Patient Access to Higher Quality Health Care Act of 2019

Repeal Section 6001 of the Affordable Care Act; section 6001 prohibits expansion of physician-owned hospitals, and Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-owned hospitals, including related provisions in H.R. 3062 and S. 2860, the Patient Access to High Quality Health Care Act, to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. Coronavirus response efforts, including support for health care providers, patients and small business, and enable physician-owned hospitals to respond to COVID-19, including related provisions in H.R. 6800, the HEROES Act; H.R. 8406, the Heroes Act; S. 4318, the American Workers, Families, and Employers Assistance Act; S. 4320, the Coronavirus Response Additional Supplemental Appropriations Act, 2020; S. 4322, the Safely Back to School and Back to Work Act; and H.R. 133, the Consolidated Appropriations Act, 2021 - P.L. 116-260.

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), Natl Economic Council (NEC), Office of the Vice President of the United States, SENATE

Advocate to repeal section 6001 of the ACA. H.R.3062 - Patient Access to Higher Quality Health Care Act S. 2860 - Patient Access to Higher Quality Health Care Act of 2019 H.R. 716 - Creating Capacity for Communities in Need Act S. 3547 - Creating Capacity for Communities in Need Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3062/S. 2860 - "Patient Access to Higher Quality Health Care Act of 2019" - Oppose efforts to repeal certain provisions relating to the Medicare exception to the prohibition on certain physician referrals for hospitals. Support access to affordable prescription drugs. H.R. 3107 - "Improving Seniors' Timely Access to Care Act" - Support legislation that streamlines and standardizes prior authorization under the Medicare Advantage program. Sought moratorium on proposed Medicaid Fiscal Accountability Regulation H.R. 6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act - Support Division C, Health Provisions for Medicare and Medicaid that support health care providers and patients Post-Acute Care - Refresh the unified PAC PPS timeline and process under the IMPACT Act, Sought Congressional support for an IMPACT Act implementation/ unified payment timeline reset Qualifying APM Professional Threshold - Support request of House Leadership to address impending MACRA changes that could derail the movement to value-based health care and alternative payment models H.R. 7663 - "Protecting Access to Post-COVID-19 Telehealth Act of 2020" - Support broader access to Medicare telehealth services H.R. 133 - "Consolidated Appropriations Act, 2021" - Advocated in support of health care extenders, E&M, GME, sequester moratorium. Support continued government funding and other provisions. H.R. 8337 - "Continuing Appropriations Act, 2021 and Other Extensions Act" - Support passage of continuing resolution, including language to improve repayment terms of Medicare Accelerated and Advanced Payment Programs. H.R. 8840 - "Medicare Sequester COVID Moratorium Act" - Support extending the temporary suspension of Medicare sequestration.

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

H.R. 3062/S. 2860 - "Patient Access to Higher Quality Health Care Act of 2019" - Oppose efforts to repeal certain provisions relating to the Medicare exception to the prohibition on certain physician referrals for hospitals. Bad Debt Payments to Hospitals - Oppose effort to lower bad debt payments to hospitals for Medicare beneficiaries who do not pay their cost-sharing for treatments provided by the hospital. H.R. 2552 - "Protecting Local Access to Care for Everyone (PLACE) Act" - Support legislation to prevent site neutral cuts. H.R. 1763/ S. 348 - "Resident Physician Shortage Reduction Act of 2019", H.R. 3414/S. 2892 - Opioid Workforce Act - Support GME legislation to reduce resident physician shortage. Support access to affordable prescription drugs. H.R. 3107 - "Improving Seniors' Timely Access to Care Act" - Support legislation that streamlines and standardizes prior authorization under the Medicare Advantage program. Sought moratorium on proposed Medicaid Fiscal Accountability Regulation H.R. 748 Coronavirus Aid, Relief, and Economic Security (CARES) Act - Advocated in support of funding and programs for hospitals and post-acute care providers to respond to COVID-19 H.R. 6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act - Supported legislation

