Patients First Act of 2026

S. 1390/H.R.2191, Physician-Led and Rural Access to Quality Care Act: To revise certain physician self-referral exemptions relating to physician-owned hospitals. S. 1640, the Medicare Patient Access and Practice Stabilization Act: Io increase support for physicians and other practitioners in adjusting to Medicare payment changes S. 1816/H.R.3514, Improving Seniors Timely Access to Care Act of 2025: Prior authorization reform in Medicare Advantage S. 2439/H.R.3890, Resident Physician Shortage Reduction Act: Medicare funding for medical residency training. S.5180/H.R. 8163, Provider Reimbursement Stability Act: Modifying Medicare's budget neutrality rules under the Medicare physician fee schedule. H.R.4002, Patient Access to Higher Quality Health Care Act of 2025: To repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. H.R. 4331, Access to Claims Data Act: To establish a process to expand access to claims data under certain Federal health plans in order to facilitate research and quality improvement. H.R.6160, Strengthening Medicare for Patients and Providers Act: To provide for an update to a single conversion factor under the Medicare physician fee schedule that is based on the Medicare economic index. H.R. 7520, Efficiency Adjustment Delay Act: To delay the implementation of an efficiency adjustment to work relative value units under the Medicare physician fee schedule. H.R. 8622. Medicare Physician Data-Driven Performance Payment System Act: To reform the Merit-based Incentive Payment System into the Data-driven Performance Payment System under the Medicare physician fee schedule. H.R.9693, Patients First Act: To modify MACRA to reform the Medicare physician payment system, including positive payment updates and improvements to the quality payment program. No Bill: Urging Congress to prevent funding for the proposed CMMI Wasteful and Inappropriate Service Reduction (WISeR) Model in the Medicare Fee-for-Service (FFS) program, which expands prior authorization to traditional Medicare.

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

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

Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Mental Health Care, Youth Mental Health; Site neutral payment reform; Program Fraud, Waste, and Abuse H.R. 7996, Improving CARE for Youth Act (118th) To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.2556 - Improving CARE for Youth Act (118th) To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Carper, Thomas R. [D-DE] H.R.4077 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Rep. Doggett, Lloyd [D-TX-37] S.2145 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Sen. Warren, Elizabeth [D-MA] H.R.668 - Coordinating Care for Senior Veterans and Wounded Warriors Act To require the Secretary of Veterans Affairs to carry out a pilot program to coordinate, navigate, and manage care and benefits for veterans enrolled in both the Medicare program and the system of annual patient enrollment of the Department of Veterans Affairs. Sponsor: Rep. Ciscomani, Juan [R-AZ-6] S.506 - Coordinating Care for Senior Veterans and Wounded Warriors Act This bill requires the Department of Veterans Affairs (VA) to implement a three-year pilot program to coordinate, navigate, and manage care and benefits for veterans who are enrolled in both the Medicare program and the VA health care system. Sponsor: Sen. Moran, Jerry [R-KS] H.R.9392 - Medicare Advantage Cost Transparency Act To amend title XVIII of the Social Security Act to require the inclusion of certain information in Medicare Advantage encounter data. Sponsor: Rep. DeGette, Diana [D-CO-1] H.R. 5243 - Supplemental Benefits Transparency Bill To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. Sponsor: Rep. McClellan, Jennifer L. [D-VA-4] H.R.3514 - Improving Seniors Timely Access to 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. Sponsor: Rep. Kelly, Mike [R-PA-16] H.R.8883 - Protecting Seniors and Stopping Fraudsters Act To amend title XVIII of the Social Security Act to provide for additional oversight of hospice programs and home health agencies under the Medicare program, and for other purposes. Sponsor: Rep. Van Duyne, Beth [R-TX-24] H.R.8871 - DME Scammer Prevention Act of 2026 To amend title XVIII of the Social Security Act to promote Medicare program integrity with respect to certain medical equipment and supplies. Sponsor: Rep. Bean, Aaron [R-FL-4] H.R.9847 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services or substance use disorder services and primary care services furnished on the same day. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.5236 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.9693 - Patients First Act of 2026 To amend title XVIII of the Social Security Act to modify certain physician payments under the Medicare program. Sponsor: Rep. Joyce, John [R-PA-13] H.R.8375 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Rep. Joyce, John [R-PA-13] S.4384 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS]

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

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

Erica Schwartz, of Florida, to be Director of the Centers for Disease Control and Prevention, vice Susan Monarez. (PN932) Heidi Overton, of New Mexico, to be Commissioner of Food and Drugs, Department of Health and Human Services, vice Martin Makary. (PN1273-17) Rural Obstetrics Readiness Act (S. 380/H.R. 1254) Jeanette Acosta Invest in Womens Health Act of 2026 (S.5546) Chloe Cole Act (H.R. 7651/H.R. 5843) State Offices of Womens Health Support and Expansion Act (H.R. 9842) Access to Claims Data Act (H.R. 4331) Patients First Act of 2026 (H.R. 9693) A Medicaid fix bill (not introduced yet) Strengthening the Exercise of Controls and Upgrading Requirements for Efficiency (SECURE) in 340B Act (H.R. 9599) SUSTAIN 340B Act (S. 5244) Safety Net Provider Drug Pricing Protection Act (not introduced yet) Medicaid streamline enrollment bill (not introduced) Protecting Taxpayers from Health Care Fraudsters Act (H.R. ____) Health Information Privacy Reform Act (S. 3097)

Client expense: $308,925 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.6160, Strengthening Medicare for Patients and Providers Act H.R.9693, Patients First Act of 2026 H.R.5454/S.2879, Medicare Advantage Prompt Pay Act. H.R.3514/S.1816, Improving Seniors Timely Access to Care Act. H.R.9970, the RESCUE Act Issues related to implementation of healthcare provisions in H.R.1. Issues related to CMS telehealth policies. Issues related to hospital outpatient reimbursement. Issues related to the Medicare area wage index. Issues related to Medicare Advantage. Issues related to Medicare GME. Issues related to Medicaid. Issues related to CMS ACCESS Model.

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

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

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

Ensuring Community Access to Pharmacist Services Act (H.R. 3164)/ Main Street Pharmacy Access Act (H.R. 3164)/ Equitable Community Access to Pharmacist Services Act  (S.2426) Inflation Reduction Act implementation, including impact on Pharmacy & Physician Reimbursement Protecting Patient Access to Cancer and Complex Therapies Act 2025 (H.R 4299) Reimbursement policies impacting drug shortages Part B drug pricing changes Preventing and mitigating generic drug shortages CMS FY 2026 Medicare Part B Physician Fee Schedule Medicare physician reimbursement CY2026 Medicare Physician Fee Schedule Rule CMS FY 2027 Medicare Physician Fee Schedule Distributor bona fide service fees Patients First Act of 2026 (H.R.9693)

Client expense: $405,804 · Firm income: Not reported

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

H.R.6248 - Healthy Competition for Better Care Act S.4027 - Healthy Competition for Better Care Act H.R.9393 - Lower Costs, More Transparency Act H.R.9693 - Patients First Act S.2355 - Patients Deserve Price Tags Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

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

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

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

Physician payment and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues related to peripheral arterial disease and other cardiovascular issues; H.R.307 - ARC Act of 2025; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues related to peripheral arterial disease and other cardiovascular issues; H.R.307 - ARC Act of 2025; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 issues, including Patients First Act (H.R.9693); access to primary care; ECAPS Act; health care access and affordability issues

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Reimbursement Policy; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · Firm income: Not reported

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

Medicare Reimbursement Policy; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · Firm income: Not reported

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

Physician payment and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · Firm income: Not reported

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Physician payment and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · Firm income: Not reported

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

Issues: Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Mental Health Care, Youth Mental Health; Site neutral payment reform; Program Fraud, Waste, and Abuse Bills: H.R.4077 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Rep. Doggett, Lloyd [D-TX-37] S.2145 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Sen. Warren, Elizabeth [D-MA] H.R.668 - Coordinating Care for Senior Veterans and Wounded Warriors Act To require the Secretary of Veterans Affairs to carry out a pilot program to coordinate, navigate, and manage care and benefits for veterans enrolled in both the Medicare program and the system of annual patient enrollment of the Department of Veterans Affairs. Sponsor: Rep. Ciscomani, Juan [R-AZ-6] S.506 - Coordinating Care for Senior Veterans and Wounded Warriors Act This bill requires the Department of Veterans Affairs (VA) to implement a three-year pilot program to coordinate, navigate, and manage care and benefits for veterans who are enrolled in both the Medicare program and the VA health care system. Sponsor: Sen. Moran, Jerry [R-KS] H.R.9392 - Medicare Advantage Cost Transparency Act To amend title XVIII of the Social Security Act to require the inclusion of certain information in Medicare Advantage encounter data. Sponsor: Rep. DeGette, Diana [D-CO-1] H.R. 5243 - Supplemental Benefits Transparency Bill To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. Sponsor: Rep. McClellan, Jennifer L. [D-VA-4] H.R.3514 - Improving Seniors Timely Access to 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. Sponsor: Rep. Kelly, Mike [R-PA-16] H.R.8883 - Protecting Seniors and Stopping Fraudsters Act To amend title XVIII of the Social Security Act to provide for additional oversight of hospice programs and home health agencies under the Medicare program, and for other purposes. Sponsor: Rep. Van Duyne, Beth [R-TX-24] H.R.8871 - DME Scammer Prevention Act of 2026 To amend title XVIII of the Social Security Act to promote Medicare program integrity with respect to certain medical equipment and supplies. Sponsor: Rep. Bean, Aaron [R-FL-4] H.R.9693 - Patients First Act of 2026 To amend title XVIII of the Social Security Act to modify certain physician payments under the Medicare program. Sponsor: Rep. Joyce, John [R-PA-13] H.R.8375 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Rep. Joyce, John [R-PA-13] S.4384 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS]

Client expense: $100,000 · 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), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office

Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Mental Health Care, Youth Mental Health; Site neutral payment reform; Program Fraud, Waste, and Abuse H.R. 7996, Improving CARE for Youth Act (118th) To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.2556 - Improving CARE for Youth Act (118th) To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Carper, Thomas R. [D-DE] H.R.4077 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Rep. Doggett, Lloyd [D-TX-37] S.2145 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Sen. Warren, Elizabeth [D-MA] H.R.668 - Coordinating Care for Senior Veterans and Wounded Warriors Act To require the Secretary of Veterans Affairs to carry out a pilot program to coordinate, navigate, and manage care and benefits for veterans enrolled in both the Medicare program and the system of annual patient enrollment of the Department of Veterans Affairs. Sponsor: Rep. Ciscomani, Juan [R-AZ-6] S.506 - Coordinating Care for Senior Veterans and Wounded Warriors Act This bill requires the Department of Veterans Affairs (VA) to implement a three-year pilot program to coordinate, navigate, and manage care and benefits for veterans who are enrolled in both the Medicare program and the VA health care system. Sponsor: Sen. Moran, Jerry [R-KS] H.R.9392 - Medicare Advantage Cost Transparency Act To amend title XVIII of the Social Security Act to require the inclusion of certain information in Medicare Advantage encounter data. Sponsor: Rep. DeGette, Diana [D-CO-1] H.R. 5243 - Supplemental Benefits Transparency Bill To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. Sponsor: Rep. McClellan, Jennifer L. [D-VA-4] H.R.3514 - Improving Seniors Timely Access to 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. Sponsor: Rep. Kelly, Mike [R-PA-16] H.R.8883 - Protecting Seniors and Stopping Fraudsters Act To amend title XVIII of the Social Security Act to provide for additional oversight of hospice programs and home health agencies under the Medicare program, and for other purposes. Sponsor: Rep. Van Duyne, Beth [R-TX-24] H.R.8871 - DME Scammer Prevention Act of 2026 To amend title XVIII of the Social Security Act to promote Medicare program integrity with respect to certain medical equipment and supplies. Sponsor: Rep. Bean, Aaron [R-FL-4] H.R.9847 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services or substance use disorder services and primary care services furnished on the same day. Sponsor: Rep. Dunn, Neal P. [R-FL-2] S.5236 - Improving CARE for Youth Act To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day. Sponsor: Sen. Hassan, Margaret Wood [D-NH] H.R.9693 - Patients First Act of 2026 To amend title XVIII of the Social Security Act to modify certain physician payments under the Medicare program. Sponsor: Rep. Joyce, John [R-PA-13] H.R.8375 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Rep. Joyce, John [R-PA-13] S.4384 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS]

Client expense: $1,240,000 · 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, White House Office

Physician payment and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · Firm income: Not reported

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

Health issues related to public research universities and the hospitals they operate, including One Big Beautiful Bill Act (H.R. 1), 340B program, Patients First Act (H.R. 9693).

Client expense: $291,000 · Firm income: Not reported

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

Physician payment and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · 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 and policy issues relating to dialysis vascular access services; H.R.7863 - Promoting Fairness for Medicare Providers Act of 2026; H.R. 9693 - Patients First Act of 2026

Client expense: Not reported · Firm income: Not reported

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

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

Issues: Medicare Advantage & MA Rate Notice; Medicare/Transparency; Mental Health Care, Youth Mental Health; Site neutral payment reform; Program Fraud, Waste, and Abuse Bills: H.R.4077 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Rep. Doggett, Lloyd [D-TX-37] S.2145 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Sen. Warren, Elizabeth [D-MA] H.R.9392 - Medicare Advantage Cost Transparency Act To amend title XVIII of the Social Security Act to require the inclusion of certain information in Medicare Advantage encounter data. Sponsor: Rep. DeGette, Diana [D-CO-1] H.R. 5243 - Supplemental Benefits Transparency Bill To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. Sponsor: Rep. McClellan, Jennifer L. [D-VA-4] H.R.3514 - Improving Seniors Timely Access to 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. Sponsor: Rep. Kelly, Mike [R-PA-16] H.R.8883 - Protecting Seniors and Stopping Fraudsters Act To amend title XVIII of the Social Security Act to provide for additional oversight of hospice programs and home health agencies under the Medicare program, and for other purposes. Sponsor: Rep. Van Duyne, Beth [R-TX-24] H.R.8871 - DME Scammer Prevention Act of 2026 To amend title XVIII of the Social Security Act to promote Medicare program integrity with respect to certain medical equipment and supplies. Sponsor: Rep. Bean, Aaron [R-FL-4] H.R.9693 - Patients First Act of 2026 To amend title XVIII of the Social Security Act to modify certain physician payments under the Medicare program. Sponsor: Rep. Joyce, John [R-PA-13] H.R.8375 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Rep. Joyce, John [R-PA-13] S.4384 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS]

Client expense: $276,347 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Issues: Same-day billing restrictions in Medicaid; Medicare Advantage & MA Rate Notice; Medicare/Transparency; Mental Health Care, Youth Mental Health; Site neutral payment reform; Program Fraud, Waste, and Abuse Bills: H.R.4077 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Rep. Doggett, Lloyd [D-TX-37] S.2145 - GUARD Veterans Health Care Act To amend title 38, United States Code, and the Social Security Act to permit recovery from the Department of Veterans Affairs of costs from Medicare Advantage and Medicare prescription drug plans and to modify the authority for recovery by the United States of reasonable charges for certain care or services furnished to veterans for non-service-connected disabilities, and for other purposes. Sponsor: Sen. Warren, Elizabeth [D-MA] H.R.668 - Coordinating Care for Senior Veterans and Wounded Warriors Act To require the Secretary of Veterans Affairs to carry out a pilot program to coordinate, navigate, and manage care and benefits for veterans enrolled in both the Medicare program and the system of annual patient enrollment of the Department of Veterans Affairs. Sponsor: Rep. Ciscomani, Juan [R-AZ-6] S.506 - Coordinating Care for Senior Veterans and Wounded Warriors Act This bill requires the Department of Veterans Affairs (VA) to implement a three-year pilot program to coordinate, navigate, and manage care and benefits for veterans who are enrolled in both the Medicare program and the VA health care system. Sponsor: Sen. Moran, Jerry [R-KS] H.R.9392 - Medicare Advantage Cost Transparency Act To amend title XVIII of the Social Security Act to require the inclusion of certain information in Medicare Advantage encounter data. Sponsor: Rep. DeGette, Diana [D-CO-1] H.R. 5243 - Supplemental Benefits Transparency Bill To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. Sponsor: Rep. McClellan, Jennifer L. [D-VA-4] H.R.3514 - Improving Seniors Timely Access to 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. Sponsor: Rep. Kelly, Mike [R-PA-16] H.R.8883 - Protecting Seniors and Stopping Fraudsters Act To amend title XVIII of the Social Security Act to provide for additional oversight of hospice programs and home health agencies under the Medicare program, and for other purposes. Sponsor: Rep. Van Duyne, Beth [R-TX-24] H.R.8871 - DME Scammer Prevention Act of 2026 To amend title XVIII of the Social Security Act to promote Medicare program integrity with respect to certain medical equipment and supplies. Sponsor: Rep. Bean, Aaron [R-FL-4] H.R.9693 - Patients First Act of 2026 To amend title XVIII of the Social Security Act to modify certain physician payments under the Medicare program. Sponsor: Rep. Joyce, John [R-PA-13] H.R.8375 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Rep. Joyce, John [R-PA-13] S.4384 - Medicare Advantage Improvement Act of 2026 To amend title XVIII of the Social Security Act to provide for certain reforms under the Medicare Advantage program, and for other purposes. Sponsor: Sen. Marshall, Roger [R-KS]

Client expense: Not reported · 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), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, White House Office