Medicare Accelerated and Advance Payments Improvement Act

Stark Law modernization; S. 966, Medicare Care Coordination Improvement Act of 2019; H.R. 2282, Medicare Care Coordination Improvement Act of 2019; Monitor implementation of Section 603 of the Bipartisan Budget Act of 2015 and site neutral policies; Issues related to Advance Notice of Proposed Rulemaking (ANPR) on International Pricing Index (IPI) and Part B reforms; S. 1895, Lower Health Care Costs Act; H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act; S. 1531; Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019; H.R. 3630, No Surprises Act; H.R. 3502, Protecting People From Surprise Medical Bills Act; H.R. 861, End Surprise Billing Act of 2019; S. 668/H.R. 1570, Removing Barriers to Colorectal Cancer Screening Act of 2019; S. 2543, Prescription Drug Pricing Reduction Act of 2019; H.R. 925, The Heroes Act; H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act, Public Law 116-159; S 4230, Telehealth Expansion Act of 2020; S.3750/HR 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020; Issues related to evaluation and management (E&M) cuts contained in the CY2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule; Extension of the Medicare Sequester; H.R. 133, Consolidated Appropriations Act, 2021 (Public Law 116-260)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 4230, Telehealth Expansion Act of 2020; S.3750/HR 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020; Issues related to evaluation and management (E&M) cuts contained in the CY2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule; Extension of the Medicare Sequester; H.R. 133,Consolidated Appropriations Act, 2021 (Public Law 116-260)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 133 Consolidate Appropriations Act of 2020:Oppose Medicare financial relief that excludes certain primary care service. HR 2774; S 2783 - Primary Care Patient Protection Act: Create a primary care benefit in high deductible health plans. HR 2815/S 1119 - Teaching Health Centers GME; Community Health Centers; National Health Service Corps; Special Diabetes Program; Special Diabetes Program for Indians: Increased funding, five-year reauthorization. HR 2895/S. 948 - Conrad State 30 & Physician Access Act: Expand program, streamline eligibility. HR 6149/S. 4088 - Kids Access to Primary Care Act/Ensuring Access to Primary Care for Women and Children Act: Increase Medicaid payment rates for primary care. HR 6788/S. 3599 Healthcare workforce Resilience Act: recapture 15,000 unused employment-based physician immigrant visas from prior fiscal years to bolster physician workforce during COVID pandemic. HR 6837/S 3750: Medicare Accelerated and Advance Payments Improvement Act of 2020: Advanced payments to Medicare Part B providers. HR 7059 Coronavirus Provider Protection Act: targeted and limited liability protections for health care providers responding to COVID pandemic. HR 7663/S 4230 - Expansion of telehealth; Protecting Access to Post-COVID-19 Telehealth Act: Expansion of telehealth services for primary care; coverage and payment parity during PHE. H.R. 8061- Community Immunity During COVID-19 Act: Support grants to increase the rates of recommended immunizations. HR 8623/S 4864 - Ensure Medicare and Medicaid coverage of COVID-19 vaccine and all recommended immunizations without cost-sharing. HR 8337 - Continuing Appropriations Act 2021 and Other Extensions Act: Extension of THCGMEs, Medicare Accelerated Payments. S. 4349 - Dr. Lorna Breen Provider Protection Act: Support the wellbeing of frontline physicians during COVID-19. P.L. 116-123 - CORONAVIRUS PREPAREDNESS AND RESPONSE SUPPLEMENTAL APPROPRIATIONS ACT, 2020: Ensure primary care physicians have adequate supplies, finances to serve their patients, are eligible for loans, payment for telehealth services. P.L. 116-127 - The Families First Coronavirus Response Act: Support for small business and non-profits during COVID crisis. P.L. 116-136 - CARES Act: Ensure primary care physicians have adequate supplies, finances to serve their patients, are eligible for Small Business loans, payment for telehealth services. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No. - Teaching Health Centers GME; Community Health Centers; National Health Service Corps; Special Diabetes Program; Special Diabetes Program for Indians: Increased funding, five-year reauthorization. No Bill No. - 501(c)(6) Non-Profits Relief: include emergency financial relief for 501(c)(6) organizations in COVID response legislation. No Bill No. - Emergency financial relief for primary care physicians: additional financial support for primary care clinicians to stabilize our nations primary care infrastructure. No Bill No. - Issues related to increase immunization utilization/distribution: Efforts to support children and adults securing needed immunizations.

Client expense: $701,260 · Firm income: Not reported

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

HR 133 Consolidate Appropriations Act of 2020:Oppose Medicare financial relief that excludes certain primary care service. HR 6149/S. 4088 - Kids Access to Primary Care Act/Ensuring Access to Primary Care for Women and Children Act: Increase Medicaid payment rates for primary care. HR 6837/S 3750: Medicare Accelerated and Advance Payments Improvement Act of 2020: Advanced payments to Medicare Part B providers. HR 7663/S 4230 - Expansion of telehealth; Protecting Access to Post-COVID-19 Telehealth Act: Expansion of telehealth services for primary care; coverage and payment parity during PHE. H.R. 8061- Community Immunity During COVID-19 Act: Support grants to increase the rates of recommended immunizations. HR 8337 - Continuing Appropriations Act 2021 and Other Extensions Act: Extension of THCGMEs, Medicare Accelerated Payments. HR 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, and for other purposes: Support temporary waiver of Medicare budget neutrality to provide financial relief to physicians impacted by COVID-19. HR 8623/S 4864 - Securing Affordable Vaccines Equally (SAVE) for Seniors Act of 2020-Ensure Medicare and Medicaid coverage of COVID-19 vaccine and all recommended immunizations without cost-sharing. HR 8702 - Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020 : Oppose Medicare financial relief that excludes certain primary care services. P.L. 116-123 - CORONAVIRUS PREPAREDNESS AND RESPONSE SUPPLEMENTAL APPROPRIATIONS ACT, 2020: Ensure primary care physicians have adequate supplies, finances to serve their patients, are eligible for loans, payment for telehealth services. P.L. 116-136 - CARES Act: Ensure primary care physicians have adequate supplies, finances to serve their patients, are eligible for Small Business loans, payment for telehealth services. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No. - Medicare administrative flexibilities for physicians: Suspension of reporting requirements and administrative processes for Medicare physicians during PHE. No Bill No. - Issues related to increase immunization utilization/distribution: Efforts to support children and adults securing needed immunizations.

Client expense: $701,260 · Firm income: Not reported

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

H.R. 8840, Medicare Sequester COVID Moratorium Act, all provisions H.R. 8702, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions S. 5007, Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, all provisions H.R. 7154, Outpatient Therapy Modernization and Stabilization Act, all provisions H.R. 3107, Improving Seniors Timely Access to Care Act of 2019, all provisions S. 5044, Improving Seniors Timely Access to Care Act of 2020y, all provisions H.R. 8727, Telehealth Modernization Act, all provisions S. 4375, Telehealth Modernization Act, all provisions H.R. 7663, Protecting Access to Post-COVID-19 Telehealth Act of 2020, all provisions H.R. 7391, Protect Telehealth Access Act of 2020, all provisions H.R. 1301, Mental Health Telemedicine Expansion Act, all provisions H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019, all provisions H.R. 5201, Telemental Health Expansion Act of 2020, provisions relating to 1834(m) of the Social Security Act; geographic and originating sites H.R. 7233, Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020, all provisions H.R. 5172, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, All provisions S. 3067, Non-Opioids Prevent Addiction In the Nation (NOPAIN) Act, All provisions H.R. 3414, Opioid Workforce Act of 2019, all provisions H.R. 7791, Value in Health Care Act of 2020, provisions relating to qualifying APM physician thresholds H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020, all provisions S. 3750, Medicare Accelerated and Advance Payments Improvement Act, all provisions 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, and for other purposes, all provisions H.R. 884, Medicare Mental Health Access Act, all provisions H.R. 945, Mental Health Access Improvement Act of 2019, all provisions H.R. 6744, Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2020, all provisions H.R. 4004, Social Determinants Accelerator Act of 2019, all provisions H.R. 4932, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions S. 2741, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions H.R. 5534, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020, all provisions S. 3353, Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2020, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, provisions related to PBM and prescription drug price transparency H.R. 19, Lower Costs, More Cures Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2020, all provisions H.R. 6090, Physician Shortage GME Cap Flex Act of 2020, all provisions H.R. 6142, Black Maternal Health Momnibus Act of 2020, all provisions Medicare program: P.L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) implementation/Accountable Care Organizations/APM thresholds Medicare program: Patient Protection and Affordable Care Act (PPACA)/Prior authorization provider and patient burdens/patient electronic access to health information Medicare program: P.L. 113-93 Protecting Access to Medicare Act (PAMA)/Imaging appropriate use criteria/Radiation Oncology APM Medicare program: FY 2021 Inpatient Rehab Facility Prospective Payment System (IRF PPS)/scope of practice issues Medicare program: CY 2021 physician fee schedule/E&M services/Budget neutrality/Part B/Sequester Medicare program: Alternative payment models (APMs) Medicare program: Merit-based Incentive Payment System (MIPS)/cost/quality/interoperability/hardship exemption Medicare program: Regulatory relief/Advanced APMs, prior authorization, and utilization management Medicare program: Shared Savings Program Medicare program: Quality Payment Program/prior authorization/electronic funds transfer Medicare program: Surprise medical billing Medicare program: Medicare-For-All Medicare program: Electronic Health Records (EHR) Certification Medicare program: 21st Century Cures Act Medicare program: Quality payment program/physician burdens Medicare program: National Coverage determination/validated home blood pressure monitors Medicare program: Health IT/physician burden Medicare program: Drug pricing Medicare program: Most favored nation drug pricing Medicare program: Provider compliance/regulatory relief Medicare program: Provider Enrollment, Chain and Ownership (PECOS) enrollment/revalidation Medicare and Medicaid programs: 21st Century Cures Act/health data and privacy Medicaid program: CMS proposed regulation Medicaid Program Medicaid program: FMAP increases Medicaid program: Interoperability

Client expense: $4,170,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), SENATE, Veterans Affairs, Dept of (VA), White House Office

COVID-19 crisis - Engaged with Congress and the administration to advocate for greater regulatory flexibility and appropriate reimbursement for hospitals through development, passage and ongoing implementation of coronavirus relief legislation: HEROES Act (HR 6800) Heroes Act 2.0 (H.R. 925) Health, Economic Assistance, Liability Protection and Schools (HEALS) Act (S. 178) The Consolidated Appropriations Act (H.R. 133) Telehealth - Urged Congress and the administration to make permanent telehealth flexibilities related to distant site and geographic limitations, expanding provider types and services available to consumers and maintain Medicare reimbursement parity. Accelerated and Advanced Payment Program - Advocated for Congress and the administration to offer forgiveness for accelerated and advanced payments during the COVID-19 public health emergency. Offered support for reduced interest rates, extended loan repayment period and reduced recoupment amounts (S. 3750/H.R. 6837/ H.R. 8337 / H.R. 133). Medicaid Disproportionate Share Hospital (DSH) Payments - Urged Congress to end or further delay implementation of Medicaid DSH payment cuts. Medicare Sequester - urged Congress to end or further delay ongoing Medicare sequestration reimbursement reductions. Enhanced Federal Medical Assistance Percentage (FMAP) - Urged Congress to extend the increased Medicaid FMAP matching rate beyond the public health emergency and increase the enhanced percentage. Medicaid Fiscal Accountability Regulation - Urged CMS to permanently withdraw the Medicaid Fiscal Accountability Regulation and advocated for Congress to rescind the proposal. COVID-19 Data Reporting Requirements for Hospitals - Urged HHS ease burden of COVID-19 mandatory reporting requirements and clarify aspects of reporting. Resident Physician Shortage Reduction Act (S. 348) - Urged Congress to pass the Resident Physician Shortage Reduction Act. Most Favored Nation - Urged CMS to withdraw or delay the start of the Most-Favored Nation regulation for drug reimbursement for hospitals and other providers.

Client expense: $160,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, U.S. Trade Representative (USTR)

H.R.7676/ S.4106 - "Health Care PRICE Transparency Act" - Oppose public disclosure of confidential hospital negotiated rates with payers H.R. 1384 - "Medicare For All Act of 2019", S.1129 - Oppose government-run national health insurance H.R. 2085/ S.1033 "Consumer Health Options and Insurance Competition Enhancement Act (CHOICE) Act", H.R. 2000/S.981 - "Medicare-X Choice Act of 2019" - Oppose public option S. 1895 - "Lower Health Care Costs Act" - Support protecting patients from surprise billing and oppose government rate setting. Advocated for appropriate transparency and contracting flexibility. S.1531 "Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019", H.R. 3630 "No Surprises Act", H.R. 3502 "Protecting People From Surprise Medical Bills Act", H.R. 5800 Ban Surprise Billing Act, H.R. 5826 "Consumer Protections Against Surprise Medical Bills Act of 2020" - Advocate to protect patients from surprise billing and oppose government rate setting. H.R. 6837/ S. 3750 "Medicare Accelerated and Advance Payments Improvement Act of 2020" - Support amended payment terms for eligible health care providers under the Medicare Accelerated and Advance Payments Program H.R. 6800 "Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act" - Support Division C, Health Provisions for Medicare and Medicaid that support health care providers and patients H.R. 6365/ S. 3559 "Immediate Relief for Rural Facilities and Providers Act of 2020" - Support expansion of access to telehealth programs for tax paying rural hospitals H.R. 7059 "Coronavirus Provider Protection Act" - Evaluated and advocated for improvements to legislation relating to liability protections during COVID-19 S. 4317 - "SAFE TO WORK Act" - Develop proposal to protect hospitals, healthcare professionals and facilities from liability due to COVID-19 H.R. 7819 / S. 4525 - " Eliminating the Provider Relief Fund Tax Penalties Act of 2020" - Support technical corrections to Provider Relief Fund to ensure funds received are not taxable H.R. 8337 - "Continuing Appropriations Act, 2021 and Other Extensions Act" - Support passage of continuing resolution, including language to improve repayment terms of Medicare Accelerated and Advance Payment Programs. H.R. 8061 - "Community Immunity During COVID-19 Act of 2020" - Support legislation that increases community access and awareness to vaccinations. S. 4421 - "The Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act" - Support legislation that provides temporary licensing reciprocity for health care professionals. H.R. 133 - "Consolidated Appropriations Act, 2021" - Advocated in support of protecting patients from surprise billing, COVID-19 response. H.Res. 1200 - "Supporting the goals and ideals of National Rural Health Day" - Support National Rural Health Day.

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

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

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 116-127/H.R. 6201 - Families First Coronavirus Response Act H.R. 6365/S. 3559 - The Immediate Relief for Rural Facilities and Providers Act H.R. 748/S. 3548 - Coronavirus Aid, Relief, and Economic Security (CARES) Act H.R. 7059: Coronavirus Provider Protection Act S. 1895 - Lower Health Care Costs Act H.R. 5800 - Ban Surprise Billing Act H.R. 5826 - Consumer Protections Against Surprise Medical Bills Act H.R. 3630 - No Surprises Act H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668/H.R. 1570 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 2372 - VA MISSION Act of 2018 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 H.R. 3656/S. 1350 - ACCESS Act of 2019 H.R. 861 - End Surprise Billing Act H.R. 3630 - No Surprises Act H.R. 3502 - Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 - Lower Health Care Costs Act S. 967 - Reducing Costs for Out of Network Services Act S. 1266 - Protecting Patients from Surprise Medical Bills Act S. 1531 - Stopping the Outrageous Practice of Surprise Bills Act S. 1607 - Medical Billing Fairness Act H. R. - 1763/S. 348 - Resident's Physician Shortage Reduction Act S. 1350 - Good Samaritan Health Professionals Act H. R. 2689/S. 1438 - Breast Cancer Research Stamp reauthorization H.R. 4350/S. 3085 - Ambulatory Surgical Center Quality and Access Act of 2019 H.R. 5855 - Bipartisan Solution to Cyclical Violence Act of 2020 H.R. 6953 - Pandemic Responder Service Award Act H.R. 6644/S. 3741 - Telehealth legislation/The Health Care at Home Act H.R. 6365/S. 3559 - Immediate Relief for Rural Facilities Act H.R. 7255 - Coronavirus Health Care Worker Wellness Act S. 3741 - Health Care at Home Act S. 3750/H.R. 6837 - Medicare Accelerated and Advanced Payments Improvement Act H.R.133 - Consolidated Appropriations Act, 2021 Phase 4 COVID-19 relief legislation H. R. 8702 - Holding Providers Harmless from Medicare Cuts During COVID-19 Act Federal Incentive Programs COVID-Safely Returning to Work and School in the Fall COVID-PPE Shortages Mental Health Issues Health Care Disparities Cures 2.0 E/M Global Code Issues Unique Patient Identifier Lower Health Care Costs Act Compromise Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) MIPS Value Pathways (MVPs) Alternative Payment Models (APM) Outpatient Prospective Payment System (OPPS) Common Rule Medicare for All National Trauma Systems Legislation Drug Pricing Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioids/Pain Management Legislation ACS THRIVE (Transforming Health care Resources to Increase Value and Efficiency) Reauthorization of Patient-Centered Outcomes Research Institute (PCORI) 2020 CMS Proposed Fee Schedule Rare earth magnet legislation

Client expense: $10,400 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 116-127/H.R. 6201 - Families First Coronavirus Response Act H.R. 6365/S. 3559 - The Immediate Relief for Rural Facilities and Providers Act H.R. 748/S. 3548 - Coronavirus Aid, Relief, and Economic Security (CARES) Act H.R. 7059: Coronavirus Provider Protection Act S. 1895 - Lower Health Care Costs Act H.R. 5800 - Ban Surprise Billing Act H.R. 5826 - Consumer Protections Against Surprise Medical Bills Act H.R. 3630 - No Surprises Act H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668/H.R. 1570 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 2372 - VA MISSION Act of 2018 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 H.R. 3656/S. 1350 - ACCESS Act of 2019 H.R. 861 - End Surprise Billing Act H.R. 3630 - No Surprises Act H.R. 3502 - Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 - Lower Health Care Costs Act S. 967 - Reducing Costs for Out of Network Services Act S. 1266 - Protecting Patients from Surprise Medical Bills Act S. 1531 - Stopping the Outrageous Practice of Surprise Bills Act S. 1607 - Medical Billing Fairness Act H. R. - 1763/S. 348 - Resident's Physician Shortage Reduction Act S. 1350 - Good Samaritan Health Professionals Act H. R. 2689/S. 1438 - Breast Cancer Research Stamp reauthorization H.R. 4350/S. 3085 - Ambulatory Surgical Center Quality and Access Act of 2019 H.R. 5855 - Bipartisan Solution to Cyclical Violence Act of 2020 H.R. 6953 - Pandemic Responder Service Award Act H.R. 6644/S. 3741 - Telehealth legislation/The Health Care at Home Act H.R. 6365/S. 3559 - Immediate Relief for Rural Facilities Act H.R. 7255 - Coronavirus Health Care Worker Wellness Act S. 3741 - Health Care at Home Act S. 3750/H.R. 6837 - Medicare Accelerated and Advanced Payments Improvement Act H.R.133 - Consolidated Appropriations Act, 2021 Phase 4 COVID-19 relief legislation H. R. 8702 - Holding Providers Harmless from Medicare Cuts During COVID-19 Act Federal Incentive Programs COVID-Safely Returning to Work and School in the Fall COVID-PPE Shortages Mental Health Issues Health Care Disparities Cures 2.0 E/M Global Code Issues Unique Patient Identifier Lower Health Care Costs Act Compromise Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) MIPS Value Pathways (MVPs) Alternative Payment Models (APM) Outpatient Prospective Payment System (OPPS) Common Rule Medicare for All National Trauma Systems Legislation Drug Pricing Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioids/Pain Management Legislation ACS THRIVE (Transforming Health care Resources to Increase Value and Efficiency) Reauthorization of Patient-Centered Outcomes Research Institute (PCORI) 2020 CMS Proposed Fee Schedule Rare earth magnet legislation

Client expense: $10,400 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 116-127/H.R. 6201 - Families First Coronavirus Response Act H.R. 6365/S. 3559 - The Immediate Relief for Rural Facilities and Providers Act H.R. 748/S. 3548 - Coronavirus Aid, Relief, and Economic Security (CARES) Act H.R. 7059: Coronavirus Provider Protection Act S. 1895 - Lower Health Care Costs Act H.R. 5800 - Ban Surprise Billing Act H.R. 5826 - Consumer Protections Against Surprise Medical Bills Act H.R. 3630 - No Surprises Act H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668/H.R. 1570 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 2372 - VA MISSION Act of 2018 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 H.R. 3656/S. 1350 - ACCESS Act of 2019 H.R. 861 - End Surprise Billing Act H.R. 3630 - No Surprises Act H.R. 3502 - Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 - Lower Health Care Costs Act S. 967 - Reducing Costs for Out of Network Services Act S. 1266 - Protecting Patients from Surprise Medical Bills Act S. 1531 - Stopping the Outrageous Practice of Surprise Bills Act S. 1607 - Medical Billing Fairness Act H. R. - 1763/S. 348 - Resident's Physician Shortage Reduction Act S. 1350 - Good Samaritan Health Professionals Act H. R. 2689/S. 1438 - Breast Cancer Research Stamp reauthorization H.R. 4350/S. 3085 - Ambulatory Surgical Center Quality and Access Act of 2019 H.R. 5855 - Bipartisan Solution to Cyclical Violence Act of 2020 H.R. 6953 - Pandemic Responder Service Award Act H.R. 6644/S. 3741 - Telehealth legislation/The Health Care at Home Act H.R. 6365/S. 3559 - Immediate Relief for Rural Facilities Act H.R. 7255 - Coronavirus Health Care Worker Wellness Act S. 3741 - Health Care at Home Act S. 3750/H.R. 6837 - Medicare Accelerated and Advanced Payments Improvement Act H.R.133 - Consolidated Appropriations Act, 2021 Phase 4 COVID-19 relief legislation H. R. 8702 - Holding Providers Harmless from Medicare Cuts During COVID-19 Act Federal Incentive Programs COVID-Safely Returning to Work and School in the Fall COVID-PPE Shortages Mental Health Issues Health Care Disparities Cures 2.0 E/M Global Code Issues Unique Patient Identifier Lower Health Care Costs Act Compromise Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) MIPS Value Pathways (MVPs) Alternative Payment Models (APM) Outpatient Prospective Payment System (OPPS) Common Rule Medicare for All National Trauma Systems Legislation Drug Pricing Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioids/Pain Management Legislation ACS THRIVE (Transforming Health care Resources to Increase Value and Efficiency) Reauthorization of Patient-Centered Outcomes Research Institute (PCORI) 2020 CMS Proposed Fee Schedule Rare earth magnet legislation

Client expense: $308,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 116-127/H.R. 6201 - Families First Coronavirus Response Act H.R. 6365/S. 3559 - The Immediate Relief for Rural Facilities and Providers Act H.R. 748/S. 3548 - Coronavirus Aid, Relief, and Economic Security (CARES) Act H.R. 7059: Coronavirus Provider Protection Act S. 1895 - Lower Health Care Costs Act H.R. 5800 - Ban Surprise Billing Act H.R. 5826 - Consumer Protections Against Surprise Medical Bills Act H.R. 3630 - No Surprises Act H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668/H.R. 1570 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 2372 - VA MISSION Act of 2018 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 H.R. 3656/S. 1350 - ACCESS Act of 2019 H.R. 861 - End Surprise Billing Act H.R. 3630 - No Surprises Act H.R. 3502 - Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 - Lower Health Care Costs Act S. 967 - Reducing Costs for Out of Network Services Act S. 1266 - Protecting Patients from Surprise Medical Bills Act S. 1531 - Stopping the Outrageous Practice of Surprise Bills Act S. 1607 - Medical Billing Fairness Act H. R. - 1763/S. 348 - Resident's Physician Shortage Reduction Act S. 1350 - Good Samaritan Health Professionals Act H. R. 2689/S. 1438 - Breast Cancer Research Stamp reauthorization H.R. 4350/S. 3085 - Ambulatory Surgical Center Quality and Access Act of 2019 H.R. 5855 - Bipartisan Solution to Cyclical Violence Act of 2020 H.R. 6953 - Pandemic Responder Service Award Act H.R. 6644/S. 3741 - Telehealth legislation/The Health Care at Home Act H.R. 6365/S. 3559 - Immediate Relief for Rural Facilities Act H.R. 7255 - Coronavirus Health Care Worker Wellness Act S. 3741 - Health Care at Home Act S. 3750/H.R. 6837 - Medicare Accelerated and Advanced Payments Improvement Act H.R.133 - Consolidated Appropriations Act, 2021 Phase 4 COVID-19 relief legislation H. R. 8702 - Holding Providers Harmless from Medicare Cuts During COVID-19 Act Federal Incentive Programs COVID-Safely Returning to Work and School in the Fall COVID-PPE Shortages Mental Health Issues Health Care Disparities Cures 2.0 E/M Global Code Issues Unique Patient Identifier Lower Health Care Costs Act Compromise Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) MIPS Value Pathways (MVPs) Alternative Payment Models (APM) Outpatient Prospective Payment System (OPPS) Common Rule Medicare for All National Trauma Systems Legislation Drug Pricing Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioids/Pain Management Legislation ACS THRIVE (Transforming Health care Resources to Increase Value and Efficiency) Reauthorization of Patient-Centered Outcomes Research Institute (PCORI) 2020 CMS Proposed Fee Schedule Rare earth magnet legislation

Client expense: $308,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

Medicare policies related to access to and payment for post-acute care services, including the "Improving Seniors' Timely Access to Care Act of 2019 (H.R. 3107)", the "Coronavirus Preparedness and Response Supplemental (H.R. 6074)", the "Families First Coronavirus Response Act (H.R. 6201)", the "Coronavirus Aid, Relief and Economic Security Act (H.R. 748)", the "Health and Economic Recovery Omnibus Emergency Solutions Act (H.R. 6800, H.R 8406)", the "Paycheck Protection Program and Health Care Enhancement Act (H.R. 266)", the "Medicare Accelerated and Advance Payment Improvement Act (S. 3750, H.R. 6837)", the "Continuing Appropriations Act, 2021 and Other Extensions Act (H.R. 8337)", the "American Workers, Families and Employer Assistance Act (S.4318)", the "Further Continuing Appropriations Act, 2021 and Other Extensions Act (H.R. 8900)", the Further Additional Continuing Appropriations Act, 2021 (H.J. Res. 107)", the "Extension of Continuing Appropriations Act, 2021 (H.J.Res 110)", the Consolidated Appropriations Act, 2021 (H.R. 133)", the "Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020 (H.R. 8702, S. 5007)", H.R. 8505 related to Medicare outpatient payments and the "Resetting the IMPACT Act of 2020 (H.R. 8826)".

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitored Congressional Proposals concerning health price transparency. H.R. 1384 - "Medicare For All Act of 2019", S.1129 - "A bill to establish a Medicare-for-all national health insurance program" - Oppose legislation to impose single payer health care delivery. H.R. 2085/ S.1033 "Consumer Health Options and Insurance Competition Enhancement Act (CHOICE) Act", H.R. 2000/S.981 - "Medicare-X Choice Act of 2019" - Oppose legislation to impose a Medicare public option. H.R. 728/S.1399 - "Title VIII Nursing Workforce Re-authorization Act of 2019" - Support legislation to provide loan repayment for nurses to practice in any care setting. S. 1895 - "Lower Health Care Costs Act" - Support protecting patients from surprise billing and oppose government rate setting. Advocated for appropriate transparency and contracting flexibility. S.1531 "Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019", H.R. 3630 "No Surprises Act", H.R. 3502 "Protecting People From Surprise Medical Bills Act", H.R. 5800 Ban Surprise Billing Act, H.R. 5826 "Consumer Protections Against Surprise Medical Bills Act of 2020" - Advocate to protect patients from surprise billing and oppose government rate setting. H.R. 2328 "Community Health Investment, Modernization, and Excellence Act of 2019", H.R. 748 "Coronavirus Aid, Relief, and Economic Security Act" - Support re-authorization of National Quality Forum. H.R. 3417 "Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019" - Supported legislation. H.R. 748 Coronavirus Aid, Relief, and Economic Security (CARES) Act, H.R. 6837/ S. 3750 "Medicare Accelerated and Advance Payments Improvement Act of 2020", H.R. 266 "Paycheck Protection Program and Health Care Enhancement Act" - Advocated in support of funding and programs for hospitals and post-acute care providers to respond to COVID-19 H.R. 6800 "Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act" - Support expanded access and affordability of COBRA and other health insurance options H.R. 6365/ S. 3559 "Immediate Relief for Rural Facilities and Providers Act of 2020" - Support expansion of access to telehealth programs for tax paying rural hospitals H.R. 7059 "Coronavirus Provider Protection Act" - Evaluated and advocated for improvements to legislation Liability Protections - Develop proposal to protect hospitals, healthcare professionals and facilities from liability due to COVID-19 Provider Relief Fund Taxability - Support technical corrections to Provider Relief Fund to ensure funds received are not taxable

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

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

Issues related Texas v. Azar that would rule ACA unconstitutional; S 4230, Telehealth Expansion Act of 2020; S.3750/HR 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020; Issues related to evaluation and management (E&M) cuts contained in the CY2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule

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

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

Issue: Educate Congress and the administration on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. H.R. 6650, S. 3634, Health Heroes 2020 Act S. 4055, Strengthening Americas Health Care Readiness Act Issue: Support increased funding for the National Health Service Corps, and National Disaster Medical Service (NDMS) demonstration pilot. Issues: Educate Congress and the administration about academic medicines response to the opioid epidemic. Support funding for training on substance use disorders, pain management, and safe prescribing practices. Support suspension of DATA waivers. Support continuation of telehealth flexibilities allowing authorized practitioners to prescribe buprenorphine. P.L. 116-22, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 Issues: Support the Hospital Preparedness Program and the reauthorization of the Pandemic and All-Hazards Preparedness Act. Support increased funding authorization levels. Issue: Oppose burdensome regulation of Laboratory Developed Tests Issues: Support high-quality affordable health insurance. Support programs and funds for safety-net providers. Issue: Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, including instituting a moratorium, increasing reporting requirements on covered entities, and imposing user fees S. 1895, Lower Health Care Costs Act H.R. 3630, No Surprises Act S. 1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 H.R. 3502, Protecting People From Surprise Medical Bills Act Issues: Educate Congress on surprise medical bills and price disclosure. Support general principles for surprise medical bills draft legislation. Oppose statutory benchmark rate setting. Oppose Senate hospital/insurer contracting provisions and onerous reporting burden. S. 1895, Lower Health Care Costs Act, Title IV Issues: Prescription drug pricing, public health, maternal mortality, and health information technology. Issue: Support legislation providing stable and predictable funding for quality measurement activities carried out by the National Quality Forum Issue: Development of Enhanced Primary Care Pilot Act proposal Issue: Educate Congress about medical education on nutrition, consent, implicit bias, and maternal health. Issue: Oppose restrictions on diversity training for federal grantees and employees. Issue: Educate Congress on the structural racism and inherent biases that have created health inequities that impact minority communities and other marginalized groups, including the disproportionate impact of COVID-19 on communities of color. Issue: Support public health guidance for law enforcement regarding tactics to reduce the risk of coronavirus transmission, and to protect all personal and health data collected as part of the COVID-19 response. Issue: Support initiatives of hospitals to promote affordable housing in local communities and eliminate other social determinants of health to improve health equity. H.R. 6637, Health Equity and Accountability Act Issue: Support programs to improve health equity and address social determinants of health. H.R. 4004, S. 2986 Social Determinants Accelerator Act of 2019 Issue: Support grants to address social determinants of health Issue: Support congressional investment in the Centers for Medicare and Medicaid Innovation (CMMI) models to reduce maternal mortality and improve maternal health. S. 3750/H.R. 6837, Medicare Accelerated and Advance Payment Improvement Act of 2020 Issue: Support improvements to the Medicare Accelerated and Advance Payment Programs. Draft, firearm safety legislation Issue: Support universal background checks, violence prevention programs, extreme risks protection orders, child access safety laws, and reinstating assault weapons ban. H.R. 8, Bipartisan Background Checks Act of 2019 Issue: Support universal background checks Issue: Support aligning 42 CFR Part 2 regulations with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and healthcare operations. S. 4349/H.R. 8094, Dr. Lorna Breen Health Care Provider Protection Act Issue: Support grants directed at improving physician burnout and well-being. P.L. 116-123, Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 P.L. 116-127, Families First Coronavirus Response Act P.L. 116-136, Coronavirus Aid, Relief, and Economic Security Act (CARES) Act H.R.6379, Take Responsibility for Workers and Families Act H.R. 6800, the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Draft Health, Economic Assistance, Liability Protection and Schools (HEALS) Act S. 178 with Amendment No. 2652 HEALS Act S. 4322, Safely Back to School and Back to Work Act S. 178, Delivering Immediate Relief to Americas Families, Schools and Small Businesses Act H.R. 8406, The Heroes Act Issues: Support emergency supplemental funding and policies for federal agencies to support coronavirus preparedness, response, relief, and testing. Ensure access to research samples. Support funding for and provide recommendations for disbursement of provider relief fund. Support revised Medicare and Medicaid reimbursement policies and increased provider flexibility. Support improvements to the Medicare Accelerated and Advance Payment Programs. Support inclusion of Medicare-supported graduate medical education positions. Support an increase in the Federal Medicaid Assistance Program. Support for current telehealth waivers to be made permanent. Provide recommendations on personal protective equipment, testing, social distancing, clinical care, and other COVID related preparedness and response efforts of the federal government. Avoid imposing standards that would encourage depletion of scarce PPE and other resources. Support enhanced national COVID-19 data collection to better address health disparities. See other additions under BUD. Issue: Support extension of public health emergency declaration. Issue: Provide feedback on COVID-19 and pandemic response centers of excellence legislation. Issue: Urge establishment and implementation of robust national COVID-19 testing strategy and functional and transparent supply chain. Urge CDC to update testing guidelines. Issue: Describe medical education approach on womens health and support efforts to promote trauma-informed care. Issue: Support science and data driven approach to HHS decision making. Issue: Support CDC mission S 4248, HR 7618, COVID-19 Bias and Anti-Racism Training Act Issue: Support grant for anti-racism training in health professions programs. H.R. 8017, Mobile Options for Testing In Our Neighborhoods (MOTION) Act Issue: Support grants for mobile COVID-testing units. S. 4160, To enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes. Issue: Support protections for hospitals that participate in the 340B Drug Pricing Program to temporarily allow them to remain eligible for the program. H.R. 8283 S. 4421, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act Issue: Support for a temporary uniform licensing standard for all practitioners in all states throughout a national emergency.

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

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

Monitor issues related to healthcare costs, surprise billing, transparency; S. 1895, Lower Health Care Costs Act; S. 1531; Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019; H.R. 3630, No Surprises Act; H.R. 3502, Protecting People From Surprise Medical Bills Act; H.R. 861, End Surprise Billing Act of 2019; H.R. 1865, Consolidated Domestic and International Assistance Bill; H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act; Public Law 116-159; S. 4230, Telehealth Expansion Act of 2020; S. 3750/H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020; Issues related to evaluation and management (E&M) cuts contained in the CY2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Stark Law modernization; S. 966, The Medicare Care Coordination Improvement Act of 2019; H.R. 2282, The Medicare Care Coordination Improvement Act of 2019; Monitor implementation of section 603 of the Bipartisan Budget Act of 2015 and site neutral policies; Issues related to Advance Notice of Proposed Rulemaking (ANPR) on International Pricing Index (IPI) and Part B reforms; S. 1895, Lower Health Care Costs Act; S. 1531; Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019; H.R. 3630, No Surprises Act; H.R. 3502, Protecting People From Surprise Medical Bills Act; H.R. 861, End Surprise Billing Act of 2019; CMS proposed rule to modernize physician self-referral law (Stark); OIG proposed rule to modernize the anti-kickback statute; H.R. 925, The Heroes Act; H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act; Public Law 116-159; S. 4230, Telehealth Expansion Act of 2020; S. 3750/H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020; Issues related to evaluation and management (E&M) cuts contained in the CY2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicaid Fiscal Accountability Regulation Rural hospital policies; HHS Rural Action Plan Graduate Medical Education (GME) funding (S. 348/H.R. 1763, Resident Physician Shortage Reduction Act of 2019; H.R. 2349/H.R. 3414 Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts (H.R. 3022, Patient Access Protection Act; H.R. 748, CARES Act; H.R.8337, Continuing Appropriations Act, 2021 and Other Extensions Act) Medicare sequestration (H.R. 748, CARES Act) Federal Medical Assistance Percentage increase (H.R. 6201, Families First Coronavirus Response Act; H.R. 748, CARES Act; H.R. 6800; S. 4108, Coronavirus Medicaid Response Act) Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 3417 Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act; all coronavirus relief packages - H.R. 6074, H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800, HEALS Act, S. 4775; physician fee schedule proposed rule Medicare hospital accelerated payment program (coronavirus relief packages-H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800, HEALS Act, S. 4775; H.R. 6837/S. 3750, Medicare Accelerated and Advance Payments Improvement Act; H.R. 7292, COVID-19 Hospital and Health Provider Loan Forgiveness Act of 2020) Post-acute care flexibilities (coronavirus relief packages - H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800, HEALS Act, S. 4775) Stark law reform Site neutral payment policy included in outpatient prospective payment system rule (H.R.2552, Protecting Local Access to Care for Everyone Act of 2019) OPPS and physician fee schedule rules Interim Final Rule establishing a Medicare Condition of Participation for COVID-19 Data Reporting (Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments (CLIA), and Patient Protection and Affordable Care Act; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Stark Law modernization; S. 966, Medicare Care Coordination Improvement Act of 2019; H.R. 2282, Medicare Care Coordination Improvement Act of 2019; Monitor implementation of Section 603 of the Bipartisan Budget Act of 2015 and site neutral policies; Issues related to Advance Notice of Proposed Rulemaking (ANPR) on International Pricing Index (IPI) and Part B reforms; S. 1895, Lower Health Care Costs Act; H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act; S. 1531; Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019; H.R. 3630, No Surprises Act; H.R. 3502, Protecting People From Surprise Medical Bills Act; H.R. 861, End Surprise Billing Act of 2019; S. 668/H.R. 1570, Removing Barriers to Colorectal Cancer Screening Act of 2019; S. 2543, Prescription Drug Pricing Reduction Act of 2019; H.R. 925, The Heroes Act; H.R. 8337, Continuing Appropriations Act, 2021 and Other Extensions Act, Public Law 116-159; S 4230, Telehealth Expansion Act of 2020; S.3750/HR 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020; Issues related to evaluation and management (E&M) cuts contained in the CY2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 4230, Telehealth Expansion Act of 2020; S.3750/HR 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020; Issues related to evaluation and management (E&M) cuts contained in the CY2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

COVID-19 crisis - Engaged with Congress and the administration to advocate for greater regulatory flexibility and appropriate reimbursement for hospitals through development, passage and ongoing implementation of coronavirus relief legislation: HEROES Act (HR 6800) Heroes Act 2.0 (H.R. 925) Health, Economic Assistance, Liability Protection and Schools (HEALS) Act S. 178 Telehealth - Urged Congress and the administration to make permanent telehealth flexibilities related to distant site and geographic limitations, expanding provider types and services available to consumers and maintaining Medicare reimbursement parity. Accelerated and Advanced Payment Program - Advocated for Congress and the administration to offer forgiveness for accelerated and advanced payments during the COVID-19 public health emergency. Offered support for reduced interest rates, extended loan repayment period and reduced recoupment amounts (S. 3750/H.R. 6837/ H.R. 8337). Medicaid Disproportionate Share Hospital (DSH) Payments - Urged Congress to end implementation of Medicaid DSH payment cuts. Medicare Sequester - urged Congress to end ongoing Medicare sequestration reimbursement reductions. Site-neutral Payments - Urged Congress to end site-neutral payment reductions. Supported passage of the PLACE Act (H.R. 2552) which would reverse site-neutral payments cuts implemented by the Centers for Medicare and Medicaid Services. Price Transparency - Urged Congress and the administration to delay implementation of regulation requiring hospitals to post payor-specific pricing information for goods and services. Enhanced Federal Medical Assistance Percentage (FMAP) - Urged Congress to extend the increased Medicaid FMAP matching rate beyond the public health emergency and increase the enhanced percentage. Medicaid Fiscal Accountability Regulation - Urged CMS to withdraw the Medicaid Fiscal Accountability Regulation and advocated for Congress to rescind the proposal. COVID-19 Data Reporting Requirements for Hospitals - requested HHS ease burden of COVID-19 mandatory reporting requirements and clarify aspects of reporting. Resident Physician Shortage Reduction Act (S. 348) - Urged Congress to pass the Resident Physician Shortage Reduction Act.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, Treasury, Dept of

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

2020 Q3 Lobbying Report - July 1-Sept. 30 HCR Continuing Appropriations Act, 2021 and Other Extensions Act (H.R. 8319) Coronavirus response legislation (H.R. 6800; S. 1624, S. 4775) Healthcare Workforce Resilience Act (S. 3599/H.R. 6788) Conrad State 30 & Physician Access Act (H.R. 2895) Public Health and Social Services Emergency Fund (coronavirus relief packages H.R. 7010, H.R. 6800) Regulatory relief in light of coronavirus (all coronavirus relief packages - H.R. 6074; H.R. 6201; H.R. 748, H.R. 6800) Transparency (surprise medical bills; public posting of hospital charges; final price transparency rule; Transparency in Coverage Proposed Rule) Surprise medical billing (H.R. 5826; H.R. 3630; S. 1531) Liability relief (all coronavirus relief packages - H.R. 6800; S. 1624; S. 4775) 340B Drug Pricing Program Drug pricing policy and drug shortages MMM Public Health Emergency designation Medicaid Fiscal Accountability Regulation Rural hospital policies Graduate Medical Education (GME) funding (S. 348/H.R. 1763; Resident Physician Shortage Reduction Act of 2019; H.R. 2349/H.R. 3414 Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts (H.R. 3022; Patient Access Protection Act) Medicare sequestration Federal Medical Assistance Percentage increase (CARES Act, H.R. 6800) Telehealth flexibilities and payment (all coronavirus relief packages - H.R. 6800, S. 1624, S. 4775) Medicare hospital accelerated payment program (coronavirus relief packages; H.R. 8319; Medicare Accelerated and Advance Payments Improvement Act, H.R. 6836/S. 3750) Post-acute care flexibilities (coronavirus relief packages - H.R. 6800; S. 1624, S. 4775) Stark law reform Site neutral payment policy included in outpatient prospective payment system rule BUD FY 2021 Appropriations bills Submitted Comments CMS-1735-P, Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2021 Rates; Quality Reporting and Medicare and Medicaid Promoting Interoperability Programs Requirements for Eligible Hospitals and Critical Access Hospitals; Proposed Rule, Federal Register (Vol. 85, No. 104) May 29, 2020 CMS-1730-P, Medicare and Medicaid Programs; CY 2021 Home Health Prospective Payment System Update: Home Health Quality Reporting Requirements; and Home Infusion Therapy Services Requirements, Federal Register (Vol. 85, No.126), June 30, 2020

Client expense: $270,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

H.R. 5201, Telemental Health Expansion Act of 2019, provisions relating to 1834(m) of the Social Security Act; geographic and originating sites H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019, all provisions H.R. 7391, Protect Telehealth Access Act of 2020, all provisions H.R. 7233, KEEP Telehealth Options Act of 2020, all provisions H.R. 7663, Protecting Access to Post-COVID-19 Telehealth Act of 2020, all provisions S. 4375, Telehealth Modernization Act, all provisions H.R. 1301, Mental Health Telemedicine Expansion Act, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, all provisions H.R. 19, Lower Costs, More Cures Act of 2019, all provisions H.R. 3414, Opioid Workforce Act of 2019, all provisions H.R. 7791, Value in Health Care Act of 2020, all provisions H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019, all provisions H.R. 6379, Take Responsibility for Workers and Families Act, provisions related to Medicare and Medicaid H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020, all provisions S. 3750, Medicare Accelerated and Advance Payments Improvement Act of 2020, all provisions H.R. 7154, Outpatient Therapy Modernization and Stabilization Act, all provisions H.R. 6585, Equitable Data Collection and Disclosure on COVID-19 Act, all provisions H.R. 884, Medicare Mental Health Access Act, all provisions S. 2772, Medicare Mental Health Access Act, all provisions H.R. 945, Mental Health Access Improvement Act of 2019, all provisions H.R. 1763, Resident Physician Shortage Reduction Act of 2019, all provisions H.R. 6774, Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2020, all provisions H.R. 4004, Social Determinants Accelerator Act of 2019, all provisions H.R. 4996, Helping Medicaid Offer Maternity Services (MOMS) Act of 2020, all provisions H.R. 6090, Physician Shortage GME Cap Flex Act of 2020, all provisions H.R. 913, CLINICAL TREATMENT Act, all provisions H.R. 4932, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions S, 2741, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions Medicare program: P.L. 113-93 Protecting Access to Medicare Act (PAMA), provisions relating to imaging appropriate use criteria Medicare program: Sequester exemption Medicare program: Laboratory developed tests for COVID-19/coverage Medicare program: Medicare for All Medicare program: CY 2021 Medicare Physician Fee Schedule/E&M/Budget Neutrality Medicare program: Inpatient Rehab Facility/Prospective Payment System (IRF/PPS)/Scope issues Medicare program: Public Health Emergency/Scope and licensure waivers sunset Medicare program: Medicare Advanced Payment Program improvements Medicare program: Regulatory Relief/Advanced Alternative Payment Models (APMs)/Prior authorization and utilization management Medicare program: Merit-based Incentive Payment System (MIPS)/Quality/cost/improvement activity/interoperability Medicare program: Program integrity Medicare program: Interoperability and data blocking Medicare program: Quality Payment Program/physician burdens Medicare program: Health IT physician burdens Medicare program: Open Payments Medicare program: PECOS Enrollment/Revalidation Medicare program: Graduate Medical Education/cap flexibility Medicare program: Diabetes Prevention Program Medicare program: MACRA/Alternative Payment Model (APM) bonus payments Medicare program: MACRA/radiation oncology payments Medicare program: Accelerated and Advance Payment Program/physician relief Medicare and Medicaid programs: Medicare Provider Relief Fund extension Medicare and Medicaid programs: 21st Century Cures Act/health data and privacy Medicare and Medicaid program: Electronic health record (EHR) certification Medicare and Medicaid programs: P.L. 114-10 Medicare Access and CHIP Reauthorization Act (MACRA) Medicare and Medicaid programs: Accountable Care Organizations Medicare and Medicaid programs: Telehealth waivers Medicare and Medicaid programs: Qualifying APM Physician Thresholds Medicare and Medicaid programs: Opioid use disorder Medicare and Medicaid programs: Validated home blood pressure monitors/coverage Medicaid program: Federal Medical Assistance Percentages (FMAP) increases Medicaid program: Georgia's Section 1332 waiver

Client expense: $4,260,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Natl Institutes of Health (NIH), Office of Natl Drug Control Policy (NDCP), President of the U.S., SENATE, State, Dept of (DOS), U.S. Immigration & Customs Enforcement (ICE), Veterans Affairs, Dept of (VA), White House Office

H.R.7676/ S.4106 - "Health Care PRICE Transparency Act" - Oppose public disclosure of confidential hospital negotiated rates with payers H.R. 1384 - "Medicare For All Act of 2019", S.1129 - Oppose government-run national health insurance H.R. 2085/ S.1033 "Consumer Health Options and Insurance Competition Enhancement Act (CHOICE) Act", H.R. 2000/S.981 - "Medicare-X Choice Act of 2019" - Oppose public option S. 1895 - "Lower Health Care Costs Act" - Support protecting patients from surprise billing and oppose government rate setting. Advocated for appropriate transparency and contracting flexibility. S.1531 "Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019", H.R. 3630 "No Surprises Act", H.R. 3502 "Protecting People From Surprise Medical Bills Act", H.R. 5800 Ban Surprise Billing Act, H.R. 5826 "Consumer Protections Against Surprise Medical Bills Act of 2020" - Advocate to protect patients from surprise billing and oppose government rate setting. H.R. 6837/ S. 3750 "Medicare Accelerated and Advance Payments Improvement Act of 2020" - Support amended payment terms for eligible health care providers under the Medicare Accelerated and Advance Payments Program H.R. 6800 "Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act" - Support Division C, Health Provisions for Medicare and Medicaid that support health care providers and patients H.R. 6365/ S. 3559 "Immediate Relief for Rural Facilities and Providers Act of 2020" - Support expansion of access to telehealth programs for tax paying rural hospitals H.R. 7059 "Coronavirus Provider Protection Act" - Evaluated and advocated for improvements to legislation relating to liability protections during COVID-19 S. 4317 - "SAFE TO WORK Act" - Develop proposal to protect hospitals, healthcare professionals and facilities from liability due to COVID-19 H.R. 7819 / S. 4525 - " Eliminating the Provider Relief Fund Tax Penalties Act of 2020" - Support technical corrections to Provider Relief Fund to ensure funds received are not taxable H.R. 8337 - "Continuing Appropriations Act, 2021 and Other Extensions Act" - Support passage of continuing resolution, including language to improve repayment terms of Medicare Accelerated and Advance Payment Programs. H.R. 8061 - "Community Immunity During COVID-19 Act of 2020" - Support legislation that increases community access and awareness to vaccinations. S. 4421 - "The Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act" - Support legislation that provides temporary licensing reciprocity for health care professionals.

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

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

P.L. 116-123 - CORONAVIRUS PREPAREDNESS AND RESPONSE SUPPLEMENTAL APPROPRIATIONS ACT, 2020 (P.L. 116-123): Ensure primary care physicians have adequate supplies, finances to serve their patients, are eligible for loans, payment for telehealth services. P.L. 116-127 - The Families First Coronavirus Response Act: Support for small business and non-profits during COVID crisis. P.L. 116-136 - CARES Act: Ensure primary care physicians have adequate supplies, finances to serve their patients, are eligible for Small Business loans, payment for telehealth services. HR 2774; S 2783 - Primary Care Patient Protection Act: Create a primary care benefit in high deductible health plans. HR 2895/S. 948 - Conrad State 30 & Physician Access Act: Expand program, streamline eligibility. HR 6149/S. 4088 - Kids Access to Primary Care Act/Ensuing Access to Primary Care for Women and Children Act: Increase Medicaid payment rates for primary care. HR 6788/S. 3599 Healthcare workforce Resilience Act: recapture 15,000 unused employment-based physician immigrant visas from prior fiscal years to bolster physician workforce during COVID pandemic. HR 6837/S 3750: Medicare Accelerated and Advance Payments Improvement Act of 2020: Advanced payments to Medicare Part B providers. HR 7059 Coronavirus Provider Protection Act: targeted and limited liability protections for health care providers responding to COVID pandemic. HR 7663/S 4230 - Expansion of telehealth; Protecting Access to Post-COVID-19 Telehealth Act: Expansion of telehealth services for primary care; coverage and payment parity during PHE. H.R. 8061- Community Immunity During COVID-19 Act: Support grants to increase the rates of recommended immunizations. HR 8337 - Continuing Appropriations Act 2021 and Other Extensions Act: Extension of THCGMEs, Medicare Accelerated Payments. S. 4349 - Dr. Lorna Breen Provider Protection Act: Support the wellbeing of frontline physicians during COVID-19. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No. - Teaching Health Centers GME; Community Health Centers; National Health Service Corps; Special Diabetes Program; Special Diabetes Program for Indians: Increased funding, five-year reauthorization. No Bill No. - 501(c)(6) Non-Profits Relief: include emergency financial relief for 501(c)(6) organizations in COVID response legislation. No Bill No. - Emergency financial relief for primary care physicians: additional financial support for primary care clinicians to stabilize our nations primary care infrastructure. No Bill No. - Issues related to increase immunization utilization/distribution: Efforts to support children and adults securing needed immunizations.

Client expense: $1,257,804 · Firm income: Not reported

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

P.L. 116-123 - CORONAVIRUS PREPAREDNESS AND RESPONSE SUPPLEMENTAL APPROPRIATIONS ACT, 2020 (P.L. 116-123): Ensure primary care physicians have adequate supplies, finances to serve their patients, are eligible for loans, payment for telehealth services. P.L. 116-136 - CARES Act: Ensure primary care physicians have adequate supplies, finances to serve their patients, are eligible for Small Business loans, payment for telehealth services. HR 6149/S. 4088 - Kids Access to Primary Care Act/Ensuing Access to Primary Care for Women and Children Act: Increase Medicaid payment rates for primary care. HR 6837/S 3750: Medicare Accelerated and Advance Payments Improvement Act of 2020: Advanced payments to Medicare Part B providers. HR 7059 Coronavirus Provider Protection Act: targeted and limited liability protections for health care providers responding to COVID pandemic. HR 7663/S 4230 - Expansion of telehealth; Protecting Access to Post-COVID-19 Telehealth Act: Expansion of telehealth services for primary care; coverage and payment parity during PHE. Support grants to increase the rates of recommended immunizations. HR 8337 - Continuing Appropriations Act 2021 and Other Extensions Act: Extension of THCGMEs, Medicare Accelerated Payments. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC. No Bill No. - Medicare administrative flexibilities for physicians: Suspension of reporting requirements and administrative processes for Medicare physicians during PHE. No Bill No. - Issues related to increase immunization utilization/distribution: Efforts to support children and adults securing needed immunizations.

Client expense: $1,257,804 · Firm income: Not reported

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

Medicare policies related to access to and payment for post-acute care services, including the "Improving Seniors' Timely Access to Care Act of 2019 (H.R. 3107)", the "Coronavirus Preparedness and Response Supplemental (H.R. 6074)", the "Families First Coronavirus Response Act (H.R. 6201)", the "Coronavirus Aid, Relief and Economic Security Act (H.R. 748)", the "Health and Economic Recovery Omnibus Emergency Solutions Act (H.R. 6800, H.R 8406)", the "Paycheck Protection Program and Health Care Enhancement Act (H.R. 266)", the "Medicare Accelerated and Advance Payment Improvement Act (S. 3750, H.R. 6837)", the "Continuing Appropriations Act, 2021 and Other Extensions Act (H.R. 8337)", and the "American Workers, Families and Employer Assistance Act (S.4318)".

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Health Emergency designation Medicaid Fiscal Accountability Regulation Rural hospital policies Graduate Medical Education (GME) funding (S. 348/H.R. 1763; Resident Physician Shortage Reduction Act of 2019; H.R. 2349/H.R. 3414 Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts (H.R. 3022; Patient Access Protection Act) Medicare sequestration Federal Medical Assistance Percentage increase (CARES Act, H.R. 6800) Telehealth flexibilities and payment (all coronavirus relief packages - H.R. 6800, S. 1624, S. 4775, physician fee schedule proposed rule) Medicare hospital accelerated payment program (coronavirus relief packages; H.R. 8319; Medicare Accelerated and Advance Payments Improvement Act, H.R. 6836/S. 3750)) Post-acute care flexibilities (coronavirus relief packages - H.R. 6800; S. 1624, S. 4775) Stark law reform Site neutral payment policy included in outpatient prospective payment system rule OPPS, IPPS and physician fee schedule rules

Client expense: $190,000 · Firm income: Not reported

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

Medicaid Fiscal Accountability Regulation Rural hospital policies Graduate Medical Education (GME) funding (S. 348/H.R. 1763, Resident Physician Shortage Reduction Act of 2019; H.R. 2349/H.R. 3414 Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts (H.R. 3022, Patient Access Protection Act; H.R. 748, CARES Act) Medicare sequestration (H.R. 748, CARES Act) Federal Medical Assistance Percentage increase (H.R. 6201, Families First Coronavirus Response Act; H.R. 748, CARES Act, H.R. 6800; S. 4108, Coronavirus Medicaid Response Act) Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 3417 Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act; all coronavirus relief packages - H.R. 6074, H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800) Medicare hospital accelerated payment program (coronavirus relief packages-H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800; H.R. 6837/S. 3750, Medicare Accelerated and Advance Payments Improvement Act; H.R. 7292, COVID-19 Hospital and Health Provider Loan Forgiveness Act of 2020) Site neutral payment policy included in outpatient prospective payment system rule (H.R.2552, Protecting Local Access to Care for Everyone Act of 2019) OPPS and physician fee schedule rules

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 116-127/H.R. 6201 - Families First Coronavirus Response Act H.R. 6365/S. 3559 - The Immediate Relief for Rural Facilities and Providers Act H.R. 748/S. 3548 - Coronavirus Aid, Relief, and Economic Security (CARES) Act H.R. 7059: Coronavirus Provider Protection Act S. 1895 - Lower Health Care Costs Act H.R. 5800 - Ban Surprise Billing Act H.R. 5826 - Consumer Protections Against Surprise Medical Bills Act H.R. 3630 - No Surprises Act H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668/H.R. 1570 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 2372 - VA MISSION Act of 2018 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 H.R. 3656/S. 1350 - ACCESS Act of 2019 H.R. 861 - End Surprise Billing Act H.R. 3630 - No Surprises Act H.R. 3502 - Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 - Lower Health Care Costs Act S. 967 - Reducing Costs for Out of Network Services Act S. 1266 - Protecting Patients from Surprise Medical Bills Act S. 1531 - Stopping the Outrageous Practice of Surprise Bills Act S. 1607 - Medical Billing Fairness Act H. R. - 1763/S. 348 - Resident's Physician Shortage Reduction Act S. 1350 - Good Samaritan Health Professionals Act H. R. 2689/S. 1438 - Breast Cancer Research Stamp reauthorization H.R. 4350/S. 3085 - Ambulatory Surgical Center Quality and Access Act of 2019 H.R. 5855 - Bipartisan Solution to Cyclical Violence Act of 2020 H.R. 6953 - Pandemic Responder Service Award Act H.R. 6644/S. 3741 - Telehealth legislation/The Health Care at Home Act H.R. 6365/S. 3559 - Immediate Relief for Rural Facilities Act H.R. 7255 - Coronavirus Health Care Worker Wellness Act S. 3741 - Health Care at Home Act S. 3750/H.R. 6837 - Medicare Accelerated and Advanced Payments Improvement Act Phase 4 COVID-19 relief legislation Federal Incentive Programs COVID-Safely Returning to Work and School in the Fall COVID-PPE Shortages Mental Health Issues Health Care Disparities Cures 2.0 E/M Global Code Issues Unique Patient Identifier Lower Health Care Costs Act Compromise Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) MIPS Value Pathways (MVPs) Alternative Payment Models (APM) Outpatient Prospective Payment System (OPPS) Common Rule Medicare for All National Trauma Systems Legislation Drug Pricing Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioids/Pain Management Legislation ACS THRIVE (Transforming Health care Resources to Increase Value and Efficiency) Reauthorization of Patient-Centered Outcomes Research Institute (PCORI) 2020 CMS Proposed Fee Schedule Rare earth magnet legislation

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 116-127/H.R. 6201 - Families First Coronavirus Response Act H.R. 6365/S. 3559 - The Immediate Relief for Rural Facilities and Providers Act H.R. 748/S. 3548 - Coronavirus Aid, Relief, and Economic Security (CARES) Act H.R. 7059: Coronavirus Provider Protection Act S. 1895 - Lower Health Care Costs Act H.R. 5800 - Ban Surprise Billing Act H.R. 5826 - Consumer Protections Against Surprise Medical Bills Act H.R. 3630 - No Surprises Act H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668/H.R. 1570 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 2372 - VA MISSION Act of 2018 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 H.R. 3656/S. 1350 - ACCESS Act of 2019 H.R. 861 - End Surprise Billing Act H.R. 3630 - No Surprises Act H.R. 3502 - Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 - Lower Health Care Costs Act S. 967 - Reducing Costs for Out of Network Services Act S. 1266 - Protecting Patients from Surprise Medical Bills Act S. 1531 - Stopping the Outrageous Practice of Surprise Bills Act S. 1607 - Medical Billing Fairness Act H. R. - 1763/S. 348 - Resident's Physician Shortage Reduction Act S. 1350 - Good Samaritan Health Professionals Act H. R. 2689/S. 1438 - Breast Cancer Research Stamp reauthorization H.R. 4350/S. 3085 - Ambulatory Surgical Center Quality and Access Act of 2019 H.R. 5855 - Bipartisan Solution to Cyclical Violence Act of 2020 H.R. 6953 - Pandemic Responder Service Award Act H.R. 6644/S. 3741 - Telehealth legislation/The Health Care at Home Act H.R. 6365/S. 3559 - Immediate Relief for Rural Facilities Act H.R. 7255 - Coronavirus Health Care Worker Wellness Act S. 3741 - Health Care at Home Act S. 3750/H.R. 6837 - Medicare Accelerated and Advanced Payments Improvement Act Phase 4 COVID-19 relief legislation Federal Incentive Programs COVID-Safely Returning to Work and School in the Fall COVID-PPE Shortages Mental Health Issues Health Care Disparities Cures 2.0 E/M Global Code Issues Unique Patient Identifier Lower Health Care Costs Act Compromise Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) MIPS Value Pathways (MVPs) Alternative Payment Models (APM) Outpatient Prospective Payment System (OPPS) Common Rule Medicare for All National Trauma Systems Legislation Drug Pricing Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioids/Pain Management Legislation ACS THRIVE (Transforming Health care Resources to Increase Value and Efficiency) Reauthorization of Patient-Centered Outcomes Research Institute (PCORI) 2020 CMS Proposed Fee Schedule Rare earth magnet legislation

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 116-127/H.R. 6201 - Families First Coronavirus Response Act H.R. 6365/S. 3559 - The Immediate Relief for Rural Facilities and Providers Act H.R. 748/S. 3548 - Coronavirus Aid, Relief, and Economic Security (CARES) Act H.R. 7059: Coronavirus Provider Protection Act S. 1895 - Lower Health Care Costs Act H.R. 5800 - Ban Surprise Billing Act H.R. 5826 - Consumer Protections Against Surprise Medical Bills Act H.R. 3630 - No Surprises Act H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668/H.R. 1570 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 2372 - VA MISSION Act of 2018 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 H.R. 3656/S. 1350 - ACCESS Act of 2019 H.R. 861 - End Surprise Billing Act H.R. 3630 - No Surprises Act H.R. 3502 - Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 - Lower Health Care Costs Act S. 967 - Reducing Costs for Out of Network Services Act S. 1266 - Protecting Patients from Surprise Medical Bills Act S. 1531 - Stopping the Outrageous Practice of Surprise Bills Act S. 1607 - Medical Billing Fairness Act H. R. - 1763/S. 348 - Resident's Physician Shortage Reduction Act S. 1350 - Good Samaritan Health Professionals Act H. R. 2689/S. 1438 - Breast Cancer Research Stamp reauthorization H.R. 4350/S. 3085 - Ambulatory Surgical Center Quality and Access Act of 2019 H.R. 5855 - Bipartisan Solution to Cyclical Violence Act of 2020 H.R. 6953 - Pandemic Responder Service Award Act H.R. 6644/S. 3741 - Telehealth legislation/The Health Care at Home Act H.R. 6365/S. 3559 - Immediate Relief for Rural Facilities Act H.R. 7255 - Coronavirus Health Care Worker Wellness Act S. 3741 - Health Care at Home Act S. 3750/H.R. 6837 - Medicare Accelerated and Advanced Payments Improvement Act Phase 4 COVID-19 relief legislation Federal Incentive Programs COVID-Safely Returning to Work and School in the Fall COVID-PPE Shortages Mental Health Issues Health Care Disparities Cures 2.0 E/M Global Code Issues Unique Patient Identifier Lower Health Care Costs Act Compromise Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) MIPS Value Pathways (MVPs) Alternative Payment Models (APM) Outpatient Prospective Payment System (OPPS) Common Rule Medicare for All National Trauma Systems Legislation Drug Pricing Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioids/Pain Management Legislation ACS THRIVE (Transforming Health care Resources to Increase Value and Efficiency) Reauthorization of Patient-Centered Outcomes Research Institute (PCORI) 2020 CMS Proposed Fee Schedule Rare earth magnet legislation

Client expense: $260,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

PL 109-417 - Pandemic and All-Hazards Preparedness Act (PAHPA) PL 116-127/H.R. 6201 - Families First Coronavirus Response Act H.R. 6365/S. 3559 - The Immediate Relief for Rural Facilities and Providers Act H.R. 748/S. 3548 - Coronavirus Aid, Relief, and Economic Security (CARES) Act H.R. 7059: Coronavirus Provider Protection Act S. 1895 - Lower Health Care Costs Act H.R. 5800 - Ban Surprise Billing Act H.R. 5826 - Consumer Protections Against Surprise Medical Bills Act H.R. 3630 - No Surprises Act H. R. 8 - Bipartisan Background Checks Act of 2019 H. R. 1418 - Competitive Health Insurance Reform Act of 2019 S. 668/H.R. 1570 - Removing Barriers to Colorectal Cancer Screening Act of 2019 S. 966 - Medicare Care Coordination Improvement Act of 2019 S. 2372 - VA MISSION Act of 2018 S. 741/H. R. 1730 - Cancer Drug Parity Act of 2019 H. R. 1379 - Ensuring Lasting Smiles Act H. R. 207 - Stop the Violence Act of 2019 H. R. 1841 - Ensuring Access to General Surgery Act of 2019 (and Senate version reintroduction) H. R. 1041 - Critical Access Hospital Relief Act of 2019 H.R. 3656/S. 1350 - ACCESS Act of 2019 H.R. 861 - End Surprise Billing Act H.R. 3630 - No Surprises Act H.R. 3502 - Protecting People from Surprise Medical Bills Act H.R. 2550 - Prevent BLEEDing Act of 2019 H. R. 2143 - Promoting Integrity in Medicare Act of 2019 H. R. 3107 - Improving Seniors' Timely Access to Care Act of 2019 H. R. 1332 - Fair Care Act of 2019 H.R. 2464 - End the Cycle of Violence Act of 2019 S. 1895 - Lower Health Care Costs Act S. 967 - Reducing Costs for Out of Network Services Act S. 1266 - Protecting Patients from Surprise Medical Bills Act S. 1531 - Stopping the Outrageous Practice of Surprise Bills Act S. 1607 - Medical Billing Fairness Act H. R. - 1763/S. 348 - Resident's Physician Shortage Reduction Act S. 1350 - Good Samaritan Health Professionals Act H. R. 2689/S. 1438 - Breast Cancer Research Stamp reauthorization H.R. 4350/S. 3085 - Ambulatory Surgical Center Quality and Access Act of 2019 H.R. 5855 - Bipartisan Solution to Cyclical Violence Act of 2020 H.R. 6953 - Pandemic Responder Service Award Act H.R. 6644/S. 3741 - Telehealth legislation/The Health Care at Home Act H.R. 6365/S. 3559 - Immediate Relief for Rural Facilities Act H.R. 7255 - Coronavirus Health Care Worker Wellness Act S. 3741 - Health Care at Home Act S. 3750/H.R. 6837 - Medicare Accelerated and Advanced Payments Improvement Act Phase 4 COVID-19 relief legislation Federal Incentive Programs COVID-Safely Returning to Work and School in the Fall COVID-PPE Shortages Mental Health Issues Health Care Disparities Cures 2.0 E/M Global Code Issues Unique Patient Identifier Lower Health Care Costs Act Compromise Bleeding Control for the Injured (Stop The Bleed campaign) Qualified clinical data registry (QCDR) Firearms Safety and Research MACRA Implementation Merit-based Incentive Payment Systems (MIPS) MIPS Value Pathways (MVPs) Alternative Payment Models (APM) Outpatient Prospective Payment System (OPPS) Common Rule Medicare for All National Trauma Systems Legislation Drug Pricing Patient-Centered Outcomes Research Institute (PCORI) Measuring Surgical Quality Medicare Physician Reimbursement Cancer Research and Funding Trauma Research and Funding Opioids/Pain Management Legislation ACS THRIVE (Transforming Health care Resources to Increase Value and Efficiency) Reauthorization of Patient-Centered Outcomes Research Institute (PCORI) 2020 CMS Proposed Fee Schedule Rare earth magnet legislation

Client expense: $260,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Veterans Affairs, Dept of (VA)

Support modification to the Protecting Access to Medicare Act to afford clinicians maximum flexibility in the use of appropriate use criteria for advanced diagnostic imaging in the least administratively burdensome manner possible while meeting the intent of the law to ensure appropriate imaging through enhanced education of ordering professionals and support for clinicians in achieving high-value performance in the Merit-based Incentive Payment System and Alternative Payment Models (No specific legislation). Changes to Medicare Policies in Response to COVID-19 Pandemic - Temporarily revise existing Medicare payment policies, including providing physicians with a positive payment update; - Temporarily suspend participation in the Merit-based Incentive Payment System (MIPS) and prior authorization practices; - Suspend the mandatory Medicare sequestration cuts of two percent that are imposed on fee-for-service Medicare claim payments; - Allow Ambulatory Surgery Centers that accept triaged patients from hospital outpatient departments for essential medical procedures to be reimbursed at the hospital outpatient department rates to ensure that supply and personnel costs are covered; - Reinstate the Medicare Accelerated and Advance Payment Program and institute more flexible program terms, support the Medicare Accelerated and Advance Payments Improvement Act (H.R. 6837 / S. 3750); - Waive the requirement for real-time video with Medicare beneficiaries and equalize telehealth payments for telephone calls.

Client expense: Not reported · Firm income: $29,250

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitored Congressional Proposals concerning health price transparency. H.R. 1384 - "Medicare For All Act of 2019", S.1129 - "A bill to establish a Medicare-for-all national health insurance program" - Oppose legislation to impose single payer health care delivery. H.R. 2085/ S.1033 "Consumer Health Options and Insurance Competition Enhancement Act (CHOICE) Act", H.R. 2000/S.981 - "Medicare-X Choice Act of 2019" - Oppose legislation to impose a Medicare public option. H.R. 728/S.1399 - "Title VIII Nursing Workforce Re-authorization Act of 2019" - Support legislation to provide loan repayment for nurses to practice in any care setting. S. 1895 - "Lower Health Care Costs Act" - Support protecting patients from surprise billing and oppose government rate setting. Advocated for appropriate transparency and contracting flexibility. S.1531 "Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019", H.R. 3630 "No Surprises Act", H.R. 3502 "Protecting People From Surprise Medical Bills Act", H.R. 5800 Ban Surprise Billing Act, H.R. 5826 "Consumer Protections Against Surprise Medical Bills Act of 2020" - Advocate to protect patients from surprise billing and oppose government rate setting. H.R. 2328 "Community Health Investment, Modernization, and Excellence Act of 2019", H.R. 748 "Coronavirus Aid, Relief, and Economic Security Act" - Support re-authorization of National Quality Forum. H.R. 3417 "Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019" - Supported legislation. H.R. 748 Coronavirus Aid, Relief, and Economic Security (CARES) Act, H.R. 6837/ S. 3750 "Medicare Accelerated and Advance Payments Improvement Act of 2020", H.R. 266 "Paycheck Protection Program and Health Care Enhancement Act" - Advocated in support of funding and programs for hospitals and post-acute care providers to respond to COVID-19 H.R. 6800 "Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act" - Support expanded access and affordability of COBRA and other health insurance options H.R. 6365/ S. 3559 "Immediate Relief for Rural Facilities and Providers Act of 2020" - Support expansion of access to telehealth programs for tax paying rural hospitals H.R. 7059 "Coronavirus Provider Protection Act" - Evaluated and advocated for improvements to legislation Liability Protections - Develop proposal to protect hospitals, healthcare professionals and facilities from liability due to COVID-19 Provider Relief Fund Taxability - Support technical corrections to Provider Relief Fund to ensure funds received are not taxable

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

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

S. 3198 Suicide Prevention Act: Legislator inquiry/Expand suicide prevention grant pilot program to primary care physicians. S. 3599; HR 6788: Healthcare workforce Resilience Act: recapture 15,000 unused employment-based physician immigrant visas from prior fiscal years to bolster physician workforce during COVID pandemic. S 3750; HR 6837: Medicare Accelerated and Advance Payments Improvement Act of 2020: Advanced payments to medicare Part B providers. S. 4088; HR 6149: Ensuring Access to Primary Care for Women and Children Act; Kids Access to Primary Care Act: Increase Medicaid payment rates for primary care. HR 748 - CARES Act: Fund CHC & THCGME, promote telemedicine in primary care, set Medicaid at Medicare parity. HR 2774, S 2793 - Primary Care Patient Protection Act: create a primary care benefit in high deductible health plans. HR 2895 Conrad State 30 &Physician Access Act; expand program, streamlined eligibility. HR 6074 - Coronavirus Preparedness & Response Supplemental Act - Ensure adequate PPE, funding and loans, telehealth care payment. HR 6201 - Families First Coronavirus Response Act: Support for small business and non-profits during pandemic. HR 7059: Coronavirus Provider Protection Act: Targeted and limited liability protections for healthcare providers responding to COVID pandemic. HR 7158 Health Enterprise Zone: Legislator inquiry/Reducing health disparities in underserved areas. No Bill No: communication with CMS on the 2021 and 2022 Part C and D proposed rule; Medicare Advantage, price transparency. No Bill No: communication with CMS on rural maternal health; Improving rural maternal health. No Bill No: communication with CMS on Covid-19 policy changes; payment for telehealth changes. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC No Bill No. - Teaching Health Centers GME; Community Health Centers; National Health Service Corps; Special Diabetes Program; Special Diabetes Program for Indians; increased finding, five-year reauthorization. No Bill No. - 501(c)(6) Non-Profits Relief; include emergency financial relief for 501(c)(6) organizations in COVID response legislation. No Bill No.: Emergency Financial relief for Primary Care Physicians: additional financial support for primary care physicians; additional financial support for primary care clinicians to stabilize our nation's primary care infrastructure. No Bill No.: Expansion of telehealth: Protecting Access to post COVID -19 telehealth act: Expansion of telehealth services for primary care; coverage and payment parity during PHE. No Bill No.: DACA status during the Covid-19 National Emergency: Maintain work authorization for individuals currently in DACA status during the covid 19 national emergency. No Bill No. - CHC & National Health Service Corps reauthorization: Health care access, scholarships and medical student debt relief. No Bill No. - Administrative Simplification: Promote reduced administrative burden on family physicians of prior authorization, EMR.

Client expense: $908,864 · Firm income: Not reported

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

S. 3599; HR 6788: Healthcare workforce Resilience Act: recapture 15,000 unused employment-based physician immigrant visas from prior fiscal years to bolster physician workforce during COVID pandemic. S 3750; HR 6837: Medicare Accelerated and Advance Payments Improvement Act of 2020: Advanced payments to medicare Part B providers. S. 4088; HR 6149: Ensuring Access to Primary Care for Women and Children Act; Kids Access to Primary Care Act: Increase Medicaid payment rates for primary care. S. 7614 2021 Appropriations: AHRQ, HRSA, NHSC, Title VII, Title X, Medical Education, Rural Health,Telehealth, Medicare Accelerated and Advanced Payment Program, CDC. HR 748 - CARES Act: Fund CHC & THCGME, promote telemedicine in primary care, set Medicaid at Medicare parity. HR 6074 - Coronavirus Preparedness & Response Supplemental Act - Ensure adequate PPE, funding and loans, telehealth care payment. HR 7158 Health Enterprise Zone: Legislator inquiry/Reducing health disparities in underserved areas. No Bill No: communication with CMS on the 2021 and 2022 Part C and D proposed rule; Medicare Advantage, price transparency. No Bill No: communication with CMS on rural maternal health; Improving rural maternal health. No Bill No: communication with CMS on Covid-19 policy changes; payment for telehealth changes. No Bill No. - Congressional Primary Care Caucus: 116th Congress Membership in the bipartisan CPCC No Bill No.: Expansion of telehealth: Protecting Access to post COVID -19 telehealth act: Expansion of telehealth services for primary care; coverage and payment parity during PHE. No Bill No.: Medicare administrative flexibilities for physicians; Suspension of reporting requirements and administrative processes for Medicare physicians during PHE. No Bill No. - Graduate Medical Education: GME to support family medicine education and rural training. No Bill No.: Medicare rule to increase E/M: value comprehensive primary care appropriately. No Bill No. - Administrative Simplification: Promote reduced administrative burden on family physicians of prior authorization, EMR. No Bill No. - Telehealth: Increase audio-only telehealth payment to equal audio-visual telehealth and in person visitation reimbursements.

Client expense: $908,864 · Firm income: Not reported

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

Issue: Educate Congress and the administration on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. Issue: Support the reauthorization of the National Health Service Corps, Community Health Centers, and Teaching Health Centers mandatory appropriation funds. H.R. 6650, S. 3634, Health Heroes 2020 Act S. 4055, Strengthening Americas Health Care Readiness Act Issue: Support increased funding for the National Health Service Corps, and National Disaster Medical Service (NDMS) demonstration pilot. Issue: Support initiatives of hospitals to promote affordable housing in local communities and eliminate other social determinants of health to improve health equity. Issues: Educate Congress and the administration about academic medicines response to the opioid epidemic. Support funding for training on substance use disorders, pain management, and safe prescribing practices. Support suspension of DATA waivers. Support continuation of telehealth flexibilities allowing authorized practitioners to prescribe buprenorphine. P.L. 116-22, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 Issues: Support the Hospital Preparedness Program and the reauthorization of the Pandemic and All-Hazards Preparedness Act. Support increased funding authorization levels. Issues: Support high-quality affordable health insurance. Support programs and funds for safety-net providers. Issue: Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, including instituting a moratorium, increasing reporting requirements on covered entities, and imposing user fees H.R. 6102, S. 3404, Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2018 Issue: Oppose burdensome regulation of Laboratory Developed Tests S. 1895, Lower Health Care Costs Act H.R. 3630, No Surprises Act S. 1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 H.R. 3502, Protecting People From Surprise Medical Bills Act Issues: Educate Congress on surprise medical bills and price transparency. Support general principles for surprise medical bills draft legislation. Oppose statutory benchmark rate setting. Oppose Senate hospital/insurer contracting provisions and onerous reporting burden. S. 1895, Lower Health Care Costs Act, Title IV Issues: Prescription drug pricing, public health, maternal mortality, and health information technology. Issue: Support legislation providing stable and predictable funding for quality measurement activities carried out by the National Quality Forum Issue: Development of Enhanced Primary Care Pilot Act proposal Issue: Educate Congress about medical education on nutrition, consent, implicit bias, and maternal health. H.R. 6637, Health Equity and Accountability Act Issue: Support programs to improve health equity and address social determinants of health. H.R. 4004, S. 2986, Social Determinants Accelerator Act of 2019 Issue: Support grants to address social determinants of health Issue: Support congressional investment in the Centers for Medicare and Medicaid Innovation (CMMI) models to reduce maternal mortality and improve maternal health. S. 3750, H.R. 6837, Medicare Accelerated and Advance Payment Improvement Act of 2020 Issue: Support improvements to the Medicare Accelerated and Advance Payment Programs. Draft, firearm safety legislation Issue: Support universal background checks, violence prevention programs, extreme risks protection orders, child access safety laws, and reinstating assault weapons ban. H.R. 8, Bipartisan Background Checks Act of 2019 Issue: Support universal background checks Issue: Support aligning 42 CFR Part 2 regulations with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and healthcare operations. P.L. 116-123, Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 P.L. 116-127, Families First Coronavirus Response Act P.L. 116-136, Coronavirus Aid, Relief, and Economic Security Act (CARES) Act H.R.6379, Take Responsibility for Workers and Families Act H.R. 6800, Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act Issues: Support emergency supplemental funding and policies for federal agencies to support coronavirus preparedness, response, relief, and testing. Support funding for and provide recommendations for disbursement of provider relief fund. Support revised Medicare and Medicaid reimbursement policies and increased provider flexibility. Support improvements to the Medicare Accelerated and Advance Payment Programs. Support inclusion of Medicare-supported graduate medical education positions. Support an increase in the Federal Medicaid Assistance Program. Support protections for hospitals that participate in the 340B Drug Pricing Program to temporarily allow them to remain eligible for the program. Support for current telehealth waivers to be made permanent. Support for a temporary uniform licensing standard for all practitioners in all states throughout a national emergency. Provide recommendations on personal protective equipment, testing, social distancing, clinical care, and other COVID related preparedness and response efforts of the federal government. Avoid imposing standards that would encourage depletion of scarce PPE and other resources. Support enhanced national COVID-19 data collection to better address health disparities. See other additions under BUD. Issue: Support extension of public health emergency declaration. Issue: Urge establishment and implementation of robust national COVID-19 testing strategy and functional and transparent supply chain. Issue: Describe medical education approach on womens health and support efforts to promote trauma-informed care.

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

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

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

2020 Q2 Lobbying Report - April 1-June 30 HCR The Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (H.R. 6074) Families First Coronavirus Response Act (H.R. 6201) The Coronavirus Aid, Relief, and Economic Security Act (H.R. 748, S. 3548) Paycheck Protection Program Flexibility Act of 2020 (H.R. 7010) Health and Economic Recovery Omnibus Emergency Solutions Act (H.R. 6800) Public Health and Social Services Emergency Fund (coronavirus relief packages-H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800) Regulatory relief in light of coronavirus (all coronavirus relief packages - H.R. 6074, H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800) Hospital Price Transparency (surprise medical bills; public posting of hospital charges; Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First; Final Rule on Price Transparency; Transparency in Coverage Proposed Rule) Surprise Medical Bills (coronavirus relief packages-H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800) Liability relief (all coronavirus relief packages - H.R. 6074, H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800) Hospital preparedness program (H.R. 6074) 340B Drug Pricing Program Drug pricing policy and drug shortages MMM Medicaid Fiscal Accountability Regulation Rural hospital policies Graduate Medical Education (GME) funding (S. 348/H.R. 1763, Resident Physician Shortage Reduction Act of 2019; H.R. 2349/H.R. 3414 Opioid Workforce Act) Delay of Medicaid Disproportionate Share Hospital payment cuts (H.R. 3022, Patient Access Protection Act; H.R. 748, CARES Act) Medicare sequestration (H.R. 748, CARES Act) Federal Medical Assistance Percentage increase (H.R. 6201, Families First Coronavirus Response Act; H.R. 748, CARES Act, H.R. 6800; Telehealth payment (H.R. 1892, Bipartisan Budget Act of 2018; H.R. 6, SUPPORT for Patients and Communities Act; H.R. 3417 Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act; all coronavirus relief packages - H.R. 6074, H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800) Medicare hospital accelerated payment program (coronavirus relief packages-H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800; H.R. 6837/S. 3750, Medicare Accelerated and Advance Payments Improvement Act; H.R. 7292, COVID-19 Hospital and Health Provider Loan Forgiveness Act of 2020) Post-acute care flexibilities (coronavirus relief packages - H.R. 6201, H.R. 748, H.R. 7010, H.R. 6800) Stark law reform Site neutral payment policy included in outpatient prospective payment system rule (H.R.2552, Protecting Local Access to Care for Everyone Act of 2019) OPPS and physician fee schedule rules Critical Access Hospitals, H.R. 6693 BUD FY 2021 Appropriations bills Submitted Comments [CMS-5529-P] Medicare Program: Comprehensive Care for Joint Replacement Model Three-Year Extension and Changes to Episode Definition and Pricing [CMS-1729-P] Medicare Program: Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2021

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

H.R. 1301, Mental Health Telemedicine Expansion Act, all provisions H.R. 3417, Beneficiary Education Tools, Telehealth, and Extenders Reauthorization (BETTER) Act of 2019, all provisions H.R. 5201, Telemental Health Expansion Act of 2019, provisions relating to 1834(m) of the Social Security Act; geographic and originating sites H.R. 7233, To direct the Secretary of Health and Human Services and the Comptroller General of the United States to conduct studies and report to Congress on actions taken to expand access to telehealth services under the Medicare, Medicaid, and Children's Health Insurance programs during the COVID-19 emergency, all provisions H.R. 4996, Helping Medicaid Offer Maternity Services Act of 2019, all provisions H.R. 6837, Medicare Accelerated and Advance Payments Improvement Act of 2020, all provisions S. 3750, Medicare Accelerated and Advance Payments Improvement Act, all provisions H.R. 6585, Equitable Data Collection and Disclosure on COVID-19 Act, all provisions H.R. 19, Lower Costs, More Cures Act of 2019, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, all provisions H.R. 4004, Social Determinants Accelerator Act of 2019, all provisions H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019, all provisions H.R. 884, Medicare Mental Health Access Act, all provisions H.R. 4932, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions S. 2741, Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, all provisions H.R. 3414, Opioid Workforce Act of 2019, all provisions H.R. 5741, Strengthening Innovation in Medicare and Medicaid Act, all provisions Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act of 2020 Medicare program: Medicare for All Medicare program: Interoperability and data blocking Medicare program: Payment and delivery reform Medicare program: Accountable Care Organizations/COVID-19 Medicare program: Evaluation and Management (E&M)/Budget neutrality Medicare program: Graduate Medical Education (GME) Medicare program: Advanced Alternative Payment Models (APMs) Medicare program: Physician-focused APMs Medicare program: Prior Authorization/Utilization Management Medicare program: Scope of practice Medicare program: Inpatient Rehabilitation Facility (IRF) coverage Medicare program: Merit-based Incentive Payment System (MIPS) Medicare program: MIPS flexibility and hardship exemptions Medicare program: MIPS Value Pathways (MVPs) Medicare program: PECOS Enrollment/Revalidation Medicare program: Autopsy standard/condition of participation Medicare program: Benefit Category Definition (BCD)/power wheelchair features/DME Medicare program: MACRA Cost Measure Development Medicare program: Diabetes prevention Medicare program: Open Payments Medicare program: Accelerated and Advance Payment Program Medicare and Medicaid programs: Contract Year 2021 and 2022 Policy and Technical Changes Medicare and Medicaid programs: Medicare Access and CHIP Reauthorization Act (MACRA) implementation Medicare and Medicaid programs: Patient Protection and Affordable Care Act/interoperability/patient access for Medicare Advantage/Medicaid Managed Care/Exchanges Medicare and Medicaid programs: Health IT Certification program Medicare and Medicaid programs: Health data and privacy Medicare and Medicaid programs: Opioid legislation implementation Medicare and Medicaid programs: Telehealth waivers Medicare and Medicaid programs: COVID-19 laboratory developed tests/coverage Medicare and Medicaid programs: COVID-19/Payment policy changes/regulatory flexibilities Medicare and Medicaid programs: Public Health Services Emergency Funding/provider relief Medicaid program: Federal Medical Assistance Percentage (FMAP) Medicaid program: Child Health Insurance Program (CHIP) Medicaid program: Maternal health Medicaid program: Provider advance payments

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

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Bureau of Prisons (BOP), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Labor, Dept of (DOL), Office of Natl Drug Control Policy (NDCP), President of the U.S., SENATE, State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), Vice President of the U.S., White House Office

Monitored Congressional Proposals concerning health price transparency. H.R. 1384 - "Medicare For All Act of 2019", S.1129 - "A bill to establish a Medicare-for-all national health insurance program" - Oppose legislation to impose single payer health care delivery. H.R. 2085/ S.1033 "Consumer Health Options and Insurance Competition Enhancement Act (CHOICE) Act", H.R. 2000/S.981 - "Medicare-X Choice Act of 2019" - Oppose legislation to impose a Medicare public option. H.R. 728/S.1399 - "Title VIII Nursing Workforce Re-authorization Act of 2019" - Support legislation to provide loan repayment for nurses to practice in any care setting. S. 1895 - "Lower Health Care Costs Act" - Support protecting patients from surprise billing and oppose government rate setting. Advocated for appropriate transparency and contracting flexibility. S.1531 "Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019", H.R. 3630 "No Surprises Act", H.R. 3502 "Protecting People From Surprise Medical Bills Act", H.R. 5800 Ban Surprise Billing Act, H.R. 5826 "Consumer Protections Against Surprise Medical Bills Act of 2020" - Advocate to protect patients from surprise billing and oppose government rate setting. H.R. 2328 "Community Health Investment, Modernization, and Excellence Act of 2019", H.R. 748 "Coronavirus Aid, Relief, and Economic Security Act" - Support re-authorization of National Quality Forum. H.R. 3417 "Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019" - Supported legislation. H.R. 748 Coronavirus Aid, Relief, and Economic Security (CARES) Act, H.R. 6837/ S. 3750 "Medicare Accelerated and Advance Payments Improvement Act of 2020", H.R. 266 "Paycheck Protection Program and Health Care Enhancement Act" - Advocated in support of funding and programs for hospitals and post-acute care providers to respond to COVID-19 H.R. 6800 "Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act" - Support expanded access and affordability of COBRA and other health insurance options H.R. 6365/ S. 3559 "Immediate Relief for Rural Facilities and Providers Act of 2020" - Support expansion of access to telehealth programs for tax paying rural hospitals H.R. 7059 "Coronavirus Provider Protection Act" - Evaluated and advocated for improvements to legislation Liability Protections - Develop proposal to protect hospitals, healthcare professionals and facilities from liability due to COVID-19 Provider Relief Fund Taxability - Support technical corrections to Provider Relief Fund to ensure funds received are not taxable

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

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