Client expense: $650,000 · Firm income: Not reported

Discussions on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussions about the work of Aligning for Health to address social determinants of health; Support HR 1041 / S 586,Critical Access Hospital Relief Act of 2019, a bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services; Support S 895, Rural Hospital Regulatory Relief Act of 2019, a bill to provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals; Support S 948,Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities, and for other purposes; Discussions in support of the Rural Emergency Medical Center Act (REACH) Act; Support for extension of the Rural Community Hospital Demonstration Program; Support for extension of the Frontier Community Health Integration Project Demonstration program; Discuss changes with House and Senate committees to Section 8122 of the SUPPORT for Patients and Communities Act; Letter of support to Energy and Commerce Committee for the hearing on legislation to strengthen our health care system and ACA market stability; Support HR 1781/ S 801, Payment Commission Data Act of 2019, a bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information; Support S 551 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 or the REFUND Act of 2019, a bill to amend title XVIII of the Social Security Act to require manufacturers of certain single-dose vial drugs payable under part B of the Medicare program to provide rebates with respect to amounts of such drugs discarded, and for other purposes; Support S 824/ HR 1767, Excellence in Mental Health and Addiction Treatment Expansion Act, a bill to increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services; Statement submitted to Senate Finance Committee on the implementation of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support HR 2552Protecting Local Access to Care for Everyone Act of 2019 or the PLACE Act of 2019, a bill to direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program; Support HR 3022, Patient Access Protection Act, a bill to amend title XIX of the Social Security Act to repeal the reductions in Medicaid DSH allotments, and for other purposes; Letter of support to the Ways and Means Committee in support of legislation to improve the quality of an access to services for Medicare beneficiaries, help train the physician workforce and reduce administrative burden on rural hospitals; Support HR 3431, HEARTS and Rural Relief Act, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2021; Support HR 3417,Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 or the BETTER Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for patient improvements and rural and quality improvements under the Medicare program; Oppose HR 1384, Medicare for All Act of 2019, a bill to establish an improved Medicare for All national health insurance program; Oppose S 1129, Medicare for All Act of 2019, a bill to establish a Medicare-for-all national health insurance program; Letter to House Committee on Ways and Means for the hearing on Pathways to Universal Health Coverage addressing concerns with Medicare for All and believe that the variety of proposals that often are used interchangeably under that name are not the solution; Oppose HR 2452, Medicare for America Act of 2019, a bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans; Letter to House Committee on Budget for the hearing on the Congressional Budget Offices (CBO) Key Design Components and Considerations for Establishing a Single-Payer Health Care System addressing concerns with Medicare for All; Oppose S 1261/ HR 2463, Choose Medicare Act, a bill to provide for the establishment of Medicare part E public health plans, and for other purposes; Oppose S 981/ HR 2000Medicare-X Choice Act of 2019A bill to establish a public health plan; Oppose S 1033/ HR 2085, CHOICE Act, a bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Oppose S 470, Medicare at 50 Act, a bill to amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare; Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes; Submitted Statement to the House Committee on Rules for the Hearing Medicare for All Act of 2019; Comment on provisions of HR 2328,Reauthorizing and Extending Americas Community Health (REACH) Act, support for the Medicaid disproportionate share hospital(DSH) program provisions included in Title III; comments on Title IV, which contains provisions of the No Surprises Act and concern with the legislations approach to determining reimbursement for out-of-network providers; Support HR 3107 Seniors Timely Access to Care Act of 2019, this legislation would establish requirements for the use of prior authorization under Medicare Advantage plans; Meeting with the Senate finance committee to discuss changes to drug bill; Meeting with CMS to discuss changes to prior authorization; Meeting with Department of Labor to discuss issues with ERISA health plans; Met with CMS staff on rural hospital issues; Regulatory burden related to new CMS guidance on documenting Crossover bad debt; Sent a Comment letter to CMS on a final rule on program integrity enhancements to the provider enrollment process for Medicare, Medicaid and Children's Health Insurance Programs; Oppose S. 2860 Patient Access to Higher Quality Health Care Act of 2019, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 4996, Helping MOMS Act of 2019, a bill amend title XIX of the Social Security Act to provide for a State option under the Medicaid program to provide for and extend continuous coverage for certain individuals, and for other purposes; Addressing hospital concerns about HR 3 Lower Drug Costs Now Act, a bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes; Sent comment letter requesting that CMS withdraw the proposed regulation related to Medicaid Program: Medicaid Fiscal Accountability Regulation ( MFAR) financing and supplemental payments. Given that the proposal would severely curtail the availability of health care services to millions of individuals and because many of its provisions are not legally permissible; Discussion with CMS for rural hospitals and critical access hospitals about the Medicare accelerated payment program, which is intended to provide necessary funds to providers, including rural hospitals and critical access hospitals, when there is a disruption in claims submission and/or claims processing; Submitted comments on CMSs proposed rule on Medicare Advantage and Part D prescription drug program for Contract Years 2021 and 2022. The letter focuses on several proposals addressing network adequacy; Letter sent to HHS, CDC, CMS, and SAMHSA requesting specialized guidance and assistance for providers who care for patients with behavioral health disorders; Support resetting the Improving Medicare Post- Acute Care Transformation (IMPACT) Act of 2014 in the next COVID-19 relief package. The IMPACT Acts implementation is behind schedule and does not take into account extensive payment reforms already underway in each post-acute care setting; Letter urging HHS to release substantial additional emergency funds to all hospitals in an expedited manner. This second wave of funding to all hospitals, targeted relief is necessary for hospitals in hot spots, hospitals with a high percentage of payments under Medicare Advantage, hospitals caring for high numbers of Medicaid patients, and rural hospitals; Support HR 6693 Critical Access Hospital Expansion Act of 2020, a bill to amend title XVIII of the Social Security Act to allow States to certify certain hospitals as necessary providers for purposes of designating such hospitals as critical access hospitals under the Medicare program; Support HR 6753/ S 3615 Rural Community Hospital Demonstration Extension Act of 2020, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the rural community hospital demonstration program; Letter urging CMS to use its authority to extend to LTCHs the existing 20% hospital add-on payment for Medicare beneficiaries diagnosed with COVID-19; Letter to CMS urging the agency to temporarily extend certain waivers and make others permanent beyond the COVID-19 public health emergency to allow hospitals to provide better and more cost effective care to their patients and communities; Sent comment letter to CMS about our concerns with the timeline proposed for implementation as well as the potential for penalties for noncompliance within this timeline on the Medicare Program: Electronic Prescribing of Controlled Substances; Sent comment letter on the FY 2021 Inpatient PPS proposed rule addressing CMS proposals related to payer-specific negotiated rate data collection, Medicare DSH payments, CAR T, bad debt, MS-DRG classifications, and quality programs, among other topics. Letter requesting that the CMS delay the implementation of the Appropriate Use Criteria for Advanced Diagnostic Imaging Services program to allow providers the opportunity to implement and test operational changes and acquire the education necessary to achieve compliance with the program; Sent comments to the CMS on the agencys long-term care hospital prospective payment system proposed policy changes and fiscal year 2021 rates; Letter to CMS asking for a delay in the start of repayments associated with the Medicare Accelerated and Advance Payment (AAP) Programs; Letter urging the CMS to continue its suspension of medical review activities throughout the ongoing COVID-19 public health emergency; Letter urging CMS to allow periodic interim payment (PIP) hospitals to carry out their accelerated payment repayment at cost settlement, as was initially communicated by the agency and also request that the agency make alternative repayment approaches available, such as direct payments to the Medicare Administrative Contractor (MAC), for all hospitals; Comment letter on CY 2021 Home Health Prospective Payment System Rate Update proposed rule. While we continue to support the PDGM objective of increasing HH PPS payment accuracy, we remain concerned that CY 2020s large behavioral offset, 4.36%, was implemented on a prospective basis; Letter urging the CMS to withdraw the condition of participation (CoP) that hospitals report daily COVID-19 data and request that CMS immediately release detailed interpretive guidance so hospitals can take the necessary steps to come into compliance; Urged CMS to withdraw its Medicaid fiscal accountability proposed rule from its regulatory agenda because it would "severely curtail the availability of health care services to millions of individuals" and "many of its provisions are not legally permissible."

