Opioid Workforce Act of 2019

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported HR 4974/S 4640: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported HR 7593/S 4103, the TREATS Act, that would increase the use of telehealth for substance use disorder treatment, and for other purposes Advocated for at least $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19, as well as direct funding from SAMHSA to opioid treatment programs and qualified practice settings Advocated for an increase in the Federal Medical Assistance Percentage for Medicaid as a result of COVID-19 Supported the Improving Medicaid Programs Response to Overdose Victims and Enhancing (IMPROVE) Addiction Care Act which would require state Medicaid programs to use their existing drug utilization review (DUR) programs to increase access to addiction treatment and boost safeguards for those on Medicaid who have experienced a non-fatal, opioid-related overdose. Opposed passage of H.R. 884 / S. 2772, the Medicare Mental Health Access Act, which would change the definition of physician under the Medicare program to include clinical psychologists. Supported the Dr. Lorna Breen Health Care Provider Protection Act (S.4349). The legislation would greatly reduce and prevent suicide and mental and behavioral health conditions among health care professionals. Submitted comments on the Center for Medicare and Medicaid Services (CMS) Value in Opioid Use Disorder Treatment (Value in Treatment) Demonstration design. The 4-year demonstration program was authorized by section 6042 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). Supported additional research funding for NIAAA to study alcohol use related to the impact of COVID-19 Submitted comments on the proposed 2021 Medicare Physician Fee Schedule (MPFS). Comments stressed the importance of the Centers for Medicare and Medicaid Services altering the MPFS to expand access to treatment for as many beneficiaries suffering from substance use disorder (SUD) as possible by introducing new codes for telehealth, expanding the range of eligible disorders for the billing of certain bundled payments, and empowering ED clinicians through the creation of a new code. Submitted its response to the Centers for Medicare and Medicaid Services (CMS) Request for Information (RFI) on Electronic Prescribing of Controlled Substances (EPCS). The RFI solicited feedback from stakeholders about whether CMS should include exceptions to the electronic prescribing of controlled substances and under what circumstances, and whether CMS should impose penalties for noncompliance with this mandate in its rulemaking, and what those penalties should be. Submitted response to CMS supporting EPCS as a way to assure quality and reduce errors and fraud in the transmission of prescriptions from the prescribing health care practitioner to the dispensing pharmacist but recommending CMS consider the financial impact of this requirement on small practices that do not yet have electronic systems in place that allow for EPCS, and extend the waiver timeline as well as provide additional resources or incentives for these practices to adopt such technology. Urged Senate leadership to include $58 million for syringe services programs (SSPs) and other harm reduction service providers in the next COVID relief package. Supported H.R. 7286, the Quit Because of COVID-19 Act. This legislation would ensure that all Medicaid and Childrens Health Insurance Program (CHIP) enrollees have access to the full array of evidence-based tobacco cessation treatments. Supported includsion of S. 348, the Resident Physician Shortage Act, in the next COVID supplemental package Opposed passage of the MORE Act H.R. 3884, which would, among other things, remove cannabis from the list of controlled substances under the CSA. Provided comments on a draft Residential Substance Abuse Treatment (RSAT) bill Provided comments on CARA 2.0 legislation, S. 5000, related to prescriber education and curricula grants Joined coalition letter to FDA urging the Commissioner to commence rulemaking to prohibit menthol as characterizing flavor in cigarettes Discussions regarding draft legislation on Medicaid reimbursement for addition treatment providers and repeal of the IMD exclusion in Medicaid for residential addiction treatment Discussions regarding the EASY MAT Act, HR 2281, CBO score Submitted letter of support for S. 4612, the Methamphetamine Response Act, which would declare methamphetamine an emerging drug threst

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported HR 4974/S 4640: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported HR 7593/S 4103, the TREATS Act, that would increase the use of telehealth for substance use disorder treatment, and for other purposes Advocated for at least $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19, as well as direct funding from SAMHSA to opioid treatment programs and qualified practice settings Advocated for an increase in the Federal Medical Assistance Percentage for Medicaid as a result of COVID-19 Supported the Improving Medicaid Programs Response to Overdose Victims and Enhancing (IMPROVE) Addiction Care Act which would require state Medicaid programs to use their existing drug utilization review (DUR) programs to increase access to addiction treatment and boost safeguards for those on Medicaid who have experienced a non-fatal, opioid-related overdose. Opposed passage of H.R. 884 / S. 2772, the Medicare Mental Health Access Act, which would change the definition of physician under the Medicare program to include clinical psychologists. Supported the Dr. Lorna Breen Health Care Provider Protection Act (S.4349). The legislation would greatly reduce and prevent suicide and mental and behavioral health conditions among health care professionals. Submitted comments on the Center for Medicare and Medicaid Services (CMS) Value in Opioid Use Disorder Treatment (Value in Treatment) Demonstration design. The 4-year demonstration program was authorized by section 6042 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). Supported additional research funding for NIAAA to study alcohol use related to the impact of COVID-19 Submitted comments on the proposed 2021 Medicare Physician Fee Schedule (MPFS). Comments stressed the importance of the Centers for Medicare and Medicaid Services altering the MPFS to expand access to treatment for as many beneficiaries suffering from substance use disorder (SUD) as possible by introducing new codes for telehealth, expanding the range of eligible disorders for the billing of certain bundled payments, and empowering ED clinicians through the creation of a new code. Submitted its response to the Centers for Medicare and Medicaid Services (CMS) Request for Information (RFI) on Electronic Prescribing of Controlled Substances (EPCS). The RFI solicited feedback from stakeholders about whether CMS should include exceptions to the electronic prescribing of controlled substances and under what circumstances, and whether CMS should impose penalties for noncompliance with this mandate in its rulemaking, and what those penalties should be. Submitted response to CMS supporting EPCS as a way to assure quality and reduce errors and fraud in the transmission of prescriptions from the prescribing health care practitioner to the dispensing pharmacist but recommending CMS consider the financial impact of this requirement on small practices that do not yet have electronic systems in place that allow for EPCS, and extend the waiver timeline as well as provide additional resources or incentives for these practices to adopt such technology. Urged Senate leadership to include $58 million for syringe services programs (SSPs) and other harm reduction service providers in the next COVID relief package. Supported H.R. 7286, the Quit Because of COVID-19 Act. This legislation would ensure that all Medicaid and Childrens Health Insurance Program (CHIP) enrollees have access to the full array of evidence-based tobacco cessation treatments. Supported includsion of S. 348, the Resident Physician Shortage Act, in the next COVID supplemental package Opposed passage of the MORE Act H.R. 3884, which would, among other things, remove cannabis from the list of controlled substances under the CSA. Provided comments on a draft Residential Substance Abuse Treatment (RSAT) bill Provided comments on CARA 2.0 legislation, S. 5000, related to prescriber education and curricula grants Joined coalition letter to FDA urging the Commissioner to commence rulemaking to prohibit menthol as characterizing flavor in cigarettes Discussions regarding draft legislation on Medicaid reimbursement for addition treatment providers and repeal of the IMD exclusion in Medicaid for residential addiction treatment Discussions regarding the EASY MAT Act, HR 2281, CBO score Submitted letter of support for S. 4612, the Methamphetamine Response Act, which would declare methamphetamine an emerging drug threst

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported HR 4974/S 4640: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported HR 7593/S 4103, the TREATS Act, that would increase the use of telehealth for substance use disorder treatment, and for other purposes Advocated for at least $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19, as well as direct funding from SAMHSA to opioid treatment programs and qualified practice settings Advocated for an increase in the Federal Medical Assistance Percentage for Medicaid as a result of COVID-19 Supported the Improving Medicaid Programs Response to Overdose Victims and Enhancing (IMPROVE) Addiction Care Act which would require state Medicaid programs to use their existing drug utilization review (DUR) programs to increase access to addiction treatment and boost safeguards for those on Medicaid who have experienced a non-fatal, opioid-related overdose. Opposed passage of H.R. 884 / S. 2772, the Medicare Mental Health Access Act, which would change the definition of physician under the Medicare program to include clinical psychologists. Supported the Dr. Lorna Breen Health Care Provider Protection Act (S.4349). The legislation would greatly reduce and prevent suicide and mental and behavioral health conditions among health care professionals. Submitted comments on the Center for Medicare and Medicaid Services (CMS) Value in Opioid Use Disorder Treatment (Value in Treatment) Demonstration design. The 4-year demonstration program was authorized by section 6042 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). Supported additional research funding for NIAAA to study alcohol use related to the impact of COVID-19 Submitted comments on the proposed 2021 Medicare Physician Fee Schedule (MPFS). Comments stressed the importance of the Centers for Medicare and Medicaid Services altering the MPFS to expand access to treatment for as many beneficiaries suffering from substance use disorder (SUD) as possible by introducing new codes for telehealth, expanding the range of eligible disorders for the billing of certain bundled payments, and empowering ED clinicians through the creation of a new code. Submitted its response to the Centers for Medicare and Medicaid Services (CMS) Request for Information (RFI) on Electronic Prescribing of Controlled Substances (EPCS). The RFI solicited feedback from stakeholders about whether CMS should include exceptions to the electronic prescribing of controlled substances and under what circumstances, and whether CMS should impose penalties for noncompliance with this mandate in its rulemaking, and what those penalties should be. Submitted response to CMS supporting EPCS as a way to assure quality and reduce errors and fraud in the transmission of prescriptions from the prescribing health care practitioner to the dispensing pharmacist but recommending CMS consider the financial impact of this requirement on small practices that do not yet have electronic systems in place that allow for EPCS, and extend the waiver timeline as well as provide additional resources or incentives for these practices to adopt such technology. Urged Senate leadership to include $58 million for syringe services programs (SSPs) and other harm reduction service providers in the next COVID relief package. Supported H.R. 7286, the Quit Because of COVID-19 Act. This legislation would ensure that all Medicaid and Childrens Health Insurance Program (CHIP) enrollees have access to the full array of evidence-based tobacco cessation treatments. Supported includsion of S. 348, the Resident Physician Shortage Act, in the next COVID supplemental package Opposed passage of the MORE Act H.R. 3884, which would, among other things, remove cannabis from the list of controlled substances under the CSA. Provided comments on a draft Residential Substance Abuse Treatment (RSAT) bill Provided comments on CARA 2.0 legislation, S. 5000, related to prescriber education and curricula grants Joined coalition letter to FDA urging the Commissioner to commence rulemaking to prohibit menthol as characterizing flavor in cigarettes Discussions regarding draft legislation on Medicaid reimbursement for addition treatment providers and repeal of the IMD exclusion in Medicaid for residential addiction treatment Discussions regarding the EASY MAT Act, HR 2281, CBO score Submitted letter of support for S. 4612, the Methamphetamine Response Act, which would declare methamphetamine an emerging drug threst

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported HR 4974/S 4640: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported HR 7593/S 4103, the TREATS Act, that would increase the use of telehealth for substance use disorder treatment, and for other purposes Advocated for at least $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19, as well as direct funding from SAMHSA to opioid treatment programs and qualified practice settings Advocated for an increase in the Federal Medical Assistance Percentage for Medicaid as a result of COVID-19 Supported the Improving Medicaid Programs Response to Overdose Victims and Enhancing (IMPROVE) Addiction Care Act which would require state Medicaid programs to use their existing drug utilization review (DUR) programs to increase access to addiction treatment and boost safeguards for those on Medicaid who have experienced a non-fatal, opioid-related overdose. Opposed passage of H.R. 884 / S. 2772, the Medicare Mental Health Access Act, which would change the definition of physician under the Medicare program to include clinical psychologists. Supported the Dr. Lorna Breen Health Care Provider Protection Act (S.4349). The legislation would greatly reduce and prevent suicide and mental and behavioral health conditions among health care professionals. Submitted comments on the Center for Medicare and Medicaid Services (CMS) Value in Opioid Use Disorder Treatment (Value in Treatment) Demonstration design. The 4-year demonstration program was authorized by section 6042 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). Supported additional research funding for NIAAA to study alcohol use related to the impact of COVID-19 Submitted comments on the proposed 2021 Medicare Physician Fee Schedule (MPFS). Comments stressed the importance of the Centers for Medicare and Medicaid Services altering the MPFS to expand access to treatment for as many beneficiaries suffering from substance use disorder (SUD) as possible by introducing new codes for telehealth, expanding the range of eligible disorders for the billing of certain bundled payments, and empowering ED clinicians through the creation of a new code. Submitted its response to the Centers for Medicare and Medicaid Services (CMS) Request for Information (RFI) on Electronic Prescribing of Controlled Substances (EPCS). The RFI solicited feedback from stakeholders about whether CMS should include exceptions to the electronic prescribing of controlled substances and under what circumstances, and whether CMS should impose penalties for noncompliance with this mandate in its rulemaking, and what those penalties should be. Submitted response to CMS supporting EPCS as a way to assure quality and reduce errors and fraud in the transmission of prescriptions from the prescribing health care practitioner to the dispensing pharmacist but recommending CMS consider the financial impact of this requirement on small practices that do not yet have electronic systems in place that allow for EPCS, and extend the waiver timeline as well as provide additional resources or incentives for these practices to adopt such technology. Urged Senate leadership to include $58 million for syringe services programs (SSPs) and other harm reduction service providers in the next COVID relief package. Supported H.R. 7286, the Quit Because of COVID-19 Act. This legislation would ensure that all Medicaid and Childrens Health Insurance Program (CHIP) enrollees have access to the full array of evidence-based tobacco cessation treatments. Supported includsion of S. 348, the Resident Physician Shortage Act, in the next COVID supplemental package Opposed passage of the MORE Act H.R. 3884, which would, among other things, remove cannabis from the list of controlled substances under the CSA. Provided comments on a draft Residential Substance Abuse Treatment (RSAT) bill Provided comments on CARA 2.0 legislation, S. 5000, related to prescriber education and curricula grants Joined coalition letter to FDA urging the Commissioner to commence rulemaking to prohibit menthol as characterizing flavor in cigarettes Discussions regarding draft legislation on Medicaid reimbursement for addition treatment providers and repeal of the IMD exclusion in Medicaid for residential addiction treatment Discussions regarding the EASY MAT Act, HR 2281, CBO score Submitted letter of support for S. 4612, the Methamphetamine Response Act, which would declare methamphetamine an emerging drug threst

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported HR 4974/S 4640: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported HR 7593/S 4103, the TREATS Act, that would increase the use of telehealth for substance use disorder treatment, and for other purposes Advocated for at least $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19, as well as direct funding from SAMHSA to opioid treatment programs and qualified practice settings Advocated for an increase in the Federal Medical Assistance Percentage for Medicaid as a result of COVID-19 Supported the Improving Medicaid Programs Response to Overdose Victims and Enhancing (IMPROVE) Addiction Care Act which would require state Medicaid programs to use their existing drug utilization review (DUR) programs to increase access to addiction treatment and boost safeguards for those on Medicaid who have experienced a non-fatal, opioid-related overdose. Opposed passage of H.R. 884 / S. 2772, the Medicare Mental Health Access Act, which would change the definition of physician under the Medicare program to include clinical psychologists. Supported the Dr. Lorna Breen Health Care Provider Protection Act (S.4349). The legislation would greatly reduce and prevent suicide and mental and behavioral health conditions among health care professionals. Submitted comments on the Center for Medicare and Medicaid Services (CMS) Value in Opioid Use Disorder Treatment (Value in Treatment) Demonstration design. The 4-year demonstration program was authorized by section 6042 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). Supported additional research funding for NIAAA to study alcohol use related to the impact of COVID-19 Submitted comments on the proposed 2021 Medicare Physician Fee Schedule (MPFS). Comments stressed the importance of the Centers for Medicare and Medicaid Services altering the MPFS to expand access to treatment for as many beneficiaries suffering from substance use disorder (SUD) as possible by introducing new codes for telehealth, expanding the range of eligible disorders for the billing of certain bundled payments, and empowering ED clinicians through the creation of a new code. Submitted its response to the Centers for Medicare and Medicaid Services (CMS) Request for Information (RFI) on Electronic Prescribing of Controlled Substances (EPCS). The RFI solicited feedback from stakeholders about whether CMS should include exceptions to the electronic prescribing of controlled substances and under what circumstances, and whether CMS should impose penalties for noncompliance with this mandate in its rulemaking, and what those penalties should be. Submitted response to CMS supporting EPCS as a way to assure quality and reduce errors and fraud in the transmission of prescriptions from the prescribing health care practitioner to the dispensing pharmacist but recommending CMS consider the financial impact of this requirement on small practices that do not yet have electronic systems in place that allow for EPCS, and extend the waiver timeline as well as provide additional resources or incentives for these practices to adopt such technology. Urged Senate leadership to include $58 million for syringe services programs (SSPs) and other harm reduction service providers in the next COVID relief package. Supported H.R. 7286, the Quit Because of COVID-19 Act. This legislation would ensure that all Medicaid and Childrens Health Insurance Program (CHIP) enrollees have access to the full array of evidence-based tobacco cessation treatments. Supported includsion of S. 348, the Resident Physician Shortage Act, in the next COVID supplemental package Opposed passage of the MORE Act H.R. 3884, which would, among other things, remove cannabis from the list of controlled substances under the CSA. Provided comments on a draft Residential Substance Abuse Treatment (RSAT) bill Provided comments on CARA 2.0 legislation, S. 5000, related to prescriber education and curricula grants Joined coalition letter to FDA urging the Commissioner to commence rulemaking to prohibit menthol as characterizing flavor in cigarettes Discussions regarding draft legislation on Medicaid reimbursement for addition treatment providers and repeal of the IMD exclusion in Medicaid for residential addiction treatment Discussions regarding the EASY MAT Act, HR 2281, CBO score Submitted letter of support for S. 4612, the Methamphetamine Response Act, which would declare methamphetamine an emerging drug threst

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

340B Drug Discount Program H.R. 1763, S. 348 - Resident Physician Shortage Reduction Act Graduate Medical Education Disproportionate Share Hospital payments Childrens Health Insurance Program Medicare Dependent Hospital Program (MDH) Medicaid Low Volume Payments (LV) Federal Medical Assistance Percentage Extension Inpatient Prospective Payment System Outpatient Prospective Payment System Bad debt/charity care Hospital Outpatient Department payments H.R. 2439, S. 2892 - Opioid Workforce Act H.R. 1358 - Advancing Medical Resident Training in Community Hospitals Act of 2019 S. 4160 - To maintain hospital 340B eligibility during the COVID-19 public health emergency S. 4160, H.R. 7838 - 340B Pandemic Eligibility Waiver bill CMS Accelerated and Advanced Payments COVID-19 Relief

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare, Medicaid, private insurance and other health care policies that impact patient access to hospital and physician care, including the "Resident Physician Shortage Reduction Act of 2019 (S. 348, H.R. 1763)", the "Lower Health Care Costs Act (S. 1895)", the "Opioid Workforce Act (H.R. 3414, S. 2892)", the "Ban Surprise Bill Act (H.R. 5800)", the "Consumer Protections Against Surprise Medical Bills Act (H.R. 5826)", the "Coronavirus Preparedness and Response Supplemental (H.R. 6074)", the "Families First Coronavirus Response Act (H.R. 6201)", the "Coronavirus Aid, Relief and Economic Security Act (H.R. 748)", the "Health and Economic Recovery Omnibus Emergency Solutions Act (H.R. 6800 and H.R 8406)", the "Paycheck Protection Program and Health Care Enhancement Act (H.R. 266)", the "Medicare Accelerated and Advance Payment Improvement Act (S. 3750, H.R. 6837)", the "Continuing Appropriations Act, 2021 and Other Extensions Act (H.R. 8337)", the "American Workers, Families and Employer Assistance Act (S.4318)", the "States Achieve Medicaid Expansion Act of 2019 (S.585)", the "Further Continuing Appropriations Act, 2021 and Other Extensions Act (H.R. 8900)", the Further Additional Continuing Appropriations Act, 2021 (H.J. Res. 107)", the "Extension of Continuing Appropriations Act, 2021 (H.J.Res 110)", the Consolidated Appropriations Act, 2021 (H.R. 133)", the "Medical Education for a Diverse America Act (H.R. 5432)", the "Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (H.R. 8702, S. 5007)", and H.R. 8505 related to Medicare physician payment.

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

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

340B Drug Discount Program H.R. 1763, S. 348 - Resident Physician Shortage Reduction Act Graduate Medical Education Disproportionate Share Hospital payments Childrens Health Insurance Program Medicare Dependent Hospital Program (MDH) Medicaid Low Volume Payments (LV) Federal Medical Assistance Percentage Extension Inpatient Prospective Payment System Outpatient Prospective Payment System Bad debt/charity care Hospital Outpatient Department payments H.R. 2439, S. 2892 - Opioid Workforce Act H.R. 1358 - Advancing Medical Resident Training in Community Hospitals Act of 2019 S. 4160 - To maintain hospital 340B eligibility during the COVID-19 public health emergency S. 4160, H.R. 7838 - 340B Pandemic Eligibility Waiver bill

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

FDA regulation of Laboratory-Developed Tests (LDTs); H.R.3414/S.2892, Opioid Workforce Act of 2019.

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

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

Graduate Medical Education - HR 3414/ S. 2892, Opioid Workforce Act 340B drug pricing drug prices DSH cuts - HR 3022, Patient Access Protection Act HEROS Act - HR 6800

Client expense: $15,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), 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) 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

opposition to DSH cuts, support increase to NIH funding and CHGME/GME funding, obtain repeal of the repeal of the imputed rural floor and work for legislative fix on impact of imputed rural floor. oppose cuts to 340B drug pricing program. support opioid workforce act of 2019 s2892/HR3414. support emergency hospital funding for covid19 related expenses and criteria for funding hospital including stimulus 1, stimulus 2, stimulus 3 and stimulus 4 legislation. Oppose new guidance on reporting on provider relief funds.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare, Medicaid, private insurance and other health care policies that impact patient access to hospital and physician care, including the "Resident Physician Shortage Reduction Act of 2019 (S. 348, H.R. 1763)", the "Lower Health Care Costs Act (S. 1895)", the "Opioid Workforce Act (H.R. 3414, S. 2892)", the "Ban Surprise Bill Act (H.R. 5800)", the "Consumer Protections Against Surprise Medical Bills Act (H.R. 5826)", the "Coronavirus Preparedness and Response Supplemental (H.R. 6074)", the "Families First Coronavirus Response Act (H.R. 6201)", the "Coronavirus Aid, Relief and Economic Security Act (H.R. 748)", the "Health and Economic Recovery Omnibus Emergency Solutions Act (H.R. 6800 and H.R 8406)", the "Paycheck Protection Program and Health Care Enhancement Act (H.R. 266)", the "Medicare Accelerated and Advance Payment Improvement Act (S. 3750, H.R. 6837)", the "Continuing Appropriations Act, 2021 and Other Extensions Act (H.R. 8337)", the "American Workers, Families and Employer Assistance Act (S.4318)", and the "States Achieve Medicaid Expansion Act of 2019 (S.585)".

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H. Res. 480, Acknowledging the racial disparities in diagnosing and treating mental health among youth in communities of color H.R. 1109, the Mental Health Services for Students Act of 2019 H.R. 1554, the Resident Education Deferred Interest Act H.R. 1763 / S. 348, the Resident Physician Shortage Reduction Act of 2019 H.R. 2279/ S. 2546, the Safe Step Act H.R. 2482/ S. 2074, the Mainstreaming Addiction Treatment Act of 2019 H.R. 2734 / S. 1448, the Safer Prescribing of Controlled Substances Act H.R. 3180/ S. 1770, the RISE from Trauma Act H.R. 3239/ S. 2135, the Humanitarian Standards for Individuals in Customs and Border Protection Custody Act H.R. 3253, the Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act H.R. 3414/ S. 2892, the Opioid Workforce Act H.R. 3417, BETTER Act of 2019 H.R. 4194/S. 2661, the National Suicide Hotline Designation Act of 2019 H.R. 4309, the Barriers to Suicide Act H.R. 4327, the Enhancing Mental Health and Suicide Prevention Through Campus Planning Act H.R. 4861/ S. 3006, the Effective Suicide Screening and Assessment in the Emergency Department Act H.R. 4932 / S. 2741, the CONNECT for Health Act H.R. 4995, the Maternal Health Quality Improvement Act of 2019 H.R. 4996, the Helping Medicaid Offer Maternity Services Act of 2019 H.R. 5, the Equality Act H.R. 5201, the Telemental Health Expansion Act of 2019 H.R. 5473, the Enhance Access to Support Essential Behavioral Health Services Act H.R.5469, the Pursuing Equity in Mental Health Act of 2019 H.R.5575, the Primary and Behavioral Health Care Access Act of 2020 Out of network billing legislation S. 1227, the Prescription Pricing for the People Act of 2019 S. 2443, the Investment in Tomorrow's Pediatric Health Care Workforce Act S. 824, the Excellence in Mental Health and Addiction Treatment Expansion Act S.1659, the Ensuring Childrens Access to Specialty Care Act of 2019 Title III Sec. 305 Timely Bills to Patients within the Lower Health Care Costs Act of 2019 (S. 1895) Cures 2.0 Title X Family Planning Program Administration Rule Efforts related to psychiatric bed shortages. H.R. 6074, the Coronavirus Preparedness and Response Supplemental Appropriations Act H.R. 6201, the Families First Coronavirus Response Act H.R. 748, the Coronavirus Aid, Relief and Economic Security (CARES) Act H.R. 2895/ S. 948, the Conrad State 30 and Physician Access Reauthorization Act H.R. 4996, the Helping Medicaid Offer Maternity Services (MOMS) Act, and Senate efforts. S. 311, the Born-Alive Abortion Survivors Protection Act S. 3275, the Pain-Capable Unborn Child Protection Act H.R. 4056 and S. 2446, the Medicare Audiologist Access and Services Act of 2019 H.R. 5575, the Primary and Behavioral Health Care Access Act Telehealth provisions as related to Covid-19. H.R. 6644, the Health Care at Home Act H.R. 748, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), including the Payroll Protection Program (PPP), the Public Health and Social Services Emergency Fund, and more. Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 and related Medicare and Medicaid payment updates. Emergency financial relief and stability funding for 501(c)(6) tax-exempt medical and dental trade associations impacted by the pandemic H.R. 7078, the Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act of 2020 (EDOT Act of 2020) H.R. 7255, the Coronavirus Health Care Worker Wellness Act of 2020 S. 3919, the Military Suicide Prevention in the 21st Century Act H.R. 7608, the Legislative Vehicle for the Fiscal 2021 Four-Bill Appropriations Package Recommendations on confidential mental health records sharing. H.R. 7539, the Strengthening Behavioral Health Parity Act H.R. 4564, the Suicide Prevention Lifeline Improvement Act of 2019 H.R. 5619, the Suicide Prevention Act H.R. 4585, the Campaign to Prevent Suicide Act H.R. 1646, the Helping Emergency Responders Overcome (HERO) Act of 2019 H.R. 2519, the Improving Mental Health Access from the Emergency Department Act of 2019 H.R. 7147, the Creating Resources to Improve Situations of Inherent Severity Act (CRISIS Act) H.R. 7159/S. 4282, the Crisis Care Improvement and Suicide Prevention Act of 2020 21st Century Cures Act, RE: Opioid State Targeted Response Grants H.R. 7689, the Improving Data Collection for Adverse Childhood Experiences Act H.R. 8094/S. 4349, the Dr. Lorna Breen Health Care Provider Protection Act H.R. 6561/S. 4440, the Improving Social Determinants of Health Act H.R. 7511/ S. 4211, the Facilitating Reforms that Offer Necessary Telehealth in Every Rural (FRONTIER) Community Act H.R. 884 / S. 2772, the Medicare Mental Health Access Act H.R. 1763, the Resident Physician Shortage Reduction Act of 2019 S. 2661, the National Suicide Hotline Designation Act of 2020 (Sen. Gardner - Energy and Commerce) H.R. 3935, the Protecting Patients Transportation to Care Act H.R. 4564, the Suicide Prevention Lifeline Improvement Act of 2020 S. Res. 738, Recognizing suicide as a serious public health problem and expressing support for the designation of September as National Suicide Prevention Month S. 4113, the Broadband Reform and Investment to Drive Growth in the Economy Act of 2020 (BRIDGE Act) H.R. 7859, the Strengthening Behavioral Health Supports for Schools Act S. 4421, the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act H.R. 8141, the Strengthening Mental Health Supports for BIPOC Communities Act HR 7510, the Assimilating Health and Equity Assessments into Decision-making Act of 2020 or AHEAD Act H.R. 5469/S.4388, the Mental Health Equity Act of 2020 H.R. 7059, the Coronavirus Provider Protection Act, S. 3792, the Tele-Mental Health Improvement Act of 2020. HR 6810 to provide COBRA subsidies for unemployed and furloughed individuals during COVID H.R. 7593/S. 4103, the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act H.R. 6645, the Mental Health Research Act H.R. 7539, the Strengthening Behavioral Health Parity Act H.R. 5201, the Telemental Health Expansion Act of 2019 H.R. 6561/S. 3595, the Ensuring Understanding for COVID-19 to Protect Public Health Act S. 4524, the Quit Because of COVID-19 Act S. 4486, the Achieving Thorough Transparency & Accessibility for Information Navigation (ATTAIN) on Mental Health Act H.R. 6800/H.R. 8406, the HEROES Act H.R. 7663, the Protecting Access to Post-COVID-19 Telehealth Act of 2020 S. 4230, the Telehealth Expansion Act of 2020 H.R. 7391, the Protect Telehealth Access Act of 2020 H.R. 7760, To make a supplemental appropriation for the COVID-19 Telehealth Program of the Federal Communications Commission for the fiscal year ending September 30, 2020 H.R.8067, the Addressing COVID-19 Health Disparities Act H.R. 2862, the VACCINES Act of 2019 (G6 letter for internal purposes) Efforts related to Collaborative Care Model S. 3197, the Improving Access to Health Care in Rural and Underserved Areas Act H.R. 6139, the COVID-19 Health Care Worker Protection Act of 2020 H.Res. 908 (S.Res. 580) Condemning all forms of Anti-Asian Sentiment as related to COVID-19 H.R. 6585, the Equitable Data Collection and Disclosure on COVID-19 Act H.R. 7078, the EDOT Act of 2020 HR 7077, the Community Solutions for COVID-19 Act S. 4441, the Crisis Assistance Helping Out On The Streets (CAHOOTS) Act

Client expense: $144,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of the Vice President of the United States, SENATE, Veterans Affairs, Dept of (VA), White House Office

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported HR 4974/S 4640: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported HR 7593/S 4103, the TREATS Act, that would increase the use of telehealth for substance use disorder treatment, and for other purposes Advocated for at least $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19, as well as direct funding from SAMHSA to opioid treatment programs and qualified practice settings Advocated for an increase in the Federal Medical Assistance Percentage for Medicaid as a result of COVID-19 Supported the Improving Medicaid Programs Response to Overdose Victims and Enhancing (IMPROVE) Addiction Care Act which would require state Medicaid programs to use their existing drug utilization review (DUR) programs to increase access to addiction treatment and boost safeguards for those on Medicaid who have experienced a non-fatal, opioid-related overdose. Opposed passage of H.R. 884 / S. 2772, the Medicare Mental Health Access Act, which would change the definition of physician under the Medicare program to include clinical psychologists. Supported the Dr. Lorna Breen Health Care Provider Protection Act (S.4349). The legislation would greatly reduce and prevent suicide and mental and behavioral health conditions among health care professionals. Submitted comments on the Center for Medicare and Medicaid Services (CMS) Value in Opioid Use Disorder Treatment (Value in Treatment) Demonstration design. The 4-year demonstration program was authorized by section 6042 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). Supported additional research funding for NIAAA to study alcohol use related to the impact of COVID-19 Submitted comments on the proposed 2021 Medicare Physician Fee Schedule (MPFS). Comments stressed the importance of the Centers for Medicare and Medicaid Services altering the MPFS to expand access to treatment for as many beneficiaries suffering from substance use disorder (SUD) as possible by introducing new codes for telehealth, expanding the range of eligible disorders for the billing of certain bundled payments, and empowering ED clinicians through the creation of a new code. Submitted its response to the Centers for Medicare and Medicaid Services (CMS) Request for Information (RFI) on Electronic Prescribing of Controlled Substances (EPCS). The RFI solicited feedback from stakeholders about whether CMS should include exceptions to the electronic prescribing of controlled substances and under what circumstances, and whether CMS should impose penalties for noncompliance with this mandate in its rulemaking, and what those penalties should be. Submitted response to CMS supporting EPCS as a way to assure quality and reduce errors and fraud in the transmission of prescriptions from the prescribing health care practitioner to the dispensing pharmacist but recommending CMS consider the financial impact of this requirement on small practices that do not yet have electronic systems in place that allow for EPCS, and extend the waiver timeline as well as provide additional resources or incentives for these practices to adopt such technology. Submitted comments on the Department of Labors (DOL) proposed update to the 2020 MHPAEA Self-Compliance Tool and commended DOL for the updates to the Self-Compliance Tool, while offering several detailed recommendations to clarify and strengthen the tool. Urged Senate leadership to include $58 million for syringe services programs (SSPs) and other harm reduction service providers in the next COVID relief package. Supported H.R. 7286, the Quit Because of COVID-19 Act. This legislation would ensure that all Medicaid and Childrens Health Insurance Program (CHIP) enrollees have access to the full array of evidence-based tobacco cessation treatments. Sent a letter to the Secretary of Health and Human Services, Alex Azar, requesting his support for a waiver of at least two years of the Health and Human Services (HHS) Office of the Inspector General (OIG) interpretation of the Anti-Kickback Statute and Civil Monetary Penalties as applied to the implementation of contingency management for the treatment of addiction. Supported includsion of S. 348, the Resident Physician Shortage Act, in the next COVID supplemental package Supported House Resolution 1057 that would express the sense of the House of Representatives that investments in mental health care and substance use disorder care are necessary to address the high prevalence of those suffering from behavioral health conditions. It also recognizes the need for health care reform to integrate mental health care and substance use disorder treatment in the health care system. Supported HR 7859, the Stregthening Behavioral Health Supports for Schools Act, that would establish in the Substance Abuse and Mental Health Services Administration a Center for School Behavioral Health Technical Assistance Informational discussions with CMS regarding coverage of digital therapeutics for addiction treatment

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported HR 4974/S 4640: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported HR 7593/S 4103, the TREATS Act, that would increase the use of telehealth for substance use disorder treatment, and for other purposes Advocated for at least $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19, as well as direct funding from SAMHSA to opioid treatment programs and qualified practice settings Advocated for an increase in the Federal Medical Assistance Percentage for Medicaid as a result of COVID-19 Supported the Improving Medicaid Programs Response to Overdose Victims and Enhancing (IMPROVE) Addiction Care Act which would require state Medicaid programs to use their existing drug utilization review (DUR) programs to increase access to addiction treatment and boost safeguards for those on Medicaid who have experienced a non-fatal, opioid-related overdose. Opposed passage of H.R. 884 / S. 2772, the Medicare Mental Health Access Act, which would change the definition of physician under the Medicare program to include clinical psychologists. Supported the Dr. Lorna Breen Health Care Provider Protection Act (S.4349). The legislation would greatly reduce and prevent suicide and mental and behavioral health conditions among health care professionals. Submitted comments on the Center for Medicare and Medicaid Services (CMS) Value in Opioid Use Disorder Treatment (Value in Treatment) Demonstration design. The 4-year demonstration program was authorized by section 6042 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). Supported additional research funding for NIAAA to study alcohol use related to the impact of COVID-19 Submitted comments on the proposed 2021 Medicare Physician Fee Schedule (MPFS). Comments stressed the importance of the Centers for Medicare and Medicaid Services altering the MPFS to expand access to treatment for as many beneficiaries suffering from substance use disorder (SUD) as possible by introducing new codes for telehealth, expanding the range of eligible disorders for the billing of certain bundled payments, and empowering ED clinicians through the creation of a new code. Submitted its response to the Centers for Medicare and Medicaid Services (CMS) Request for Information (RFI) on Electronic Prescribing of Controlled Substances (EPCS). The RFI solicited feedback from stakeholders about whether CMS should include exceptions to the electronic prescribing of controlled substances and under what circumstances, and whether CMS should impose penalties for noncompliance with this mandate in its rulemaking, and what those penalties should be. Submitted response to CMS supporting EPCS as a way to assure quality and reduce errors and fraud in the transmission of prescriptions from the prescribing health care practitioner to the dispensing pharmacist but recommending CMS consider the financial impact of this requirement on small practices that do not yet have electronic systems in place that allow for EPCS, and extend the waiver timeline as well as provide additional resources or incentives for these practices to adopt such technology. Submitted comments on the Department of Labors (DOL) proposed update to the 2020 MHPAEA Self-Compliance Tool and commended DOL for the updates to the Self-Compliance Tool, while offering several detailed recommendations to clarify and strengthen the tool. Urged Senate leadership to include $58 million for syringe services programs (SSPs) and other harm reduction service providers in the next COVID relief package. Supported H.R. 7286, the Quit Because of COVID-19 Act. This legislation would ensure that all Medicaid and Childrens Health Insurance Program (CHIP) enrollees have access to the full array of evidence-based tobacco cessation treatments. Sent a letter to the Secretary of Health and Human Services, Alex Azar, requesting his support for a waiver of at least two years of the Health and Human Services (HHS) Office of the Inspector General (OIG) interpretation of the Anti-Kickback Statute and Civil Monetary Penalties as applied to the implementation of contingency management for the treatment of addiction. Supported includsion of S. 348, the Resident Physician Shortage Act, in the next COVID supplemental package Supported House Resolution 1057 that would express the sense of the House of Representatives that investments in mental health care and substance use disorder care are necessary to address the high prevalence of those suffering from behavioral health conditions. It also recognizes the need for health care reform to integrate mental health care and substance use disorder treatment in the health care system. Supported HR 7859, the Stregthening Behavioral Health Supports for Schools Act, that would establish in the Substance Abuse and Mental Health Services Administration a Center for School Behavioral Health Technical Assistance Informational discussions with CMS regarding coverage of digital therapeutics for addiction treatment

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported HR 4974/S 4640: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported HR 7593/S 4103, the TREATS Act, that would increase the use of telehealth for substance use disorder treatment, and for other purposes Advocated for at least $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19, as well as direct funding from SAMHSA to opioid treatment programs and qualified practice settings Advocated for an increase in the Federal Medical Assistance Percentage for Medicaid as a result of COVID-19 Supported the Improving Medicaid Programs Response to Overdose Victims and Enhancing (IMPROVE) Addiction Care Act which would require state Medicaid programs to use their existing drug utilization review (DUR) programs to increase access to addiction treatment and boost safeguards for those on Medicaid who have experienced a non-fatal, opioid-related overdose. Opposed passage of H.R. 884 / S. 2772, the Medicare Mental Health Access Act, which would change the definition of physician under the Medicare program to include clinical psychologists. Supported the Dr. Lorna Breen Health Care Provider Protection Act (S.4349). The legislation would greatly reduce and prevent suicide and mental and behavioral health conditions among health care professionals. Submitted comments on the Center for Medicare and Medicaid Services (CMS) Value in Opioid Use Disorder Treatment (Value in Treatment) Demonstration design. The 4-year demonstration program was authorized by section 6042 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). Supported additional research funding for NIAAA to study alcohol use related to the impact of COVID-19 Submitted comments on the proposed 2021 Medicare Physician Fee Schedule (MPFS). Comments stressed the importance of the Centers for Medicare and Medicaid Services altering the MPFS to expand access to treatment for as many beneficiaries suffering from substance use disorder (SUD) as possible by introducing new codes for telehealth, expanding the range of eligible disorders for the billing of certain bundled payments, and empowering ED clinicians through the creation of a new code. Submitted its response to the Centers for Medicare and Medicaid Services (CMS) Request for Information (RFI) on Electronic Prescribing of Controlled Substances (EPCS). The RFI solicited feedback from stakeholders about whether CMS should include exceptions to the electronic prescribing of controlled substances and under what circumstances, and whether CMS should impose penalties for noncompliance with this mandate in its rulemaking, and what those penalties should be. Submitted response to CMS supporting EPCS as a way to assure quality and reduce errors and fraud in the transmission of prescriptions from the prescribing health care practitioner to the dispensing pharmacist but recommending CMS consider the financial impact of this requirement on small practices that do not yet have electronic systems in place that allow for EPCS, and extend the waiver timeline as well as provide additional resources or incentives for these practices to adopt such technology. Submitted comments on the Department of Labors (DOL) proposed update to the 2020 MHPAEA Self-Compliance Tool and commended DOL for the updates to the Self-Compliance Tool, while offering several detailed recommendations to clarify and strengthen the tool. Urged Senate leadership to include $58 million for syringe services programs (SSPs) and other harm reduction service providers in the next COVID relief package. Supported H.R. 7286, the Quit Because of COVID-19 Act. This legislation would ensure that all Medicaid and Childrens Health Insurance Program (CHIP) enrollees have access to the full array of evidence-based tobacco cessation treatments. Sent a letter to the Secretary of Health and Human Services, Alex Azar, requesting his support for a waiver of at least two years of the Health and Human Services (HHS) Office of the Inspector General (OIG) interpretation of the Anti-Kickback Statute and Civil Monetary Penalties as applied to the implementation of contingency management for the treatment of addiction. Supported includsion of S. 348, the Resident Physician Shortage Act, in the next COVID supplemental package Supported House Resolution 1057 that would express the sense of the House of Representatives that investments in mental health care and substance use disorder care are necessary to address the high prevalence of those suffering from behavioral health conditions. It also recognizes the need for health care reform to integrate mental health care and substance use disorder treatment in the health care system. Supported HR 7859, the Stregthening Behavioral Health Supports for Schools Act, that would establish in the Substance Abuse and Mental Health Services Administration a Center for School Behavioral Health Technical Assistance Informational discussions with CMS regarding coverage of digital therapeutics for addiction treatment

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported HR 4974/S 4640: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported HR 7593/S 4103, the TREATS Act, that would increase the use of telehealth for substance use disorder treatment, and for other purposes Advocated for at least $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19, as well as direct funding from SAMHSA to opioid treatment programs and qualified practice settings Advocated for an increase in the Federal Medical Assistance Percentage for Medicaid as a result of COVID-19 Supported the Improving Medicaid Programs Response to Overdose Victims and Enhancing (IMPROVE) Addiction Care Act which would require state Medicaid programs to use their existing drug utilization review (DUR) programs to increase access to addiction treatment and boost safeguards for those on Medicaid who have experienced a non-fatal, opioid-related overdose. Opposed passage of H.R. 884 / S. 2772, the Medicare Mental Health Access Act, which would change the definition of physician under the Medicare program to include clinical psychologists. Supported the Dr. Lorna Breen Health Care Provider Protection Act (S.4349). The legislation would greatly reduce and prevent suicide and mental and behavioral health conditions among health care professionals. Submitted comments on the Center for Medicare and Medicaid Services (CMS) Value in Opioid Use Disorder Treatment (Value in Treatment) Demonstration design. The 4-year demonstration program was authorized by section 6042 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). Supported additional research funding for NIAAA to study alcohol use related to the impact of COVID-19 Submitted comments on the proposed 2021 Medicare Physician Fee Schedule (MPFS). Comments stressed the importance of the Centers for Medicare and Medicaid Services altering the MPFS to expand access to treatment for as many beneficiaries suffering from substance use disorder (SUD) as possible by introducing new codes for telehealth, expanding the range of eligible disorders for the billing of certain bundled payments, and empowering ED clinicians through the creation of a new code. Submitted its response to the Centers for Medicare and Medicaid Services (CMS) Request for Information (RFI) on Electronic Prescribing of Controlled Substances (EPCS). The RFI solicited feedback from stakeholders about whether CMS should include exceptions to the electronic prescribing of controlled substances and under what circumstances, and whether CMS should impose penalties for noncompliance with this mandate in its rulemaking, and what those penalties should be. Submitted response to CMS supporting EPCS as a way to assure quality and reduce errors and fraud in the transmission of prescriptions from the prescribing health care practitioner to the dispensing pharmacist but recommending CMS consider the financial impact of this requirement on small practices that do not yet have electronic systems in place that allow for EPCS, and extend the waiver timeline as well as provide additional resources or incentives for these practices to adopt such technology. Submitted comments on the Department of Labors (DOL) proposed update to the 2020 MHPAEA Self-Compliance Tool and commended DOL for the updates to the Self-Compliance Tool, while offering several detailed recommendations to clarify and strengthen the tool. Urged Senate leadership to include $58 million for syringe services programs (SSPs) and other harm reduction service providers in the next COVID relief package. Supported H.R. 7286, the Quit Because of COVID-19 Act. This legislation would ensure that all Medicaid and Childrens Health Insurance Program (CHIP) enrollees have access to the full array of evidence-based tobacco cessation treatments. Sent a letter to the Secretary of Health and Human Services, Alex Azar, requesting his support for a waiver of at least two years of the Health and Human Services (HHS) Office of the Inspector General (OIG) interpretation of the Anti-Kickback Statute and Civil Monetary Penalties as applied to the implementation of contingency management for the treatment of addiction. Supported includsion of S. 348, the Resident Physician Shortage Act, in the next COVID supplemental package Supported House Resolution 1057 that would express the sense of the House of Representatives that investments in mental health care and substance use disorder care are necessary to address the high prevalence of those suffering from behavioral health conditions. It also recognizes the need for health care reform to integrate mental health care and substance use disorder treatment in the health care system. Supported HR 7859, the Stregthening Behavioral Health Supports for Schools Act, that would establish in the Substance Abuse and Mental Health Services Administration a Center for School Behavioral Health Technical Assistance Informational discussions with CMS regarding coverage of digital therapeutics for addiction treatment

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported HR 4974/S 4640: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported HR 7593/S 4103, the TREATS Act, that would increase the use of telehealth for substance use disorder treatment, and for other purposes Advocated for at least $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19, as well as direct funding from SAMHSA to opioid treatment programs and qualified practice settings Advocated for an increase in the Federal Medical Assistance Percentage for Medicaid as a result of COVID-19 Supported the Improving Medicaid Programs Response to Overdose Victims and Enhancing (IMPROVE) Addiction Care Act which would require state Medicaid programs to use their existing drug utilization review (DUR) programs to increase access to addiction treatment and boost safeguards for those on Medicaid who have experienced a non-fatal, opioid-related overdose. Opposed passage of H.R. 884 / S. 2772, the Medicare Mental Health Access Act, which would change the definition of physician under the Medicare program to include clinical psychologists. Supported the Dr. Lorna Breen Health Care Provider Protection Act (S.4349). The legislation would greatly reduce and prevent suicide and mental and behavioral health conditions among health care professionals. Submitted comments on the Center for Medicare and Medicaid Services (CMS) Value in Opioid Use Disorder Treatment (Value in Treatment) Demonstration design. The 4-year demonstration program was authorized by section 6042 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). Supported additional research funding for NIAAA to study alcohol use related to the impact of COVID-19 Submitted comments on the proposed 2021 Medicare Physician Fee Schedule (MPFS). Comments stressed the importance of the Centers for Medicare and Medicaid Services altering the MPFS to expand access to treatment for as many beneficiaries suffering from substance use disorder (SUD) as possible by introducing new codes for telehealth, expanding the range of eligible disorders for the billing of certain bundled payments, and empowering ED clinicians through the creation of a new code. Submitted its response to the Centers for Medicare and Medicaid Services (CMS) Request for Information (RFI) on Electronic Prescribing of Controlled Substances (EPCS). The RFI solicited feedback from stakeholders about whether CMS should include exceptions to the electronic prescribing of controlled substances and under what circumstances, and whether CMS should impose penalties for noncompliance with this mandate in its rulemaking, and what those penalties should be. Submitted response to CMS supporting EPCS as a way to assure quality and reduce errors and fraud in the transmission of prescriptions from the prescribing health care practitioner to the dispensing pharmacist but recommending CMS consider the financial impact of this requirement on small practices that do not yet have electronic systems in place that allow for EPCS, and extend the waiver timeline as well as provide additional resources or incentives for these practices to adopt such technology. Submitted comments on the Department of Labors (DOL) proposed update to the 2020 MHPAEA Self-Compliance Tool and commended DOL for the updates to the Self-Compliance Tool, while offering several detailed recommendations to clarify and strengthen the tool. Urged Senate leadership to include $58 million for syringe services programs (SSPs) and other harm reduction service providers in the next COVID relief package. Supported H.R. 7286, the Quit Because of COVID-19 Act. This legislation would ensure that all Medicaid and Childrens Health Insurance Program (CHIP) enrollees have access to the full array of evidence-based tobacco cessation treatments. Sent a letter to the Secretary of Health and Human Services, Alex Azar, requesting his support for a waiver of at least two years of the Health and Human Services (HHS) Office of the Inspector General (OIG) interpretation of the Anti-Kickback Statute and Civil Monetary Penalties as applied to the implementation of contingency management for the treatment of addiction. Supported includsion of S. 348, the Resident Physician Shortage Act, in the next COVID supplemental package Supported House Resolution 1057 that would express the sense of the House of Representatives that investments in mental health care and substance use disorder care are necessary to address the high prevalence of those suffering from behavioral health conditions. It also recognizes the need for health care reform to integrate mental health care and substance use disorder treatment in the health care system. Supported HR 7859, the Stregthening Behavioral Health Supports for Schools Act, that would establish in the Substance Abuse and Mental Health Services Administration a Center for School Behavioral Health Technical Assistance Informational discussions with CMS regarding coverage of digital therapeutics for addiction treatment

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported HR 4974/S 4640: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported HR 7593/S 4103, the TREATS Act, that would increase the use of telehealth for substance use disorder treatment, and for other purposes Advocated for at least $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19, as well as direct funding from SAMHSA to opioid treatment programs and qualified practice settings Advocated for an increase in the Federal Medical Assistance Percentage for Medicaid as a result of COVID-19 Supported the Improving Medicaid Programs Response to Overdose Victims and Enhancing (IMPROVE) Addiction Care Act which would require state Medicaid programs to use their existing drug utilization review (DUR) programs to increase access to addiction treatment and boost safeguards for those on Medicaid who have experienced a non-fatal, opioid-related overdose. Opposed passage of H.R. 884 / S. 2772, the Medicare Mental Health Access Act, which would change the definition of physician under the Medicare program to include clinical psychologists. Supported the Dr. Lorna Breen Health Care Provider Protection Act (S.4349). The legislation would greatly reduce and prevent suicide and mental and behavioral health conditions among health care professionals. Submitted comments on the Center for Medicare and Medicaid Services (CMS) Value in Opioid Use Disorder Treatment (Value in Treatment) Demonstration design. The 4-year demonstration program was authorized by section 6042 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act). Supported additional research funding for NIAAA to study alcohol use related to the impact of COVID-19 Submitted comments on the proposed 2021 Medicare Physician Fee Schedule (MPFS). Comments stressed the importance of the Centers for Medicare and Medicaid Services altering the MPFS to expand access to treatment for as many beneficiaries suffering from substance use disorder (SUD) as possible by introducing new codes for telehealth, expanding the range of eligible disorders for the billing of certain bundled payments, and empowering ED clinicians through the creation of a new code. Submitted its response to the Centers for Medicare and Medicaid Services (CMS) Request for Information (RFI) on Electronic Prescribing of Controlled Substances (EPCS). The RFI solicited feedback from stakeholders about whether CMS should include exceptions to the electronic prescribing of controlled substances and under what circumstances, and whether CMS should impose penalties for noncompliance with this mandate in its rulemaking, and what those penalties should be. Submitted response to CMS supporting EPCS as a way to assure quality and reduce errors and fraud in the transmission of prescriptions from the prescribing health care practitioner to the dispensing pharmacist but recommending CMS consider the financial impact of this requirement on small practices that do not yet have electronic systems in place that allow for EPCS, and extend the waiver timeline as well as provide additional resources or incentives for these practices to adopt such technology. Submitted comments on the Department of Labors (DOL) proposed update to the 2020 MHPAEA Self-Compliance Tool and commended DOL for the updates to the Self-Compliance Tool, while offering several detailed recommendations to clarify and strengthen the tool. Urged Senate leadership to include $58 million for syringe services programs (SSPs) and other harm reduction service providers in the next COVID relief package. Supported H.R. 7286, the Quit Because of COVID-19 Act. This legislation would ensure that all Medicaid and Childrens Health Insurance Program (CHIP) enrollees have access to the full array of evidence-based tobacco cessation treatments. Sent a letter to the Secretary of Health and Human Services, Alex Azar, requesting his support for a waiver of at least two years of the Health and Human Services (HHS) Office of the Inspector General (OIG) interpretation of the Anti-Kickback Statute and Civil Monetary Penalties as applied to the implementation of contingency management for the treatment of addiction. Supported includsion of S. 348, the Resident Physician Shortage Act, in the next COVID supplemental package Supported House Resolution 1057 that would express the sense of the House of Representatives that investments in mental health care and substance use disorder care are necessary to address the high prevalence of those suffering from behavioral health conditions. It also recognizes the need for health care reform to integrate mental health care and substance use disorder treatment in the health care system. Supported HR 7859, the Stregthening Behavioral Health Supports for Schools Act, that would establish in the Substance Abuse and Mental Health Services Administration a Center for School Behavioral Health Technical Assistance Informational discussions with CMS regarding coverage of digital therapeutics for addiction treatment

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

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

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

340B Drug Discount Program H.R. 1763, S. 348 - Resident Physician Shortage Reduction Act Graduate Medical Education Disproportionate Share Hospital payments Childrens Health Insurance Program Medicare Dependent Hospital Program (MDH) Medicaid Low Volume Payments (LV) Federal Medical Assistance Percentage Extension Inpatient Prospective Payment System Outpatient Prospective Payment System Bad debt/charity care Hospital Outpatient Department payments H.R. 2439, S. 2892 - Opioid Workforce Act H.R. 1358 - Advancing Medical Resident Training in Community Hospitals Act of 2019 S. 4160 - To maintain hospital 340B eligibility during the COVID-19 public health emergency

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H. Res. 480, Acknowledging the racial disparities in diagnosing and treating mental health among youth in communities of color H.R. 1109, the Mental Health Services for Students Act of 2019 H.R. 1554, the Resident Education Deferred Interest Act H.R. 1763 / S. 348, the Resident Physician Shortage Reduction Act of 2019 H.R. 2062 / S. 1012 (42 CFR Part 2) H.R. 2279/ S. 2546, the Safe Step Act H.R. 2482/ S. 2074, the Mainstreaming Addiction Treatment Act of 2019 H.R. 2734 / S. 1448, the Safer Prescribing of Controlled Substances Act H.R. 2862, the VACCINES Act of 2019 H.R. 3, Lower Drug Costs Now Act of 2019 H.R. 3180/ S. 1770, the RISE from Trauma Act H.R. 3239/ S. 2135, the Humanitarian Standards for Individuals in Customs and Border Protection Custody Act H.R. 3253, the Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act H.R. 3414/ S. 2892, the Opioid Workforce Act H.R. 3417, BETTER Act of 2019 H.R. 4194, S. 2661, the National Suicide Hotline Designation Act of 2019 H.R. 4309, the Barriers to Suicide Act H.R. 4327, the Enhancing Mental Health and Suicide Prevention Through Campus Planning Act H.R. 4861/ S. 3006, the Effective Suicide Screening and Assessment in the Emergency Department Act H.R. 4932 / S. 2741, the CONNECT for Health Act H.R. 4995, the Maternal Health Quality Improvement Act of 2019 H.R. 4996, the Helping Medicaid Offer Maternity Services Act of 2019 H.R. 5, the Equality Act H.R. 5201, the Telemental Health Expansion Act of 2019 H.R. 5473, the Enhance Access to Support Essential Behavioral Health Services Act H.R.5469, the Pursuing Equity in Mental Health Act of 2019 H.R.5575, the Primary and Behavioral Health Care Access Act of 2020 Out of network billing legislation S. 1227, the Prescription Pricing for the People Act of 2019 S. 2443, the Investment in Tomorrow's Pediatric Health Care Workforce Act S. 824, the Excellence in Mental Health and Addiction Treatment Expansion Act S.1659, the Ensuring Childrens Access to Specialty Care Act of 2019 Title III Sec. 305 Timely Bills to Patients within the Lower Health Care Costs Act of 2019 (S. 1895) Cures 2.0 Suggestions related to addressing mental health in rural communities. Title X Family Planning Program Administration Rule Efforts related to psychiatric bed shortages. H.R. 6074, the Coronavirus Preparedness and Response Supplemental Appropriations Act H.R. 6201, the Families First Coronavirus Response Act H.R. 748, the Coronavirus Aid, Relief and Economic Security (CARES) Act H.R. 2895, S. 948, the Conrad State 30 and Physician Access Reauthorization Act H.R. 4996, the Helping Medicaid Offer Maternity Services (MOMS) Act, and Senate efforts. S. 311, the Born-Alive Abortion Survivors Protection Act S. 3275, the Pain-Capable Unborn Child Protection Act H.R. 4056 and S. 2446, the Medicare Audiologist Access and Services Act of 2019 H.R. 5575, the Primary and Behavioral Health Care Access Act Telehealth provisions as related to Covid-19. H.R. 6644, the Health Care at Home Act H.R. 748, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), including the Payroll Protection Program (PPP), the Public Health and Social Services Emergency Fund, the provider fund (for MH funding), and more. Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 and related Medicare and Medicaid payment updates. Emergency financial relief and stability funding for 501(c)(6) tax-exempt medical and dental trade associations impacted by the pandemic H.R.7078 , the Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act of 2020 (EDOT Act of 2020) H.R. 7255, the Coronavirus Health Care Worker Wellness Act of 2020 S.3919, Military Suicide Prevention in the 21st Century Act H.R. 7608, Legislative Vehicle for the Fiscal 2021 Four-Bill Appropriations Package H.R. 6788/S. 3599, Healthcare Workforce Resilience Act Recommendations on confidential mental health records sharing. H.R. 4564, the Suicide Prevention Lifeline Improvement Act of 2019 H.R. 5619, the Suicide Prevention Act H.R. 4585, the Campaign to Prevent Suicide Act H.R. 1646, the Helping Emergency Responders Overcome (HERO) Act of 2019 H.R.884/S. 2772, the Medicare Mental Health Access Act H.R. 2519, the Improving Mental Health Access from the Emergency Department Act of 2019 H.R. 7147, the Creating Resources to Improve Situations of Inherent Severity Act (CRISIS Act) H.R. 7159, the Crisis Care Improvement and Suicide Prevention Act of 2020 21st Century Cures Act, RE: Opioid State Targeted Response Grants S.4088, the Ensuring Access to Primary Care for Women & Children Act H.R. 6159, the KIDS Access to Primary Care Act S. 3741, the Health Care at Home Act S. 3792, the Tele-mental Health Improvement Act H.R. 6697, the Local Chamber, Tourism, and 501(c)(6) Protection Act

Client expense: $162,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of the Vice President of the United States, SENATE, Veterans Affairs, Dept of (VA), White House Office

Graduate Medical Education - HR 3414/ S. 2892, Opioid Workforce Act 340B drug pricing drug prices DSH cuts - HR 3022, Patient Access Protection Act CARES Act - HR 748 HEROS Act - HR 6800

Client expense: $15,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), 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

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

opposition to DSH cuts, support increase to NIH funding and CHGME/GME funding, obtain repeal of the repeal of the imputed rural floor and work for legislative fix on impact of imputed rural floor. oppose cuts to 340B drug pricing program. support opioid workforce act of 2019 s2892/HR3414. support emergency hospital funding for covid19 related expenses and criteria for funding hospital including stimulus 1, stimulus 2 and stimulus 3 legislation.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare, Medicaid, private insurance and other health care policies that impact patient access to hospital and physician care, including the "Resident Physician Shortage Reduction Act of 2019 (S. 348, H.R. 1763)", the "Lower Health Care Costs Act (S. 1895)", the "Opioid Workforce Act (H.R. 3414, S. 2892)", the "Ban Surprise Bill Act (H.R. 5800)", the "Consumer Protections Against Surprise Medical Bills Act (H.R. 5826)", the "Coronavirus Preparedness and Response Supplemental (H.R. 6074)", the "Families First Coronavirus Response Act (H.R. 6201)", the "Coronavirus Aid, Relief and Economic Security Act (H.R. 748)", the "Health and Economic Recovery Omnibus Emergency Solutions Act (H.R. 6800)", the "Paycheck Protection Program and Health Care Enhancement Act (H.R. 266)", and the "Medicare Accelerated and Advance Payment Improvement Act (S. 3750)".

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1920 - Medicaid Bump Act - To amend title XIX of the Social Security Act to provide a higher Federal matching rate for increased expenditures under Medicaid for mental and behavioral health services, and for other purposes. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported S 824/HR 1767 - Excellence in Mental Health and Addiction Treatment Expansion Act This legislation would extend and expand the Certified Community Behavioral Health Clinic (CCBHC) demonstration, which is set to end in mid-2019. Supported the Parity Enforcement Act (HR 2848). This legislation would give the U.S. Department of Labor authority to levy civil monetary penalties against health insurers and plan sponsors for parity violations of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported S.1012/ HR 2062 Protecting Jessica Grubbs Legacy Act/ Overdose Prevention and Patient Safety Act to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records. Supported HR 4974: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported the Reversing the Youth Tobacco Epidemic Act of 2019 (HR 2339) which would, among other things, amend the Federal Food, Drug, and Cosmetic Act with respect to the sale and marketing of tobacco products Supported HR 4742, Protecting American Lungs Act, a bill to impose a tax on nicotine used in e-cigarettes. Supported HR 5632, The FDA Accountability for Public Safety Act, which would require the FDA Commissioner to make the final decision on drug approvals if the advisory committee advises against approval, among other things. Advocated for the addiction of a Medicaid Provider Status requirement on any new State Opioid Response Grant funding Advocated for the use of audio-visual telehealth for initation of new OTP patients to be treated with methadone Advocated for an increase in the DATA 2000 waiver patient limit Advocated for telehealth buprenorphine initiation as an exception to Ryan Haight Advocated for addiction CMS guidance and coverage related to telehealth Advocated to allow Opioid Treatment Programs (OTPs) to operate mobile units without requiring them to obtain a separate registration as well as more flexibility regarding take-home medications dispensed from an OTP Advocated for $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19 Advocated for inclusion of provisions in HR 748 of the CARES Act, related to the Opioid Workforce Act, the Reducing Barriers to Substance Use Disorder Treatment, Medicaid Reentry, emergency health care provider relief funds, reform of 42 CFR Part 2, amont other ASAM priorities Advocated for eventual filing of the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act (S. 4103). For purposes of prescribing Schedule III and IV medications, including buprenorphine for the treatment of opioid use disorder, the TREATS Act would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement. The TREATS Act would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, substance use disorder telehealth services after an in-person or telehealth evaluation

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1920 - Medicaid Bump Act - To amend title XIX of the Social Security Act to provide a higher Federal matching rate for increased expenditures under Medicaid for mental and behavioral health services, and for other purposes. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported S 824/HR 1767 - Excellence in Mental Health and Addiction Treatment Expansion Act This legislation would extend and expand the Certified Community Behavioral Health Clinic (CCBHC) demonstration, which is set to end in mid-2019. Supported the Parity Enforcement Act (HR 2848). This legislation would give the U.S. Department of Labor authority to levy civil monetary penalties against health insurers and plan sponsors for parity violations of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported S.1012/ HR 2062 Protecting Jessica Grubbs Legacy Act/ Overdose Prevention and Patient Safety Act to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records. Supported HR 4974: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported the Reversing the Youth Tobacco Epidemic Act of 2019 (HR 2339) which would, among other things, amend the Federal Food, Drug, and Cosmetic Act with respect to the sale and marketing of tobacco products Supported HR 4742, Protecting American Lungs Act, a bill to impose a tax on nicotine used in e-cigarettes. Supported HR 5632, The FDA Accountability for Public Safety Act, which would require the FDA Commissioner to make the final decision on drug approvals if the advisory committee advises against approval, among other things. Advocated for the addiction of a Medicaid Provider Status requirement on any new State Opioid Response Grant funding Advocated for the use of audio-visual telehealth for initation of new OTP patients to be treated with methadone Advocated for an increase in the DATA 2000 waiver patient limit Advocated for telehealth buprenorphine initiation as an exception to Ryan Haight Advocated for addiction CMS guidance and coverage related to telehealth Advocated to allow Opioid Treatment Programs (OTPs) to operate mobile units without requiring them to obtain a separate registration as well as more flexibility regarding take-home medications dispensed from an OTP Advocated for $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19 Advocated for inclusion of provisions in HR 748 of the CARES Act, related to the Opioid Workforce Act, the Reducing Barriers to Substance Use Disorder Treatment, Medicaid Reentry, emergency health care provider relief funds, reform of 42 CFR Part 2, amont other ASAM priorities Advocated for eventual filing of the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act (S. 4103). For purposes of prescribing Schedule III and IV medications, including buprenorphine for the treatment of opioid use disorder, the TREATS Act would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement. The TREATS Act would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, substance use disorder telehealth services after an in-person or telehealth evaluation

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1920 - Medicaid Bump Act - To amend title XIX of the Social Security Act to provide a higher Federal matching rate for increased expenditures under Medicaid for mental and behavioral health services, and for other purposes. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported S 824/HR 1767 - Excellence in Mental Health and Addiction Treatment Expansion Act This legislation would extend and expand the Certified Community Behavioral Health Clinic (CCBHC) demonstration, which is set to end in mid-2019. Supported the Parity Enforcement Act (HR 2848). This legislation would give the U.S. Department of Labor authority to levy civil monetary penalties against health insurers and plan sponsors for parity violations of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported S.1012/ HR 2062 Protecting Jessica Grubbs Legacy Act/ Overdose Prevention and Patient Safety Act to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records. Supported HR 4974: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported the Reversing the Youth Tobacco Epidemic Act of 2019 (HR 2339) which would, among other things, amend the Federal Food, Drug, and Cosmetic Act with respect to the sale and marketing of tobacco products Supported HR 4742, Protecting American Lungs Act, a bill to impose a tax on nicotine used in e-cigarettes. Supported HR 5632, The FDA Accountability for Public Safety Act, which would require the FDA Commissioner to make the final decision on drug approvals if the advisory committee advises against approval, among other things. Advocated for the addiction of a Medicaid Provider Status requirement on any new State Opioid Response Grant funding Advocated for the use of audio-visual telehealth for initation of new OTP patients to be treated with methadone Advocated for an increase in the DATA 2000 waiver patient limit Advocated for telehealth buprenorphine initiation as an exception to Ryan Haight Advocated for addiction CMS guidance and coverage related to telehealth Advocated to allow Opioid Treatment Programs (OTPs) to operate mobile units without requiring them to obtain a separate registration as well as more flexibility regarding take-home medications dispensed from an OTP Advocated for $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19 Advocated for inclusion of provisions in HR 748 of the CARES Act, related to the Opioid Workforce Act, the Reducing Barriers to Substance Use Disorder Treatment, Medicaid Reentry, emergency health care provider relief funds, reform of 42 CFR Part 2, amont other ASAM priorities Advocated for eventual filing of the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act (S. 4103). For purposes of prescribing Schedule III and IV medications, including buprenorphine for the treatment of opioid use disorder, the TREATS Act would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement. The TREATS Act would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, substance use disorder telehealth services after an in-person or telehealth evaluation

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1920 - Medicaid Bump Act - To amend title XIX of the Social Security Act to provide a higher Federal matching rate for increased expenditures under Medicaid for mental and behavioral health services, and for other purposes. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported S 824/HR 1767 - Excellence in Mental Health and Addiction Treatment Expansion Act This legislation would extend and expand the Certified Community Behavioral Health Clinic (CCBHC) demonstration, which is set to end in mid-2019. Supported the Parity Enforcement Act (HR 2848). This legislation would give the U.S. Department of Labor authority to levy civil monetary penalties against health insurers and plan sponsors for parity violations of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported S.1012/ HR 2062 Protecting Jessica Grubbs Legacy Act/ Overdose Prevention and Patient Safety Act to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records. Supported HR 4974: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported the Reversing the Youth Tobacco Epidemic Act of 2019 (HR 2339) which would, among other things, amend the Federal Food, Drug, and Cosmetic Act with respect to the sale and marketing of tobacco products Supported HR 4742, Protecting American Lungs Act, a bill to impose a tax on nicotine used in e-cigarettes. Supported HR 5632, The FDA Accountability for Public Safety Act, which would require the FDA Commissioner to make the final decision on drug approvals if the advisory committee advises against approval, among other things. Advocated for the addiction of a Medicaid Provider Status requirement on any new State Opioid Response Grant funding Advocated for the use of audio-visual telehealth for initation of new OTP patients to be treated with methadone Advocated for an increase in the DATA 2000 waiver patient limit Advocated for telehealth buprenorphine initiation as an exception to Ryan Haight Advocated for addiction CMS guidance and coverage related to telehealth Advocated to allow Opioid Treatment Programs (OTPs) to operate mobile units without requiring them to obtain a separate registration as well as more flexibility regarding take-home medications dispensed from an OTP Advocated for $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19 Advocated for inclusion of provisions in HR 748 of the CARES Act, related to the Opioid Workforce Act, the Reducing Barriers to Substance Use Disorder Treatment, Medicaid Reentry, emergency health care provider relief funds, reform of 42 CFR Part 2, amont other ASAM priorities Advocated for eventual filing of the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act (S. 4103). For purposes of prescribing Schedule III and IV medications, including buprenorphine for the treatment of opioid use disorder, the TREATS Act would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement. The TREATS Act would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, substance use disorder telehealth services after an in-person or telehealth evaluation

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1920 - Medicaid Bump Act - To amend title XIX of the Social Security Act to provide a higher Federal matching rate for increased expenditures under Medicaid for mental and behavioral health services, and for other purposes. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported S 824/HR 1767 - Excellence in Mental Health and Addiction Treatment Expansion Act This legislation would extend and expand the Certified Community Behavioral Health Clinic (CCBHC) demonstration, which is set to end in mid-2019. Supported the Parity Enforcement Act (HR 2848). This legislation would give the U.S. Department of Labor authority to levy civil monetary penalties against health insurers and plan sponsors for parity violations of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported S.1012/ HR 2062 Protecting Jessica Grubbs Legacy Act/ Overdose Prevention and Patient Safety Act to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records. Supported HR 4974: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported the Reversing the Youth Tobacco Epidemic Act of 2019 (HR 2339) which would, among other things, amend the Federal Food, Drug, and Cosmetic Act with respect to the sale and marketing of tobacco products Supported HR 4742, Protecting American Lungs Act, a bill to impose a tax on nicotine used in e-cigarettes. Supported HR 5632, The FDA Accountability for Public Safety Act, which would require the FDA Commissioner to make the final decision on drug approvals if the advisory committee advises against approval, among other things. Advocated for the addiction of a Medicaid Provider Status requirement on any new State Opioid Response Grant funding Advocated for the use of audio-visual telehealth for initation of new OTP patients to be treated with methadone Advocated for an increase in the DATA 2000 waiver patient limit Advocated for telehealth buprenorphine initiation as an exception to Ryan Haight Advocated for addiction CMS guidance and coverage related to telehealth Advocated to allow Opioid Treatment Programs (OTPs) to operate mobile units without requiring them to obtain a separate registration as well as more flexibility regarding take-home medications dispensed from an OTP Advocated for $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19 Advocated for inclusion of provisions in HR 748 of the CARES Act, related to the Opioid Workforce Act, the Reducing Barriers to Substance Use Disorder Treatment, Medicaid Reentry, emergency health care provider relief funds, reform of 42 CFR Part 2, amont other ASAM priorities Advocated for eventual filing of the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act (S. 4103). For purposes of prescribing Schedule III and IV medications, including buprenorphine for the treatment of opioid use disorder, the TREATS Act would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement. The TREATS Act would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, substance use disorder telehealth services after an in-person or telehealth evaluation

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Advocated for FY2021 Labor HHS Appropriations bill - appropriations related to strengthening the addiction services workforce, including full funding of the loan repayment program for the substance use disorder treatment workforce authorized in the SUPPORT Act, increase in funding for the mental and substance use disorders training demonstration program authorized in 21st Century Cures Act, funding for preventive medicine residency programs, and $8.8 billion for discretionary Health Resources and Services Administration programs. Supported HR 3414 (and prior versions)/ S. 2892 - Opioid Workforce Act of 2019 - bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain management programs, with an aggregate increase of 1,000 positions over a five-year period. Supported HR 3165 and S 1737 - Mental Health Parity Compliance Act - strengthen parity in mental health and substance use disorder benefits. Advocated for its inclusion in the Lower Health Care Costs Act of 2019. Supported S 873 and HR 1879 - Stabilize Medicaid and CHIP Coverage Act which would provide for 12 months of continuous enrollment in Medicaid and CHIP to ensure better access to care and reduce churn. This bill is not specific to mental health, but it would provide significant stability to those patients and providers. Supported H.R.1920 - Medicaid Bump Act - To amend title XIX of the Social Security Act to provide a higher Federal matching rate for increased expenditures under Medicaid for mental and behavioral health services, and for other purposes. Supported H.R.1329 - Medicaid Reentry Act - This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release. Supported S 824/HR 1767 - Excellence in Mental Health and Addiction Treatment Expansion Act This legislation would extend and expand the Certified Community Behavioral Health Clinic (CCBHC) demonstration, which is set to end in mid-2019. Supported the Parity Enforcement Act (HR 2848). This legislation would give the U.S. Department of Labor authority to levy civil monetary penalties against health insurers and plan sponsors for parity violations of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Supported S.1012/ HR 2062 Protecting Jessica Grubbs Legacy Act/ Overdose Prevention and Patient Safety Act to amend the Public Health Service Act to protect the confidentiality of substance use disorder patient records. Supported HR 4974: the MATE Act - to amend the Controlled Substances Act to require physicians and other prescribers of controlled substances to complete training on treating and managing patients with opioid and other substance use disorders (which shall also satisfy certain training required to receive a waiver for dispensing narcotic drugs for maintenance or detoxification treatment),and for other purposes. Supported a conditional endorsement of The Mainstreaming Addiction Treatment Act, which is contingent upon the elimination of DEA regulations on medications in Schedules III-V that are based on the prescribing intent to treat addiction and a requirement that all DEA controlled substance prescribers complete medical education on addiction. Supported the Humane Correctional Health Care Act , H.R. 4141/S. 2305, which would repeal the Medicaid Inmate Exclusion. The exclusion strips health coverage from Medicaid enrollees who are involved in the criminal justice system. Supported H.R. 3925, the Reducing Barriers to Substance Use Treatment Act, introduced by Representatives Paul Tonko (D-NY) and David McKinley (R-VA). The bill would prohibit state Medicaid programs, beginning in October 1, 2020, and ending September 30, 2025, from imposing prior authorizations or other types of utilization control policies or procedures on medications approved to treat OUD, including, with respect to the provision of those medications, counseling services and behavioral therapy. Supported the Reversing the Youth Tobacco Epidemic Act of 2019 (HR 2339) which would, among other things, amend the Federal Food, Drug, and Cosmetic Act with respect to the sale and marketing of tobacco products Supported HR 4742, Protecting American Lungs Act, a bill to impose a tax on nicotine used in e-cigarettes. Supported HR 5632, The FDA Accountability for Public Safety Act, which would require the FDA Commissioner to make the final decision on drug approvals if the advisory committee advises against approval, among other things. Advocated for the addiction of a Medicaid Provider Status requirement on any new State Opioid Response Grant funding Advocated for the use of audio-visual telehealth for initation of new OTP patients to be treated with methadone Advocated for an increase in the DATA 2000 waiver patient limit Advocated for telehealth buprenorphine initiation as an exception to Ryan Haight Advocated for addiction CMS guidance and coverage related to telehealth Advocated to allow Opioid Treatment Programs (OTPs) to operate mobile units without requiring them to obtain a separate registration as well as more flexibility regarding take-home medications dispensed from an OTP Advocated for $38.5B in emergency relief funds for mental health disorder and addiction treatment providers as a result of losses suffered due to COVID-19 Advocated for inclusion of provisions in HR 748 of the CARES Act, related to the Opioid Workforce Act, the Reducing Barriers to Substance Use Disorder Treatment, Medicaid Reentry, emergency health care provider relief funds, reform of 42 CFR Part 2, amont other ASAM priorities Advocated for eventual filing of the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act (S. 4103). For purposes of prescribing Schedule III and IV medications, including buprenorphine for the treatment of opioid use disorder, the TREATS Act would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement. The TREATS Act would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, substance use disorder telehealth services after an in-person or telehealth evaluation

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Natl Drug Control Policy (NDCP), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

General Medicaid/Medicare issues, Opioid Workforce Act (H.R. 2439), Resident Physician Shortage Reduction Act of 2019 (H.R. 1763/S. 348), Opioid Workforce Act of 2019 (S.2892), Issues related to surprise billing

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

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) 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

Graduate Medical Education - HR 3414/ S. 2892, Opioid Workforce Act 340B drug pricing drug prices DSH cuts - HR 3022, Patient Access Protection Act CARES Act - HR 748

Client expense: $15,000 · Firm income: Not reported

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

340B Drug Discount Program H.R. 1763, S. 348 - Resident Physician Shortage Reduction Act Graduate Medical Education Disproportionate Share Hospital payments Childrens Health Insurance Program Medicare Dependent Hospital Program (MDH) Medicaid Low Volume Payments (LV) Federal Medical Assistance Percentage Extension Inpatient Prospective Payment System Outpatient Prospective Payment System Bad debt/charity care Hospital Outpatient Department payments H.R. 2439, S. 2892 - Opioid Workforce Act H.R. 1358 - Advancing Medical Resident Training in Community Hospitals Act of 2019

Client expense: $100,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

opposition to DSH cuts, support increase to NIH funding and CHGME/GME funding, obtain repeal of the repeal of the imputed rural floor and work for legislative fix on impact of imputed rural floor. oppose cuts to 340B drug pricing program. support opioid workforce act of 2019 s2892/HR3414. support emergency hospital funding for covid19 related expenses and criteria for funding hospitals.

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

Government targets: HOUSE OF REPRESENTATIVES, 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

H.R. 3502, Protecting People From Surprise Medical Bills Act, all provisions H.R. 3630, No Surprises Act, all provisions H.R. 2328, Community Health Investment, Modernization, and Excellence Act of 2019, all provisions S. 1895, Lower Health Care Costs Act, all provisions H.R. 5826, Consumer Protections Against Surprise Medical Bills Act of 2020, provisions relating to unanticipated billing for physician services, private contracting, rate setting S. 1531, Stopping The Outrageous Practice of (STOP) Surprise Medical Bills Act of 2019, all provisions H.R. 2279, Safe Step Act, all provisions S. 2032, Cannabidiol and Marihuana Research Expansion Act, all provisions H.R. 4004, Social Determinants Accelerator Act of 2019, all provisions H.R. 6102, Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2020, provisions relating to FDA oversight of laboratory developed tests H.R. 2339, Protecting American Lungs and Reversing the Youth Tobacco Epidemic Act of 2020, all provisions H.R. 4742, Protecting American Lungs Act of 2019, all provisions H.R. 5482, Providing Resources to End the Vaping Epidemic Now for Teenagers (PREVENT) Act of 2020, all provisions H.R. 6139, COVID-19 Health Care Worker Protection Act of 2020, all provisions S. 3559, A bill to provide emergency financial assistance to rural health care facilities and providers impacted by the COVID-19 emergency, all provisions H.R. 4100, Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms Act of 2019, all provisions S. 2892, Opioid Workforce Act of 2019, all provisions H.R. 2482, Mainstreaming Addiction Treatment Act of 2019, all provisions H.R. 1503, Orange Book Transparency Act of 2019, all provisions H.R. 1520, Purple Book Continuity Act of 2019, all provisions H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act, all provisions H.R. 4995, Maternal Health Quality Improvement Act of 2019, all provisions COVID-19 Pandemic Affordable Care Act (ACA) stabilization Immediate Relief for Rural Facilities and Providers Act of 2020, all provisions Prescription drug pricing/transparency/importation/value/prior authorizations Health reform/Universal coverage Retired physicians Public Health Emergency Fund financial assistance Protecting physician speech Opioids Surprise billing Health Disparities Physician Suicide/Burnout Telehealth AMA Privacy Framework Privacy legislation/administrative simplification 42 CFR Part 2, HIPAA Augmented Intelligence (AI)/federal health IT strategy Maternal mortality and morbidity COVID-19 emergency declaration/Section 1135 authority SARS-CoV-2 Testing COVID-19/ personal protective equipment (PPE) COVID-19/Controlled substances Diabetes prevention 21st Century Cures Act Pharmacy Benefits Manager (PBM)

Client expense: $6,630,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Office of Management & Budget (OMB), Office of Natl Drug Control Policy (NDCP), SENATE, State, Dept of (DOS), U.S. Immigration & Customs Enforcement (ICE), Veterans Affairs, Dept of (VA), Vice President of the U.S., White House Office

H. Res. 480, Acknowledging the racial disparities in diagnosing and treating mental health among youth in communities of color H.R. 1109, the Mental Health Services for Students Act of 2019 H.R. 1554, the Resident Education Deferred Interest Act H.R. 1763 / S. 348, the Resident Physician Shortage Reduction Act of 2019 H.R. 2062 / S. 1012 (42 CFR Part 2) and S. 3374, the Protecting Jessica Grubb's Legacy Act H.R. 2279/ S. 2546, the Safe Step Act H.R. 2482/ S. 2074, the Mainstreaming Addiction Treatment Act of 2019 H.R. 2734 / S. 1448, the Safer Prescribing of Controlled Substances Act H.R. 2862, the VACCINES Act of 2019 H.R. 3, Lower Drug Costs Now Act of 2019 H.R. 3180/ S. 1770, the RISE from Trauma Act H.R. 3239/ S. 2135, the Humanitarian Standards for Individuals in Customs and Border Protection Custody Act H.R. 3253, the Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act H.R. 3414/ S. 2892, the Opioid Workforce Act H.R. 3417, BETTER Act of 2019 H.R. 4194, S. 2661, the National Suicide Hotline Designation Act of 2019 H.R. 4309, the Barriers to Suicide Act H.R. 4327, the Enhancing Mental Health and Suicide Prevention Through Campus Planning Act H.R. 4861/ S. 3006, the Effective Suicide Screening and Assessment in the Emergency Department Act H.R. 4932 / S. 2741, the CONNECT for Health Act H.R. 4995, the Maternal Health Quality Improvement Act of 2019 H.R. 4996, the Helping Medicaid Offer Maternity Services Act of 2019 H.R. 5, the Equality Act H.R. 5201, the Telemental Health Expansion Act of 2019 H.R. 5473, the Enhance Access to Support Essential Behavioral Health Services Act H.R.5469, the Pursuing Equity in Mental Health Act of 2019 H.R.5575, the Primary and Behavioral Health Care Access Act of 2020 Out of network billing legislation S. 1227, the Prescription Pricing for the People Act of 2019 S. 2443, the Investment in Tomorrow's Pediatric Health Care Workforce Act S. 824, the Excellence in Mental Health and Addiction Treatment Expansion Act S.1659, the Ensuring Childrens Access to Specialty Care Act of 2019 Title III Sec. 305 Timely Bills to Patients within the Lower Health Care Costs Act of 2019 (S. 1895) Cures 2.0 Suggestions related to addressing mental health in rural communities. Title X Family Planning Program Administration Rule Efforts related to psychiatric bed shortages. H.R. 6074, the Coronavirus Preparedness and Response Supplemental Appropriations Act H.R. 6201, the Families First Coronavirus Response Act H.R. 748, the Coronavirus Aid, Relief and Economic Security (CARES) Act H.R. 2895, S. 948, the Conrad State 30 and Physician Access Reauthorization Act H.R. 4996, the Helping Medicaid Offer Maternity Services (MOMS) Act, and Senate efforts. S. 311, the Born-Alive Abortion Survivors Protection Act S. 3275, the Pain-Capable Unborn Child Protection Act H.R. 4056 and S. 2446, the Medicare Audiologist Access and Services Act of 2019 H.R. 5575, the Primary and Behavioral Health Care Access Act H.R. 6143, the MOMS Matter Act H.R. 1309, the Workplace Violence Prevention for Health Care and Social Service Workers Act

Client expense: $210,000 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of the Vice President of the United States, President of the U.S., SENATE, U.S. Immigration & Customs Enforcement (ICE), Veterans Affairs, Dept of (VA), White House Office

Medicare Fiscal Accountability Regulation Price Transparency Final Rule Information Blocking and Interoperability Final Rule Rural hospital policies (S. 586/H.R. 1041, Critical Access Hospital Relief Act of 2019; H.R. 1052; S. 895, Rural Hospital Regulatory Relief Act of 2019; S. 948/H.R. 2895, Conrad 30 and Physician Access Act; H.R. 3429, the HEARTS and Rural Relief Act; Rural Hospital Closure Relief Act (S. 3101/H.R. 5481) (Ways and Means Health Task Force on Rural and Underserved Communities, RFI, Rural America Health Corps Act S.2406/H.R. 4899) Graduate Medical Education (GME) funding (S. 348/H.R. 1763, Resident Physician Shortage Reduction Act of 2019; S. 2892/H.R. 3414 Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 3417 Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act Reform of the Stark Law and Anti-Kickback Statute Hospital outpatient payment policy (CY 2020 OPPS Proposed, Final Rule; Price Transparency Final Rule) Site neutral payment policy included in outpatient prospective payment system rule Improving Seniors Timely Access to Care Act (H.R. 3107) Chronic Care Management Improvement Act (H.R. 3436) Proposed AWI changes in inpatient prospective payment system proposed rule Executive Order on Improving Price and Quality Transparency Helping Medicaid Offer Maternity Services (MOMS) Act (H.R. 4996) Rural hospital policies (S. 586/H.R. 1041, Critical Access Hospital Relief Act of 2019; H.R. 1052; S. 895, Rural Hospital Regulatory Relief Act of 2019; S. 948/H.R. 2895, Conrad 30 and Physician Access Act; H.R. 3429, the HEARTS and Rural Relief Act; Rural Hospital Closure Relief Act (S. 3101/H.R. 5481) (Ways and Means Health Task Force on Rural and Underserved Communities, RFI, Rural America Health Corps Act S.2406/H.R. 4899) Graduate Medical Education (GME) funding (S. 348/H.R. 1763, Resident Physician Shortage Reduction Act of 2019; S. 2892/H.R. 3414 Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 3417 Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act) Reform of the Stark Law and Anti-Kickback Statute Hospital outpatient payment policy (CY 2020 OPPS Proposed, Final Rule; Price Transparency Final Rule) Site neutral payment policy included in outpatient prospective payment system rule Improving Seniors Timely Access to Care Act (H.R. 3107) Chronic Care Management Improvement Act (H.R. 3436) Proposed AWI changes in inpatient prospective payment system proposed rule Executive Order on Improving Price and Quality Transparency Helping Medicaid Offer Maternity Services (MOMS) Act (H.R. 4996)

Client expense: $240,000 · Firm income: Not reported

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

Medicare, Medicaid, private insurance and other health care policies that impact patient access to hospital and physician care, including the "Resident Physician Shortage Reduction Act of 2019 (S. 348, H.R. 1763)", the "Lower Health Care Costs Act (S. 1895)", the "Opioid Workforce Act (H.R. 3414, S. 2892)", the "Ban Surprise Bill Act (H.R. 5800)", the "Consumer Protections Against Surprise Medical Bills Act (H.R. 5826)", the "Coronavirus Preparedness and Response Supplemental (H.R. 6074)", the "Families First Coronavirus Response Act (H.R. 6201)", the "Coronavirus Aid, Relief and Economic Security Act (H.R. 748)".

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE