HCBS Infrastructure Improvement Act

HCBS Infrastructure Improvement Act, S.3277; Better Care Better Jobs Act, S.2210; American Rescue Plan Act of 2021, H.R.1319; Build Back Better Act, H.R.5376; Recognizing the Role of Direct Support Professionals Act (S.1437/ H.R.4779); Supporting Our Direct Care Workforce and Family Caregivers Act, S.2344;

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HCBS Infrastructure Improvement Act, S.3277; Better Care Better Jobs Act, S.2210; American Rescue Plan Act of 2021, H.R.1319; Build Back Better Act, H.R.5376

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated for expansion of Medicaid HCBS services; HCBS Infrastructure Improvement Act, S. 3277, Better Care Better Jobs act, S. 22210; American ReCue Plan Act of 2021, HR 1319; Build Back Better Act, HR 5376 Submitted comments in response to CMS proposed rule, "Reassignment of Medicaid Provider Claims"

Client expense: Not reported · Firm income: Not reported

Government targets: Bureau of Labor Statistics (BLS), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

Advocated for expansion of Medicaid HCBS services; HCBS Infrastructure Improvement Act, S. 3277, Better Care Better Jobs act, S. 22210; American ReCue Plan Act of 2021, HR 1319; Build Back Better Act, HR 5376 Submitted comments in response to CMS proposed rule, "Reassignment of Medicaid Provider Claims"

Client expense: Not reported · Firm income: Not reported

Government targets: Bureau of Labor Statistics (BLS), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT)

HCBS Infrastructure Improvement Act, S.3277; Better Care Better Jobs Act, S.2210; American Rescue Plan Act of 2021, H.R.1319; Build Back Better Act, H.R.5376

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 - DelBene - prior authorization in Medicare Advantage H.R. 3925 - Reducing Barriers to Substance Use Treatment Act - Tonko - Opioids H.R. 3935 - Protecting Patients Transportation to Care Act - Carter - Medicaid coverage for transportation H.R. 4453 - Protecting Seniors from Health Care Fraud Act of 2019 - Ruiz -Distributing information to Medicare beneficiaries to prevent fraud H.R. 4529 - Promoting Access to Broadband Act of 2019 - Maloney - Medicaid H.R. 4583 - Medicare Extra Rx Higher Eligibility Limits in Part D Act of 2019 - Schneider - prescription drug affordability H.R. 4620 - More Help for Seniors Act of 2019 - Rose - expand eligibility for low-income subsidies under part D of the Medicare program H.R. 4621 - Collecting and Analyzing Resources Integral and Necessary for Guidance for Social Determinants Act of 2019 - Blunt Rochester - best practices re social determinants of health H.R. 4629 - Star Rating for Biosimilars Act - Tonko - biosimilars H.R. 4632 - Better Transparency in Information for Medicare Beneficiaries Act of 2019 - Kind - provides consumers information regarding premiums under LIS benchmark plans H.R. 4671 - Helping Seniors Afford Health Care Act - Kim - Medicare affordability and low income beneficiaries H.R. 4996 - Helping Medicaid Offer Maternity Services Act of 2020 - Kelly - extend Medicaid coverage post-partum H.R. 5006 - Expanding Access to Inpatient Mental Health Act - Emmer - Medicaid coverage for SUD/mental health for institutionalized H.R. 5201 - Telemental Health Expansion Act of 2019 - Matsui - Medicare coverage of mental telehealth H.R. 5232 - Road to Recovery Act - Fitzpatrick - Medicaid and CHIP SUD treatment H.R. 5693 - Primary Health Services Enhancement Act - Kind - Medicare rural health H.R. 5808 - Save Rural Communities Act of 2020 - Arrington - rural emergency medical access services under Medicare H.R. 5833 - To amend title XVIII of the Social Security Act to permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain - Latta - Medicare coverage in telehealth H.R. 5882 - GENE Therapy Payment Act - Schrader - value based care H.R. 6098 - To amend title XXI of the Social Security Act to allow States to expand income eligibility standards under the Children's Health Insurance Program -Barragan - CHIP eligibility H.R. 6151 - CARING for Kids Act - Fineknauer - CHIP H.R. 6179 - Increasing Access to Biosimilars Act of 2020 - Cardenas - payments to providers of biosimilars under Medicare H.R. 6209 - Reducing Unnecessary Senior Hospitalizations Act of 2020 or the RUSH Act of 2020 -Kuster - Medicare coverage for certain services in hospital emergency departments H.R. 6244 - To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Children's Health Insurance Program - Kelly - Medicaid coverage of COVID-19 related visits and testing H.R. 6263 - To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19 -Sarbanes - Medicare coverage of COVID-19 related visits and testing H.R. 6273 - Protecting Vulnerable Americans in Times of Crisis Act of 2020 - Butterfield - FMAP H.R. 6311 - Care for COVID-19 Act - Ruiz - COVID-19 cost sharing H.R. 6336 - Increasing Hospital Capacity to Fight the Coronavirus Act of 2020 - Bishop - Medicare and Medicaid payments during COVID-19 emergency H.R. 6462 - Emergency Medicaid for Coronavirus Treatment Act - Gallego - Medicaid coverage H.R. 6511 - Ensuring Vaccination and Treatment Affordability Act - Pappas - COVID H.R. 6521 - To prohibit the Secretary of Health and Human Services from taking certain actions with respect to Medicaid supplemental payments reporting requirements, and for other purposes - Diaz Barragan - Medicaid, delays implementation of MFAR H.R. 6538 - Modernized Medicine Act - Kennedy - Medicaid, Telehealth H.R. 6539 - Coronavirus Medicaid Response Act - Lee - FMAP H.R. 6572 - To direct the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, to carry out a national campaign to increase awareness and knowledge of COVID-19. -Bilirakis - COVID H.R. 6583 - To amend title XVIII of the Social Security Act to establish a risk corridor program for Medicare Advantage plans during the COVID-19 emergency, and for other purposes. - Houlahan - COVID H.R. 6616 - Stronger Medicaid Response to the COVID-19 Pandemic Act -Cardenas - COVID H.R. 6640 - Medicare Advantage COVID Treatment Act - Mucarsel-Powell - COVID H.R. 6658 - Insular Area Medicaid Coronavirus Recovery Act - Sablan - FMAP H.R. 6727 - To hold Medicare beneficiaries harmless for specified COVID-19 treatment services furnished under part A or part B of the Medicare program - Schrier - COVID H.R. 6744 - Computer and Internet Equity Act - Davis - internet access for Lifeline program H.R. 6753 - Save Rural Hospitals Act of 2020 - Finkenauer - Medicare hospital payments H.R. 6792 - Improving Telehealth for Underserved Communities Act of 2020 - Smith - telehealth H.R. 6797 - CHIPPER Act - Wild - CHIP, COVID H.R. 6837 - Medicare Accelerated and Advance Payments Improvement Act of 2020 -Schneider - COVID H.R. 7154 - Outpatient Therapy Modernization and Stabilization Act -Boyle - outpatient therapy services H.R. 7187 - HEALTH Act of 2020 -Thompson -Smith - telehealth H.R. 7292 - To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program. - Kaptur - advance payments H.R. 7338 - To amend title XVIII of the Social Security Act to permit the Secretary of Health and Human Services to waive requirements relating to the furnishing of telehealth services under the Medicare program, and for other purposes. - Cheney - Telehealth H.R. 7391 - To amend title XVIII of the Social Security Act to remove certain geographic and originating site restrictions on the furnishing of telehealth services under the Medicare program - Sherrill- Telehealth H.R. 7606 - MFAR Transparency Act - Williams - report on impact of MFAR to Congress H.R. 7627 - MORE Savings Act - Dean - Medicare access to opioid treatment and MAT H.R. 7663 - Protecting Access to Post-COVID-19 Telehealth Act of 2020 - Thompson - waive or modify application of Medicare requirements with respect to telehealth during PHE H.R. 7791 - Value in Health Care Act of 2020 - Welch - Medicare shared savings program and alternative payment arrangements H.R. 7877 - Lowering Drug Costs for Seniors Act of 2020 - Katko - Medicare Part D costs H.R. 7892 - Medicaid Expansion During Crisis Act - Coleman - extend eligibility period for Medicaid enrollment application H.R. 8177 - Renal Anemia Innovation Support and Expansion Act - OHalleran - Medicare prescription drug coverage for chronic kidney disease H.R. 8218 - Rural Ambulance Reimbursement Fairness Act - Gianforte - Medicare payment for rural ambulance services H.R. 8254 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Blumenauer - integrated care for Medicare beneficiaries with ESRD H.R. 8427 - To provide for certain reports on enrollment in the Lifeline program, and for other purposes - Luria - Lifeline program H.R. 8476 - TIKES Act -Blunt Rochester - telehealth coverage in Medicaid H.R. 8505 - To amend title XVIII of the Social Security Act to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule - Burgess - Medicare physician fee schedule H.R. 8525 - Expanded Genetic Screening Act of 2020 - Speier - Medicaid coverage of non-invasive prenatal genetic screening H.R. 8529 - Protecting Access to Affordable Medicines Act of 2020 - Butterfield - rebates under the Medicaid program for certain noninnovator multiple source drugs H.R. 8546 - Fair Drug Prices for Kids Act -Wild - Medicaid drug rebate program in CHIP H.R. 8558 - Comprehensive Breast Reconstruction Act of 2020 - Hastings - extends coverage of certain breast reconstructive services following mastectomy under the Medicare and Medicaid programs H.R. 8561 - Restoring Fairness to Medicaid Reimbursement Act of 2020 - Johnson - FMAP H.R. 8574 - PROTECT Long Term Care Facilities Act -Sherrill - long term care in COVID-19 H.R. 8586 - Medicaid Coverage for Addiction Recovery Expansion Act -Foster - Substance Use Disorder H.R. 8623 - SAVE for Seniors Act - Spanberger - Medicare coverage of COVID-19 vaccines H.R. 8624 - Protecting Access to Innovation During COVID-19 Act - Wenstrup - extension of pass-through status under the Medicare program H.R. 8702 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 -Bera - part B Medicare payments during COVID H.R. 8725 - HAPI Act - Soto - Medicaid Coverage of adult vaccines H.R. 8727 - Telehealth Modernization Act - Carter - Medicare telehealth payments H.R. 8755 - Expanded Telehealth Access Act -Sherrill - Medicare telehealth coverage H.R. 8756 - COVID Health Care Provider Assurance Act of 2020 - Riggleman - Medicare Part B payments during COVID-19 H.R. 8826 - The Resetting the Impact Act (TRIA) of 2020 - Sewell - amends the IMPACT Act of 2014 H.R. 8840 - Medicare Sequester COVID Moratorium Act - Schneider - extend temporary Medicare sequestration H.R. 8871 - COVID HCBS Relief Act of 2020 - Dingell - funding for state Medicaid programs HCBS H.R. 8934 - Community Integration Act of 2020 - Cartwright - Medicaid HCBS H.R. 8958 - Supporting Best Practices for Healthy Moms Act - Kelly - guidance for state Medicaid programs on maternal health H.R. 9002 - To amend title XIX of the Social Security Act to provide States an option to cover a children's program of all-inclusive coordinated care (ChiPACC) under Medicaid program - DeGette - Childrens health under Medicaid H.R. 9006 - To amend title XIX of the Social Security Act to provide for coverage under the Medicaid program under such title of routine patient costs associated with participation in certain clinical trials - Garcia - Medicaid coverage of clinical trials H.R. 9035 - Permanency for Audio-Only Telehealth Act - Smith - Audio only telehealth in Medicare S. 2846 - Protecting Patients Transportation to Care Act - Isakson - Medicaid coverage of transportation S. 2911 - Seniors Prescription Drug Relief Act of 2019 - Cassidy - Part D smoothing S. 3013 - Encouraging Innovative Benefit Design to Lower Costs for Seniors Act - Crapo - offer additional prescription drugs under Part D S. 3220 - Ensuring Access to Direct Support Professionals Act - Portman - Medicaid coverage in acute care hospitals S. 3238 - Preventive Home Visit Act - King - preventative home visits S. 3277 - HCBS Infrastructure Improvement Act - Casey - access to community based services S. 3353 - Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020 - Cassidy - Medicare coverage of kidney transplant services S. 3384 - Lowering Prescription Drug Prices for America's Seniors and Families Act of 2020 - McSally - Medicare Part D drug pricing negotiation S. 3399 - FCHIP Extension Act - Tester - rural health S. 3442 - Care for COVID-19 Act - Booker - COVID-19 cost sharing S. 3443 - Improving Coverage and Care for Mothers Act - Casey - Medicaid coverage for all pregnant and postpartum women S. 3447 - RUSH Act of 2020 - Thune - Medicare coverage for certain services in hospital emergency departments S. 3466 - ACCESS for Biosimilars Act of 2020 - McSally - eliminates cost sharing for biosimilar biological products furnished under part B of the Medicare program S. 3615 - Rural Community Hospital Demonstration Extension Act of 2020 - Murkowski - rural community hospital demonstration program S. 3665 - Save Rural Hospitals Act of 2020 - Alexander - Medicare hospital payments S. 3750 - Medicare Accelerated and Advance Payments Improvement Act of 2020 - Shaheen - COVID S. 3881 - CHIPPER Act - Casey - CHIP, COVID S. 3998 - HEALTH Act of 2020 - Hyde-Smith - telehealth S. 3999 - Mental and Behavioral Health Connectivity Act - King - Mental Health S. 4108 - A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns - Casey - FMAP S. 4151 - SOS: Sustaining Outpatient Services Act - Hoeven - Medicare OPPS coverage S. 4230 - Telehealth Expansion Act of 2020 - Wyden - Telehealth mental health services in Medicare S. 4274 - Legalizing Drug Discounts for Seniors Act of 2020 - Paul - exclude discounts for covered part D drugs from the anti-kickback prohibition S. 4295 - Public Health Emergency Pass-Through Payment Fairness Act of 2020 - Paul - access to drugs and devices under Medicare S. 4358 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Bennet - Medicaid coverage for vaccines and treatment for COVID-19 for uninsured without cost-sharing S. 4375 - Telehealth Modernization Act - Alexander - make permanent Medicare telehealth flexibilities S. 4423 - COVID-19 Hospice Respite Care Relief Act of 2020 - Brown - Medicare hospice care S. 4448- Fair Drug Prices for Kids Act - Warner - extend Medicaid drug rebate program to CHIP S. 4574 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Young - integrated care for Medicare beneficiaries with ESRD S. 4690 - Maternal Immunization Enhancement Act - Hassan - Medicaid and maternal health S. 4705 - Maternal Immunization Coverage Act - Cassidy - Medicaid coverage S. 4717 - Accelerating Kids Access to Care Act - Grassley - Medicaid enrollment S. 4742 - CLINICAL TREATMENT Act - Burr - Medicaid coverage S. 4825 - Ensuring Access to COVID-19 Vaccines for Seniors Act - Reed - Medicare coverage of COVID-19 vaccines S. 4840 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2020 -Roberts - audio-only risk adjustment in Medicare Advantage S. 4859 - Connected MOM Act - Cassidy - expanded coverage of remote physiologic devices and related services under Medicaid S. 4864 - HAPI Act - Brown - Medicaid coverage of adult vaccines S. 4944 - Equality in Medicare and Medicaid Treatment Act of 2020 - Booker - CMMI models for SDOH in Medicare/Medicaid S. 4949 - Supporting Best Practices for Healthy Moms Act - Toomey - guidance for state Medicaid programs on maternal health S. 4957 - COVID HCBS Relief Act of 2020 - Casey - funding for state Medicaid programs HCBS S. 5007 - Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 - Boozman - increase in Medicare part B payment S. 5044 - Bill to amend title XVIII of the SSA to establish requirement with respect to the use of prior authorization under the Medicare Advantage plans - Brown - Prior authorization S. 5077 - A bill to amend title XIX of the Social Security Act to adjust the limitations on Medicaid disproportionate share hospital payments - Cornyn - Medicaid DSH payments Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2021 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in and public option; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2022 Rate Notice; Executive Orders relating to international pricing, Part D rebates, insulin costs, and importation; issues related to MLTSS; issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; issues related to health insurance tax for MA and Part D plans; implications of physician fee schedule on MA; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's health plan models; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) and the Bipartisan Budget Act of 2018 changes to the Part D coverage gap; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; issues relating to prescription drug price blueprint; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.

Client expense: $2,400,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Council of Economic Advisers (CEA), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, Treasury, Dept of, White House Office

All issues before the Senate and House of Representatives related to federal public transportation and highway programs, high-speed and intercity passenger rail programs, including issues related to authorization and appropriations laws, annual budget resolutions, legislation concerning the Highway Trust Fund and other transportation-related tax and revenue issues, and proposals for a new infrastructure investment initiative. Tax policy as it relates to public transportation including the alternative fuel volumetric tax credit for Compressed Natural Gas and Liquefied Natural Gas used in transit vehicles, the alternative fuel vehicle refueling property tax credit, the treatment of municipal bonds, the commuter tax benefit, tax credit bonds, private activity bonds, investment tax credits, Transportation Infrastructure Finance and Innovation Act (TIFIA) and Railroad Rehabilitation & Improvement Financing (RRIF) financing, and the solvency of the Federal Highway Trust Fund. Matters related to the implementation of the Moving Ahead for Progress in the 21st Century (MAP-21) Act and the Fixing America's Surface Transportation (FAST) Act. Legislation concerning Department of Transportation (DOT) regulations. Issues related to implementation of Positive Train Control technologies on commuter railroads as mandated under the P.L. 110-432, the Rail Safety Improvement Act of 2008 and P.L. 114-73, the Surface Transportation Extension Act of 2015. Issues related to successor legislation to the FAST Act. Issues related to existing or new transportation grant programs. Budget and appropriation issues for FY 2020 and FY 2021 including the Capital Investment Grant Program (CIG), the Better Utilizing Investments to Leverage Development (BUILD) program, transit security grants, Amtrak funding, and other funding. Issues relating to transit security funding and programs. Funding and financing proposals for a new infrastructure spending initiative. Administrative actions for transportation related rules, regulations, guidance, guidelines, and best practices, including the (DOT) BUILD grant selections. Legislation affecting transportation programs in response to the Novel Coronavirus (COVID-19). Specific bills include S. 146, the Move America Act of 2019; S. 203 the Building Rail Access for Customers and the Economy (BRACE) Act of 2019; S. 228 the Non-Emergency Ambulance Transportation Sustainability and Accountability (NEATSA) Act of 2019; S. 353, the Revitalizing American Priorities for Infrastructure Development (RAPID) Act, H.R. 731, the Transportation Funding Fairness Act, and H. R. 1849, the Transportation Funding Fairness Act; S. 436, the Transit Worker and Pedestrian Protection Act, S. 713, the Highway-Rail Grade Crossing Safety Act of 2019 and H.R. 1139, the Transit Worker and Pedestrian Protection Act; S. Res. 59, H. Res. 109, and S.Res.59 ,Resolution Recognizing the duty of the Federal Government to create a Green New Deal; H.R. 1515, the High-Speed Refund Act and H.R. 1600, the Repurposing Assets to Increase Long-term Water Availability and Yield Act or the RAILWAY Act; H.R. 879, the Support Local Transportation Act; H.R. 927, the Sustainable Communities Act of 2019; H.R. 1517 the Connecting Opportunities through Mobility Metrics and Unlocking Transportation Efficiencies Act or the COMMUTE Act; H.R. 2164 the Green Bus Act; S. 1487, Zero-Emission Vehicles Act of 2019; S. 1992 and H.R. 3612, to amend the FAST Act to repeal a rescission of funds; S. 2031, Veterans Enhancing Transportation Act; H.R. 2472, to strengthen Buy American requirements, and for other purposes; H.R. 2520, Metro Accountability and Investment Act; S. 1663, The Metro Safety, Accountability, and Investment Act of 2019; H.R. 2542, the PLACE Act; H.R. 2726, Banning Smoking on Amtrak Act of 2019; H.R. 2739, the Transit Infrastructure Vehicle Security Act; H.R. 2755, Buy America 2.0 Act; S. 1546 and H.R. 2838, Enhancing the Strength and Capacity of America's Primary Evacuation routes Act; H.R. 3261, Less Traffic with Smart Stop Lights Act of 2019; H.R. 3262, Sami's Law; S.1939 and H.R. 3388, Moving and Fostering Innovation to Revolutionize Smarter Transportation Act; S. 1979 and H.R. 1748, Safe Freight Act of 2019; H.R. 3437, The Saving Transit Art Resources Act; H.R. 3459, Made in America Act of 2019; S. 1790 and H.R. 2500, the National Defense Authorization Act (NDAA) for Fiscal Year 2020; S. 2077 and H.R. 3663, Complete Streets Act of 2019; H.R. 3669, Weatherizing Infrastructure in the North and Terrorism Emergency Readiness Act of 2019; H.R. 3671, Federal Permitting Reform and Jobs Act; S. 2041 and H.R. 3681, Green Spaces, Green Vehicles Act of 2019; H.R. 3779, Resilience Revolving Loan Fund Act of 2019; H.R. 3781, Improving National Safety by Updating the Required Amount of Insurance Needed by Commercial Motor Vehicles per Event (INSURANCE) Act of 2019; H.R. 3822, Green Transportation Act; H.R. 3896, Protection of American Jobs in Cross-Border Rail Operations With Mexico Act; H.R. 3904, Highway Trust Fund Reform Act of 2019; S. 2236 and H.R. 3923, Environmental Justice Act of 2019; H.R. 3935, Protecting Patients Transportation to Care Act; H.R. 4001, Bikeshare Transit Act of 2019; S. 2284 and H.R. 4051, Climate Action Rebate Act of 2019; H.R. 4101, Build Local, Hire Local Act; S. 2344 and H.R. 4127, Broadband Infrastructure Finance and Innovation Act of 2019; S. 2467 and H.R. 4273, Transit to Trails Act of 2019; H.R. 4293, United States Commission on an Open Society with Security Act of 2019; H.R. 4307, Build More Housing Near Transit Act; H.R. 4347, PREPARE Act of 2019; H.R. 4358, Preliminary Damage Assessment Improvement Act of 2019; S. 2056, Build America, Buy America Act; S. 2084, GREEN Streets Act; S. 2122 and H.R. 3872, National Flood Insurance Program Consultant Accountability Act of 2019; S. 2129, A bill to require the Secretary of Transportation to develop best practices for incorporating resilience into emergency relief projects, and for other purposes; S. 2192, State Flood Mitigation Revolving Fund Act of 2019; S. 2193, Charging Helps Agencies Realize General Efficiencies Act; S. 2299, PIPES Act of 2019; S. 2302, America's Transportation Infrastructure Act of 2019; S. 2318 and H.R. 4237, Advancing Cybersecurity Diagnostics and Mitigation Act"; S. 2344 and H.R. 4127, Broadband Infrastructure Finance and Innovation Act of 2019; S. 2403, Community Health and Clean Transit Act of 2019; S. 2520 and H.R. 3163, Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2020; S.Con.Res. 22 and H.Con.Res. 52, Concurrent resolution expressing the sense of Congress that there is a climate emergency which demands a massive-scale mobilization to halt, reverse, and address its consequences and causes; S.Res. 316 and H.Con.Res. 65, Resolution supporting the clean vehicle emissions standards of the United States and defending the authority of States under the Clean Air Act to protect the people of those States from harmful air pollution; H.R. 4378, Continuing Appropriations Act, 2020, and Health Extenders Act of 2019; H.R. 1865, Further Consolidated Appropriations Act, 2020; H.R. 4780, National Infrastructure Investment Corporation Act of 2019; H.R. 4808, Housing, Opportunity, Mobility, and Equity Act of 2019; H.R. 4819, Vision Zero Act of 2019; H.R. 4856, Reliable Emergency Alert Distribution Improvement Act of 2019; H.R. 4871, Protecting Roadside First Responders Act; H.R. 5072, A Just Society: A Place to Prosper Act of 2019; H.R. 5117, Rebuilding Our Communities by Keeping aggregates Sustainable Act or ROCKS Act; H.R.5118, Promoting Service in Transportation Act; H.R. 5135, Housing Homeless Veterans Act of 2019; H.R. 5139, Stop Sexual Assault and Harassment in Transportation Act; H.R. 5152, Transportation Equity Act; H.R.5244, Homes for All Act of 2019; H.R. 5255, Maximizing Our Redevelopment and Efficiency for Transit Oriented Development Act; H.R. 5393, Affordable American-made Automobile Act; H.R. 5449, Road User Charge Advancement Act of 2019; H.R. 5508, Transportation Megaprojects Accountability and Oversight Act of 2019; S. 2663, Small Community Transit Improvement Act of 2019; S. 2684, Housing, Opportunity, Mobility, and Equity Act of 2019; S. 2700, Protecting Roadside First Responders Act; S. 2805, TOD Advancement Act of 2019; S. 2846, Protecting Patients Transportation to Care Act; S. 2922, Rail Passenger Fairness Act; S. 2951, Housing is Infrastructure Act of 2019; S. 2979, Preventing Opioid and Drug Impairment in Transportation Act; H.R. 5538, Mandatory Spending Control and Accountability Act; H.R. 5731, Transportation Funding Accountability and Transparency Act; H.R. 5748, Jobs, On-the-Job "Earn-While-You-Learn" Training, and Apprenticeships for Young African-Americans Act; H.R. 5756, Resiliency Enhancement Act of 2020; H.R. 5783, Equitable Transit Oriented Development Support Act; H.R. 5805, High Speed Rail Corridor Development Act of 2020; H.R. 5812, BUILD UP Act; H.R. 5871, Natural Infrastructure and Resilience Act; H.R. 5891, Safe Routes to School Expansion Act; H.R. 5903, Transit Revitalization And Infrastructure Needs Act (TRAIN Act); H.R. 6066, Passenger Train Safety Act; H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; H.R. 6101, Ending Passenger Rail Forced Arbitration Act; H.R. 6156, Transportation Workforce Investment Act of 2020; H.R. 6171, Moving Towards A Safe Climate Act; H.R. 6201, Families First Coronavirus Response Act; H.R. 6206, Pandemic Response and Emergency Preparedness Act of 2020 (PREP Act); H.R. 6207, Coronavirus Worker Relief Act; H.R. 6223, Dont BLock Our Communities Act (D-BLOC Act); H.R. 6224, Building Much Needed Rail Grade Separations Act of 2020; H.R. 6225, Every Person Deserves Peace and Quiet Act of 2020; H.R. 6226, Improving the Metra Commuter Experience Act of 2020; H.R. 6248, Disability Access to Transportation Act; H.R. 6288, Responsibly Responding to Pandemics Act; H.R. 748, Coronavirus Aid, Relief, and Economic Security Act (CARES Act); S. 2302, the Americas Transportation Infrastructure Act (ATIA); S.3175, Smart Transportation Advancement and Transition Act; S. 3277, HCBS Infrastructure Improvement Act; S. 3303, Promoting Service in Transportation Act; S. 3373, Low or No Emission Bus Access Act of 2020; S. 3387, Capital Investment Grant Program Improvement Act of 2020; S. 3391, Connecting America's Active Transportation System Act; S. 3400, Ending Passenger Rail Forced Arbitration Act; S. 3463, Warren Cowles Grade Crossing Safety Act; H.R. 2, Investing in a New Vision for the Environment and Surface Transportation (INVEST) in America Act; H.R.6434, Small Transit Communities Modernization Act; H.R.6463, Improving Access to Services Act; H.R.6575, National Transit Workforce Training Act of 2020; H.R.6747, Rural Transportation Improvement Act; H.R.6800, The Heroes Act; H.R.6770, Mobility Options, Resiliency, and Efficiency (MORE) through TDM Act; H.R.7074; Promoting Equitable Transit-Oriented Development and Mobility Corridors Act; H.R.7110; H.R.7130, One Federal Decision Act of 2020; H.R.7248, To authorize funds for Federal-aid highways, highway safety programs, and transit programs, and for other purposes; H.R.7365 - To amend title 49, United States Code, with respect to grants for buses and bus facilities, and for other purposes; H.R.7389, To direct the Secretary of Transportation to carry out a grant program to support efforts to provide fare-free transit service, and for other purposes; H.R.6452, Railroad Rehabilitation and Improvement Financing Equity Act; H.R.6476, To amend the CARES Act to establish a loan program to provide liquidity to eligible lenders for the purpose of providing loans under the Paycheck Protection Program, and for other purposes; S.4030, BRAIN TRAIN Act; H.R. 7617, Defense, Commerce, Justice, Science, Energy and Water Development, Financial Services and General Government, Labor, Health and Human Services, Education, Transportation, Housing, and Urban Development Appropriations Act, 2021; H.R. 7653, Pedestrian Safety Study Act of 2020; H.R. 7904, Critical Infrastructure Employee Protection Act of 2020; H.R. 8262, Accessible Transit For All Act of 2020; H.R. 8266, FEMA Assistance Relief Act of 2020; H.R. 8319, Continuing Appropriations Act, 2021 and Other Extensions Act; H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act; H.R. 8389, To amend title 49, United States Code, to require Amtrak to convey of certain properties to the Commonwealth of Pennsylvania, and for other purposes; H.R. 8406/H.R. 925, The Heroes Act; S. 3728, Critical Infrastructure Employee Protection Act of 2020; S. 4320, Coronavirus Response Additional Supplemental Appropriations Act, 2020; S. 4332, A bill to provide for the use of additional funds for transportation projects that were affected by Coronavirus Disease 2019 (COVID-19), and for other purposes; S. 4468, Investments in Rural Transit Act of 2020; S. 4651, A bill to amend title 49, United States Code, to establish a National Transit Frontline Workforce Training Center, and for other purposes; ; H.R. 8900, Further Continuing Appropriations Act, 2021, and Other Extensions Act; H.R. 8926, American High-Speed Rail Act; H.Res. 1258, Declaring that public transit is a national priority which requires funding equal to the level of highway funding; H.R. 9010, To direct the Secretary of Transportation to carry out a study on the feasibility of certain transit options in the Campbellton Road transportation corridor in Atlanta, Georgia, and for other purposes; H.J.Res. 110, Extension of Continuing Appropriations Act, 2021; S. ____, the Emergency Coronavirus Relief Act of 2020; H.R. 133, Consolidated Appropriations Act, 2021;

Client expense: $360,000 · Firm income: Not reported

Government targets: Federal Railroad Administration, Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

Legislation before the Senate and House of Representatives related to mobility services funded by Department of Health and Human Services programs and other programs. Legislation regarding coordination and efficiencies among the dozens of federal programs supporting non-emergency medical transportation (NEMT) across several different federal departments. Legislation related to the Coordinating Council on Access and Mobility (CCAM), originally established under Executive Order No. 13330 and codified in Section 3006(c) of the FAST Act. Specific bills include S. 228, the Non-Emergency Ambulance Transportation Sustainability and Accountability (NEATSA) Act of 2019 to amend title XVIII of the Social Security Act to restructure the payment adjustment for non-emergency ESRD ambulance transports under the Medicare program and H.R. 2740, making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2020, and for other purposes; H.R. 4378, Continuing Appropriations Act, 2020, and Health Extenders Act of 2019; H.R. 3935, Protecting Patients Transportation to Care Act"; S.2846, Protecting Patients Transportation to Care Act; S. 3277, HCBS Infrastructure Improvement Act; H.R. 2, Investing in a New Vision for the Environment and Surface Transportation (INVEST) in America Act; H.R. 6800, The Heroes Act; H.R. 8406/H.R. 925, The Heroes Act; H.R. 133, Consolidated Appropriations Act, 2021;

Client expense: $360,000 · Firm income: Not reported

Government targets: Federal Railroad Administration, Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

H.R. 884, the Medicare Mental Health Access Act H.R. 2293, the Protecting Access to Wheelchairs Act H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation Technology Act of 2019 H.R. 3429, the HEARTS and Rural Relief Act (Section 4) H.R. 4386/S. 2496, the Stop the Wait Act H.R. 4945, the Safeguarding Medicare Access to Respiratory Therapy (SMART) Act H.R. 5262, the Medicare Orthotic and Prosthetics Patient Centered Care Act H.R. 5429/S. 3010, the SENIOR CARE Act S. 1223, the Protecting Beneficiary Access to Complex Rehabilitation Technology Act of 2019 S. 1280/H.R. 2477, the BENES Act of 2019 S. 3277, the HCBS Infrastructure Improvement Act S. 3544, the Coronavirus Relief for Seniors and People with Disabilities Act of 2020 Medicaid block grants Potential expansion of Medicare Discussions on interaction between Medicare Part B and Tricare for medically retired veterans

Client expense: $74,880 · Firm income: Not reported

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Transportation Security Administration (TSA), Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), Veterans Employment & Training Service

General education around long term services and supports and home and community-based services issues; P.L. 116-123, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; P.L. 116-127, Families First Coronavirus Response Act; P.L. 116-136, Coronavirus Aid, Relief, and Economic Security Act; S.3544 and H.R.6305, Coronavirus Relief for Seniors and People with Disabilities Act of 2020;S.3277, HCBS Infrastructure Improvement Act; P.L. 116-139, the Paycheck Protection Program and Health Care Enhancement Act; S.3768, Nursing Home COVID-19 Protection and Prevention Act of 2020; H.R. 6800, the Heroes Act; H.R. 8406, the Heroes Act; Senate Amendment 2652 related to COVID-19 relief; P.L. 116-159, the Continuing Appropriations Act, 2021 and Other Extensions Act; and P.L. 116-260, Consolidated Appropriations Act, 2021.

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

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

H.R.6514/S. 4717 - Worker Health Coverage Protection Act - Advocate for passage; H.R.6559/S 3677/COVID-19 Every Worker Protection Act of 2020 - Advocate for passage; S. 4089/HR 7370 - Protecting Employees and Retirees in Business Bankruptcies Act of 2020; H.R.7700/S. 3277 - COVID-19 Mine Worker Protection Act; Energy and Water Appropriations - Advocated for Hazardous worker training programs

Client expense: $300,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, U.S. Trade Representative (USTR)

H.R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 - DelBene - prior authorization in Medicare Advantage H.R. 3925 - Reducing Barriers to Substance Use Treatment Act - Tonko - Opioids H.R. 3935 - Protecting Patients Transportation to Care Act - Carter - Medicaid coverage for transportation H.R. 4453 - Protecting Seniors from Health Care Fraud Act of 2019 - Ruiz -Distributing information to Medicare beneficiaries to prevent fraud H.R. 4529 - Promoting Access to Broadband Act of 2019 - Maloney - Medicaid H.R. 4583 - Medicare Extra Rx Higher Eligibility Limits in Part D Act of 2019 - Schneider - prescription drug affordability H.R. 4620 - More Help for Seniors Act of 2019 - Rose - expand eligibility for low-income subsidies under part D of the Medicare program H.R. 4621 - Collecting and Analyzing Resources Integral and Necessary for Guidance for Social Determinants Act of 2019 - Blunt Rochester - best practices re social determinants of health H.R. 4629 - Star Rating for Biosimilars Act - Tonko - biosimilars H.R. 4632 - Better Transparency in Information for Medicare Beneficiaries Act of 2019 - Kind - provides consumers information regarding premiums under LIS benchmark plans H.R. 4671 - Helping Seniors Afford Health Care Act - Kim - Medicare affordability and low income beneficiaries H.R. 4996 - Helping Medicaid Offer Maternity Services Act of 2020 - Kelly - extend Medicaid coverage post-partum H.R. 5006 - Expanding Access to Inpatient Mental Health Act - Emmer - Medicaid coverage for SUD/mental health for institutionalized H.R. 5201 - Telemental Health Expansion Act of 2019 - Matsui - Medicare coverage of mental telehealth H.R. 5232 - Road to Recovery Act - Fitzpatrick - Medicaid and CHIP SUD treatment H.R. 5693 - Primary Health Services Enhancement Act - Kind - Medicare rural health H.R. 5808 - Save Rural Communities Act of 2020 - Arrington - rural emergency medical access services under Medicare H.R. 5833 - To amend title XVIII of the Social Security Act to permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain - Latta - Medicare coverage in telehealth H.R. 5882 - GENE Therapy Payment Act - Schrader - value based care H.R. 6098 - To amend title XXI of the Social Security Act to allow States to expand income eligibility standards under the Children's Health Insurance Program -Barragan - CHIP eligibility H.R. 6151 - CARING for Kids Act - Fineknauer - CHIP H.R. 6179 - Increasing Access to Biosimilars Act of 2020 - Cardenas - payments to providers of biosimilars under Medicare H.R. 6209 - Reducing Unnecessary Senior Hospitalizations Act of 2020 or the RUSH Act of 2020 -Kuster - Medicare coverage for certain services in hospital emergency departments H.R. 6244 - To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Children's Health Insurance Program - Kelly - Medicaid coverage of COVID-19 related visits and testing H.R. 6263 - To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19 -Sarbanes - Medicare coverage of COVID-19 related visits and testing H.R. 6273 - Protecting Vulnerable Americans in Times of Crisis Act of 2020 - Butterfield - FMAP H.R. 6311 - Care for COVID-19 Act - Ruiz - COVID-19 cost sharing H.R. 6336 - Increasing Hospital Capacity to Fight the Coronavirus Act of 2020 - Bishop - Medicare and Medicaid payments during COVID-19 emergency H.R. 6462 - Emergency Medicaid for Coronavirus Treatment Act - Gallego - Medicaid coverage H.R. 6511 - Ensuring Vaccination and Treatment Affordability Act - Pappas - COVID H.R. 6521 - To prohibit the Secretary of Health and Human Services from taking certain actions with respect to Medicaid supplemental payments reporting requirements, and for other purposes - Diaz Barragan - Medicaid, delays implementation of MFAR H.R. 6538 - Modernized Medicine Act - Kennedy - Medicaid, Telehealth H.R. 6539 - Coronavirus Medicaid Response Act - Lee - FMAP H.R. 6572 - To direct the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, to carry out a national campaign to increase awareness and knowledge of COVID-19. -Bilirakis - COVID H.R. 6583 - To amend title XVIII of the Social Security Act to establish a risk corridor program for Medicare Advantage plans during the COVID-19 emergency, and for other purposes. - Houlahan - COVID H.R. 6616 - Stronger Medicaid Response to the COVID-19 Pandemic Act -Cardenas - COVID H.R. 6640 - Medicare Advantage COVID Treatment Act - Mucarsel-Powell - COVID H.R. 6658 - Insular Area Medicaid Coronavirus Recovery Act - Sablan - FMAP H.R. 6727 - To hold Medicare beneficiaries harmless for specified COVID-19 treatment services furnished under part A or part B of the Medicare program - Schrier - COVID H.R. 6744 - Computer and Internet Equity Act - Davis - internet access for Lifeline program H.R. 6753 - Save Rural Hospitals Act of 2020 - Finkenauer - Medicare hospital payments H.R. 6792 - Improving Telehealth for Underserved Communities Act of 2020 - Smith - telehealth H.R. 6797 - CHIPPER Act - Wild - CHIP, COVID H.R. 6837 - Medicare Accelerated and Advance Payments Improvement Act of 2020 -Schneider - COVID H.R. 7154 - Outpatient Therapy Modernization and Stabilization Act -Boyle - outpatient therapy services H.R. 7187 - HEALTH Act of 2020 -Thompson -Smith - telehealth H.R. 7292 - To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program. - Kaptur - advance payments H.R. 7338 - To amend title XVIII of the Social Security Act to permit the Secretary of Health and Human Services to waive requirements relating to the furnishing of telehealth services under the Medicare program, and for other purposes. - Cheney - Telehealth H.R. 7391 - To amend title XVIII of the Social Security Act to remove certain geographic and originating site restrictions on the furnishing of telehealth services under the Medicare program - Sherrill- Telehealth H.R. 7606 - MFAR Transparency Act - Williams - report on impact of MFAR to Congress H.R. 7627 - MORE Savings Act - Dean - Medicare access to opioid treatment and MAT H.R. 7663 - Protecting Access to Post-COVID-19 Telehealth Act of 2020 - Thompson - waive or modify application of Medicare requirements with respect to telehealth during PHE H.R. 7791 - Value in Health Care Act of 2020 - Welch - Medicare shared savings program and alternative payment arrangements H.R. 7877 - Lowering Drug Costs for Seniors Act of 2020 - Katko - Medicare Part D costs H.R. 7892 - Medicaid Expansion During Crisis Act - Coleman - extend eligibility period for Medicaid enrollment application H.R. 8177 - Renal Anemia Innovation Support and Expansion Act - OHalleran - Medicare prescription drug coverage for chronic kidney disease H.R. 8218 - Rural Ambulance Reimbursement Fairness Act - Gianforte - Medicare payment for rural ambulance services H.R. 8254 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Blumenauer - integrated care for Medicare beneficiaries with ESRD H.R. 8427 - To provide for certain reports on enrollment in the Lifeline program, and for other purposes - Luria - Lifeline program S. 2846 - Protecting Patients Transportation to Care Act - Isakson - Medicaid coverage of transportation S. 2911 - Seniors Prescription Drug Relief Act of 2019 - Cassidy - Part D smoothing S. 3013 - Encouraging Innovative Benefit Design to Lower Costs for Seniors Act - Crapo - offer additional prescription drugs under Part D S. 3220 - Ensuring Access to Direct Support Professionals Act - Portman - Medicaid coverage in acute care hospitals S. 3238 - Preventive Home Visit Act - King - preventative home visits S. 3277 - HCBS Infrastructure Improvement Act - Casey - access to community based services S. 3353 - Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020 - Cassidy - Medicare coverage of kidney transplant services S. 3384 - Lowering Prescription Drug Prices for America's Seniors and Families Act of 2020 - McSally - Medicare Part D drug pricing negotiation S. 3399 - FCHIP Extension Act - Tester - rural health S. 3442 - Care for COVID-19 Act - Booker - COVID-19 cost sharing S. 3443 - Improving Coverage and Care for Mothers Act - Casey - Medicaid coverage for all pregnant and postpartum women S. 3447 - RUSH Act of 2020 - Thune - Medicare coverage for certain services in hospital emergency departments S. 3466 - ACCESS for Biosimilars Act of 2020 - McSally - eliminates cost sharing for biosimilar biological products furnished under part B of the Medicare program S. 3615 - Rural Community Hospital Demonstration Extension Act of 2020 - Murkowski - rural community hospital demonstration program S. 3665 - Save Rural Hospitals Act of 2020 - Alexander - Medicare hospital payments S. 3750 - Medicare Accelerated and Advance Payments Improvement Act of 2020 - Shaheen - COVID S. 3881 - CHIPPER Act - Casey - CHIP, COVID S. 3998 - HEALTH Act of 2020 - Hyde-Smith - telehealth S. 3999 - Mental and Behavioral Health Connectivity Act - King - Mental Health S. 4108 - A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns - Casey - FMAP S. 4151 - SOS: Sustaining Outpatient Services Act - Hoeven - Medicare OPPS coverage S. 4230 - Telehealth Expansion Act of 2020 - Wyden - Telehealth mental health services in Medicare S. 4274 - Legalizing Drug Discounts for Seniors Act of 2020 - Paul - exclude discounts for covered part D drugs from the anti-kickback prohibition S. 4295 - Public Health Emergency Pass-Through Payment Fairness Act of 2020 - Paul - access to drugs and devices under Medicare S. 4358 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Bennet - Medicaid coverage for vaccines and treatment for COVID-19 for uninsured without cost-sharing S. 4375 - Telehealth Modernization Act - Alexander - make permanent Medicare telehealth flexibilities S. 4423 - COVID-19 Hospice Respite Care Relief Act of 2020 - Brown - Medicare hospice care S. 4448 - Fair Drug Prices for Kids Act - Warner - extend Medicaid drug rebate program to CHIP S. 4574 - Bringing Enhanced Treatments and Therapies to ESRD Recipients Kidney Care Act - Young - integrated care for Medicare beneficiaries with ESRD S. 4690 - A bill to increase vaccination rates among pregnant women enrolled in Medicaid or CHIP, and for other purposes - Hassan - Medicaid and maternal health S. 4705 - A bill to amend title XIX requiring coverage under Medicaid of vaccines for pregnant women - Cassidy - Medicaid coverage S. 4717 - A bill to amend title XIX of the Social Security Act to streamline enrollment of certain Medicaid providers across State lines, and for other purposes - Grassley - Medicaid enrollment S. 4742 - A bill to amend title XIX of the Social Security Act to promote access to life-saving therapies for Medicaid enrollees by ensuring coverage of routine patient costs for items and services furnished in connection with participation in qualifying clinical trials, and for other purposes - Burr - Medicaid coverage Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2021 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in and public option; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2022 Rate Notice; Executive Orders relating to international pricing, Part D rebates, insulin costs, and importation; issues related to MLTSS; issues related to proposed changes to removal of safe harbor protection for rebates (proposed rule); issues relating to COVID-19, including testing; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) and the Bipartisan Budget Act of 2018 changes to the Part D coverage gap; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; issues relating to prescription drug price blueprint; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.

Client expense: $2,230,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

General education around long term services and supports and home and community-based services issues; P.L. 116-123, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; P.L. 116-127, Families First Coronavirus Response Act; P.L. 116-136, Coronavirus Aid, Relief, and Economic Security (CARES) Act; S.3544 and H.R.6305, Coronavirus Relief for Seniors and People with Disabilities Act of 2020; S.3277, HCBS Infrastructure Improvement Act; P.L. 116-139, the Paycheck Protection Program and Health Care Enhancement Act; S.3768, Nursing Home COVID-19 Protection and Prevention Act of 2020; H.R.6800, The Heroes Act; H.R.8337, Continuing Appropriations Act, 2021 and Other Extensions Act; S.4775, Delivering Immediate Relief to America's Families, Schools and Small Businesses Act.

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

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

Legislation before the Senate and House of Representatives related to mobility services funded by Department of Health and Human Services programs and other programs. Legislation regarding coordination and efficiencies among the dozens of federal programs supporting non-emergency medical transportation (NEMT) across several different federal departments. Legislation related to the Coordinating Council on Access and Mobility (CCAM), originally established under Executive Order No. 13330 and codified in Section 3006(c) of the FAST Act. Specific bills include S. 228, the Non-Emergency Ambulance Transportation Sustainability and Accountability (NEATSA) Act of 2019 to amend title XVIII of the Social Security Act to restructure the payment adjustment for non-emergency ESRD ambulance transports under the Medicare program and H.R. 2740, making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2020, and for other purposes; H.R. 4378, Continuing Appropriations Act, 2020, and Health Extenders Act of 2019; H.R. 3935, Protecting Patients Transportation to Care Act"; S.2846, Protecting Patients Transportation to Care Act; S. 3277, HCBS Infrastructure Improvement Act; H.R. 2, Investing in a New Vision for the Environment and Surface Transportation (INVEST) in America Act; H.R. 6800, The Heroes Act; H.R. 8406/H.R. 925, The Heroes Act;

Client expense: $420,000 · Firm income: Not reported

Government targets: Federal Railroad Administration, Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

All issues before the Senate and House of Representatives related to federal public transportation and highway programs, high-speed and intercity passenger rail programs, including issues related to authorization and appropriations laws, annual budget resolutions, legislation concerning the Highway Trust Fund and other transportation-related tax and revenue issues, and proposals for a new infrastructure investment initiative. Tax policy as it relates to public transportation including the alternative fuel volumetric tax credit for Compressed Natural Gas and Liquefied Natural Gas used in transit vehicles, the alternative fuel vehicle refueling property tax credit, the treatment of municipal bonds, the commuter tax benefit, tax credit bonds, private activity bonds, investment tax credits, Transportation Infrastructure Finance and Innovation Act (TIFIA) and Railroad Rehabilitation & Improvement Financing (RRIF) financing, and the solvency of the Federal Highway Trust Fund. Matters related to the implementation of the Moving Ahead for Progress in the 21st Century (MAP-21) Act and the Fixing America's Surface Transportation (FAST) Act. Legislation concerning Department of Transportation (DOT) regulations. Issues related to implementation of Positive Train Control technologies on commuter railroads as mandated under the P.L. 110-432, the Rail Safety Improvement Act of 2008 and P.L. 114-73, the Surface Transportation Extension Act of 2015. Issues related to successor legislation to the FAST Act. Issues related to existing or new transportation grant programs. Budget and appropriation issues for FY 2020 and FY 2021 including the Capital Investment Grant Program (CIG), the Better Utilizing Investments to Leverage Development (BUILD) program, transit security grants, Amtrak funding, and other funding. Issues relating to transit security funding and programs. Funding and financing proposals for a new infrastructure spending initiative. Administrative actions for transportation related rules, regulations, guidance, guidelines, and best practices, including the (DOT) BUILD grant selections. Legislation affecting transportation programs in response to the Novel Coronavirus (COVID-19). Specific bills include S. 146, the Move America Act of 2019; S. 203 the Building Rail Access for Customers and the Economy (BRACE) Act of 2019; S. 228 the Non-Emergency Ambulance Transportation Sustainability and Accountability (NEATSA) Act of 2019; S. 353, the Revitalizing American Priorities for Infrastructure Development (RAPID) Act, H.R. 731, the Transportation Funding Fairness Act, and H. R. 1849, the Transportation Funding Fairness Act; S. 436, the Transit Worker and Pedestrian Protection Act, S. 713, the Highway-Rail Grade Crossing Safety Act of 2019 and H.R. 1139, the Transit Worker and Pedestrian Protection Act; S. Res. 59, H. Res. 109, and S.Res.59 ,Resolution Recognizing the duty of the Federal Government to create a Green New Deal; H.R. 1515, the High-Speed Refund Act and H.R. 1600, the Repurposing Assets to Increase Long-term Water Availability and Yield Act or the RAILWAY Act; H.R. 879, the Support Local Transportation Act; H.R. 927, the Sustainable Communities Act of 2019; H.R. 1517 the Connecting Opportunities through Mobility Metrics and Unlocking Transportation Efficiencies Act or the COMMUTE Act; H.R. 2164 the Green Bus Act; S. 1487, Zero-Emission Vehicles Act of 2019; S. 1992 and H.R. 3612, to amend the FAST Act to repeal a rescission of funds; S. 2031, Veterans Enhancing Transportation Act; H.R. 2472, to strengthen Buy American requirements, and for other purposes; H.R. 2520, Metro Accountability and Investment Act; S. 1663, The Metro Safety, Accountability, and Investment Act of 2019; H.R. 2542, the PLACE Act; H.R. 2726, Banning Smoking on Amtrak Act of 2019; H.R. 2739, the Transit Infrastructure Vehicle Security Act; H.R. 2755, Buy America 2.0 Act; S. 1546 and H.R. 2838, Enhancing the Strength and Capacity of America's Primary Evacuation routes Act; H.R. 3261, Less Traffic with Smart Stop Lights Act of 2019; H.R. 3262, Sami's Law; S.1939 and H.R. 3388, Moving and Fostering Innovation to Revolutionize Smarter Transportation Act; S. 1979 and H.R. 1748, Safe Freight Act of 2019; H.R. 3437, The Saving Transit Art Resources Act; H.R. 3459, Made in America Act of 2019; S. 1790 and H.R. 2500, the National Defense Authorization Act (NDAA) for Fiscal Year 2020; S. 2077 and H.R. 3663, Complete Streets Act of 2019; H.R. 3669, Weatherizing Infrastructure in the North and Terrorism Emergency Readiness Act of 2019; H.R. 3671, Federal Permitting Reform and Jobs Act; S. 2041 and H.R. 3681, Green Spaces, Green Vehicles Act of 2019; H.R. 3779, Resilience Revolving Loan Fund Act of 2019; H.R. 3781, Improving National Safety by Updating the Required Amount of Insurance Needed by Commercial Motor Vehicles per Event (INSURANCE) Act of 2019; H.R. 3822, Green Transportation Act; H.R. 3896, Protection of American Jobs in Cross-Border Rail Operations With Mexico Act; H.R. 3904, Highway Trust Fund Reform Act of 2019; S. 2236 and H.R. 3923, Environmental Justice Act of 2019; H.R. 3935, Protecting Patients Transportation to Care Act; H.R. 4001, Bikeshare Transit Act of 2019; S. 2284 and H.R. 4051, Climate Action Rebate Act of 2019; H.R. 4101, Build Local, Hire Local Act; S. 2344 and H.R. 4127, Broadband Infrastructure Finance and Innovation Act of 2019; S. 2467 and H.R. 4273, Transit to Trails Act of 2019; H.R. 4293, United States Commission on an Open Society with Security Act of 2019; H.R. 4307, Build More Housing Near Transit Act; H.R. 4347, PREPARE Act of 2019; H.R. 4358, Preliminary Damage Assessment Improvement Act of 2019; S. 2056, Build America, Buy America Act; S. 2084, GREEN Streets Act; S. 2122 and H.R. 3872, National Flood Insurance Program Consultant Accountability Act of 2019; S. 2129, A bill to require the Secretary of Transportation to develop best practices for incorporating resilience into emergency relief projects, and for other purposes; S. 2192, State Flood Mitigation Revolving Fund Act of 2019; S. 2193, Charging Helps Agencies Realize General Efficiencies Act; S. 2299, PIPES Act of 2019; S. 2302, America's Transportation Infrastructure Act of 2019; S. 2318 and H.R. 4237, Advancing Cybersecurity Diagnostics and Mitigation Act"; S. 2344 and H.R. 4127, Broadband Infrastructure Finance and Innovation Act of 2019; S. 2403, Community Health and Clean Transit Act of 2019; S. 2520 and H.R. 3163, Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2020; S.Con.Res. 22 and H.Con.Res. 52, Concurrent resolution expressing the sense of Congress that there is a climate emergency which demands a massive-scale mobilization to halt, reverse, and address its consequences and causes; S.Res. 316 and H.Con.Res. 65, Resolution supporting the clean vehicle emissions standards of the United States and defending the authority of States under the Clean Air Act to protect the people of those States from harmful air pollution; H.R. 4378, Continuing Appropriations Act, 2020, and Health Extenders Act of 2019; H.R. 1865, Further Consolidated Appropriations Act, 2020; H.R. 4780, National Infrastructure Investment Corporation Act of 2019; H.R. 4808, Housing, Opportunity, Mobility, and Equity Act of 2019; H.R. 4819, Vision Zero Act of 2019; H.R. 4856, Reliable Emergency Alert Distribution Improvement Act of 2019; H.R. 4871, Protecting Roadside First Responders Act; H.R. 5072, A Just Society: A Place to Prosper Act of 2019; H.R. 5117, Rebuilding Our Communities by Keeping aggregates Sustainable Act or ROCKS Act; H.R.5118, Promoting Service in Transportation Act; H.R. 5135, Housing Homeless Veterans Act of 2019; H.R. 5139, Stop Sexual Assault and Harassment in Transportation Act; H.R. 5152, Transportation Equity Act; H.R.5244, Homes for All Act of 2019; H.R. 5255, Maximizing Our Redevelopment and Efficiency for Transit Oriented Development Act; H.R. 5393, Affordable American-made Automobile Act; H.R. 5449, Road User Charge Advancement Act of 2019; H.R. 5508, Transportation Megaprojects Accountability and Oversight Act of 2019; S. 2663, Small Community Transit Improvement Act of 2019; S. 2684, Housing, Opportunity, Mobility, and Equity Act of 2019; S. 2700, Protecting Roadside First Responders Act; S. 2805, TOD Advancement Act of 2019; S. 2846, Protecting Patients Transportation to Care Act; S. 2922, Rail Passenger Fairness Act; S. 2951, Housing is Infrastructure Act of 2019; S. 2979, Preventing Opioid and Drug Impairment in Transportation Act; H.R. 5538, Mandatory Spending Control and Accountability Act; H.R. 5731, Transportation Funding Accountability and Transparency Act; H.R. 5748, Jobs, On-the-Job "Earn-While-You-Learn" Training, and Apprenticeships for Young African-Americans Act; H.R. 5756, Resiliency Enhancement Act of 2020; H.R. 5783, Equitable Transit Oriented Development Support Act; H.R. 5805, High Speed Rail Corridor Development Act of 2020; H.R. 5812, BUILD UP Act; H.R. 5871, Natural Infrastructure and Resilience Act; H.R. 5891, Safe Routes to School Expansion Act; H.R. 5903, Transit Revitalization And Infrastructure Needs Act (TRAIN Act); H.R. 6066, Passenger Train Safety Act; H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; H.R. 6101, Ending Passenger Rail Forced Arbitration Act; H.R. 6156, Transportation Workforce Investment Act of 2020; H.R. 6171, Moving Towards A Safe Climate Act; H.R. 6201, Families First Coronavirus Response Act; H.R. 6206, Pandemic Response and Emergency Preparedness Act of 2020 (PREP Act); H.R. 6207, Coronavirus Worker Relief Act; H.R. 6223, Dont BLock Our Communities Act (D-BLOC Act); H.R. 6224, Building Much Needed Rail Grade Separations Act of 2020; H.R. 6225, Every Person Deserves Peace and Quiet Act of 2020; H.R. 6226, Improving the Metra Commuter Experience Act of 2020; H.R. 6248, Disability Access to Transportation Act; H.R. 6288, Responsibly Responding to Pandemics Act; H.R. 748, Coronavirus Aid, Relief, and Economic Security Act (CARES Act); S. 2302, the Americas Transportation Infrastructure Act (ATIA); S.3175, Smart Transportation Advancement and Transition Act; S. 3277, HCBS Infrastructure Improvement Act; S. 3303, Promoting Service in Transportation Act; S. 3373, Low or No Emission Bus Access Act of 2020; S. 3387, Capital Investment Grant Program Improvement Act of 2020; S. 3391, Connecting America's Active Transportation System Act; S. 3400, Ending Passenger Rail Forced Arbitration Act; S. 3463, Warren Cowles Grade Crossing Safety Act; H.R. 2, Investing in a New Vision for the Environment and Surface Transportation (INVEST) in America Act; H.R.6434, Small Transit Communities Modernization Act; H.R.6463, Improving Access to Services Act; H.R.6575, National Transit Workforce Training Act of 2020; H.R.6747, Rural Transportation Improvement Act; H.R.6800, The Heroes Act; H.R.6770, Mobility Options, Resiliency, and Efficiency (MORE) through TDM Act; H.R.7074; Promoting Equitable Transit-Oriented Development and Mobility Corridors Act; H.R.7110; H.R.7130, One Federal Decision Act of 2020; H.R.7248, To authorize funds for Federal-aid highways, highway safety programs, and transit programs, and for other purposes; H.R.7365 - To amend title 49, United States Code, with respect to grants for buses and bus facilities, and for other purposes; H.R.7389, To direct the Secretary of Transportation to carry out a grant program to support efforts to provide fare-free transit service, and for other purposes; H.R.6452, Railroad Rehabilitation and Improvement Financing Equity Act; H.R.6476, To amend the CARES Act to establish a loan program to provide liquidity to eligible lenders for the purpose of providing loans under the Paycheck Protection Program, and for other purposes; S.4030, BRAIN TRAIN Act; H.R. 7617, Defense, Commerce, Justice, Science, Energy and Water Development, Financial Services and General Government, Labor, Health and Human Services, Education, Transportation, Housing, and Urban Development Appropriations Act, 2021; H.R. 7653, Pedestrian Safety Study Act of 2020; H.R. 7904, Critical Infrastructure Employee Protection Act of 2020; H.R. 8262, Accessible Transit For All Act of 2020; H.R. 8266, FEMA Assistance Relief Act of 2020; H.R. 8319, Continuing Appropriations Act, 2021 and Other Extensions Act; H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act; H.R. 8389, To amend title 49, United States Code, to require Amtrak to convey of certain properties to the Commonwealth of Pennsylvania, and for other purposes; H.R. 8406/H.R. 925, The Heroes Act; S. 3728, Critical Infrastructure Employee Protection Act of 2020; S. 4320, Coronavirus Response Additional Supplemental Appropriations Act, 2020; S. 4332, A bill to provide for the use of additional funds for transportation projects that were affected by Coronavirus Disease 2019 (COVID-19), and for other purposes; S. 4468, Investments in Rural Transit Act of 2020; S. 4651, A bill to amend title 49, United States Code, to establish a National Transit Frontline Workforce Training Center, and for other purposes;

Client expense: $420,000 · Firm income: Not reported

Government targets: Federal Railroad Administration, Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

H.R. 884, the Medicare Mental Health Access Act H.R. 2293, the Protecting Access to Wheelchairs Act H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation Technology Act of 2019 H.R. 3429, the HEARTS and Rural Relief Act (Section 4) H.R. 4386/S. 2496, the Stop the Wait Act H.R. 4945, the Safeguarding Medicare Access to Respiratory Therapy (SMART) Act H.R. 5262, the Medicare Orthotic and Prosthetics Patient Centered Care Act H.R. 5429/S. 3010, the SENIOR CARE Act S. 1223, the Protecting Beneficiary Access to Complex Rehabilitation Technology Act of 2019 S. 3277, the HCBS Infrastructure Improvement Act S. 3544, the Coronavirus Relief for Seniors and People with Disabilities Act of 2020 Medicaid block grants Potential expansion of Medicare

Client expense: $78,368 · Firm income: Not reported

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Transportation Security Administration (TSA), Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), Veterans Employment & Training Service

H.R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 - DelBene - prior authorization in Medicare Advantage H.R. 3925 - Reducing Barriers to Substance Use Treatment Act - Tonko - Opioids H.R. 3935 - Protecting Patients Transportation to Care Act - Carter - Medicaid coverage for transportation H.R. 4453 - Protecting Seniors from Health Care Fraud Act of 2019 - Ruiz -Distributing information to Medicare beneficiaries to prevent fraud H.R. 4529 - Promoting Access to Broadband Act of 2019 - Maloney - Medicaid H.R. 4583 - Medicare Extra Rx Higher Eligibility Limits in Part D Act of 2019 - Schneider - prescription drug affordability H.R. 4620 - More Help for Seniors Act of 2019 - Rose - expand eligibility for low-income subsidies under part D of the Medicare program H.R. 4621 - Collecting and Analyzing Resources Integral and Necessary for Guidance for Social Determinants Act of 2019 - Blunt Rochester - best practices re social determinants of health H.R. 4629 - Star Rating for Biosimilars Act - Tonko - biosimilars H.R. 4632 - Better Transparency in Information for Medicare Beneficiaries Act of 2019 - Kind - provides consumers information regarding premiums under LIS benchmark plans H.R. 4671 - Helping Seniors Afford Health Care Act - Kim - Medicare affordability and low income beneficiaries H.R. 5006 - Expanding Access to Inpatient Mental Health Act - Emmer - Medicaid coverage for SUD/mental health for institutionalized H.R. 5201 - Telemental Health Expansion Act of 2019 - Matsui - Medicare coverage of mental telehealth H.R. 5232 - Road to Recovery Act - Fitzpatrick - Medicaid and CHIP SUD treatment H.R. 5693 - Primary Health Services Enhancement Act - Kind - Medicare rural health H.R. 5808 - Save Rural Communities Act of 2020 - Jodey Arrington - rural emergency medical access services under Medicare H.R. 5833 - To amend title XVIII of the Social Security Act to permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain - Latta - Medicare coverage in telehealth H.R. 5882 - GENE Therapy Payment Act - Schrader - value based care H.R. 6098 - To amend title XXI of the Social Security Act to allow States to expand income eligibility standards under the Children's Health Insurance Program - Barragan - CHIP eligibility H.R. 6151 - CARING for Kids Act - Abby Fineknauer - CHIP H.R. 6179 - Increasing Access to Biosimilars Act of 2020 - Cardenas - payments to providers of biosimilars under Medicare H.R. 6209 - Reducing Unnecessary Senior Hospitalizations Act of 2020 or the RUSH Act of 2020 -Kuster - Medicare coverage for certain services in hospital emergency departments H.R. 6244 - To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Children's Health Insurance Program - Kelly - Medicaid coverage of COVID-19 related visits and testing H.R. 6263 - To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19 -Sarbanes - Medicare coverage of COVID-19 related visits and testing H.R. 6273 - Protecting Vulnerable Americans in Times of Crisis Act of 2020 - Butterfield - FMAP H.R. 6311 - Care for COVID-19 Act - Ruiz - COVID-19 cost sharing H.R. 6336 - Increasing Hospital Capacity to Fight the Coronavirus Act of 2020 - Bishop - Medicare and Medicaid payments during COVID-19 emergency H.R. 6462 - Emergency Medicaid for Coronavirus Treatment Act - Gallego - Medicaid coverage H.R. 6511 - Ensuring Vaccination and Treatment Affordability Act - Pappas - COVID H.R. 6521 - To prohibit the Secretary of Health and Human Services from taking certain actions with respect to Medicaid supplemental payments reporting requirements, and for other purposes - Diaz Barragan H.R. 6538 - Modernized Medicine Act - Kennedy - Medicaid, Telehealth H.R. 6539 - Coronavirus Medicaid Response Act - Lee - FMAP H.R. 6572 - To direct the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, to carry out a national campaign to increase awareness and knowledge of COVID-19. - Bilirakis - COVID H.R. 6583 - To amend title XVIII of the Social Security Act to establish a risk corridor program for Medicare Advantage plans during the COVID-19 emergency, and for other purposes. - Houlahan - COVID H.R. 6616 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Cardenas - COVID H.R. 6640 - Medicare Advantage COVID Treatment Act - Mucarsel-Powell - COVID H.R. 6658 - Insular Area Medicaid Coronavirus Recovery Act - Sablan - FMAP H.R. 6727 - To hold Medicare beneficiaries harmless for specified COVID-19 treatment services furnished under part A or part B of the Medicare program - Schrier - COVID H.R. 6744 - Computer and Internet Equity Act - Davis - internet access for Lifeline program H.R. 6753 - Save Rural Hospitals Act of 2020 - Finkenauer - Medicare hospital payments H.R. 6792 - Improving Telehealth for Underserved Communities Act of 2020 - Smith - telehealth H.R. 6797 - CHIPPER Act - Wild - CHIP, COVID H.R. 6837 - Medicare Accelerated and Advance Payments Improvement Act of 2020 - Schneider - COVID H.R. 7154 - Outpatient Therapy Modernization and Stabilization Act - Boyle - outpatient therapy services H.R. 7187 - HEALTH Act of 2020 -Thompson -Smith - telehealth H.R. 7297 - To amend title XVIII of the Social Security Act to provide for forgiveness of certain accelerated and advance payments under parts A and B of the Medicare program. - Kaptur H.R. 7338 - To amend title XVIII of the Social Security Act to permit the Secretary of Health and Human Services to waive requirements relating to the furnishing of telehealth services under the Medicare program, and for other purposes. - Cheney - Telehealth H.R. 7391 - To amend title XVIII of the Social Security Act to remove certain geographic and originating site restrictions on the furnishing of telehealth services under the Medicare program - Sherrill - Telehealth S. 2846 - Protecting Patients Transportation to Care Act - Isakson - Medicaid coverage of transportation S. 2911 - Seniors Prescription Drug Relief Act of 2019 - Cassidy - Part D smoothing S. 3220 - Ensuring Access to Direct Support Professionals Act - Portman - Medicaid coverage in acute care hospitals S. 3238 - Preventive Home Visit Act - King - preventative home visits S. 3277 - HCBS Infrastructure Improvement Act - Casey - access to community based services S. 3353 - Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020 - Cassidy - Medicare coverage of kidney transplant services S. 3384 - Lowering Prescription Drug Prices for America's Seniors and Families Act of 2020 - McSally - Medicare Part D drug pricing negotiation S. 3399 - FCHIP Extension Act - Tester - rural health S. 3442 - Care for COVID-19 Act - Booker - COVID-19 cost sharing S. 3443 - Improving Coverage and Care for Mothers Act - Casey - Medicaid coverage for all pregnant and postpartum women S. 3447 - RUSH Act of 2020 - Thune - Medicare coverage for certain services in hospital emergency departments S. 3466 - ACCESS for Biosimilars Act of 2020 - McSally - eliminates cost sharing for biosimilar biological products furnished under part B of the Medicare program S. 3615 - Rural Community Hospital Demonstration Extension Act of 2020 - Murkowski - rural community hospital demonstration program S. 3665 - Save Rural Hospitals Act of 2020 - Alexander - Medicare hospital payments S. 3750 - Medicare Accelerated and Advance Payments Improvement Act of 2020 - Shaheen - COVID S. 3881 - CHIPPER Act - Casey - CHIP, COVID S. 3998 - HEALTH Act of 2020 - Hyde-Smith - telehealth S. 3999 - Mental and Behavioral Health Connectivity Act - King - Mental Health S. 4108 - A bill to amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns - Casey - FMAP Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2021 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in and public option; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2021 Rate Notice and Call Letter; issues related to MLTSS; issues related to proposed changes to removal of safe harbor protection for rebates (proposed rule); issues relating to COVID-19; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) and the Bipartisan Budget Act of 2018 changes to the Part D coverage gap; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; issues relating to prescription drug price blueprint; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.

Client expense: $2,250,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

Legislation before the Senate and House of Representatives related to mobility services funded by Department of Health and Human Services programs and other programs. Legislation regarding coordination and efficiencies among the dozens of federal programs supporting non-emergency medical transportation (NEMT) across several different federal departments. Legislation related to the Coordinating Council on Access and Mobility (CCAM), originally established under Executive Order No. 13330 and codified in Section 3006(c) of the FAST Act. Specific bills include S. 228, the Non-Emergency Ambulance Transportation Sustainability and Accountability (NEATSA) Act of 2019 to amend title XVIII of the Social Security Act to restructure the payment adjustment for non-emergency ESRD ambulance transports under the Medicare program and H.R. 2740, making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2020, and for other purposes; H.R. 4378, Continuing Appropriations Act, 2020, and Health Extenders Act of 2019; H.R. 3935, Protecting Patients Transportation to Care Act"; S.2846, Protecting Patients Transportation to Care Act; S. 3277, HCBS Infrastructure Improvement Act; H.R. 2, Investing in a New Vision for the Environment and Surface Transportation (INVEST) in America Act; H.R. 6800, The Heroes Act

Client expense: $460,000 · Firm income: Not reported

Government targets: Federal Railroad Administration, Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

All issues before the Senate and House of Representatives related to federal public transportation and highway programs, high-speed and intercity passenger rail programs, including issues related to authorization and appropriations laws, annual budget resolutions, legislation concerning the Highway Trust Fund and other transportation-related tax and revenue issues, and proposals for a new infrastructure investment initiative. Tax policy as it relates to public transportation including the alternative fuel volumetric tax credit for Compressed Natural Gas and Liquefied Natural Gas used in transit vehicles, the alternative fuel vehicle refueling property tax credit, the treatment of municipal bonds, the commuter tax benefit, tax credit bonds, private activity bonds, investment tax credits, Transportation Infrastructure Finance and Innovation Act (TIFIA) and Railroad Rehabilitation & Improvement Financing (RRIF) financing, and the solvency of the Federal Highway Trust Fund. Matters related to the implementation of the Moving Ahead for Progress in the 21st Century (MAP-21) Act and the Fixing America's Surface Transportation (FAST) Act. Legislation concerning Department of Transportation (DOT) regulations. Issues related to implementation of Positive Train Control technologies on commuter railroads as mandated under the P.L. 110-432, the Rail Safety Improvement Act of 2008 and P.L. 114-73, the Surface Transportation Extension Act of 2015. Issues related to successor legislation to the FAST Act. Issues related to existing or new transportation grant programs. Budget and appropriation issues for FY 2020 and FY 2021 including the Capital Investment Grant Program (CIG), the Better Utilizing Investments to Leverage Development (BUILD) program, transit security grants, Amtrak funding, and other funding. Issues relating to transit security funding and programs. Funding and financing proposals for a new infrastructure spending initiative. Administrative actions for transportation related rules, regulations, guidance, guidelines, and best practices, including the (DOT) BUILD grant selections. Legislation affecting transportation programs in response to the Novel Coronavirus (COVID-19). Specific bills include S. 146, the Move America Act of 2019; S. 203 the Building Rail Access for Customers and the Economy (BRACE) Act of 2019; S. 228 the Non-Emergency Ambulance Transportation Sustainability and Accountability (NEATSA) Act of 2019; S. 353, the Revitalizing American Priorities for Infrastructure Development (RAPID) Act, H.R. 731, the Transportation Funding Fairness Act, and H. R. 1849, the Transportation Funding Fairness Act; S. 436, the Transit Worker and Pedestrian Protection Act, S. 713, the Highway-Rail Grade Crossing Safety Act of 2019 and H.R. 1139, the Transit Worker and Pedestrian Protection Act; S. Res. 59, H. Res. 109, and S.Res.59 ,Resolution Recognizing the duty of the Federal Government to create a Green New Deal; H.R. 1515, the High-Speed Refund Act and H.R. 1600, the Repurposing Assets to Increase Long-term Water Availability and Yield Act or the RAILWAY Act; H.R. 879, the Support Local Transportation Act; H.R. 927, the Sustainable Communities Act of 2019; H.R. 1517 the Connecting Opportunities through Mobility Metrics and Unlocking Transportation Efficiencies Act or the COMMUTE Act; H.R. 2164 the Green Bus Act; S. 1487, Zero-Emission Vehicles Act of 2019; S. 1992 and H.R. 3612, to amend the FAST Act to repeal a rescission of funds; S. 2031, Veterans Enhancing Transportation Act; H.R. 2472, to strengthen Buy American requirements, and for other purposes; H.R. 2520, Metro Accountability and Investment Act; S. 1663, The Metro Safety, Accountability, and Investment Act of 2019; H.R. 2542, the PLACE Act; H.R. 2726, Banning Smoking on Amtrak Act of 2019; H.R. 2739, the Transit Infrastructure Vehicle Security Act; H.R. 2755, Buy America 2.0 Act; S. 1546 and H.R. 2838, Enhancing the Strength and Capacity of America's Primary Evacuation routes Act; H.R. 3261, Less Traffic with Smart Stop Lights Act of 2019; H.R. 3262, Sami's Law; S.1939 and H.R. 3388, Moving and Fostering Innovation to Revolutionize Smarter Transportation Act; S. 1979 and H.R. 1748, Safe Freight Act of 2019; H.R. 3437, The Saving Transit Art Resources Act; H.R. 3459, Made in America Act of 2019; S. 1790 and H.R. 2500, the National Defense Authorization Act (NDAA) for Fiscal Year 2020; S. 2077 and H.R. 3663, Complete Streets Act of 2019; H.R. 3669, Weatherizing Infrastructure in the North and Terrorism Emergency Readiness Act of 2019; H.R. 3671, Federal Permitting Reform and Jobs Act; S. 2041 and H.R. 3681, Green Spaces, Green Vehicles Act of 2019; H.R. 3779, Resilience Revolving Loan Fund Act of 2019; H.R. 3781, Improving National Safety by Updating the Required Amount of Insurance Needed by Commercial Motor Vehicles per Event (INSURANCE) Act of 2019; H.R. 3822, Green Transportation Act; H.R. 3896, Protection of American Jobs in Cross-Border Rail Operations With Mexico Act; H.R. 3904, Highway Trust Fund Reform Act of 2019; S. 2236 and H.R. 3923, Environmental Justice Act of 2019; H.R. 3935, Protecting Patients Transportation to Care Act; H.R. 4001, Bikeshare Transit Act of 2019; S. 2284 and H.R. 4051, Climate Action Rebate Act of 2019; H.R. 4101, Build Local, Hire Local Act; S. 2344 and H.R. 4127, Broadband Infrastructure Finance and Innovation Act of 2019; S. 2467 and H.R. 4273, Transit to Trails Act of 2019; H.R. 4293, United States Commission on an Open Society with Security Act of 2019; H.R. 4307, Build More Housing Near Transit Act; H.R. 4347, PREPARE Act of 2019; H.R. 4358, Preliminary Damage Assessment Improvement Act of 2019; S. 2056, Build America, Buy America Act; S. 2084, GREEN Streets Act; S. 2122 and H.R. 3872, National Flood Insurance Program Consultant Accountability Act of 2019; S. 2129, A bill to require the Secretary of Transportation to develop best practices for incorporating resilience into emergency relief projects, and for other purposes; S. 2192, State Flood Mitigation Revolving Fund Act of 2019; S. 2193, Charging Helps Agencies Realize General Efficiencies Act; S. 2299, PIPES Act of 2019; S. 2302, America's Transportation Infrastructure Act of 2019; S. 2318 and H.R. 4237, Advancing Cybersecurity Diagnostics and Mitigation Act"; S. 2344 and H.R. 4127, Broadband Infrastructure Finance and Innovation Act of 2019; S. 2403, Community Health and Clean Transit Act of 2019; S. 2520 and H.R. 3163, Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2020; S.Con.Res. 22 and H.Con.Res. 52, Concurrent resolution expressing the sense of Congress that there is a climate emergency which demands a massive-scale mobilization to halt, reverse, and address its consequences and causes; S.Res. 316 and H.Con.Res. 65, Resolution supporting the clean vehicle emissions standards of the United States and defending the authority of States under the Clean Air Act to protect the people of those States from harmful air pollution; H.R. 4378, Continuing Appropriations Act, 2020, and Health Extenders Act of 2019; H.R. 1865, Further Consolidated Appropriations Act, 2020; H.R. 4780, National Infrastructure Investment Corporation Act of 2019; H.R. 4808, Housing, Opportunity, Mobility, and Equity Act of 2019; H.R. 4819, Vision Zero Act of 2019; H.R. 4856, Reliable Emergency Alert Distribution Improvement Act of 2019; H.R. 4871, Protecting Roadside First Responders Act; H.R. 5072, A Just Society: A Place to Prosper Act of 2019; H.R. 5117, Rebuilding Our Communities by Keeping aggregates Sustainable Act or ROCKS Act; H.R.5118, Promoting Service in Transportation Act; H.R. 5135, Housing Homeless Veterans Act of 2019; H.R. 5139, Stop Sexual Assault and Harassment in Transportation Act; H.R. 5152, Transportation Equity Act; H.R.5244, Homes for All Act of 2019; H.R. 5255, Maximizing Our Redevelopment and Efficiency for Transit Oriented Development Act; H.R. 5393, Affordable American-made Automobile Act; H.R. 5449, Road User Charge Advancement Act of 2019; H.R. 5508, Transportation Megaprojects Accountability and Oversight Act of 2019; S. 2663, Small Community Transit Improvement Act of 2019; S. 2684, Housing, Opportunity, Mobility, and Equity Act of 2019; S. 2700, Protecting Roadside First Responders Act; S. 2805, TOD Advancement Act of 2019; S. 2846, Protecting Patients Transportation to Care Act; S. 2922, Rail Passenger Fairness Act; S. 2951, Housing is Infrastructure Act of 2019; S. 2979, Preventing Opioid and Drug Impairment in Transportation Act; H.R. 5538, Mandatory Spending Control and Accountability Act; H.R. 5731, Transportation Funding Accountability and Transparency Act; H.R. 5748, Jobs, On-the-Job "Earn-While-You-Learn" Training, and Apprenticeships for Young African-Americans Act; H.R. 5756, Resiliency Enhancement Act of 2020; H.R. 5783, Equitable Transit Oriented Development Support Act; H.R. 5805, High Speed Rail Corridor Development Act of 2020; H.R. 5812, BUILD UP Act; H.R. 5871, Natural Infrastructure and Resilience Act; H.R. 5891, Safe Routes to School Expansion Act; H.R. 5903, Transit Revitalization And Infrastructure Needs Act (TRAIN Act); H.R. 6066, Passenger Train Safety Act; H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; H.R. 6101, Ending Passenger Rail Forced Arbitration Act; H.R. 6156, Transportation Workforce Investment Act of 2020; H.R. 6171, Moving Towards A Safe Climate Act; H.R. 6201, Families First Coronavirus Response Act; H.R. 6206, Pandemic Response and Emergency Preparedness Act of 2020 (PREP Act); H.R. 6207, Coronavirus Worker Relief Act; H.R. 6223, Dont BLock Our Communities Act (D-BLOC Act); H.R. 6224, Building Much Needed Rail Grade Separations Act of 2020; H.R. 6225, Every Person Deserves Peace and Quiet Act of 2020; H.R. 6226, Improving the Metra Commuter Experience Act of 2020; H.R. 6248, Disability Access to Transportation Act; H.R. 6288, Responsibly Responding to Pandemics Act; H.R. 748, Coronavirus Aid, Relief, and Economic Security Act (CARES Act); S. 2302, the Americas Transportation Infrastructure Act (ATIA); S.3175, Smart Transportation Advancement and Transition Act; S. 3277, HCBS Infrastructure Improvement Act; S. 3303, Promoting Service in Transportation Act; S. 3373, Low or No Emission Bus Access Act of 2020; S. 3387, Capital Investment Grant Program Improvement Act of 2020; S. 3391, Connecting America's Active Transportation System Act; S. 3400, Ending Passenger Rail Forced Arbitration Act; S. 3463, Warren Cowles Grade Crossing Safety Act; H.R. 2, Investing in a New Vision for the Environment and Surface Transportation (INVEST) in America Act; H.R.6434, Small Transit Communities Modernization Act; H.R.6463, Improving Access to Services Act; H.R.6575, National Transit Workforce Training Act of 2020; H.R.6747, Rural Transportation Improvement Act; H.R.6800, The Heroes Act; H.R.6770, Mobility Options, Resiliency, and Efficiency (MORE) through TDM Act; H.R.7074; Promoting Equitable Transit-Oriented Development and Mobility Corridors Act; H.R.7110; H.R.7130, One Federal Decision Act of 2020; H.R.7248, To authorize funds for Federal-aid highways, highway safety programs, and transit programs, and for other purposes; H.R.7365 - To amend title 49, United States Code, with respect to grants for buses and bus facilities, and for other purposes; H.R.7389, To direct the Secretary of Transportation to carry out a grant program to support efforts to provide fare-free transit service, and for other purposes; H.R.6452, Railroad Rehabilitation and Improvement Financing Equity Act; H.R.6476, To amend the CARES Act to establish a loan program to provide liquidity to eligible lenders for the purpose of providing loans under the Paycheck Protection Program, and for other purposes; S.4030, BRAIN TRAIN Act;

Client expense: $460,000 · Firm income: Not reported

Government targets: Federal Railroad Administration, Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

General education around long term services and supports and home and community-based services issues; H.R.1994, H.R.3253, Sustaining Excellence in Medicaid Act of 2019; P.L. 116-123, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; P.L. 116-127, Families First Coronavirus Response Act; P.L. 116-136, Coronavirus Aid, Relief, and Economic Security (CARES) Act; S.3544 and H.R.6305, Coronavirus Relief for Seniors and People with Disabilities Act of 2020; S.3277, HCBS Infrastructure Improvement Act; P.L. 116-139, the Paycheck Protection Program and Health Care Enhancement Act.

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

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

H.R. 2293, the Protecting Access to Wheelchairs Act H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation Technology Act of 2019 H.R. 3429, the HEARTS and Rural Relief Act (Section 4) H.R. 4386/S. 2496, the Stop the Wait Act H.R. 4945, the Safeguarding Medicare Access to Respiratory Therapy (SMART) Act H.R. 5262, the Medicare Orthotic and Prosthetics Patient Centered Care Act H.R. 5429/S. 3010, the SENIOR CARE Act S. 1223, the Protecting Beneficiary Access to Complex Rehabilitation Technology Act of 2019 S. 3277, the HCBS Infrastructure Improvement Act S. 3544, the Coronavirus Relief for Seniors and People with Disabilities Act of 2020 Medicaid block grants Potential expansion of Medicare

Client expense: $71,212 · Firm income: Not reported

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Architectural & Transportation Barriers Compliance Board, Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA), Veterans Employment & Training Service

S. 3277, HCBS Infrastructure Improvement Act S.2000/H.R. 1343, Protecting Married Seniors from Impoverishment Act H.R. 1342, the Empower Care Act H.R. 748, CARES Act, Secs. 2201, 3811, and 3812 S. 3544, H.R. 6305, Coronavirus Relief for Seniors and People with Disabilities Act of 2020

Client expense: $66,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 - DelBene - prior authorization in Medicare Advantage H.R. 3925 - Reducing Barriers to Substance Use Treatment Act - Tonko - Opioids H.R. 3935 - Protecting Patients Transportation to Care Act - Carter - Medicaid coverage for transportation H.R. 4453 - Protecting Seniors from Health Care Fraud Act of 2019 - Ruiz -Distributing information to Medicare beneficiaries to prevent fraud H.R. 4529 - Promoting Access to Broadband Act of 2019 - Maloney - Medicaid H.R. 4583 - Medicare Extra Rx Higher Eligibility Limits in Part D Act of 2019 - Schneider - prescription drug affordability H.R. 4620 - More Help for Seniors Act of 2019 - Rose - expand eligibility for low-income subsidies under part D of the Medicare program H.R. 4621 - Collecting and Analyzing Resources Integral and Necessary for Guidance for Social Determinants Act of 2019 - Blunt Rochester - best practices re social determinants of health H.R. 4629 - Star Rating for Biosimilars Act - Tonko - biosimilars H.R. 4632 - Better Transparency in Information for Medicare Beneficiaries Act of 2019 - Kind - provides consumers information regarding premiums under LIS benchmark plans H.R. 4671 - Helping Seniors Afford Health Care Act - Kim - Medicare affordability and low income beneficiaries H.R. 5006 - Expanding Access to Inpatient Mental Health Act - Emmer - Medicaid coverage for SUD/mental health for institutionalized H.R. 5201 - Telemental Health Expansion Act of 2019 - Matsui - Medicare coverage of mental telehealth H.R. 5232 - Road to Recovery Act - Fitzpatrick - Medicaid and CHIP SUD treatment H.R. 5693 - Primary Health Services Enhancement Act - Kind - Medicare rural health H.R. 5808 - Save Rural Communities Act of 2020 - Jodey Arrington - rural emergency medical access services under Medicare H.R. 5833 - To amend title XVIII of the Social Security Act to permit the use of certain psychological evaluation via telehealth for Medicare coverage of neurostimulation services for the treatment of chronic pain - Latta - Medicare coverage in telehealth H.R. 5882 - GENE Therapy Payment Act - Schrader - value based care H.R. 6098 - To amend title XXI of the Social Security Act to allow States to expand income eligibility standards under the Children's Health Insurance Program -Barragan - CHIP eligibility H.R. 6151 - CARING for Kids Act - Abby Fineknauer - CHIP H.R. 6179 - Increasing Access to Biosimilars Act of 2020 - Cardenas - payments to providers of biosimilars under Medicare H.R. 6209 - Reducing Unnecessary Senior Hospitalizations Act of 2020 or the RUSH Act of 2020 -Kuster - Medicare coverage for certain services in hospital emergency departments H.R. 6244 - To amend titles XVIII and XIX to provide for coverage at no cost sharing of COVID-19 testing under the Medicaid program and Children's Health Insurance Program - Kelly - Medicaid coverage of COVID-19 related visits and testing H.R. 6263 - To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19 -Sarbanes - Medicare coverage of COVID-19 related visits and testing H.R. 6273 - Protecting Vulnerable Americans in Times of Crisis Act of 2020 - Butterfield - FMAP H.R. 6311 - Care for COVID-19 Act - Ruiz - COVID-19 cost sharing H.R. 6336 - To amend title XI of the Social Security Act to provide for a waiver of payment reductions under the Medicare and Medicaid programs for certain nonapproved capital expenditures undertaken by health care facilities during the COVID-19 emergency - Bishop - Medicare and Medicaid payments during COVID-19 emergency S. 2846 - Protecting Patients Transportation to Care Act - Isakson - Medicaid coverage of transportation S. 2911 - Seniors Prescription Drug Relief Act of 2019 - Cassidy - Part D smoothing S. 3220 - Ensuring Access to Direct Support Professionals Act - Portman - Medicaid coverage in acute care hospitals S. 3238 - Preventive Home Visit Act - King - preventative home visits S. 3277 - HCBS Infrastructure Improvement Act - Casey - access to community based services S. 3353 - Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020 - Cassidy - Medicare coverage of kidney transplant services S. 3384 - Lowering Prescription Drug Prices for America's Seniors and Families Act of 2020 - McSally - Medicare Part D drug pricing negotiation S. 3399 - FCHIP Extension Act - Tester - rural health S. 3442 - Care for COVID-19 Act - Booker - COVID-19 cost sharing S. 3443 - Improving Coverage and Care for Mothers Act - Casey - Medicaid coverage for all pregnant and postpartum women S. 3447 - RUSH Act of 2020 - Thune - Medicare coverage for certain services in hospital emergency departments S. 3466 - ACCESS for Biosimilars Act of 2020 - McSally - eliminates cost sharing for biosimilar biological products furnished under part B of the Medicare program Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2021 policy and technical regulation for MA and Part D; MA and Part D proposed rule on drug pricing changes for 2020; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in and public option; CMSs price transparency proposal for direct-to-consumer advertisements; issues relating to 2021 Rate Notice and Call Letter; issues related to MLTSS; issues related to proposed changes to removal of safe harbor protection for rebates (proposed rule); issues relating to COVID-19; issues related to addressing the social determinants of health, including housing, transportation, nutrition, and educational opportunities; in-home health risk assessments; Medicare Medical Loss Ratio issues; implementation of sequestration under the Medicare Advantage and Part D programs; implications of the health insurer fee for MA and Part D plans; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value-based insurance design (VBID) demonstration; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; implementation of the Affordable Care Act (ACA) and the Bipartisan Budget Act of 2018 changes to the Part D coverage gap; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; new payment system for physicians under MACRA, including implications for MA and Part D plans; Medicare clinical trials; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the ACA including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; issues relating to prescription drug price blueprint; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.

Client expense: $3,630,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, Treasury, Dept of, White House Office

All issues before the Senate and House of Representatives related to federal public transportation and highway programs, high-speed and intercity passenger rail programs, including issues related to authorization and appropriations laws, annual budget resolutions, legislation concerning the Highway Trust Fund and other transportation-related tax and revenue issues, and proposals for a new infrastructure investment initiative. Tax policy as it relates to public transportation including the alternative fuel volumetric tax credit for Compressed Natural Gas and Liquefied Natural Gas used in transit vehicles, the alternative fuel vehicle refueling property tax credit used in transit vehicles, the alternative fuel vehicle refueling property tax credit, the treatment of municipal bonds, the commuter tax benefit, tax credit bonds, private activity bonds, investment tax credits, Transportation Infrastructure Finance and Innovation Act (TIFIA) and Railroad Rehabilitation & Improvement Financing (RRIF) financing, and the solvency of the Federal Highway Trust Fund. Matters related to the implementation of Moving Ahead for Progress in the 21st Century (MAP-21) and the Fixing America's Surface Transportation (FAST) Act. Legislation concerning Department of Transportation (DOT) regulations. Issues related to implementation of Positive Train Control technologies on commuter railroads as mandated under the P.L. 110-432, the Rail Safety Improvement Act of 2008 and P.L. 114-73, the Surface Transportation Extension Act of 2015. Issues related to successor legislation to the FAST Act. Issues related to existing or new transportation grant programs. Budget and appropriation issues for FY 2020 and FY 2021 including the Capital Investment Grant Program (CIG), the Better Utilizing Investments to Leverage Development (BUILD) program, transit security grants, Amtrak funding, and other funding. Issues relating to transit security funding and programs. Funding and financing proposals for a new infrastructure spending initiative. Administrative actions for transportation related rules, regulations, guidance, guidelines, and best practices, including the (DOT) BUILD grant selections. Legislation affecting transportation programs in response to the Novel Coronavirus (COVID-19). Specific bills include S. 146, the Move America Act of 2019; S. 203 the Building Rail Access for Customers and the Economy (BRACE) Act of 2019; S. 228 the Non-Emergency Ambulance Transportation Sustainability and Accountability (NEATSA) Act of 2019; S. 353, the Revitalizing American Priorities for Infrastructure Development (RAPID) Act, H.R. 731, the Transportation Funding Fairness Act, and H. R. 1849, the Transportation Funding Fairness Act; S. 436, the Transit Worker and Pedestrian Protection Act, S. 713, the Highway-Rail Grade Crossing Safety Act of 2019 and H.R. 1139, the Transit Worker and Pedestrian Protection Act; S. Res. 59, H. Res. 109, and S.Res.59 ,Resolution Recognizing the duty of the Federal Government to create a Green New Deal; H.R. 1515, the High-Speed Refund Act and H.R. 1600, the Repurposing Assets to Increase Long-term Water Availability and Yield Act or the RAILWAY Act; H.R. 879, the Support Local Transportation Act; H.R. 927, the Sustainable Communities Act of 2019; H.R. 1517 the Connecting Opportunities through Mobility Metrics and Unlocking Transportation Efficiencies Act or the COMMUTE Act; H.R. 2164 the Green Bus Act; S. 1487, Zero-Emission Vehicles Act of 2019; S. 1992 and H.R. 3612, to amend the FAST Act to repeal a rescission of funds; S. 2031, Veterans Enhancing Transportation Act; H.R. 2472, to strengthen Buy American requirements, and for other purposes; H.R. 2520, Metro Accountability and Investment Act; S. 1663, The Metro Safety, Accountability, and Investment Act of 2019; H.R. 2542, the PLACE Act; H.R. 2726, Banning Smoking on Amtrak Act of 2019; H.R. 2739, the Transit Infrastructure Vehicle Security Act; H.R. 2755, Buy America 2.0 Act; S. 1546 and H.R. 2838, Enhancing the Strength and Capacity of America's Primary Evacuation routes Act; H.R. 3261, Less Traffic with Smart Stop Lights Act of 2019; H.R. 3262, Sami's Law; S.1939 and H.R. 3388, Moving and Fostering Innovation to Revolutionize Smarter Transportation Act; S. 1979 and H.R. 1748, Safe Freight Act of 2019; H.R. 3437, The Saving Transit Art Resources Act; H.R. 3459, Made in America Act of 2019; S. 1790 and H.R. 2500, the National Defense Authorization Act (NDAA) for Fiscal Year 2020; S. 2077 and H.R. 3663, Complete Streets Act of 2019; H.R. 3669, Weatherizing Infrastructure in the North and Terrorism Emergency Readiness Act of 2019; H.R. 3671, Federal Permitting Reform and Jobs Act; S. 2041 and H.R. 3681, Green Spaces, Green Vehicles Act of 2019; H.R. 3779, Resilience Revolving Loan Fund Act of 2019; H.R. 3781, Improving National Safety by Updating the Required Amount of Insurance Needed by Commercial Motor Vehicles per Event (INSURANCE) Act of 2019; H.R. 3822, Green Transportation Act; H.R. 3896, Protection of American Jobs in Cross-Border Rail Operations With Mexico Act; H.R. 3904, Highway Trust Fund Reform Act of 2019; S. 2236 and H.R. 3923, Environmental Justice Act of 2019; H.R. 3935, Protecting Patients Transportation to Care Act; H.R. 4001, Bikeshare Transit Act of 2019; S. 2284 and H.R. 4051, Climate Action Rebate Act of 2019; H.R. 4101, Build Local, Hire Local Act; S. 2344 and H.R. 4127, Broadband Infrastructure Finance and Innovation Act of 2019; S. 2467 and H.R. 4273, Transit to Trails Act of 2019; H.R. 4293, United States Commission on an Open Society with Security Act of 2019; H.R. 4307, Build More Housing Near Transit Act; H.R. 4347, PREPARE Act of 2019; H.R. 4358, Preliminary Damage Assessment Improvement Act of 2019; S. 2056, Build America, Buy America Act; S. 2084, GREEN Streets Act; S. 2122 and H.R. 3872, National Flood Insurance Program Consultant Accountability Act of 2019; S. 2129, A bill to require the Secretary of Transportation to develop best practices for incorporating resilience into emergency relief projects, and for other purposes; S. 2192, State Flood Mitigation Revolving Fund Act of 2019; S. 2193, Charging Helps Agencies Realize General Efficiencies Act; S. 2299, PIPES Act of 2019; S. 2302, America's Transportation Infrastructure Act of 2019; S. 2318 and H.R. 4237, Advancing Cybersecurity Diagnostics and Mitigation Act"; S. 2344 and H.R. 4127, Broadband Infrastructure Finance and Innovation Act of 2019; S. 2403, Community Health and Clean Transit Act of 2019; S. 2520 and H.R. 3163, Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2020; S.Con.Res. 22 and H.Con.Res. 52, Concurrent resolution expressing the sense of Congress that there is a climate emergency which demands a massive-scale mobilization to halt, reverse, and address its consequences and causes; S.Res. 316 and H.Con.Res. 65, Resolution supporting the clean vehicle emissions standards of the United States and defending the authority of States under the Clean Air Act to protect the people of those States from harmful air pollution; H.R. 4378, Continuing Appropriations Act, 2020, and Health Extenders Act of 2019; H.R. 1865, Further Consolidated Appropriations Act, 2020; H.R. 4780, National Infrastructure Investment Corporation Act of 2019; H.R. 4808, Housing, Opportunity, Mobility, and Equity Act of 2019; H.R. 4819, Vision Zero Act of 2019; H.R. 4856, Reliable Emergency Alert Distribution Improvement Act of 2019; H.R. 4871, Protecting Roadside First Responders Act; H.R. 5072, A Just Society: A Place to Prosper Act of 2019; H.R. 5117, Rebuilding Our Communities by Keeping aggregates Sustainable Act or ROCKS Act; H.R.5118, Promoting Service in Transportation Act; H.R. 5135, Housing Homeless Veterans Act of 2019; H.R. 5139, Stop Sexual Assault and Harassment in Transportation Act; H.R. 5152, Transportation Equity Act; H.R.5244, Homes for All Act of 2019; H.R. 5255, Maximizing Our Redevelopment and Efficiency for Transit Oriented Development Act; H.R. 5393, Affordable American-made Automobile Act; H.R. 5449, Road User Charge Advancement Act of 2019; H.R. 5508, Transportation Megaprojects Accountability and Oversight Act of 2019; S. 2663, Small Community Transit Improvement Act of 2019; S. 2684, Housing, Opportunity, Mobility, and Equity Act of 2019; S. 2700, Protecting Roadside First Responders Act; S. 2805, TOD Advancement Act of 2019; S. 2846, Protecting Patients Transportation to Care Act; S. 2922, Rail Passenger Fairness Act; S. 2951, Housing is Infrastructure Act of 2019; S. 2979, Preventing Opioid and Drug Impairment in Transportation Act; H.R. 5538, Mandatory Spending Control and Accountability Act; H.R. 5731, Transportation Funding Accountability and Transparency Act; H.R. 5748, Jobs, On-the-Job "Earn-While-You-Learn" Training, and Apprenticeships for Young African-Americans Act; H.R. 5756, Resiliency Enhancement Act of 2020; H.R. 5783, Equitable Transit Oriented Development Support Act; H.R. 5805, High Speed Rail Corridor Development Act of 2020; H.R. 5812, BUILD UP Act; H.R. 5871, Natural Infrastructure and Resilience Act; H.R. 5891, Safe Routes to School Expansion Act; H.R. 5903, Transit Revitalization And Infrastructure Needs Act (TRAIN Act); H.R. 6066, Passenger Train Safety Act; H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; H.R. 6101, Ending Passenger Rail Forced Arbitration Act; H.R. 6156, Transportation Workforce Investment Act of 2020; H.R. 6171, Moving Towards A Safe Climate Act; H.R. 6201, Families First Coronavirus Response Act; H.R. 6206, Pandemic Response and Emergency Preparedness Act of 2020 (PREP Act); H.R. 6207, Coronavirus Worker Relief Act; H.R. 6223, Dont BLock Our Communities Act (D-BLOC Act); H.R. 6224, Building Much Needed Rail Grade Separations Act of 2020; H.R. 6225, Every Person Deserves Peace and Quiet Act of 2020; H.R. 6226, Improving the Metra Commuter Experience Act of 2020; H.R. 6248, Disability Access to Transportation Act; H.R. 6288, Responsibly Responding to Pandemics Act; H.R. 748, Coronavirus Aid, Relief, and Economic Security Act (CARES Act); S. 2302, the Americas Transportation Infrastructure Act (ATIA); S.3175, Smart Transportation Advancement and Transition Act; S. 3277, HCBS Infrastructure Improvement Act; S. 3303, Promoting Service in Transportation Act; S. 3373, Low or No Emission Bus Access Act of 2020; S. 3387, Capital Investment Grant Program Improvement Act of 2020; S. 3391, Connecting America's Active Transportation System Act; S. 3400, Ending Passenger Rail Forced Arbitration Act; S. 3463, Warren Cowles Grade Crossing Safety Act.

Client expense: $410,000 · Firm income: Not reported

Government targets: Federal Railroad Administration, Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

Legislation before the Senate and House of Representatives related to mobility services funded by Department of Health and Human Services programs and other programs. Legislation regarding coordination and efficiencies among the dozens of federal programs supporting non-emergency medical transportation (NEMT) across several different federal departments. Legislation related to the Coordinating Council on Access and Mobility (CCAM), originally established under Executive Order No. 13330 and codified in Section 3006(c) of the FAST Act. Specific bills include S. 228, the Non-Emergency Ambulance Transportation Sustainability and Accountability (NEATSA) Act of 2019 to amend title XVIII of the Social Security Act to restructure the payment adjustment for non-emergency ESRD ambulance transports under the Medicare program and H.R. 2740, making appropriations for the Departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending September 30, 2020, and for other purposes; H.R. 4378, Continuing Appropriations Act, 2020, and Health Extenders Act of 2019; H.R. 3935, Protecting Patients Transportation to Care Act"; S.2846, Protecting Patients Transportation to Care Act; S. 3277, HCBS Infrastructure Improvement Act.

Client expense: $410,000 · Firm income: Not reported

Government targets: Federal Railroad Administration, Federal Transit Administration (FTA), HOUSE OF REPRESENTATIVES, SENATE, Transportation, Dept of (DOT)

General education around long term services and supports and home and community-based services issues; H.R.1994, H.R.3253, Sustaining Excellence in Medicaid Act of 2019; P.L. 116-123, Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020; P.L. 116-127, Families First Coronavirus Response Act; P.L. 116-136, Coronavirus Aid, Relief, and Economic Security (CARES) Act; S.3544 and H.R.6305, Coronavirus Relief for Seniors and People with Disabilities Act of 2020; S.3277, HCBS Infrastructure Improvement Act.

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

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

H.R. 2293, the Protecting Access to Wheelchairs Act H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation Technology Act of 2019 H.R. 3429, the HEARTS and Rural Relief Act (Section 4) H.R. 4386/S. 2496, the Stop the Wait Act H.R. 4945, the Safeguarding Medicare Access to Respiratory Therapy (SMART) Act H.R. 5262, the Medicare Orthotic and Prosthetics Patient Centered Care Act H.R. 5429/S. 3010, the SENIOR CARE Act S. 1223, the Protecting Beneficiary Access to Complex Rehabilitation Technology Act of 2019 S. 3277, the HCBS Infrastructure Improvement Act S. 3544, the Coronavirus Relief for Seniors and People with Disabilities Act of 2020 Medicaid block grants Potential expansion of Medicare

Client expense: $74,586 · Firm income: Not reported

Government targets: AMTRAK - Natl Railroad Passenger Corporation, Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), SENATE, Transportation Security Administration (TSA), Transportation, Dept of (DOT), U.S. Architectural & Transportation Barriers Compliance Board (ACCESS), Veterans Affairs, Dept of (VA), Veterans Employment & Training Service

H.R. 748, CARES Act, provisions related to the Money Follows the Person Rebalancing Demonstration Program, possible waivers under the Individuals with Disabilities Education Act and other laws, and other provisions that could affect the autism community. S. 3277, HCBS Infrastructure Improvement Act, all provisions. H.R. 1342/ S.548 EMPOWER Care Act of 2019, provision related to the Money Follows the Person Rebalancing Demonstration. A bill not yet introduced relating to Fiscal Year 2021 appropriations for the Department of Health and Human Services, the Department of Defense, and other federal departments, provisions related to autism funding. A bill not yet introduced related to further COVID-19 relief, provisions that may benefit the autism community. A bill not yet introduced to improve direct services for individuals with autism and their families. A bill not yet introduced to improve interagency collaboration, based on the Promoting Readiness of Minors in SSI program. A bill not yet introduced related to apprenticeships for individuals with disabilities. A bill not yet introduced to improve professional development opportunities for educators. A bill not yet introduced to amend the Higher Education Act (P.L. 89-329) A bill not yet introduced to create Patient-Centered Health Reform Proposed Rulemaking - Strengthening the Program Integrity of the Medicaid Eligibility Determination Process (CMS-2421-P; RIN 0938-AU00) Implementation of 1905(r) of the Social Security Act, related to provisions of early and periodic screening, diagnostic, and treatment services. Implementation of the RAISE Family Caregivers Act

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Natl Institute of Mental Health (NIMH), SENATE

H.R. 6074, Coronavirus Preparedness and Response Supplemental Appropriations Act. H.R. 6201, Families First Coronavirus Response Act; H.R. 748, Coronavirus Aid, Relief, and Economic Security (CARES) Act - Discussed Medicare enrollment national open enrollment period, medical expense deduction, cost-sharing protections for commercial/private health insurance holders, telehealth access, nursing homes, virtual visitation, home and community-based services, Older Americans Act programs, Medicare home health care, and family caregiving, no-cost COVID-19 testing, equitable relief payments, retirement savings tax relief, suspensions of foreclosures and evictions, expanded unemployment benefits, paid sick and family leave, affordable broadband, and government operations, among other issues. S. 3517, Discussed Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act (ACCESS Act). S. 753/H.R. 1682, Improving Access to Medicare Coverage Act. H.R. 6305, To assist older Americans and people with disabilities affected by COVID-19.; S. 3544, Coronavirus Relief for Seniors and People with Disabilities Act. H.R. 6379, Take Responsibility for Workers and Families Act. Discussed Medicaid HCBS grants and virtual visitation provisions. No bill number, discussed Nursing Home Modernization Reform Act of 2019. No bill number, discussed Elder Justice Act Reauthorization and nursing home bill. S. 2807, discussed Hospice Care Improvement Act of 2019. H.R. 1343, Protecting Married Seniors from Impoverishment Act. Discussed Medicaid home and community-based services and family financial impacts. No bill number. Discussed nursing homes, criminal background checks, inappropriate use of anti-psychotropic drugs, guardianship, and Elder Justice Act Reauthorization. H.R. 5821, Helping Our Senior Population in Comfort Environments (HOSPICE) Act. Discussed HOSPICE Act and live discharges of long-term terminally ill individuals from hospice. S. 3277; Discussed feedback on HCBS Infrastructure Improvement Act and the bill. No bill number. Discussed long-term services and supports financing legislation, Social Security, Administrations Medicaid guidance, and Ways and Means Caring for Aging Americans hearing statement from November 2019. No bill number. Discussed family caregiving supports, Medicare Advantage (MA) Value-Based Insurance Design (VBID) Demonstration, and the MA VBID hospice demonstration component. H.R. 5821, Helping Our Senior Population in Comfort Environments Act. No bill number. Discussed issues impacting dual-eligibles. S. 296/H.R.2150, Home Health Care Planning Improvement Act. No bill number. CMS nursing home Coronavirus guidance. No bill number. Discussed nursing home virtual visitation. S. 3548/H.R. 748, P.L. 116-136, CARES Act Lobbied regarding nursing homes, virtual visitation, home and community-based services, Older Americans Act programs, Medicare home health care, and family caregiving. S.1999 - Improving Low Income Access to Prescription Drugs Act. H.R. 3, the Lower Drug Costs Now Act. S. 2543, the Prescription Drug Pricing Reduction Act. No bill number - Discussed surprise medical billing. H.R. 5800 - Ban Surprise Billing Act. H.R. 5826 - Consumer Protections Against Surprise Medical Bills Act. No bill number - Discussed Alaska-specific nursing home legislation.

Client expense: $2,210,000 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Financial Protection Bureau (CFPB), Corporation for Natl & Community Service, Federal Deposit Insurance Corporation (FDIC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Indian Health Service, Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Office of the Comptroller of the Currency (OCC), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Social Security Administration (SSA), Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Commercial, civil and defense transportation; Department of Defense Authorization; Intelligence Authorization; FAA Authorization; NASA Appropriations; NASA Authorization; Department of Defense Appropriations; Intelligence Appropriations; Commercial Space Launch Amendments Act; S.3277 Space Frontier Act, marine vessel licensing, issues related to the National Airspace System; matters related to Export-Import Bank.

Client expense: $610,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Export-Import Bank of the United States (EXIM Bank), Federal Aviation Administration (FAA), HOUSE OF REPRESENTATIVES, Natl Aeronautics & Space Administration (NASA), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Office of the Vice President of the United States, SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), U.S. Coast Guard (USCG)

Commercial, civil and defense transportation; Department of Defense Authorization; Intelligence Authorization; FAA Authorization; NASA Appropriations; NASA Authorization; Department of Defense Appropriations; Intelligence Appropriations; Commercial Space Launch Amendments Act; S.3277 Space Frontier Act, marine vessel licensing, issues related to the National Airspace System; matters related to Export-Import Bank.

Client expense: $590,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Export-Import Bank of the United States (EXIM Bank), Federal Aviation Administration (FAA), HOUSE OF REPRESENTATIVES, Natl Aeronautics & Space Administration (NASA), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Office of the Vice President of the United States, SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), U.S. Coast Guard (USCG)

H.R.3055 - Commerce, Justice, Science, Agriculture, Rural Development, Food and Drug Administration, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2020. S. 2584 - Commerce, Justice, Science Appropriations, 2020. H.R. 6226, American Space SAFE Management Act. Aeronautics. Acquisition Policy. Broadband Satellite. Commercial Space Launch. Human Space Flight. International Space Station. Satellite Servicing. Science Education. Science Programs. Spectrum. Space Exploration. Space Launch System. S. 3277 - Space Frontier Act. H.R. 6910 - Leading Human Spaceflight Act. NASA Authorization Act of 2019. S. 584 - Advancing Human Spaceflight Act.

Client expense: $3,150,000 · Firm income: Not reported

Government targets: Air Force, Dept of, Army, Dept of (Other), Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Export-Import Bank of the United States (EXIM Bank), Federal Aviation Administration (FAA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Security Council (NSC), Navy, Dept of, Office of the Vice President of the United States, SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

H.R.3055 - Commerce, Justice, Science, Agriculture, Rural Development, Food and Drug Administration, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2020. S. XXXX. - Commerce, Justice, Science Appropriations. H.J. Res.31 - Consolidated Appropriations Act, 2019, J. Report 116-9 (includes FY19 Commerce, Justice, and Science Appropriations). H.R. 6226, American Space SAFE Management Act. Aeronautics. Acquisition Policy. Broadband Satellite. Commercial Space Launch. Human Space Flight. International Space Station. Satellite Servicing. Science Education. Science Programs. Spectrum. Space Exploration. Space Launch System. S. 3277 - Space Frontier Act. H.R. 6910 - Leading Human Spaceflight Act. NASA Authorization S. 584 - Advancing Human Spaceflight Act Space Frontier Act

Client expense: $3,930,000 · Firm income: Not reported

Government targets: Air Force, Dept of, Army, Dept of (Other), Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Export-Import Bank of the United States (EXIM Bank), Federal Aviation Administration (FAA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Security Council (NSC), Navy, Dept of, Office of the Vice President of the United States, SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Commercial, civil and defense transportation; Department of Defense Authorization; Intelligence Authorization; FAA Authorization; NASA Appropriations; NASA Authorization; Department of Defense Appropriations; Intelligence Appropriations; Commercial Space Launch Amendments Act; S.3277 Space Frontier Act, marine vessel licensing, issues related to the National Airspace System.

Client expense: $620,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Federal Aviation Administration (FAA), HOUSE OF REPRESENTATIVES, Natl Aeronautics & Space Administration (NASA), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Office of the Vice President of the United States, SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), U.S. Coast Guard (USCG)

H.R. 1625 - Consolidated Appropriations Act, 2018. H.J. Res.31 - Consolidated Appropriations Act, 2019, J. Report 116-9 (includes FY19 Commerce, Justice, and Science Appropriations). H.R. 6226, American Space SAFE Management Act. Aeronautics. Acquisition Policy. Broadband Satellite. Commercial Space Launch. Human Space Flight. International Space Station. Satellite Servicing. Science Education. Science Programs. Spectrum. Space Exploration. Space Launch System. S. 3277 - Space Frontier Act. H.R. 6910 - Leading Human Spaceflight Act. NASA Authorization S. 584 - Advancing Human Spaceflight Act Space Frontier Act

Client expense: $3,330,000 · Firm income: Not reported

Government targets: Air Force, Dept of, Army, Dept of (Other), Commerce, Dept of (DOC), Defense, Dept of (DOD), Energy, Dept of, Environmental Protection Agency (EPA), Export-Import Bank of the United States (EXIM Bank), Federal Aviation Administration (FAA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Security Council (NSC), Navy, Dept of, Office of the Vice President of the United States, SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Trade Representative (USTR), White House Office

Commercial, civil and defense transportation; Department of Defense Authorization; Intelligence Authorization; FAA Authorization; NASA Appropriations; NASA Authorization; Department of Defense Appropriations; Intelligence Appropriations; Commercial Space Launch Amendments Act; S.3277 Space Frontier Act, marine vessel licensing, issues related to the National Airspace System.

Client expense: $560,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), Defense, Dept of (DOD), Executive Office of the President (EOP), Federal Aviation Administration (FAA), HOUSE OF REPRESENTATIVES, Natl Aeronautics & Space Administration (NASA), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), Office of the Vice President of the United States, SENATE, State, Dept of (DOS), Transportation, Dept of (DOT), U.S. Coast Guard (USCG)