H.R. 3062/S. 2860 - "Patient Access to Higher Quality Health Care Act of 2019" - Oppose efforts to repeal certain provisions relating to the Medicare exception to the prohibition on certain physician referrals for hospitals. H.R. 2552 - "Protecting Local Access to Care for Everyone (PLACE) Act" - Support legislation to prevent site neutral cuts. Support access to affordable prescription drugs. H.R. 3107 - "Improving Seniors' Timely Access to Care Act" - Support legislation that streamlines and standardizes prior authorization under the Medicare Advantage program. Sought moratorium on proposed Medicaid Fiscal Accountability Regulation H.R. 6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act - Support Division C, Health Provisions for Medicare and Medicaid that support health care providers and patients Post-Acute Care - Refresh the unified PAC PPS timeline and process under the IMPACT Act, Sought Congressional support for an IMPACT Act implementation/ unified payment timeline reset Qualifying APM Professional Threshold - Support request of House Leadership to address impending MACRA changes that could derail the movement to value-based health care and alternative payment models H.R. 7663 - "Protecting Access to Post-COVID-19 Telehealth Act of 2020" - Support broader access to Medicare telehealth services

Client expense: $700,000 · Firm income: Not reported

Advocate to repeal section 6001 of the ACA. H.R.3062 - Patient Access to Higher Quality Health Care Act S. 2860 - Patient Access to Higher Quality Health Care Act of 2019 H.R. 716 - Creating Capacity for Communities in Need Act S. 3547 - Creating Capacity for Communities in Need Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Recovery audit contractor reform; Medicare regulatory reform, including physician payment reforms; network adequacy oversight; prior authorization reform; Medicare accountable care organizations; electronic health record interoperability and vendor accountability; physician-owned hospital barriers, including related provisions in H.R. 3062 and S. 2860, the Patient Access to High Quality Health Care Act, to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; private contracting, mandatory participation in demonstrations; telehealth services; and use of step therapy in Medicare and health insurance coverage. Coronavirus response efforts, including support for health care providers, patients and small business, including related provisions in H.R. 6800, the HEROES Act; H.R. 8406, the Heroes Act; S. 4318, the American Workers, Families, and Employers Assistance Act; S. 4320, the Coronavirus Response Additional Supplemental Appropriations Act, 2020; and S. 4322, the Safely Back to School and Back to Work Act; related provisions in Sec. 2501 of H.R. 8337, the Continuing Appropriations Act, 2021 and Other Extensions Act re: modifications to the Accelerated and Advance Payment Programs. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including related provisions in H.R. 5741, the Strengthening Innovation in Medicare and Medicaid Act.

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

Repeal Section 6001 of the Affordable Care Act; section 6001 prohibits expansion of physician-owned hospitals, and Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-owned hospitals, including related provisions in H.R. 3062 and S. 2860, the Patient Access to High Quality Health Care Act, to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. Coronavirus response efforts, including support for health care providers, patients and small business, and enable physician-owned hospitals to respond to COVID-19, including related provisions in H.R. 6800, the HEROES Act; H.R. 8406, the Heroes Act; S. 4318, the American Workers, Families, and Employers Assistance Act; S. 4320, the Coronavirus Response Additional Supplemental Appropriations Act, 2020; and S. 4322, the Safely Back to School and Back to Work Act.

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

H.R. 3062/S. 2860 - "Patient Access to Higher Quality Health Care Act of 2019" - Oppose efforts to repeal certain provisions relating to the Medicare exception to the prohibition on certain physician referrals for hospitals. Bad Debt Payments to Hospitals - Oppose effort to lower bad debt payments to hospitals for Medicare beneficiaries who do not pay their cost-sharing for treatments provided by the hospital. H.R. 2552 - "Protecting Local Access to Care for Everyone (PLACE) Act" - Support legislation to prevent site neutral cuts. H.R. 1763/ S. 348 - "Resident Physician Shortage Reduction Act of 2019", H.R. 3414/S. 2892 - Opioid Workforce Act - Support GME legislation to reduce resident physician shortage. Support access to affordable prescription drugs. H.R. 3107 - "Improving Seniors' Timely Access to Care Act" - Support legislation that streamlines and standardizes prior authorization under the Medicare Advantage program. Sought moratorium on proposed Medicaid Fiscal Accountability Regulation H.R. 748 Coronavirus Aid, Relief, and Economic Security (CARES) Act - Advocated in support of funding and programs for hospitals and post-acute care providers to respond to COVID-19 H.R. 6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act - Supported legislation

Client expense: $640,000 · Firm income: Not reported

Discussions on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussions about the work of Aligning for Health to address social determinants of health; Support HR 1041 / S 586,Critical Access Hospital Relief Act of 2019, a bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services; Support S 895, Rural Hospital Regulatory Relief Act of 2019, a bill to provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals; Support S 948,Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities, and for other purposes; Discussions in support of the Rural Emergency Medical Center Act (REACH) Act; Support for extension of the Rural Community Hospital Demonstration Program; Support for extension of the Frontier Community Health Integration Project Demonstration program; Discuss changes with House and Senate committees to Section 8122 of the SUPPORT for Patients and Communities Act; Letter of support to Energy and Commerce Committee for the hearing on legislation to strengthen our health care system and ACA market stability; Support HR 1781/ S 801, Payment Commission Data Act of 2019, a bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information; Support S 551 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 or the REFUND Act of 2019, a bill to amend title XVIII of the Social Security Act to require manufacturers of certain single-dose vial drugs payable under part B of the Medicare program to provide rebates with respect to amounts of such drugs discarded, and for other purposes; Support S 824/ HR 1767, Excellence in Mental Health and Addiction Treatment Expansion Act, a bill to increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services; Statement submitted to Senate Finance Committee on the implementation of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support HR 2552Protecting Local Access to Care for Everyone Act of 2019 or the PLACE Act of 2019, a bill to direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program; Support HR 3022, Patient Access Protection Act, a bill to amend title XIX of the Social Security Act to repeal the reductions in Medicaid DSH allotments, and for other purposes; Letter of support to the Ways and Means Committee in support of legislation to improve the quality of an access to services for Medicare beneficiaries, help train the physician workforce and reduce administrative burden on rural hospitals; Support HR 3431, HEARTS and Rural Relief Act, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2021; Support HR 3417,Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 or the BETTER Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for patient improvements and rural and quality improvements under the Medicare program; Oppose HR 1384, Medicare for All Act of 2019, a bill to establish an improved Medicare for All national health insurance program; Oppose S 1129, Medicare for All Act of 2019, a bill to establish a Medicare-for-all national health insurance program; Letter to House Committee on Ways and Means for the hearing on Pathways to Universal Health Coverage addressing concerns with Medicare for All and believe that the variety of proposals that often are used interchangeably under that name are not the solution; Oppose HR 2452, Medicare for America Act of 2019, a bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans; Letter to House Committee on Budget for the hearing on the Congressional Budget Offices (CBO) Key Design Components and Considerations for Establishing a Single-Payer Health Care System addressing concerns with Medicare for All; Oppose S 1261/ HR 2463, Choose Medicare Act, a bill to provide for the establishment of Medicare part E public health plans, and for other purposes; Oppose S 981/ HR 2000Medicare-X Choice Act of 2019A bill to establish a public health plan; Oppose S 1033/ HR 2085, CHOICE Act, a bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Oppose S 470, Medicare at 50 Act, a bill to amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare; Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes; Submitted Statement to the House Committee on Rules for the Hearing Medicare for All Act of 2019; Comment on provisions of HR 2328,Reauthorizing and Extending Americas Community Health (REACH) Act, support for the Medicaid disproportionate share hospital(DSH) program provisions included in Title III; comments on Title IV, which contains provisions of the No Surprises Act and concern with the legislations approach to determining reimbursement for out-of-network providers; Support HR 3107 Seniors Timely Access to Care Act of 2019, this legislation would establish requirements for the use of prior authorization under Medicare Advantage plans; Meeting with the Senate finance committee to discuss changes to drug bill; Meeting with CMS to discuss changes to prior authorization; Meeting with Department of Labor to discuss issues with ERISA health plans; Met with CMS staff on rural hospital issues; Regulatory burden related to new CMS guidance on documenting Crossover bad debt; Sent a Comment letter to CMS on a final rule on program integrity enhancements to the provider enrollment process for Medicare, Medicaid and Children's Health Insurance Programs; Oppose S. 2860 Patient Access to Higher Quality Health Care Act of 2019, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 4996, Helping MOMS Act of 2019, a bill amend title XIX of the Social Security Act to provide for a State option under the Medicaid program to provide for and extend continuous coverage for certain individuals, and for other purposes; Addressing hospital concerns about HR 3 Lower Drug Costs Now Act, a bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes; Sent comment letter requesting that CMS withdraw the proposed regulation related to Medicaid Program: Medicaid Fiscal Accountability Regulation ( MFAR) financing and supplemental payments. Given that the proposal would severely curtail the availability of health care services to millions of individuals and because many of its provisions are not legally permissible; Discussion with CMS for rural hospitals and critical access hospitals about the Medicare accelerated payment program, which is intended to provide necessary funds to providers, including rural hospitals and critical access hospitals, when there is a disruption in claims submission and/or claims processing; Submitted comments on CMSs proposed rule on Medicare Advantage and Part D prescription drug program for Contract Years 2021 and 2022. The letter focuses on several proposals addressing network adequacy; Letter sent to HHS, CDC, CMS, and SAMHSA requesting specialized guidance and assistance for providers who care for patients with behavioral health disorders; Support resetting the Improving Medicare Post- Acute Care Transformation (IMPACT) Act of 2014 in the next COVID-19 relief package. The IMPACT Acts implementation is behind schedule and does not take into account extensive payment reforms already underway in each post-acute care setting; Letter urging HHS to release substantial additional emergency funds to all hospitals in an expedited manner. This second wave of funding to all hospitals, targeted relief is necessary for hospitals in hot spots, hospitals with a high percentage of payments under Medicare Advantage, hospitals caring for high numbers of Medicaid patients, and rural hospitals; Support HR 6693 Critical Access Hospital Expansion Act of 2020, a bill to amend title XVIII of the Social Security Act to allow States to certify certain hospitals as necessary providers for purposes of designating such hospitals as critical access hospitals under the Medicare program; Support HR 6753/ S 3615 Rural Community Hospital Demonstration Extension Act of 2020, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the rural community hospital demonstration program; Letter urging CMS to use its authority to extend to LTCHs the existing 20% hospital add-on payment for Medicare beneficiaries diagnosed with COVID-19; Letter to CMS urging the agency to temporarily extend certain waivers and make others permanent beyond the COVID-19 public health emergency to allow hospitals to provide better and more cost effective care to their patients and communities.

Advocate to repeal section 6001 of the ACA. H.R.3062 - Patient Access to Higher Quality Health Care Act S. 2860 - Patient Access to Higher Quality Health Care Act of 2019 H.R. 716 - Creating Capacity for Communities in Need Act S. 3547 - Creating Capacity for Communities in Need Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3062/S. 2860 - "Patient Access to Higher Quality Health Care Act of 2019" - Oppose efforts to repeal certain provisions relating to the Medicare exception to the prohibition on certain physician referrals for hospitals. Bad Debt Payments to Hospitals - Oppose effort to lower bad debt payments to hospitals for Medicare beneficiaries who do not pay their cost-sharing for treatments provided by the hospital. H.R. 2552 - "Protecting Local Access to Care for Everyone (PLACE) Act" - Support legislation to prevent site neutral cuts. H.R. 1763/ S. 348 - "Resident Physician Shortage Reduction Act of 2019", H.R. 3414/S. 2892 - Opioid Workforce Act - Support GME legislation to reduce resident physician shortage. Support access to affordable prescription drugs. H.R. 3107 - "Improving Seniors' Timely Access to Care Act" - Support legislation that streamlines and standardizes prior authorization under the Medicare Advantage program. Sought moratorium on proposed Medicaid Fiscal Accountability Regulation H.R. 748 Coronavirus Aid, Relief, and Economic Security (CARES) Act - Advocated in support of funding and programs for hospitals and post-acute care providers to respond to COVID-19 H.R. 6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act - Supported legislation

Client expense: $650,000 · Firm income: Not reported

Recovery audit contractor reform; Medicare regulatory reform, including physician payment reforms; network adequacy oversight; prior authorization reform; Medicare accountable care organizations; electronic health record interoperability and vendor accountability; physician-owned hospital barriers, including related provisions in H.R. 3062 and S. 2860, the Patient Access to High Quality Health Care Act, to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; private contracting, mandatory participation in demonstrations; telehealth services; and use of step therapy in Medicare and health insurance coverage. Coronavirus response efforts, including support for health care providers, patients and small business, and related provisions in H.R. 6800, the HEROES Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including related provisions in H.R. 5741, the Strengthening Innovation in Medicare and Medicaid Act.

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

Repeal Section 6001 of the Affordable Care Act; section 6001 prohibits expansion of physician-owned hospitals, and Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-owned hospitals, including related provisions in H.R. 3062 and S. 2860, the Patient Access to High Quality Health Care Act, to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. Coronavirus response efforts, including support for health care providers, patients and small business, and enable physician-owned hospitals to respond to COVID-19, including related provisions in H.R. 6800, the HEROES Act.

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

Discussions on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussions about the work of Aligning for Health to address social determinants of health; Support HR 1041 / S 586,Critical Access Hospital Relief Act of 2019, a bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services; Support S 895, Rural Hospital Regulatory Relief Act of 2019, a bill to provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals; Support S 948,Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities, and for other purposes; Discussions in support of the Rural Emergency Medical Center Act (REACH) Act; Support for extension of the Rural Community Hospital Demonstration Program; Support for extension of the Frontier Community Health Integration Project Demonstration program; Discuss changes with House and Senate committees to Section 8122 of the SUPPORT for Patients and Communities Act; Letter of support to Energy and Commerce Committee for the hearing on legislation to strengthen our health care system and ACA market stability; Support HR 1781/ S 801, Payment Commission Data Act of 2019, a bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information; Support S 551 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 or the REFUND Act of 2019, a bill to amend title XVIII of the Social Security Act to require manufacturers of certain single-dose vial drugs payable under part B of the Medicare program to provide rebates with respect to amounts of such drugs discarded, and for other purposes; Support S 824/ HR 1767, Excellence in Mental Health and Addiction Treatment Expansion Act, a bill to increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services; Statement submitted to Senate Finance Committee on the implementation of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support HR 2552Protecting Local Access to Care for Everyone Act of 2019 or the PLACE Act of 2019, a bill to direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program; Support HR 3022, Patient Access Protection Act, a bill to amend title XIX of the Social Security Act to repeal the reductions in Medicaid DSH allotments, and for other purposes; Letter of support to the Ways and Means Committee in support of legislation to improve the quality of an access to services for Medicare beneficiaries, help train the physician workforce and reduce administrative burden on rural hospitals; Support HR 3431, HEARTS and Rural Relief Act, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2021; Support HR 3417,Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 or the BETTER Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for patient improvements and rural and quality improvements under the Medicare program; Oppose HR 1384, Medicare for All Act of 2019, a bill to establish an improved Medicare for All national health insurance program; Oppose S 1129, Medicare for All Act of 2019, a bill to establish a Medicare-for-all national health insurance program; Letter to House Committee on Ways and Means for the hearing on Pathways to Universal Health Coverage addressing concerns with Medicare for All and believe that the variety of proposals that often are used interchangeably under that name are not the solution; Oppose HR 2452, Medicare for America Act of 2019, a bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans; Letter to House Committee on Budget for the hearing on the Congressional Budget Offices (CBO) Key Design Components and Considerations for Establishing a Single-Payer Health Care System addressing concerns with Medicare for All; Oppose S 1261/ HR 2463, Choose Medicare Act, a bill to provide for the establishment of Medicare part E public health plans, and for other purposes; Oppose S 981/ HR 2000Medicare-X Choice Act of 2019A bill to establish a public health plan; Oppose S 1033/ HR 2085, CHOICE Act, a bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Oppose S 470, Medicare at 50 Act, a bill to amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare; Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes; Submitted Statement to the House Committee on Rules for the Hearing Medicare for All Act of 2019; Comment on provisions of HR 2328,Reauthorizing and Extending Americas Community Health (REACH) Act, support for the Medicaid disproportionate share hospital(DSH) program provisions included in Title III; comments on Title IV, which contains provisions of the No Surprises Act and concern with the legislations approach to determining reimbursement for out-of-network providers; Support HR 3107 Seniors Timely Access to Care Act of 2019, this legislation would establish requirements for the use of prior authorization under Medicare Advantage plans; Meeting with the Senate finance committee to discuss changes to drug bill; Meeting with CMS to discuss changes to prior authorization; Meeting with Department of Labor to discuss issues with ERISA health plans; Met with CMS staff on rural hospital issues; Regulatory burden related to new CMS guidance on documenting Crossover bad debt; Sent a Comment letter to CMS on a final rule on program integrity enhancements to the provider enrollment process for Medicare, Medicaid and Children's Health Insurance Programs; Oppose S. 2860 Patient Access to Higher Quality Health Care Act of 2019, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 4996, Helping MOMS Act of 2019, a bill amend title XIX of the Social Security Act to provide for a State option under the Medicaid program to provide for and extend continuous coverage for certain individuals, and for other purposes; Addressing hospital concerns about HR 3 Lower Drug Costs Now Act, a bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes; Sent comment letter requesting that CMS withdraw the proposed regulation related to Medicaid Program: Medicaid Fiscal Accountability Regulation ( MFAR) financing and supplemental payments. Given that the proposal would severely curtail the availability of health care services to millions of individuals and because many of its provisions are not legally permissible.

Recovery audit contractor reform; Medicare regulatory reform, including physician payment reforms; network adequacy oversight; prior authorization reform; Medicare accountable care organizations; electronic health record interoperability and vendor accountability; physician-owned hospital barriers, including related provisions in H.R. 3062 and S. 2860, the Patient Access to High Quality Health Care Act, to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; private contracting, mandatory participation in demonstrations; telehealth services; and use of step therapy in Medicare and health insurance coverage. Coronavirus response efforts, including support for health care providers, patients and small business, and related provisions in: (1) H.R. 6074, the Coronavirus Preparedness and Response Supplemental Appropriations Act; (2) H.R. 6201, the Families First Coronavirus Response Act; and (3) H.R. 748, the Coronavirus Aid, Relief, and Economic Security Act. Enhance Center for Medicare & Medicaid Innovation quality initiatives and patient access to Medicare Part B covered drugs, including related provisions in H.R. 5741, the Strengthening Innovation in Medicare and Medicaid Act.

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

Repeal Section 6001 of the Affordable Care Act; section 6001 prohibits expansion of physician-owned hospitals, and Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-owned hospitals, including related provisions in H.R. 3062 and S. 2860, the Patient Access to High Quality Health Care Act, to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals. Coronavirus response efforts, including support for health care providers, patients and small business, and enable physician-owned hospitals to respond to COVID-19, including related provisions in: (1) H.R. 6074, the Coronavirus Preparedness and Response Supplemental Appropriations Act; (2) H.R. 6201, the Families First Coronavirus Response Act; and (3) H.R. 748, the Coronavirus Aid, Relief, and Economic Security Act.

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

Advocate to repeal section 6001 of the ACA. H.R.3062 - Patient Access to Higher Quality Health Care Act S. 2860 - Patient Access to Higher Quality Health Care Act of 2019

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare issues related to physician-owned hospitals H.R. 3062/S. 2860 - the Patient Access to Higher Quality Health Care Act of 2019 Health care transparency H.R. 748 - Coronavirus Aid, Relief, and Economic Security (CARES) Act [P.L. No. 116-136]

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3062/S. 2860 - "Patient Access to Higher Quality Health Care Act of 2019" - Oppose efforts to repeal certain provisions relating to the Medicare exception to the prohibition on certain physician referrals for hospitals. Bad Debt Payments to Hospitals - Oppose any effort to lower bad debt payments to hospitals for Medicare beneficiaries who fail to pay their cost-sharing obligations for treatments provided by the hospital. H.R. 2552 - "Protecting Local Access to Care for Everyone (PLACE) Act" - Support legislation to prevent site neutral cuts. H.R. 1763/ S. 348 - "Resident Physician Shortage Reduction Act of 2019" - Support GME legislation to reduce resident physician shortage. H.R. 3414/S. 2892 - Opioid Workforce Act - Support GME legislation to reduce resident physician shortage. Support access to affordable prescription drugs. H.R. 3107 - "Improving Seniors' Timely Access to Care Act" - Support legislation that streamlines and standardizes prior authorization under the Medicare Advantage program. Sought moratorium on proposed Medicaid Fiscal Accountability Regulation H.R. 748 Coronavirus Aid, Relief, and Economic Security (CARES) Act - Advocated in support of lifting sequester, increasing DRG payments, DSH cut delay, accelerated payment program, and waiving IRF and LTCH Medicare payment requirements in response to COVID-19. H.R. 4899/S. 2406 - Rural America Health Corps Act, H.R. 4900/S. 2408 - Telehealth Across State Lines Act of 2019, H.R. 4898/S. 2411 - Rural Health Innovation Act of 2019 - support expanded access to telehealth and broadband.

Client expense: $640,000 · Firm income: Not reported

Repeal Section 6001 of the Affordable Care Act; section 6001 prohibits expansion of physician-owned hospitals, and Center for Medicare & Medicaid Innovation demonstration to expand patient access to physician-owned hospitals, including related provisions in H.R. 3062 and S. 2860, the Patient Access to High Quality Health Care Act, to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals.

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

Discussions on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussions about the work of Aligning for Health to address social determinants of health; Support HR 1041 / S 586,Critical Access Hospital Relief Act of 2019, a bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services; Support S 895, Rural Hospital Regulatory Relief Act of 2019, a bill to provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals; Support S 948,Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities, and for other purposes; Discussions in support of the Rural Emergency Medical Center Act (REACH) Act; Support for extension of the Rural Community Hospital Demonstration Program; Support for extension of the Frontier Community Health Integration Project Demonstration program; Discuss changes with House and Senate committees to Section 8122 of the SUPPORT for Patients and Communities Act; Letter of support to Energy and Commerce Committee for the hearing on legislation to strengthen our health care system and ACA market stability; Letter urging the Centers for Medicare & Medicaid Services (CMS)to consider alternative payment solutions for Chimeric Antigen Receptor T-cell (CAR T) therapy; Joint letter urging Congress to delay the start of the Medicaid disproportionate share hospital (DSH) cuts, which are scheduled to begin in fiscal year (FY) 2020; Comments to CMS on exploring ways continually to improve the Medicaid managed care program to ensure access to high-quality care for the Medicaid population; Support HR 1781/ S 801, Payment Commission Data Act of 2019, a bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information; Support S 551 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 or the REFUND Act of 2019, a bill to amend title XVIII of the Social Security Act to require manufacturers of certain single-dose vial drugs payable under part B of the Medicare program to provide rebates with respect to amounts of such drugs discarded, and for other purposes; Support S 824/ HR 1767, Excellence in Mental Health and Addiction Treatment Expansion Act, a bill to increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services; Statement submitted to Senate Finance Committee on the implementation of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support HR 2552Protecting Local Access to Care for Everyone Act of 2019 or the PLACE Act of 2019, a bill to direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program; Support HR 3022, Patient Access Protection Act, a bill to amend title XIX of the Social Security Act to repeal the reductions in Medicaid DSH allotments, and for other purposes; Letter of support to the Ways and Means Committee in support of legislation to improve the quality of an access to services for Medicare beneficiaries, help train the physician workforce and reduce administrative burden on rural hospitals; Support HR 3431, HEARTS and Rural Relief Act, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2021; Support HR 3417,Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 or the BETTER Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for patient improvements and rural and quality improvements under the Medicare program; Oppose HR 1384, Medicare for All Act of 2019, a bill to establish an improved Medicare for All national health insurance program; Oppose S 1129, Medicare for All Act of 2019, a bill to establish a Medicare-for-all national health insurance program; Letter to House Committee on Ways and Means for the hearing on Pathways to Universal Health Coverage addressing concerns with Medicare for All and believe that the variety of proposals that often are used interchangeably under that name are not the solution; Oppose HR 2452, Medicare for America Act of 2019, a bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans; Letter to House Committee on Budget for the hearing on the Congressional Budget Offices (CBO) Key Design Components and Considerations for Establishing a Single-Payer Health Care System addressing concerns with Medicare for All; Oppose S 1261/ HR 2463, Choose Medicare Act, a bill to provide for the establishment of Medicare part E public health plans, and for other purposes; Oppose S 981/ HR 2000Medicare-X Choice Act of 2019A bill to establish a public health plan; Oppose S 1033/ HR 2085, CHOICE Act, a bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Oppose S 470, Medicare at 50 Act, a bill to amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare; Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes; Submitted Statement to the House Committee on Rules for the Hearing Medicare for All Act of 2019; Comment on provisions of HR 2328,Reauthorizing and Extending Americas Community Health (REACH) Act, support for the Medicaid disproportionate share hospital(DSH) program provisions included in Title III; comments on Title IV, which contains provisions of the No Surprises Act and concern with the legislations approach to determining reimbursement for out-of-network providers; Support HR 3107 Seniors Timely Access to Care Act of 2019, this legislation would establish requirements for the use of prior authorization under Medicare Advantage plans; Meeting with the Senate finance committee to discuss changes to drug bill; Meeting with CMS to discuss changes to prior authorization; Meeting with Department of Labor to discuss issues with ERISA health plans; Met with CMS staff on rural hospital issues; Regulatory burden related to new CMS guidance on documenting Crossover bad debt; Sent a Comment letter to CMS on a final rule on program integrity enhancements to the provider enrollment process for Medicare, Medicaid and Children's Health Insurance Programs; Oppose S. 2860 Patient Access to Higher Quality Health Care Act of 2019, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 4996, Helping MOMS Act of 2019, a bill amend title XIX of the Social Security Act to provide for a State option under the Medicaid program to provide for and extend continuous coverage for certain individuals, and for other purposes; Addressing hospital concerns about HR 3 Lower Drug Costs Now Act, a bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes.

Advocate to repeal section 6001 of the ACA. H.R.3062 - Patient Access to Higher Quality Health Care Act S. 2860 - Patient Access to Higher Quality Health Care Act of 2019

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Recovery audit contractor reform; Medicare regulatory reform, including physician payment reforms; network adequacy oversight; prior authorization reform; Medicare accountable care organizations; electronic health record interoperability and vendor accountability; physician-owned hospital barriers, including related provisions in H.R. 3062 and S. 2860, the Patient Access to High Quality Health Care Act, to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals; private contracting, mandatory participation in demonstrations; telehealth services; and use of step therapy in Medicare and health insurance coverage."

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

Medicare issues related to physician-owned hospitals H.R. 3062/S. 2860 - the Patient Access to Higher Quality Health Care Act of 2019 Health care transparency

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE