Rural Physician Workforce Production Act of 2019

Student loan deferral during the COVID-19 national emergency and loan forgiveness for physicians providing direct care to COVID-19 patients H.R.1554-Resident Education Deferred Interest (REDI) Act S.289-Rural Physician Workforce Production Act of 2019

Client expense: $391,824 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issue: Support repeal or a delay in the implementation of the Medicaid disproportionate share hospital (DSH) cuts Issue: Educate Congress on concerns related to potentially burdensome Medicaid supplemental payment reporting proposals Issue: Educate Congress on the negative impact of the proposed Medicaid Fiscal Accountability Regulation (MFAR) and urge the administration to withdraw or delay the proposal Issue: ACA Medicaid expansion. Maintain commitment to match State spending on medical care for Medicaid beneficiaries without limits, caps, or block grants. Maintain and enforce network adequacy requirements and mandate sufficient payments to providers. S. 1343, Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (MOMMIES) Act Issue: Support expansion of Medicaid and CHIP coverage for postpartum women from current 90 days to 1 year. S. 585, States Achieve Medicaid Expansion (SAME) Act of 2019 Issue: Support legislation to allow states that expanded Medicaid after 2014 to receive the same full federal matching funds as states that previously expanded Medicaid under the Affordable Care Act H.R. 1763 / S. 348, Resident Physician Shortage Reduction Act of 2019 Issue: Support additional Medicare funding for graduate medical education H.R. 3414 / H.R. 2439, Opioid Workforce Act Issue: Support additional Medicare funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs S. 289, Rural Physician Workforce Production Act of 2019 Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals H.R. 8892, Rural-Urban Physician Workforce Act of 2020 Issue: Support improvements to Rural Training Track programs. H.R.1358, Advancing Medical Resident Training in Community Hospitals Act of 2019 H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act Issue: Support Medicare Graduate Medical Education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issue: Oppose reduction of Medicare GME/IME payments Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose Medicare hospital cuts Issue: Oppose overly burdensome Medicaid GME transparency language. Issue: Support technical correction to increase access to physician services in rural communities by allowing teaching hospitals to count resident time spent in critical access hospitals for purposes of Medicare GME payments. H.R. 5432, Medical Education for a Diverse America Act Issue: Ensure that time medical residents spend in unconscious bias training is counted toward the determination of FTE for Medicare GME Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives H.R. 3107, Improving Seniors Timely Access to Care Act of 2019 Issue: Support protecting patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency Issue: Modify CMS Hospital Compare Star Ratings to allow stakeholders time to work together to address concerns with methodology. Support inclusion of sociodemographic status as part of quality programs HHS Rebate Rule Medicare Part D benefit re-design Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) S. 1343, Maximizing Outcomes for Moms through Medicaid Improvement and Enhancements of Services (MOMMIES) Act H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2020 Issue: Support expansion of Medicaid coverage for postpartum women. H.R. 8702 Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020 Issue: Support relief for providers from pending evaluation and management cuts included in the CY 2021 Physician Fee Schedule (PSF) rule. H.R. 8840 Medicare Sequester COVID Moratorium Act Issue: Support extension of Medicare sequester. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support making permanent the CMS policy allowing teaching physicians to provide supervision via real-time, interactive audio/video technology to meet resident supervision requirements. Issue: Support making permanent the interim final rule that allows hospitals that unknowingly trigger their Medicare GME caps and per resident amounts to not have that happen and instead retain the ability to build a new resident cap / PRA so long as the cap / PRA is not above a minimum amount. Issue: Support CMS introducing new regulations to make permanent the interim final rule that ensures teaching hospitals that increased their number of inpatient beds to accommodate the surge in patients during the public health emergency to not have their Indirect Medical Education (IME) payments reduced by CMS. Issue: Oppose CMS hospital price transparency rule. Issue: Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Oppose Hospital co-location draft guidance. Issue: Oppose finalizing proposed rule for Medicare Coverage of Innovative Technology (MCIT) and definition of reasonable and necessary. Issue: Oppose enforcement of linking Medicare Conditions of Participation (CoP) compliance with requiring that hospitals report 38 COVID-19 related measures. Issue: Support continuation of the 3-Day Skilled Nursing Facility (SNF) Stay waiver after the conclusion of the COVID-19 public health emergency. Issue: Oppose finalizing prior authorization policy in CY 2020 for certain HOPD services and in CY 2021 to include new service categories. Issue: Oppose efforts to remove five exclusion criteria that would allow over 270 new procedures to be performed in ASC settings in CY 2021. Issue: Oppose the elimination of the Inpatient Only List over a three-year period Issue: Oppose policy of incorporating revenue distinctions into the Medicare Shared Savings Program.

Client expense: $1,035,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), Office of the Vice President of the United States, SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Rural Physician Workforce Act S.289; S.304; Home Health Care Planning Improvement Act S.296/H.R.2150; No Surprises Act; Lower Health Care Costs Act S.1895; H.R.748; H.R.6201; 340B general issues / no legislation at this time; HR133

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare-Graduate Medical Education HRSA THCGME Program Resident Physician Shortage Reduction Act of 2019 (H.R. 1763/S. 348) Rural Physician Workforce Production Act of 2019 (S. 289) Training the Next Generation of Primary Care Doctors Act of 2019 (H.R. 2815/S. 1191) Opioid Workforce Act of 2019 (H.R. 3414/S. 2892) Advancing Medical Resident Training in Community Hospitals Act of 2019 (H.R. 3425) Supporting Graduate Medical Education at Community Hospitals Act of 2019 (H.R. 3753/S. 2116) PPE to Address COVID-19 Pandemic Community Health Center Fund in COVID stimulus COVID-19 impact on health professions education COVID-19 impact on osteopathic medical education Coronavirus Health Care Worker Wellness Act (H.R. 7255) Restoring Rural Residencies Act of 2019 (S. 1240) Community and Public Health Programs Extension Act (S.192) Public health and public health infrastructure support in COVID-19 stimulus Title VII and Title VIII program support in COVID-19 stimulus Ensuring Understanding of COVID-19 to Protect Public Health Act (S. 3595/H.R. 6701) Dr. Lorna Breen Health Care Provider Protection Act (H.R. 8094/S. 4349) Addressing COVID-19 Health Disparities Act (H.R.8067) Debt and economic relief for frontline workers Federal funding for rural hospitals and physician practices impacted by COVID-19 Funding for federal research agencies to prevent and respond to pandemic-related disruptions to federally-funded research

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HRSC THCGME Program; NIH research opportunities for osteopathic doctors. Advancing Medical Resident Training in Community Hospitals Act of 2019 (H.R. 1358), Resident Physician Shortage Reduction Act of 2019 (S. 348/ H.R. 1763), Rural Physician Workforce Production Act of 2019 (S. 289) COVID-19 pandemic relief

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

H.R. 1358, Advancing Medical Residencies Training in Community Hospitals Act of 2019; S.289, Rural Physicians Workforce Protection Act of 2019; appropriations for the Agency for Healthcare Research and Quality and title 7 primary care funding under the Public Health Service Act; reauthorization for title 7 primary care funding; COVID 19 issues involving AHRQ and title 7 funding as well as preceptorship related issues; CARES Act (S. 3548); HEROES Act (HR 6800)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issue: Support repeal or a delay in the implementation of the Medicaid disproportionate share hospital (DSH) cuts Issue: Educate Congress on concerns related to potentially burdensome Medicaid supplemental payment reporting proposals Issue: Educate Congress on the negative impact of the proposed Medicaid Fiscal Accountability Regulation (MFAR) and urge the administration to withdraw or delay the proposal Issue: ACA Medicaid expansion. Maintain commitment to match State spending on medical care for Medicaid beneficiaries without limits, caps, or block grants. Maintain and enforce network adequacy requirements and mandate sufficient payments to providers. S. 1343, Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (MOMMIES) Act Issue: Support expansion of Medicaid and CHIP coverage for postpartum women from current 90 days to 1 year. H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2020 Issue: Support expansion of Medicaid coverage for postpartum women. S. 585, States Achieve Medicaid Expansion (SAME) Act of 2019 Issue: Support legislation to allow states that expanded Medicaid after 2014 to receive the same full federal matching funds as states that previously expanded Medicaid under the Affordable Care Act H.R. 1763, S. 348, Resident Physician Shortage Reduction Act of 2019 Issue: Support additional Medicare funding for graduate medical education H.R. 3414, H.R. 2439, Opioid Workforce Act Issue: Support additional Medicare funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issue: Oppose reduction of Medicare GME/IME payments Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. S. 289, Rural Physician Workforce Production Act of 2019 Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals H.R.1358, Advancing Medical Resident Training in Community Hospitals Act of 2019 H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act Issue: Support Medicare Graduate Medical Education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose Medicare hospital cuts Issue: Oppose overly burdensome Medicaid GME transparency language. Issue: Support technical correction to increase access to physician services in rural communities by allowing teaching hospitals to count resident time spent in critical access hospitals for purposes of Medicare GME payments. H.R. 5432, Medical Education for a Diverse America Act Issue: Ensure that time medical residents spend in unconscious bias training is counted toward the determination of FTE for Medicare GME Issue: Educate Congress on role of academic medicine as it relates to price disclosure initiatives H.R. 3107, Improving Seniors Timely Access to Care Act of 2019 Issue: Support protecting patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency Issue: Modify CMS Hospital Compare Star Ratings to allow stakeholders time to work together to address concerns with methodology. Support inclusion of sociodemographic status as part of quality programs HHS Rebate Rule Medicare Part D benefit re-design Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Issue: Support nominees for MedPAC

Client expense: $1,095,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), Office of the Vice President of the United States, SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Medicare-Graduate Medical Education HRSA THCGME Program Resident Physician Shortage Reduction Act of 2019 (H.R. 1763/S. 348) Rural Physician Workforce Production Act of 2019 (S. 289) Training the Next Generation of Primary Care Doctors Act of 2019 (H.R. 2815/S. 1191) Opioid Workforce Act of 2019 (H.R. 3414/S. 2892) Advancing Medical Resident Training in Community Hospitals Act of 2019 (H.R. 3425) Supporting Graduate Medical Education at Community Hospitals Act of 2019 (H.R. 3753/S. 2116) PPE to Address COVID-19 Pandemic Community Health Center Fund in COVID stimulus COVID-19 impact on health professions education COVID-19 impact on osteopathic medical education Coronavirus Health Care Worker Wellness Act (H.R. 7255) Restoring Rural Residencies Act of 2019 (S. 1240) Community and Public Health Programs Extension Act (S.192) Public health and public health infrastructure support in COVID-19 stimulus Title VII and Title VIII program support in COVID-19 stimulus Ensuring Understanding of COVID-19 to Protect Public Health Act (S. 3595/H.R. 6701) Indian Health Service Health Professions Tax Fairness Act (H.R. 6448/S. 2871) Building a Health Care Workforce for the Future Act (H.R. 7470) Dr. Lorna Breen Health Care Provider Protection Act (H.R. 8094/S. 4349) Addressing COVID-19 Health Disparities Act (H.R.8067) Debt and economic relief for frontline workers Federal funding for rural hospitals and physician practices impacted by COVID-19 Funding for federal research agencies to prevent and respond to pandemic-related disruptions to federally-funded research

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Rural Physician Workforce Act S.289; S.304; Home Health Care Planning Improvement Act S.296/H.R.2150; No Surprises Act; Lower Health Care Costs Act S.1895; H.R.748; H.R.6201; 340B general issues / no legislation at this time;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Rural Physician Workforce Act S.289; S.304; Home Health Care Planning Improvement Act S.296/H.R.2150; No Surprises Act; Lower Health Care Costs Act S.1895; H.R.748; H.R.6201; 340B general issues / no legislation at this time;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HRSC THCGME Program; NIH research opportunities for osteopathic doctors. Advancing Medical Resident Training in Community Hospitals Act of 2019 (H.R. 1358), Resident Physician Shortage Reduction Act of 2019 (S. 348/ H.R. 1763), Rural Physician Workforce Production Act of 2019 (S. 289) COVID-19 pandemic relief

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

Graduate Medical Education Affordable Care Act Teaching Health Centers Re-authorization - S.192, S.304, S.1191, HR2815, HR4378 Continuing Appropriations Act 2020 Health Extenders Act of 2019 Primary Care Exception Under Teaching Physician Regulation Rural Graduate Medical Education Regulations & sub-regulatory issues re: Teaching Physician Regulation HR 1358 Advancing Resident Training in Community Hospitals Act of 2019; HR3417 The Rural Physician Workforce Production Act of 2019 S.289, draft legislation in House S.348/HR 1763 Resident Physician Shortage Reduction Act of 2019 Draft legislation regarding GME cap flexibility (rep Raul Ruiz) HR748 CARES Act HR6074 Coronavirus Preparedness & Response Supplemental Appropriations Act 2020 HR6201 - Families First Coronavirus Response Act Draft COVID-19 package #4; Health, Economic Assistance, Liabilities protections, and Schools (HEALS) Act S.4775 Delivering Immediate Relief to America's Families, Schools, and Small Business Act; HR6800, HEROES Act CMS waivers RE: COVID-19 public health emergency

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), President of the U.S., SENATE, Veterans Affairs, Dept of (VA)

Student loan deferral during the COVID-19 national emergency and loan forgiveness for physicians providing direct care to COVID-19 patients H.R.1554-Resident Education Deferred Interest (REDI) Act S.289-Rural Physician Workforce Production Act of 2019

Client expense: $314,376 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Price transparency, out-of-network reimbursement of emergency medical services, surprise medical bills Opioids, pain management Federal funding for Substance Use Disorder treatments Drug Shortages P.L.116-139-Paycheck Protection Program and Health Care Enhancement Act P.L.116-142-Paycheck Protection Program Flexibility Act of 2020 H.R.501-Poison Center Network Enhancement Act of 2019 H.R.861-End Surprise Billing Act of 2019 H.R.1301-Mental Health Telemedicine Expansion Act H.R.1309-Workplace Violence Prevention for Health Care and Social Service Workers Act H.R.1418-Competitive Health Insurance Reform Act of 2019 H.R.1554-Resident Education Deferred Interest (REDI) Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.1767-Excellence in Mental Health and Addiction Treatment Expansion Act H.R.2281-Easy Medication Access and Treatment (MAT) for Opioid Addiction Act H.R.2328-Reauthorizing and Extending Americas Community Health Act H.R.2464-End the Cycle of Violence Act of 2019 H.R.2482-Mainstreaming Addiction Treatment Act of 2019 H.R.2519-Improving Mental Health Access from the Emergency Department Act of 2019 H.R.2550-Prevent Blood Loss with Emergency Equipment Devices Act of 2019 H.R.2569-Comprehensive Addiction Resources Emergency Act of 2019 H.R.3107-Improving Seniors Timely Access to Care Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.3502-Protecting People From Surprise Medical Bills Act H.R.3630-No Surprises Act H.R.3984-Health Care Safety Net Enhancement Act of 2019 H.R.4861-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 H.R.4932-Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2019 H.R.5800-Ban Surprise Billing Act H.R.5826-Consumer Protections Against Surprise Medical Bills Act of 2020 H.R.6800-Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act H.R.6910-Emergency Room Hero and Patient Safety Act H.R.7059-Coronavirus Provider Protection Act H.R.7255-Coronavirus Health Care Worker Wellness Act of 2020 S.289-Rural Physician Workforce Production Act of 2019 S.299-Geriatrics Workforce Improvement Act S.350-Competitive Health Insurance Reform Act of 2019 S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019 S.824-Excellence in Mental Health and Addiction Treatment Expansion Act S.851-Workplace Violence Prevention for Health Care and Social Service Workers Act S.1199-Poison Center Network Enhancement Act of 2019 S.1266-Protecting Patients from Surprise Medical Bills Act S.1334-Improving Mental Health Access from the Emergency Department S.1350-Good Samaritan Health Professionals Act of 2019 S.1365-Comprehensive Addiction Resources Emergency Act of 2019 S.1531-Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 S.1895-Lower Health Care Costs Act S.2074-Mainstreaming Addiction Treatment Act of 2019 S.2741-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 S.3006-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 S.3143-Magnet Injury Prevention Act S.3346-Prevent Blood Loss with Emergency Equipment Devices Act of 2020

Client expense: $314,376 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1358, Advancing Medical Residencies Training in Community Hospitals Act of 2019; S.289, Rural Physicians Workforce Protection Act of 2019; appropriations for the Agency for Healthcare Research and Quality and title 7 primary care funding under the Public Health Service Act; reauthorization for title 7 primary care funding; COVID 19 issues involving AHRQ and title 7 funding as well as preceptorship related issues; CARES Act (S. 3548); HEROES Act (HR 6800)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.1554-Resident Education Deferred Interest (REDI) Act S.289-Rural Physician Workforce Production Act of 2019 Student loan deferral during the COVID-19 national emergency and loan forgiveness for physicians providing direct care to COVID-19 patients

Client expense: $595,871 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Price transparency, out-of-network reimbursement of emergency medical services, surprise medical bills Opioids, pain management Federal funding for Substance Use Disorder treatments Drug Shortages H.R.501-Poison Center Network Enhancement Act of 2019 H.R.861-End Surprise Billing Act of 2019 H.R.1301-Mental Health Telemedicine Expansion Act H.R.1309-Workplace Violence Prevention for Health Care and Social Service Workers Act H.R.1418-Competitive Health Insurance Reform Act of 2019 H.R.1554-Resident Education Deferred Interest (REDI) Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.1767-Excellence in Mental Health and Addiction Treatment Expansion Act H.R.2281-Easy Medication Access and Treatment (MAT) for Opioid Addiction Act H.R.2328-Reauthorizing and Extending Americas Community Health Act H.R.2464-End the Cycle of Violence Act of 2019 H.R.2482-Mainstreaming Addiction Treatment Act of 2019 H.R.2519-Improving Mental Health Access from the Emergency Department Act of 2019 H.R.2550-Prevent Blood Loss with Emergency Equipment Devices Act of 2019 H.R.2569-Comprehensive Addiction Resources Emergency Act of 2019 H.R.3107-Improving Seniors Timely Access to Care Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.3502-Protecting People From Surprise Medical Bills Act H.R.3630-No Surprises Act H.R.3984-Health Care Safety Net Enhancement Act of 2019 H.R.4861-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 H.R.4932-Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2019 H.R.5800-Ban Surprise Billing Act H.R.5826-Consumer Protections Against Surprise Medical Bills Act of 2020 S.289-Rural Physician Workforce Production Act of 2019 S.299-Geriatrics Workforce Improvement Act S.350-Competitive Health Insurance Reform Act of 2019 S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019 S.824-Excellence in Mental Health and Addiction Treatment Expansion Act S.851-Workplace Violence Prevention for Health Care and Social Service Workers Act S.1199-Poison Center Network Enhancement Act of 2019 S.1266-Protecting Patients from Surprise Medical Bills Act S.1334-Improving Mental Health Access from the Emergency Department S.1350-Good Samaritan Health Professionals Act of 2019 S.1365-Comprehensive Addiction Resources Emergency Act of 2019 S.1531-Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 S.1895-Lower Health Care Costs Act S.2074-Mainstreaming Addiction Treatment Act of 2019 S.2741-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 S.3006-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 S.3143-Magnet Injury Prevention Act S.3346-Prevent Blood Loss with Emergency Equipment Devices Act of 2020

Client expense: $595,871 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Graduate Medical Education Affordable Care Act Teaching Health Centers Re-authorization - S.192, S.304, S.1191, HR2815, HR4378 Continuing Appropriations Act 2020 Health Extenders Act of 2019 Primary Care Exception Under Teaching Physician Regulation Rural Graduate Medical Education Regulations & sub-regulatory issues re: Teaching Physician Regulation HR 1358 Advancing Resident Training in Community Hospitals Act of 2019; HR3417 The Rural Physician Workforce Production Act of 2019 S.289, draft legislation in House S.348/HR 1763 Resident Physician Shortage Reduction Act of 2019 Draft legislation regarding GME cap flexibility (rep Raul Ruiz) HR748 CARES Act HR6074 Coronavirus Preparedness & Response Supplemental Appropriations Act 2020 HR6201 - Families First Coronavirus Response Act Draft COVID-19 package #4; Unknown name for the Senate version; HR6800, HEROES Act CMS waivers RE: COVID-19 public health emergency

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), President of the U.S., SENATE, Veterans Affairs, Dept of (VA)

Issue: Support repeal or a delay in the implementation of the Medicaid disproportionate share hospital (DSH) cuts Issue: Educate Congress on concerns related to potentially burdensome Medicaid supplemental payment reporting proposals Issue: Educate Congress on the negative impact of the proposed Medicaid Fiscal Accountability Regulation (MFAR) and urge the administration to withdraw or delay the proposal Issue: ACA Medicaid expansion. Maintain commitment to match State spending on medical care for Medicaid beneficiaries without limits, caps, or block grants. Maintain and enforce network adequacy requirements and mandate sufficient payments to providers. S. 1343, Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (MOMMIES) Act Issue: Support expansion of Medicaid and CHIP coverage for postpartum women from current 90 days to 1 year. S. 585, States Achieve Medicaid Expansion (SAME) Act of 2019 Issue: Support legislation to allow states that expanded Medicaid after 2014 to receive the same full federal matching funds as states that previously expanded Medicaid under the Affordable Care Act H.R. 1763, S. 348, Resident Shortage Physician Reduction Act of 2019 Issue: Support additional Medicare funding for graduate medical education H.R. 3414, H.R. 2439, Opioid Workforce Act Issue: Support additional funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issue: Oppose reduction of Medicare GME/IME payments Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. S. 289, Rural Physician Workforce Production Act of 2019 Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals H.R.1358, Advancing Medical Resident Training in Community Hospitals Act of 2019 H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act Issue: Support Medicare Graduate Medical Education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose Medicare hospital cuts Issue: Oppose overly burdensome Medicaid GME transparency language. Issue: Support technical correction to increase access to physician services in rural communities by allowing teaching hospitals to count resident time spent in critical access hospitals for purposes of Medicare GME payments. H.R. 5432, Medical Education for a Diverse America Act Issue: Ensure that time medical residents spend in unconscious bias training is counted toward the determination of FTE for Medicare GME Issue: Educate Congress on role of academic medicine as it relates to price transparency initiatives H.R. 3107, Improving Seniors Timely Access to Care Act of 2019 Issue: Support protecting patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency Issue: Modify CMS Hospital Compare Star Ratings to allow stakeholders time to work together to address concerns with methodology. Support inclusion of sociodemographic status as part of quality programs HHS Rebate Rule Medicare Part D benefit re-design Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Issue: Support nominees for MedPAC

Client expense: $1,316,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), Office of the Vice President of the United States, SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Medicare-Graduate Medical Education HRSA THCGME Program Resident Physician Shortage Reduction Act of 2019 (H.R. 1763/S. 348) Rural Physician Workforce Production Act of 2019 (S. 289) Training the Next Generation of Primary Care Doctors Act of 2019 (H.R. 2815/S. 1191) Opioid Workforce Act of 2019 (H.R. 3414/S. 2892) Advancing Medical Resident Training in Community Hospitals Act of 2019 (H.R. 3425) Supporting Graduate Medical Education at Community Hospitals Act of 2019 (H.R. 3753/S. 2116) Improving Access to Health Care in Rural and Underserved Areas Act (S. 3194) PPE to Address COVID-19 Pandemic Community Health Center Fund COVID-19 impact on health professions education Ensuring Understanding of COVID-19 to Protect Public Health Act (S. 3595/H.R. 6701) Coronavirus Health Care Worker Wellness Act (H.R. 7255) Restoring Rural Residencies Act of 2019 (S. 1240) Community and Public Health Programs Extension Act (S.192) Indian Health Service Health Professions Tax Fairness Act (H.R. 6448/S. 2871) Public health and public health infrastructure support in COVID-19 stimulus Title VII and Title VIII program support in COVID-19 stimulus AHRQ support in COVID-19 stimulus Veterans Affairs research support in COVID-19 stimulus COVID-19 impact on osteopathic medical education Osteopathic medical education priorities for NIH Strategic Framework 2021-2025

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

General education around physician payment, administrative burden and teaching health center graduate medical education program issues; S.289, Rural Physician Workforce Production Act of 2019; H.R.1358, Advancing Medical Resident Training in Community Hospitals Act of 2019; H.R.2774, Primary Care Patient Protection Act of 2019; H.R.3107, Improving Seniors' Timely Access to Care Act of 2019; H.R. 2815 and S. 1191, Training the Next Generation of Primary Care Physicians; P.L. 116-123, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; P.L. 116-127, Families First Coronavirus Response Act; P.L. 116-136, Coronavirus Aid, Relief, and Economic Security (CARES) Act; P.L. 116-139, the Paycheck Protection Program and Health Care Enhancement Act.

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

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

General education around physician payment, administrative burden and teaching health center graduate medical education program issues; S.289, Rural Physician Workforce Production Act of 2019; H.R.1358, Advancing Medical Resident Training in Community Hospitals Act of 2019; H.R.2774, Primary Care Patient Protection Act of 2019; H.R.3107, Improving Seniors' Timely Access to Care Act of 2019; H.R. 2815 and S. 1191, Training the Next Generation of Primary Care Physicians; P.L. 116-123, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; P.L. 116-127, Families First Coronavirus Response Act; P.L. 116-136, Coronavirus Aid, Relief, and Economic Security (CARES) Act; P.L. 116-139, the Paycheck Protection Program and Health Care Enhancement Act.

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

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

Rural Physician Workforce Act S.289; S.304; Home Health Care Planning Improvement Act S.296/H.R.2150; No Surprises Act; Lower Health Care Costs Act S.1895; H.R.748; H.R.6201

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1358, Advancing Medical Residencies Training in Community Hospitals Act of 2019; S.289, Rural Physicians Workforce Protection Act of 2019; appropriations for the Agency for Healthcare Research and Quality and title 7 primary care funding under the Public Health Service Act; reauthorization for title 7 primary care funding; COVID 19 issues involving AHRQ and title 7 funding as well as preceptorship related issues; CARES Act (S. 3548); HEROES Act (HR 6800)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HRSC THCGME Program; NIH research opportunities for osteopathic doctors. Advancing Medical Resident Training in Community Hospitals Act of 2019 (H.R. 1358), Resident Physician Shortage Reduction Act of 2019 (S. 348/ H.R. 1763), Rural Physician Workforce Production Act of 2019 (S. 289) COVID-19 pandemic relief

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

Graduate Medical Education Affordable Care Act Teaching Health Centers Re-authorization - S.192, S.304, S.1191, HR2815, HR4378 Continuing Appropriations Act 2020 Health Extenders Act of 2019 Primary Care Exception Under Teaching Physician Regulation Rural Graduate Medical Education Regulations & sub-regulatory issues re: Teaching Physician Regulation HR 1358 Advancing Resident Training in Community Hospitals Act of 2019; HR3417 The Rural Physician Workforce Production Act of 2019 S.289, draft legislation in House S.348/HR 1763 Resident Physician Shortage Reduction Act of 2019 Draft legislation regarding GME cap flexibility (rep Raul Ruiz) HR748 CARES Act HR6074 Coronavirus Preparedness & Response Supplemental Appropriations Act 2020 HR6201 - Families First Coronavirus Response Act Draft COVID-19 package #4

Client expense: $59,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), President of the U.S., SENATE, Veterans Affairs, Dept of (VA)

Issue: Support repeal or a delay in the implementation of the Medicaid disproportionate share hospital (DSH) cuts Issue: Educate Congress on concerns related to potentially burdensome Medicaid supplemental payment reporting proposals Issue: Educate Congress on the negative impact of the proposed Medicaid Fiscal Accountability Regulation (MFAR) and urge the administration to withdraw or delay the proposal Issue: ACA Medicaid expansion. Maintain commitment to match State spending on medical care for Medicaid beneficiaries without limits, caps, or block grants. Maintain and enforce network adequacy requirements and mandate sufficient payments to providers. S. 1343, Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (MOMMIES) Act Issue: Support expansion of Medicaid and CHIP coverage for postpartum women from current 90 days to 1 year. S. 585, States Achieve Medicaid Expansion (SAME) Act of 2019 Issue: Support legislation to allow states that expanded Medicaid after 2014 to receive the same full federal matching funds as states that previously expanded Medicaid under the Affordable Care Act H.R. 1763 / S. 348, Resident Shortage Physician Reduction Act of 2019 Issue: Support additional Medicare funding for graduate medical education H.R. 3414 / H.R. 2439, Opioid Workforce Act Issue: Support additional funding for graduate medical education for addiction medicine, addiction psychiatry, and pain medicine residency programs Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments Issue: Oppose reduction of Medicare GME/IME payments Issue: Oppose redesign of Medicare Indirect Medical Education financing and redistribution. S. 289, Rural Physician Workforce Production Act of 2019 Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals H.R.1358, Advancing Medical Resident Training in Community Hospitals Act of 2019 H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act Issue: Support Medicare Graduate Medical Education (GME) per resident amount and cap-setting technical corrections and administrative relief. Issue: Oppose reduction in Medicare hospital outpatient department reimbursement. Issue: Oppose Medicare hospital cuts Issue: Oppose overly burdensome Medicaid GME transparency language. Issue: Support technical correction to increase access to physician services in rural communities by allowing teaching hospitals to count resident time spent in critical access hospitals for purposes of Medicare GME payments. H.R. 5432, Medical Education for a Diverse America Act Issue: Ensure that time medical residents spend in unconscious bias training is counted toward the determination of FTE for Medicare GME Issue: Educate Congress on role of academic medicine as it relates to price transparency initiatives H.R. 3107, Improving Seniors Timely Access to Care Act of 2019 Issue: Support protecting patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency Issue: Modify CMS Hospital Compare Star Ratings to allow stakeholders time to work together to address concerns with methodology. Support inclusion of sociodemographic status as part of quality programs HHS Rebate Rule Medicare Part D benefit re-design Issue: Support policies to reduce prescription drug prices Issue: Support implementation of the 21st Century Cures Act (Cures) interoperability and health data sharing provisions. Issue: Support changes and improvements to the Medicare Shared Savings Program. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)

Client expense: $982,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Internal Revenue Service (IRS), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), Office of Science & Technology Policy (OSTP), Office of the Vice President of the United States, SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Medicare-Graduate Medical Education HRSA THCGME Program Resident Physician Shortage Reduction Act of 2019 (H.R. 1763/S. 348) Rural Physician Workforce Production Act of 2019 (S. 289) Training the Next Generation of Primary Care Doctors Act of 2019 (H.R. 2815/S. 1191) Opioid Workforce Act of 2019 (H.R. 3414/S. 2892) Advancing Medical Resident Training in Community Hospitals Act of 2019 (H.R. 3425) Supporting Graduate Medical Education at Community Hospitals Act of 2019 (H.R. 3753/S. 2116) Improving Access to Health Care in Rural and Underserved Areas Act (S. 3194) COVID-19 impact on health professions education PPE to Address COVID-19 Pandemic Community Health Center Fund Defense Protection Act Special Diabetes Program Special Diabetes Program for Indians

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 289: Physician Workforce/GME Reform: Increasing the number of family medicine residency slots; GME reform to support rural residency training. HR 748 - CARES Act: Fund CHC & THCGME, promote telemedicine in primary care, set Medicaid at Medicare parity. HR 3107 - Prior Authorization: Improve healthcare access & reduce administrative burden. HR 4996 - Support MOMS Act: Support or legislation to increase Medicaid funding to support postpartum care and to reduce maternal mortality. HR 4996, HR 4995, S. 2793, S. 289, S. 916. S. 289 - Maternal Health: Letter to the Senate Finance Cmt urging support for health care best practices and maternal health bills focused on Medicaid, quality improvement, data collection, primary care access under high deductible health care plans, unconscious bias, and rural health care. HR 5741 - Strengthening Innovation in Medicare and Medicaid Act: Oppose the effort to stifle CMMI innovation. HR 5800 - Surprise Billing: Hold patients to in-network rates and prevent premium hikes. HR 6074 - Coronavirus Preparedness & Response Supplemental Act - Ensure adequate PPE, funding and loans, telehealth care payment. No Bill No.: Advisory Committee on Training and Primary Care Medicine & Dentistry-Title VII Primary Care Training & Enhancement grants. No Bill No. - GME Reform: GME reform to increase family physician workforce. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No. - Administrative Simplification: Promote reduced administrative burden on family physicians of prior authorization, EMR. No Bill No. - Communicaeion to CMS on scope of practice: maintain state rights. No Bill No. - Communicate to CME on transparency in coverage: regarding insurance coverage. No Bill No. - Communicate to CMS on ACA benefit and payment parameters for 2021: Regarding Insurance coverage. No Bill No. - communication to CMS on MIPS and extreme circumstances: Extending MIPS deadlines. No Bill No. - Communicate with CMS on 2021/2022 Part C/D: Medicare Advantage and prescription drugs.

Client expense: $1,039,649 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

S 289: Physician Workforce/GME Reform: Increasing the number of family medicine residency slots; GME reform to support rural residency training S 1191; HR 2815; HR 2328 - Teaching Health Center GME Re-authorization: Support for increased and long-term funding for the HRSA THCGME funding. HR 4996, HR 4995, S. 2793, S. 289, S. 916. S. 289 - Maternal Health: Letter to the Senate Finance Cmt urging support for health care best practices and maternal health bills focused on Medicaid, quality improvement, data collection, primary care access under high deductible health care plans, unconscious bias, and rural health care. No Bill No.: Advisory Committee on Training and Primary Care Medicine & Dentistry-Title VII Primary Care Training & Enhancement grants. No Bill No. - GME Reform: GME reform to increase family physician workforce. No Bill No.- CDC FY 2021 budget request: Family medicine public health priorities. No Bill No. - CHC & National Health Service Corps reauthorization: Health care access, scholarships and medical student debt relief. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No.: Black Maternal Health Momnibus Act: Support for a comprehensive bill to address maternal Health disparities.

Client expense: $1,039,649 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

S 289: Physician Workforce/GME Reform: Increasing the number of family medicine residency slots; GME reform to support rural residency training. HR 748 - CARES Act: Fund CHC & THCGME, promote telemedicine in primary care, set Medicaid at Medicare parity. S. 304; S 1191; HR 2815; HR 2328 - Teaching Health Center GME Re-authorization: Support for increased and long-term funding for the HRSA THCGME funding; funding for new rural programs. HR 2339 - Tobacco Use Prevention: Urged support for the Preventing the Youth Tobacco Epidemic Act. HR 2774, S 2793 - Primary Care Patient Protection Act: create a primary care benefit in high deductible health plans. HR 3107 - Prior Authorization: Improve healthcare access & reduce administrative burden. HR 4995 - Maternal Health Quality Improvement Act: Legislation to support best practice programs and safety bundles. HR 4996, HR 4995, S. 2793, S. 289, S. 916. S. 289 - Maternal Health: Letter to the Senate Finance Cmt urging support for health care best practices and maternal health bills focused on Medicaid, quality improvement, data collection, primary care access under high deductible health care plans, unconscious bias, and rural health care. HR 5741 - Strengthening Innovation in Medicare and Medicaid Act: Oppose the effort to stifle CMMI innovation. HR 5800 - Surprise Billing: Hold patients to in-network rates and prevent premium hikes. HR 6379 - Take Responsibility for Workers and Families Act: Include healthcare providers in emergency leave requirements. HR 6074 - Coronavirus Preparedness & Response Supplemental Act - Ensure adequate PPE, funding and loans, telehealth care payment. HR 6201 - Families First Coronavirus Response Act: Support for small business and non-profits during pandemic. No Bill No.- CDC FY 2021 budget request: Family medicine public health priorities. No Bill No. - CHC & National Health Service Corps reauthorization: Health care access, scholarships and medical student debt relief. No Bill No. - AHRQ FY 2021 budget request: primary care research. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No. - Non-compete clauses in physician employment contracts: Restrictive covenants can disrupt the patient-physician relationship. No Bill No. - Administrative Simplification: Promote reduced administrative burden on family physicians of prior authorization, EMR. No Bill No. - Truth in Healthcare Marketing Act: Prevent deceptive advertising on health care licensure. No Bill No. - Abortion Access: Letter to FDA urging flexibility from current safety protocols to allow physicians to administer drugs via telehealth. No Bill No. - Community Health Center Funding: Letters, briefing to support funding for community health centers. Outreach to Hill offices to urge support for health extenders, which includes THCGME, community health centers, and National Health Service Corps. No Bill No.: Black Maternal Health Momnibus Act: Support for a comprehensive bill to address maternal Health disparities. No Bill No. - Defeat Infant and Maternal Mortality Act (DIMMA): Supporting legislation to allow the Department of Defense to share information with civilian entities on maternal and infant health. No Bill No. - Health IT interoperability: Ensure Health IT interoperability regulations and recommendations promote primary care/do not burden physicians. No Bill No. - CDC prevention issues to cover: communication on What work the CDC should do.

Client expense: $1,039,649 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), SENATE

General education around physician payment, administrative burden and teaching health center graduate medical education program issues; S.289, Rural Physician Workforce Production Act of 2019; H.R.1358, Advancing Medical Resident Training in Community Hospitals Act of 2019; H.R.2774, Primary Care Patient Protection Act of 2019; H.R.3107, Improving Seniors' Timely Access to Care Act of 2019; H.R. 2815 and S. 1191, Training the Next Generation of Primary Care Physicians; P.L. 116-123, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; P.L. 116-127, Families First Coronavirus Response Act; P.L. 116-136, Coronavirus Aid, Relief, and Economic Security (CARES) Act.

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

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

S. 1563 - Coronavirus Aid, Relief, and Economic Security (CARES) Act: Provisions related to hospital funding for COVID-19 related patients costs. H.R. 6201 - Families First Act: Provisions related to the Federal Medical Assistance Percentage increase. S.289 - The Rural-Urban Physician Workforce Act, S. 2892, H.R. 2439, H.R. 3414 - The Opioid Workforce Act; Issues related to the provision of additional graduate medical education positions. Issues related to Medicaid Disproportionate Share Hospital payments. Centers for Medicare and Medicaid Service proposed rule regarding Radiation Oncology Model and proton beam reimbursement. Issues related to surprise billing legislation.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Rural Physician Workforce Act S.289; S.304; Home Health Care Planning Improvement Act S.296/H.R.2150; No Surprises Act; Lower Health Care Costs Act S.1895; H.R.748; H.R.6201

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HRSC THCGME Program; NIH research opportunities for osteopathic doctors. Advancing Medical Resident Training in Community Hospitals Act of 2019 (H.R. 1358), Resident Physician Shortage Reduction Act of 2019 (S. 348/ H.R. 1763), Rural Physician Workforce Production Act of 2019 (S. 289)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, White House Office

H.R. 1358, Advancing Medical Residencies Training in Community Hospitals Act of 2019; S.289, Rural Physicians Workforce Protection Act of 2019; appropriations for the Agency for Healthcare Research and Quality and title 7 primary care funding under the Public Health Service Act; reauthorization for title 7 primary care funding; COVID 19 issues involving AHRQ and title 7 funding as well as preceptorship related issues.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S106; S192; HR1943; HR1983; HR 2328, - National Health Service Corps: Medical Student Debt Relief and Rural and Under-served area access. S 289 - Rural Physician Workforce Protection Act: GME reform to support rural residency training. S 304; HR 2815; HR 2328 - Teaching Health Center GME Re-authorization: Increased, extended THCGME funding. S 2372 Rural Moms Act: Supported a rural maternal health bill and urged members to support it. HR 1358 - GME Reform: Allow the establishment of new family physician residencies. HR 2328 Community Health Investment, and Modernization, and Excellence Act: Also, THCGME, along with Community Health Centers, National Health Service Corps, and Medicaid Funding for the Territories. HR 2328 - Reauthorizing and Extending America's Community Health Act: Support for key primary care extenders, Patient-Centered Outcomes Research Initiative, Independence at Home, Medicaid for the Territories. HR 2895 - Conrad State 30 & Physician Access Act: Expand J-1 visa waiver program for medical residents. No Bill No. - Opioid Use Disorder Treatment GME: Medication-assisted treatment training. No Bill No. - Physician Workforce/GME Reform: Increasing the number of family residency slots. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No. - Teaching Health Center GME funding/Training the Next Generation of Primary Care Doctors Act. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No. - Title VII Primary Care training Enhancement Grants: Support for family medicine training.

Client expense: $997,393 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

S106; S192; HR1943; HR1983; HR 2328, - National Health Service Corps: Medical Student Debt Relief and Rural and Under-served area access. S 289 - Rural Physician Workforce Protection Act: GME reform to support rural residency training. HR 1358 - GME Reform: Allow the establishment of new family physician residencies. HR 2328 Community Health Investment, and Modernization, and Excellence Act: Also, THCGME, along with Community Health Centers, National Health Service Corps, and Medicaid Funding for the Territories. HR 2328 - Reauthorizing and Extending America's Community Health Act: Support for key primary care extenders, Patient-Centered Outcomes Research Initiative, Independence at Home, Medicaid for the Territories. HR 3107 - Prior Authorization: Improve healthcare access and reduce administrative burden. HR 3436 Chronic Care Management: to remove cost-sharing responsibilities for chronic care management services under the medicare plan. No Bill No. - Opioid prescribing guideline: Responding to FDA inquiry on opioid prescribing guidelines. No Bill No. - Opioid Use Disorder Treatment GME: Medication-assisted treatment training. No Bill No. - Physician Workforce/GME Reform: Increasing the number of family residency slots. No Bill No. - Administrative Burden: Reduced administrative burden on family physicians. No Bill No. - Primary Care Investment: Increased spending on primary care. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No. - Insurance network adequacy to avoid "surprise medical bills": protecting patients and families from unanticipated medical bills. No Bill No. - Administrative Simplification: Suggestions to reduce burdens for FPs. No Bill No. - Medicare coverage of acupuncture: AAFP supporting CMS proposal. No Bill No. - Access to Medicaid Services: Need for higher payment to ensure access to primary care. No Bill No. - Delay in 2017 APM bonuses: Need for CMS to pay APM bonuses to encourage FPs. No Bill No. - 2020 proposed Medicare physician fee schedule: Payments to PCPs. No Bill No. - 2020 proposed outpatient perspective payment system: Site of service neutrality and transparency in hospital charges. No Bill No. - Lower Health Care Costs Act/Surprise Billing: Support for vaccines, maternal health, transparency, and reducing administrative burdens. Also, support for reauthorizing the Teaching Health Center GME (THCGME) program, along with Community Health Centers and National Health Service Corps. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No. - Insurance network adequacy to avoid "surprise medical bills": Health care coverage for all, administrative simplification. No Bill No. - AHRQ Center for Primary Care Research: Primary Care research at AHRQ.

Client expense: $997,393 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

S106; S192; HR1943; HR1983; HR 2328, - National Health Service Corps: Medical Student Debt Relief and Rural and Under-served area access. S 289 - Rural Physician Workforce Protection Act: GME reform to support rural residency training. S 304; HR 2815; HR 2328 - Teaching Health Center GME Re-authorization: Increased, extended THCGME funding. S 2372 Rural Moms Act: Supported a rural maternal health bill and urged members to support it. HR 2328 Community Health Investment, and Modernization, and Excellence Act: Also, THCGME, along with Community Health Centers, National Health Service Corps, and Medicaid Funding for the Territories. HR 2328 - Reauthorizing and Extending America's Community Health Act: Support for key primary care extenders, Patient-Centered Outcomes Research Initiative, Independence at Home, Medicaid for the Territories. HR 2740 - HHS FY 2020 Appropriations; Women's Health Research: AAFP funding priorities. Increased funding for women's health research. HR 2774 - Primary Care Patient Protection Act: Create a Primary Care benefit in high deductible health plans. HR 2895 - Conrad State 30 & Physician Access Act: Expand J-1 visa waiver program for medical residents. HR 3030 - Patient Centered Outcomes Research Institute reauthorization: Patient-centered, primary care research, AHRQ funding. HR 3107 - Prior Authorization: Improve healthcare access and reduce administrative burden. HR 3436 - Chronic Care Management: to remove cost-sharing responsibilities for chronic care management services under the medicare plan. No Bill No. - Obesity Drug Study: Responding to GAO inquiry on AAFP policy on obesity drugs. No Bill No. - Opioid prescribing guideline: Responding to FDA inquiry on opioid prescribing guidelines. No Bill No. - Healthcare Coverage for All: Retaining ACA coverage gains and expanding coverage. No Bill No. - Administrative Burden: Reduced administrative burden on family physicians. No Bill No. - Rural Health: Improved access to quality care for rural populations. No Bill No. - Primary Care Investment: Increased spending on primary care. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No. - Insurance network adequacy to avoid "surprise medical bills": protecting patients and families from unanticipated medical bills. No Bill No. - Comment on the definition of Health Literacy: Health Literacy for all patients. No Bill No. - Administrative Simplification: Suggestions to reduce burdens for FPs. No Bill No. - Nondiscrimination in health plans: Healthcare for all. No Bill No. - Patient access to effective drugs: Opioid Issues. No. Bill No. - Telehealth for low-income consumers: Access to high speed internet. No Bill No. - Access to Medicaid Services: Need for higher payment to ensure access to primary care. No Bill No. - 2020 proposed outpatient perspective payment system: Site of service neutrality and transparency in hospital charges. No Bill No. - Lower Health Care Costs Act/Surprise Billing: Support for vaccines, maternal health, transparency, and reducing administrative burdens. Also, support for reauthorizing the Teaching Health Center GME (THCGME) program, along with Community Health Centers and National Health Service Corps. No Bill No. - Teaching Health Center GME funding/Training the Next Generation of Primary Care Doctors Act. No Bill No. - Tobacco Use Prevention: Urged support for Reversing the Youth Tobacco Epidemic Act, Safe Kids Act, and Tobacco to 21 bill. No Bill No. - Surprise Billing: Shared letter on surprise billing. No Bill No. - Drug Prices: Recommendations for various biologic and insulin drug pricing bills. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC.

Client expense: $997,393 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, White House Office

H.R.1554-Resident Education Deferred Interest (REDI) Act S.289-Rural Physician Workforce Production Act of 2019

Client expense: $861,628 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Price transparency, out-of-network reimbursement of emergency medical services, surprise medical bills Opioids, pain management Federal funding for Substance Use Disorder treatments Drug Shortages H.R.501-Poison Center Network Enhancement Act of 2019 H.R.861-End Surprise Billing Act of 2019 H.R.1301-Mental Health Telemedicine Expansion Act H.R.1309-Workplace Violence Prevention for Health Care and Social Service Workers Act H.R.1418-Competitive Health Insurance Reform Act of 2019 H.R.1554-Resident Education Deferred Interest (REDI) Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.1767-Excellence in Mental Health and Addiction Treatment Expansion Act H.R.2281-Easy MAT for Opioid Addiction Act H.R.2328-Reauthorizing and Extending Americas Community Health Act H.R.2464-End the Cycle of Violence Act of 2019 H.R.2482-Mainstreaming Addiction Treatment Act of 2019 H.R.2519-Improving Mental Health Access from the Emergency Department Act of 2019 H.R.2550-Prevent Blood Loss with Emergency Equipment Devices Act of 2019 H.R.2569-Comprehensive Addiction Resources Emergency Act of 2019 H.R.3107-Improving Seniors Timely Access to Care Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.3502-Protecting People From Surprise Medical Bills Act H.R.3630-No Surprises Act H.R.3984-Health Care Safety Net Enhancement Act of 2019 H.R.4861-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 H.R.4932-Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2019 S.289-Rural Physician Workforce Production Act of 2019 S.299-Geriatrics Workforce Improvement Act S.350-Competitive Health Insurance Reform Act of 2019 S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019 S.824-Excellence in Mental Health and Addiction Treatment Expansion Act S.851-Workplace Violence Prevention for Health Care and Social Service Workers Act S.1173-Emergency Medical Services for Children Program Reauthorization Act of 2019 S.1199-Poison Center Network Enhancement Act of 2019 S.1266-Protecting Patients from Surprise Medical Bills Act S.1334-Improving Mental Health Access from the Emergency Department S.1350-Good Samaritan Health Professionals Act of 2019 S.1365-Comprehensive Addiction Resources Emergency Act of 2019 S.1531-Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 S.1895-Lower Health Care Costs Act S.2074-Mainstreaming Addiction Treatment Act of 2019 S.2741-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 S.3006-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 S.3143-Magnet Injury Prevention Act

Client expense: $861,628 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Price transparency, out-of-network reimbursement of emergency medical services, surprise medical bills Opioids, pain management Federal funding for Substance Use Disorder treatments Drug Shortages H.R.501-Poison Center Network Enhancement Act of 2019 H.R.776-Emergency Medical Services for Children Program Reauthorization Act of 2019 H.R.861-End Surprise Billing Act of 2019 H.R.1301-Mental Health Telemedicine Expansion Act H.R.1309-Workplace Violence Prevention for Health Care and Social Service Workers Act H.R.1418-Competitive Health Insurance Reform Act of 2019 H.R.1554-Resident Education Deferred Interest (REDI) Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.1767-Excellence in Mental Health and Addiction Treatment Expansion Act H.R.2281-Easy MAT for Opioid Addiction Act H.R.2328-Reauthorizing and Extending Americas Community Health Act H.R.2464-End the Cycle of Violence Act of 2019 H.R.2482-Mainstreaming Addiction Treatment Act of 2019 H.R.2519-Improving Mental Health Access from the Emergency Department Act of 2019 H.R.2550-Prevent Blood Loss with Emergency Equipment Devices Act of 2019 H.R.3107-Improving Seniors Timely Access to Care Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.3502-Protecting People From Surprise Medical Bills Act H.R.3630-No Surprises Act H.R.3984-Health Care Safety Net Enhancement Act of 2019 S.289-Rural Physician Workforce Production Act of 2019 S.299-Geriatrics Workforce Improvement Act S.350-Competitive Health Insurance Reform Act of 2019 S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019 S.824-Excellence in Mental Health and Addiction Treatment Expansion Act S.851-Workplace Violence Prevention for Health Care and Social Service Workers Act S.1173-Emergency Medical Services for Children Program Reauthorization Act of 2019 S.1199-Poison Center Network Enhancement Act of 2019 S.1266-Protecting Patients from Surprise Medical Bills Act S.1334-Improving Mental Health Access from the Emergency Department S.1531-Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 S.1895-Lower Health Care Costs Act S.2074-Mainstreaming Addiction Treatment Act of 2019

Client expense: $419,250 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R.1554-Resident Education Deferred Interest (REDI) Act S.289-Rural Physician Workforce Production Act of 2019

Client expense: $419,250 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Graduate Medical Education Affordable Care Act Teaching Health Centers Re-authorization - S.192, S.304, S.1191, HR2815, HR4378 Continuing Appropriations Act 2020, and Health Extenders Act of 2019 Primary Care Exception Under Teaching Physician Regulation Rural Graduate Medical Education Regulations & sub-regulatory issues re: Teaching Physician Regulation HR 1358 Advancing Resident Training in Community Hospitals Act of 2019; HR3417 The Rural Physician Workforce Production Act of 2019 S.289 S.348/HR 1763 Resident Physician Shortage Reduction Act of 2019 Student Documentation under the teaching physician regulation and the CY 2020 medicare fee schedule Draft legislation regarding GME cap flexibility (rep Raul Ruiz)

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), President of the U.S., SENATE, Veterans Affairs, Dept of (VA)

Issues related to Medicaid Disproportionate Share Hospital payments. Issues related to 340B drug pricing. Centers for Medicare and Medicaid Service proposed rule regarding Radiation Oncology Model and proton beam reimbursement. S.289 - The Rural-Urban Physician Workforce Act, S. 2892, H.R. 2439, H.R. 3414 - The Opioid Workforce Act; Issues related to the provision of additional graduate medical education positions. Issues related to surprise billing legislation. Issues related to liver allocation.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE