4206/S. 1261 - CONNECT for Health Act; nursing home medical director transparency issues; The Patients First Act (H.R.9693)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Physician Fee Schedule reform legislation, Medicare Patient Access and Practice Stabilization Act (H.R. 879)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician Fee Schedule Provider Relief HR 879 Medicare Patient Access and Practice Stabilization Act Telehealth extension HR 5269 The RESULTS Act S.2761 The RESULTS Act H.R.2477 The PURE Act S.1168 The PURE Act

Client expense: $81,111 · Firm income: Not reported

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

issues relative to hospitals and healthcare; S3389 Lowering Healthcare Costs for Americans Act; S3315 Healthcare Cybersecurity and Resiliency Act 2026; H.Res Recognizing the 250th Anniversary of US and Importance of Healthcare; HR 7884 Healthcare Human Act 2026; HR 1160 Healthcare Provider Shortage Minimization Act; HR 706 AI in Healthcare Efficiency Study Act; HR6246 Save American Healthcare Act; S 729 Hospital Transparency Compliance Act; HR 1339 Safeguarding Social Security and Medicare Act; HR 879 Medicare Patient Access and Practice Stabilization Act 2025; HR 538 Critical Access Hospital Relief Act 2025; H.R.3023 Preventing Hospital Overbilling of Medicare Act; H.R.3684 Save Americas Rural Hospitals Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE