Dr. Lorna Breen Health Care Provider Protection Act

Provider Relief Fund Deadline Extension Act (S. 2493/H.R. 4735) Infrastructure Investment and Jobs Act Build Back Better Act (H.R. 5376) Dr. Lorna Breen Health Care Provider Protection Act (S. 4349/H.R. 8094) Provider Relief Fund Improvement Act (H.R. 5963) Public Service Loan Forgiveness program/physician federal loan forgiveness Healthcare Workforce Resilience Act of 2021 Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Conrad State 30 & Physician Access Act Public Health and Social Services Emergency Fund Regulatory relief in light of coronavirus Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Leading Infrastructure for Tomorrows America Act/LIFT America Act (H.R. 1848) Rural America Health Corps Act (S. 924/H.R. 2130), Strengthening Americas Health Care Readiness Act (S. 54) Resident Physician Shortage Act (S. 834/H.R. 2256) OSHA rule on COVID-19 Healthcare Workplace Safety No Surprises Act regulations Rural health care innovation (PA Rural Health Model and Community Health Access and Rural Transformation Model (CHART) Coverage policy (H.R. 1976, Medicare for All) Social Determinants Accelerator Act (H.R. 2503) Public Health Emergency designation Executive Order on Promoting Competition in the American Economy COVID Data Reporting Vaccine mandate policy

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Build Back Better Act H.R 5376 (Reconciliation bill) Infrastructure Investment and Jobs Act H.R. 2638 (Infrastructure legislation) Dr. Lorna Breen Health Care Provider Protection Act S. 4349/HR 8094 Provider Relief Fund Deadline Extension Act S.2493/HR 4735 Provider Relief Fund Improvement Act H.R. 5963 Healthcare Workforce Resilience Act of 2021 Rural America Health Corps Act S.54 Maternal health: MOMMAs Act S. 411/HR 3407; Black Maternal Health Omnibus Act of 2021 S. 346/H.R. 959; Data to Save Moms Act S. 347/HR 925; IMPACT to Save Moms Act S 1675/HR 4387; Maternal Health Quality Improvement Act S. 1675/H.R. 4387 Conrad State 30 & Physician Access Reauthorization Act S. 1810/H.R. 3541 Public Health and Social Services Emergency Fund Regulatory relief in light of coronavirus Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Leading Infrastructure for Tomorrows America Act/LIFT America Act H.R. 1848 Rural Hospital Closure Relief Act H.R. 1639/S.644 Rural and Underserved Small Hospital Protection Act/RUSH Act (H.R. 1885) Rural America Health Corps Act (S. 924/H.R. 2130), Strengthening Americas Health Care Readiness Act (S. 54) Resident Physician Shortage Act (S. 834/H.R. 2256) Social Determinants Accelerator Act (H.R. 2503), Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act (S. 509) OSHA rule on COVID-19 Healthcare Workplace Safety Drug-price Transparency for Competition (DTC) Act (S. 2304) No Surprises Act regulations Protecting Providers Everywhere in America Act (S. 308/H.R. 1436) 340B legislation (S. 773 HR 3203) Childrens Mental Health Infrastructure Act H.R. 4945; Helping Kids Cope Act H.R. 4944; Child Suicide Prevention and Lethal Means Safety Act H.R. 5035

Client expense: $180,000 · Firm income: Not reported

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

12-Month Continuous Eligibility for Children in Medicaid/CHIP Easy Enrollment in Health Care Act of 2021 Provider Relief Fund Reporting Requirements Accelerating Kids Access to Care Act (H.R. 3089/S. 1544) Connect for Health Act of 2021 Medicaid Payment Parity Coronavirus Medicaid Response Act (S. 4108) H.R. 2347, Strengthening the Vaccines for Children program Act HR 1025, the Kids Access to Primary Care Act S. 1833 The Ensuring Access to Primary Care for Women and Children Act of 2021 Medicaid Maintenance of Effort (MOE) Protections Comprehensive Access to Robust Insurance Now Guaranteed (CARING) for Kids Act (H.R.66) H.R. 1791 Childrens Health Insurance Program Permanency (CHIPP) Act Stabilize Medicaid and CHIP Coverage Act (H.R. 1738) Permanent CHIP Funding Extension Permanent Extension of Express Lane Eligibility Option Pediatrics Home and Community-Based Services (HCBS) in Medicaid Medicaid Reentry Act Accelerating Kids Access to Care Act Expanding Medicaid HCBS Services for Children Maternal Health H.R. 4996 Helping Moms Act H.R.4995 - Maternal Health Quality Improvement Act of 2020 Postpartum Medicaid Extension and Maternal Health Improvements Closing the Medicaid Coverage Gap Increased Funding for Childrens Hospitals Graduate Medical Education Allow for the home and other secure locations as originating (patient) and distant (provider) sites in telehealth Waive telehealth cost-sharing for patients in telehealth Pay for telehealth care visits at parity with that of in-person visits Allow telehealth care for both new and established patients Including Preventive Medicine Service Codes to be Eligible for Telehealth Increased Access To Broadband to Expand Telehealth Services Financial Relief to Medicaid Providers Financial Relief for Pediatricians Provider Relief Fund COVID-19 Response Medicaid/CHIP Eligibility Redeterminations post PHE Build Back Better Act FY22 National Defense Authorization Act: Stopping Proposals to Reduce Military Medical Personnel Billets Changes to the Defense Health Agency TRICARE Autism Care Demonstration Home- and Community-Based Services for Children (Better Care Better Jobs Act and Build Back Better Plan) Immunizations: Strengthening the Vaccines for Children Program Act (HR 2347/S 2691and Ensuring Availability of COVID-19 Vaccines for Children Newborn Screening Saves Lives Reauthorization Act (HR 482) NURSE Act (HR 3166/S 1602) FY 22 Appropriations Gun violence prevention research funding Firearm safety (H.R. 5035) Child passenger safety COVID-19 pandemic response for AI/AN communities Maternal, Infant, and Early Childhood Home Visiting Program funding Infant sleep product safety (S. 1259, H.R. 3182) Lead exposure prevention Food safety Paid family and medical leave, Building an Economy for Families Act, Build Back Better Act Climate change Vehicle emissions standards Button battery ingestions (H.R. 5313) Early childhood education Drowning prevention Pesticide regulation Federal Indian Boarding School Program Furniture tip-overs (S. 441, H.R. 1314) Child Abuse Prevention and Treatment Act reauthorization, CAPTA Reauthorization Act of 2021 CAPTA Plans of safe care grants Family First Prevention Services Act implementation Issues related to the COVID-19 pandemic and providing supports for the child welfare community CAPTA Fatalities Prevention and Response Title IV-B Reauthorization Ensuring Medicaid continuity for Children in Foster Care Act (S. 2689/H.R. 5414) Congregate care reform Mental health supports for foster youth/former foster youth Tobacco Tax Equity Act Regulation of E-Cigarettes (premarket review, synthetic nicotine) Federal cannabis policy Title X Family Planning Program Pediatric Subspecialty Loan Repayment Program Fiscal Year (FY) 2022 appropriations Kids Internet Design Safety Act Standards in CBP Custody Standards in ICE Family Detention Standards in ORR Custody Licensure of ORR Shelters Emergency Intake Sites Public Charge Child Nutrition Reauthorization/WIC SNAP Mental Health for Children H.R. 6, DREAM Act Family Separation and Detention Medical Nutrition Equity Act Lift the Bar Act CARE for Families Act HR 3107 WIC Act Keep Families Together Act Breastfeeding Peer Counseling Program Public Health Preparedness and Response Research for Pregnant and Lactating Women Funding for Pediatric Device Consortia Funding for Emergency Medical Services for Children Program HRSA Pediatric Mental Health Care Access Program PUMP Act Dietary Guidelines Child Poverty Coronavirus Response Legislation Asylum Child Poverty Reduction Act Suicide Prevention Dr Lorna Breen Health Care Provider Protection Act S. 4349 CBP Medical Services Contract Child Nutrition Waivers School Meal Standards Universal School Meals Eviction Moratorium Equality Act Mental Health Services for Students Act Medicaid Bump Act Youth Mental Health and Suicide Prevention Act Child Tax Credit Comprehensive Mental Health in Schools Pilot Program Appropriations - global child and youth-focused global health subaccounts (Vulnerable Children, Maternal and Child Health, Nutrition, WASH) Global Child Thrive Act Implementation Strengthening Efforts to End Violence Against Children Act of 2021 (not yet introduced) Reach Every Mother and Child Act of 2021 (S. 1451)

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

Government targets: Administration for Children & Families (ACF), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Product Safety Commission (CPSC), Defense, Dept of (DOD), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Indian Health Service, Interior, Dept of (DOI), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, U.S. Agency for International Development (USAID), U.S. Customs & Border Protection, U.S. Immigration & Customs Enforcement (ICE)

Build Back Better Act H.R 5376 (Reconciliation bill) Infrastructure Investment and Jobs Act H.R. 2638 (Infrastructure legislation) Dr. Lorna Breen Health Care Provider Protection Act S. 4349/HR 8094 Provider Relief Fund Deadline Extension Act S.2493/HR 4735 Healthcare Workforce Resilience Act of 2021 Rural America Health Corps Act S.54 Maternal health: Black Maternal Health Omnibus Act of 2021 S. 346/H.R. 959; Data to Save Moms Act S. 347/HR 925; IMPACT to Save Moms Act S 1675/HR 4387; Maternal Health Quality Improvement Act S. 1675/H.R. 4387 Conrad State 30 & Physician Access Reauthorization Act S. 1810/H.R. 3541 Public Health and Social Services Emergency Fund Regulatory relief in light of coronavirus Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Leading Infrastructure for Tomorrows America Act/LIFT America Act H.R. 1848 Rural Hospital Closure Relief Act H.R. 1639/S.644 Rural and Underserved Small Hospital Protection Act/RUSH Act (H.R. 1885) Rural America Health Corps Act (S. 924/H.R. 2130), Strengthening Americas Health Care Readiness Act (S. 54) Resident Physician Shortage Act (S. 834/H.R. 2256) Social Determinants Accelerator Act (H.R. 2503), Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act (S. 509) OSHA rule on COVID-19 Healthcare Workplace Safety Drug-price Transparency for Competition (DTC) Act (S. 2304) No Surprises Act regulations Protecting Providers Everywhere in America Act (S. 308/H.R. 1436) 340B legislation: S. 773 HR 3203

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

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

Coronavirus Medicaid Response Act (S. 4108) H.R. 2347, Strengthening the Vaccines for Children program Act HR 1025, the Kids' Access to Primary Care Act S. 1833 The Ensuring Access to Primary Care for Women and Children Act of 2021 Medicaid Maintenance of Effort (MOE) Protections Comprehensive Access to Robust Insurance Now Guaranteed (CARING) for Kids Act (H.R.66) H.R. 1791 Childrens Health Insurance Program Permanency (CHIPP) Act Stabilize Medicaid and CHIP Coverage Act (H.R. 1738) Legislation to remove opt-out for mothers and newborns benefits Expanded Coverage for Foster Youth Act Mandatory Pediatrics Home and Community-Based Services (HCBS) in Medicaid American Rescue Plan Accelerating Kids Access to Care Act Expanding Medicaid HCBS Services for Children Maternal Health H.R. 4996 Helping Moms Act H.R.4995 - Maternal Health Quality Improvement Act of 2020 Expanding Medicaid to 12 Months Post-Partum Medicaid Premiums and Cost Sharing Expanding the use of Telehealth in Medicaid/CHIP/Private Insurance Allow for the home and other secure locations as originating (patient) and distant (provider) sites in telehealth Waive telehealth cost-sharing for patients in telehealth Pay for telehealth care visits at parity with that of in-person visits Allow telehealth care for both new and established patients Including Preventive Medicine Service Codes to be Eligible for Telehealth Increased Access To Broadband to Expand Telehealth Services Financial Relief to Medicaid Providers Financial Relief for Pediatricians Provider Relief Fund COVID-19 Response FY22 Labor, Health and Human Services, and Education Appropriations Bill: Pediatric Mental Health Care Access Program, Pediatric Subspecialty Loan Repayment Program, Sudden Unexpected Infant Death and Sudden Unexpected Death in Childhood, Firearm Injury and Mortality Prevention Research, National Center for Birth Defects and Developmental Disabilities, Global Immunization, VACCINES Act, Emergency Medical Services for Children FY22 Agriculture-FDA Appropriations Bill: Pediatric Device Consortia, USDA Dietary Guidelines, WIC Breastfeeding Peer Counselor Program Immunizations: Strengthening the Vaccines for Children Program Act, Immunization Infrastructure Modernization Act, COVID-19 Vaccines for Adolescents Protecting Our Students in Schools Act Hallways to Health Care Act Changes to the Defense Health Agency TRICARE Autism Care Demonstration FY22 National Defense Authorization Act: Stopping Proposals to Reduce Military Medical Personnel Billets Home- and Community-Based Services for Children SSI Restoration Act of 2021 and Improvements to the Supplemental Security Income Program Promoting Physical Activity for Americans Act and Reducing Inequities in Physical Activity and Youth Sports Keeping All Students Safe Act Federal funding for education to help schools address the COVID-19 pandemic Newborn Screening Saves Lives Reauthorization Act Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET) NURSE Act Standards in CBP Custody Standards in ICE Family Detention Standards in ORR Custody Emergency Intake Sites Public Charge Child Nutrition Reauthorization/WIC SNAP Mental Health for Children H.R. 6, DREAM Act Family Separation and Detention Medical Nutrition Equity Act CARE for Families Act HR 3107 WIC Act Keep Families Together Act Breastfeeding Peer Counseling Program Public Health Preparedness and Response Research for Pregnant and Lactating Women Funding for Pediatric Device Consortia Funding for Emergency Medical Services for Children Program HRSA Pediatric Mental Health Care Access Program Palliative Care and Hospice Education and Training Act (S. 2080) PUMP Act Dietary Guidelines Child Poverty HEROES Act Coronavirus Response Legislation Asylum Child Poverty Reduction Act Suicide Prevention Dr Lorna Breen Health Care Provider Protection Act S. 4349 CBP Medical Services Contract Child Nutrition Waivers School Meal Standards Universal School Meals Eviction Moratorium Equality Act Mental Health Services for Students Act Medicaid Bump Act Youth Mental Health and Suicide Prevention Act Child Tax Credit Gun violence prevention research funding Child product safety Child passenger safety COVID-19 pandemic response for AI/AN communities Maternal, Infant, and Early Childhood Home Visiting Program funding Infant sleep product safety (S. 1259, H.R. 3182) Lead exposure prevention Regulation of air pollutants Food safety Paid family and medical leave Climate change IHS funding Child Abuse Prevention and Treatment Act reauthorization CAPTA Plans of safe care grants Family First Prevention Services Act implementation Issues related to the COVID-19 pandemic and providing supports for the child welfare community CAPTA Fatalities Prevention and Response Title IV-B Reauthorization Funding for Scarletts Sunshine for Unexpected Death Data Act Furniture tipovers Consolidated Appropriations Act Global Child Thrive Act Implementation Strengthening Efforts to End Violence Against Children Act of 2021 (not yet introduced) Reach Every Mother and Child Act of 2021 (S. 1451) Support UNFPA Funding Act (H.R. 3938) USAID Maternal and Child Health financing FY 2022 Appropriations for Pediatric Subspecialty Loan Repayment Program  FY 2022 Appropriations for Eunice Kennedy Shriver National Institute of Child Health and Human Development FY 2022 Appropriations for Environmental-influences on Child Health Outcomes Program (NIH) Healthcare Workforce Resilience Act (H.R. 2255/S. 1024) Women's Health Protection Act (H.R. 3755/S. 1975) Prohibition of Menthol Cigarettes

Client expense: $370,000 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Product Safety Commission (CPSC), Defense, Dept of (DOD), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Indian Health Service, Labor, Dept of (DOL), Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Natl Security Council (NSC), Occupational Safety & Health Administration (OSHA), SENATE, Transportation, Dept of (DOT), U.S. Agency for International Development (USAID), U.S. Customs & Border Protection, U.S. Immigration & Customs Enforcement (ICE)

12-Month Continuous Medicaid/CHIP Eligibility Medicaid Work Requirements Medicaid Block Grants Medicaid Per Capita Caps Section 1115 Medicaid Waivers Medicaid Payment Parity Coronavirus Medicaid Response Act (S. 4108) H.R. 2347, Strengthening the Vaccines for Children program Act HR 1025, the Kids Access to Primary Care Act Medicaid Maintenance of Effort (MOE) Protections Comprehensive Access to Robust Insurance Now Guaranteed (CARING) for Kids Act (H.R.66) Stabilize Medicaid and CHIP Coverage Act (H.R. 1738) American Rescue Plan Accelerating Kids Access to Care Act Expanding Medicaid HCBS Services for Children Maternal Health H.R. 4996 Helping Moms Act H.R.4995 - Maternal Health Quality Improvement Act of 2020 Expanding Medicaid to 12 Months Post-Partum Medicaid Premiums and Cost Sharing Expanding the use of Telehealth in Medicaid/CHIP/Private Insurance Allow for the home and other secure locations as originating (patient) and distant (provider) sites in telehealth Waive telehealth cost-sharing for patients in telehealth Pay for telehealth care visits at parity with that of in-person visits Allow telehealth care for both new and established patients Including Preventive Medicine Service Codes to be Eligible for Telehealth Increased Access To Broadband to Expand Telehealth Services Financial Relief to Medicaid Providers Financial Relief for Pediatricians Provider Relief Fund Expanding Provider Relief Fund Eligibility to Those Pediatricians Who Received a Small Medicare Allotment COVID-19 Response Fully implementing the 2021 outpatient E/M changes. Immediately implement the vaccine administration payment increases proposed in the 2021 MPFS. FY2021 Labor, Health and Human Services, and Education Appropriations: Pediatric Subspecialty Loan Repayment, Firearm Injury and Mortality Prevention Research, Pediatric Mental Health Care Access, Scarletts Sunshine Act Grants, Emergency Medical Services for Children, National Center for Birth Defects and Developmental Disabilities, Pediatric Disaster Care Pilot Program, CDC Global Immunization, Reducing Underage Drinking Through Screening and Brief Intervention FY2021 Agriculture, FDA, and Rural Development Appropriations: USDA Implementation of 2020 Dietary Guidelines, Pediatric Device Consortia, WIC Breastfeeding Peer Counseling Program Strengthening the Vaccines for Children Program Act of 2021 VACCINES Act Community Immunity During COVID-19 Act FY 2021 National Defense Authorization Act: Prohibiting proposed reductions of military medical personnel Alice Cogswell and Anne Sullivan Macy Act Public Health Infrastructure Saves Lives Act American Rescue Plan Act, including funding to help schools safely reopen and respond to COVID-19 and dedicated funding for school nurses Urging prioritization of pediatric clinical trials for COVID-19 vaccines Newborn Screening Saves Lives Reauthorization Act Standards in CBP Custody Standards in ICE Family Detention Standards in ORR Custody Emergency Intake Sites Public Charge Child Nutrition Reauthorization/WIC SNAP Mental Health for Children H.R. 6, DREAM Act Family Separation and Detention CARE for Families Act HR 3107 WIC Act Keep Families Together Act Breastfeeding Peer Counseling Program Public Health Preparedness and Response Research for Pregnant and Lactating Women Funding for Pediatric Device Consortia Funding for Emergency Medical Services for Children Program HRSA Pediatric Mental Health Care Access Program Palliative Care and Hospice Education and Training Act (S. 2080) PUMP Act Dietary Guidelines Child Poverty HEROES Act Coronavirus Response Legislation Asylum Child Poverty Reduction Act Suicide Prevention Dr Lorna Breen Health Care Provider Protection Act S. 4349 CBP Medical Services Contract Child Nutrition Waivers School Meal Standards Universal School Meals Eviction Moratorium Equality Act Mental Health Services for Students Act

Client expense: $200,000 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Product Safety Commission (CPSC), Defense, Dept of (DOD), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Indian Health Service, Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, U.S. Customs & Border Protection, U.S. Immigration & Customs Enforcement (ICE)

S.3548, CARES Act: To provide emergency assistance and health care response for individuals, families, and businesses affected by the 2020 coronavirus pandemic; Practice Support/Grants to Practice S.3599, Healthcare Workforce Resilience Act: Foreign physician immigration status H.R. 7059, Coronavirus Provider Protection Act: Liability protection for healthcare providers Public Law No: 116-142, Paycheck Protection Program Flexibility Act of 2020 S.3201, Temporary Reauthorization and Study of the Emergency Scheduling of Fentanyl Analogues Act: Letter to Congressional Leadership regarding Fentanyl S.2723, Mitigating Emergency Drug Shortages Act: reducing drug shortages H.R. 3502, Protecting People From Surprise Medical Bills Act: Surprise Medical Bills H.R. 2500, National Defense Authorization Act for Fiscal Year 2020: Krishnamoorthi amdt on drug shortages H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019: pre-authorization S. 1895, Lower Health Care Costs Act H.R. 3692, Addiction Treatment Access Improvement Act of 2017: Medically assisted treatment; opioids H.R. 5761, Ending Maternal Mortality Act of 2018: Maternal mortality H.R. 5718, Perioperative Reduction of Opioids Act: Opioids H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S. 2516, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S.2680, Opioid Crisis Response Act of 2018: Medically assisted treatment; opioids S.2456, CARA 2.0 Act of 2018: Medically assisted treatment; opioids H.R. 1565, Saving Lives, Saving Costs S.1475, Saving Lives, Saving Costs S.4349, Dr. Lorna Breen Health Care Provider Protection Act: physician health Comprehensive Addiction and Recovery Act of 2016 (PL 114-198) FY 2021 LHHS Appropriations: Fiscal Year 2021 Appropriations for Subcommittee on Labor, Health and Human Services Outside Witness Testimony Affordable Care Act reform efforts H.R. 1628, American Health Care Act of 2017 S. Amdt. 1030 to H.R. 1628, "Graham-Cassidy" Better Care Reconciliation Act of 2017 H.R. 1492, Medical Controlled Substances Transportation Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 3545, Overdose Prevention and Patient Safety Act H.R. 3446, Restoring Board Immunity Act of 2017: Professional Licensing S.2260, Opioids and STOP Pain Initiative ACT:opioids 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care H.R.3928, Truth in Healthcare Marketing Act of 2017 H.R. 1554, REDI Act: student loan debt repayment for residents H.R.842, Protecting the Right to Organize Act of 2021: PRO Act, labor protections 21st Century Cures Initiative Drug Shortages - FDA, DEA, HHS, CMS, GAO, House Energy and Commerce Committee, Senate HELP Committee DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee FDA SMART TOTS - pediatric anesthesia research USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Sequestration Opioids and opioid abuse; Brain health Certified Anesthesiologist Assistants Blood management COVID-19: Increased supply of PPE and ventilators, Funding for physician practices impacted by the cancellation of elective surgeries, unique role of anesthesiologists in responding to COVID-19 pandemic, medical liability, Scope of Practice (Waiver of federal supervision requirement under the Emergency Declaration), insurance moratorium; COVID Update Memorandum 4/21/20 Centre for Clinical and Applied Services Provision Research

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Health Insurance Coverage (general); Health Disparities (general); Breastfeeding (general); Assisted Reproductive Technology (general); Smoking Cessation (general); Substance Use Disorder (general); Gynecologic Cancer (general); Gynecologic Devices (general); Reproductive Health (general); Intimate Partner Violence (general); Gun Violence (general); Immunization (general); Breast Cancer (general); Medical Liability Reform (general); Health IT (general); Patient-Physician Relationship (general); Child Welfare (general); Prematurity (general); Maternal Mortality and Morbidity (general); Graduate Medical Education (general); Contraception (general); Abortion (general); Indian Health (general); Teaching Health Centers Graduate Medical Education (general); Community Health Centers (general); National Health Service Corps (general); Special Diabetes Program (general); Special Diabetes Program for Indians (general); Sexuality Education (general); Teen Pregnancy Prevention Program (general); Personal Responsibility Education Program (general); Research in Pregnant and Breastfeeding Women (general); Health Care Reform (general); Title X Family Planning Program (general); Womens Preventive Services (general); Administrative Burden (general); Surprise Billing (general); Pediatric Loan Repayment Program (general); COVID-19 Response (general); Personal Protective Equipment (general); Risk Evaluation and Mitigation Strategies (general); Data Collection (general); Health Equity (general); Pregnancy Risk Assessment Monitoring System (CDC); Provider Relief Fund (general); Maternal Mental Health (general); Violence Against Women Act (general); Secretarys Advisory Committee on Infant Mortality (general); H.R. 2975/S. 1645, Womens Health Protection Act; S. 1895, Lower Health Care Costs Act; H.R. 2862/S. 1619, VACCINES Act; implementation of P.L. 115-344, Preventing Maternal Deaths Act; implementation of P.L. 115-320, Improving Access to Maternity Care Act; S. 2586, Maternal Outcomes Matter Act; HR 3630, No Surprises Act; HR 3502, Protecting People From Surprise Medical Bills Act; H.R. 4495, Maternal Health Quality Improvement Act of 2019; H.R. 5640/S. 3152, the Data Mapping to Save Moms Lives Act; H.R. 6142/ S. 3424, the Black Maternal Health Momnibus Act of 2020 implementation of P.L. 116-123, the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020; implementation of P.L. 116-127, the Families First Coronavirus Response Act; implementation of P.L. 116-136, the Coronavirus Aid, Relief, and Economic Security Act; implementation of P.L. 116-139, Paycheck Protection Program and Health Care Enhancement Act; H.R. 6800, the Heroes Act; H.R. 1425, the Affordable Care Act Enhancement Act; H.R. 7059 the Coronavirus Provider Protection Act; H.R. 6953/ S. 3763 the Pandemic Responder Service Award Act; H.R. 6697, the Local Chamber, Tourism, and 501(c)(6) Protection Act; S.___, the Health, Economic Assistance, Liability Protection, and Schools Act; H.R. 2694, the Pregnant Workers Fairness Act; H.R. 8027, the Maternal Health Pandemic Response Act; S. 4524, the Quit Because of COVID-19 Act; HRes 1069/ SRes 655, Declaring racism a public health crisis; S. 4269 the Mothers and Newborns Success Act; S. 4349, Lorna Breen Health Care Provider Protection Act.

Client expense: $404,940 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Indian Health Service, Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), U.S. Agency for International Development (USAID), Veterans Affairs, Dept of (VA), White House Office

Price transparency, out-of-network reimbursement of emergency medical services, surprise medical bills Opioids, pain management Federal funding for Substance Use Disorder treatments Drug Shortages H.R.451-Dont Break Up the T-Band Act of 2020 H.R.501-Poison Center Network Enhancement Act of 2019 H.R.861-End Surprise Billing Act of 2019 H.R.925-The Heroes Act H.R.1301-Mental Health Telemedicine Expansion Act H.R.1309-Workplace Violence Prevention for Health Care and Social Service Workers Act H.R.1418-Competitive Health Insurance Reform Act of 2019 H.R.1554-Resident Education Deferred Interest (REDI) Act H.R.1646-Helping Emergency Responders Overcome (HERO) Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.1767-Excellence in Mental Health and Addiction Treatment Expansion Act H.R.2281-Easy Medication Access and Treatment (MAT) for Opioid Addiction Act H.R.2328-Reauthorizing and Extending Americas Community Health Act H.R.2464-End the Cycle of Violence Act of 2019 H.R.2482-Mainstreaming Addiction Treatment Act of 2019 H.R.2519-Improving Mental Health Access from the Emergency Department Act of 2019 H.R.2550-Prevent Blood Loss with Emergency Equipment Devices Act of 2019 H.R.2569-Comprehensive Addiction Resources Emergency Act of 2019 H.R.3107-Improving Seniors Timely Access to Care Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.3502-Protecting People From Surprise Medical Bills Act H.R.3630-No Surprises Act H.R.3935-Protecting Patients Transportation to Care Act H.R.3984-Health Care Safety Net Enhancement Act of 2019 H.R.4194-National Suicide Hotline Designation Act of 2019 H.R.4861-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 H.R.4932-Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2019 H.R.5619-Suicide Prevention Act H.R.5727-Research Empirical Solutions to End Ambulance Reversals from Closed Hospitals (RESEARCH) Act of 2020 H.R.5800-Ban Surprise Billing Act H.R.5826-Consumer Protections Against Surprise Medical Bills Act of 2020 H.R.5855-Bipartisan Solution to Cyclical Violence Act of 2020 H.R.6663-Truth in Healthcare Marketing Act of 2020 H.R.6800-Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act H.R.6910-Emergency Room Hero and Patient Safety Act H.R.6930-Manufacturing API, Drugs, and Excipients (MADE) in America Act of 2020 H.R.7059-Coronavirus Provider Protection Act H.R.7255-Coronavirus Health Care Worker Wellness Act of 2020 H.R.7574-Strengthening Americas Strategic National Stockpile Act of 2020 H.R.7819-Eliminating the Provider Relief Fund Tax Penalties Act of 2020 H.R.8094-Dr. Lorna Breen Health Care Provider Protection Act H.R.8441-Frontlines Heroes Act 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 H.R.8702-Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 S.289-Rural Physician Workforce Production Act of 2019 S.299-Geriatrics Workforce Improvement Act S.350-Competitive Health Insurance Reform Act of 2019 S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019 S.824-Excellence in Mental Health and Addiction Treatment Expansion Act S.851-Workplace Violence Prevention for Health Care and Social Service Workers Act S.1199-Poison Center Network Enhancement Act of 2019 S.1266-Protecting Patients from Surprise Medical Bills Act S.1334-Improving Mental Health Access from the Emergency Department S.1350-Good Samaritan Health Professionals Act of 2019 S.1365-Comprehensive Addiction Resources Emergency Act of 2019 S.1531-Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 S.1895-Lower Health Care Costs Act S.2074-Mainstreaming Addiction Treatment Act of 2019 S.2661-National Suicide Hotline Designation Act of 2020 S.2741-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 S.3006-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 S.3143-Magnet Injury Prevention Act S.3198-Suicide Prevention Act S.3346-Prevent Blood Loss with Emergency Equipment Devices Act of 2020 S.4349-Dr. Lorna Breen Health Care Provider Protection Act S.5007-Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020

Client expense: $340,838 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Price transparency, out-of-network reimbursement of emergency medical services, surprise medical bills Opioids, pain management Federal funding for Substance Use Disorder treatments Drug Shortages H.R.451-Dont Break Up the T-Band Act of 2020 H.R.501-Poison Center Network Enhancement Act of 2019 H.R.861-End Surprise Billing Act of 2019 H.R.925-The Heroes Act H.R.1301-Mental Health Telemedicine Expansion Act H.R.1309-Workplace Violence Prevention for Health Care and Social Service Workers Act H.R.1418-Competitive Health Insurance Reform Act of 2019 H.R.1554-Resident Education Deferred Interest (REDI) Act H.R.1646-Helping Emergency Responders Overcome (HERO) Act H.R.1682-Improving Access to Medicare Coverage Act of 2019 H.R.1767-Excellence in Mental Health and Addiction Treatment Expansion Act H.R.2281-Easy Medication Access and Treatment (MAT) for Opioid Addiction Act H.R.2328-Reauthorizing and Extending Americas Community Health Act H.R.2464-End the Cycle of Violence Act of 2019 H.R.2482-Mainstreaming Addiction Treatment Act of 2019 H.R.2519-Improving Mental Health Access from the Emergency Department Act of 2019 H.R.2550-Prevent Blood Loss with Emergency Equipment Devices Act of 2019 H.R.2569-Comprehensive Addiction Resources Emergency Act of 2019 H.R.3107-Improving Seniors Timely Access to Care Act of 2019 H.R.3417-Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 H.R.3502-Protecting People From Surprise Medical Bills Act H.R.3630-No Surprises Act H.R.3935-Protecting Patients Transportation to Care Act H.R.3984-Health Care Safety Net Enhancement Act of 2019 H.R.4194-National Suicide Hotline Designation Act of 2019 H.R.4861-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 H.R.4932-Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2019 H.R.5619-Suicide Prevention Act H.R.5727-Research Empirical Solutions to End Ambulance Reversals from Closed Hospitals (RESEARCH) Act of 2020 H.R.5800-Ban Surprise Billing Act H.R.5826-Consumer Protections Against Surprise Medical Bills Act of 2020 H.R.5855-Bipartisan Solution to Cyclical Violence Act of 2020 H.R.6663-Truth in Healthcare Marketing Act of 2020 H.R.6800-Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act H.R.6910-Emergency Room Hero and Patient Safety Act H.R.6930-Manufacturing API, Drugs, and Excipients (MADE) in America Act of 2020 H.R.7059-Coronavirus Provider Protection Act H.R.7255-Coronavirus Health Care Worker Wellness Act of 2020 H.R.7574-Strengthening Americas Strategic National Stockpile Act of 2020 H.R.7819-Eliminating the Provider Relief Fund Tax Penalties Act of 2020 H.R.8094-Dr. Lorna Breen Health Care Provider Protection Act S.289-Rural Physician Workforce Production Act of 2019 S.299-Geriatrics Workforce Improvement Act S.350-Competitive Health Insurance Reform Act of 2019 S.618-Medicare Choices Empowerment and Protection Act S.753-Improving Access to Medicare Coverage Act of 2019 S.824-Excellence in Mental Health and Addiction Treatment Expansion Act S.851-Workplace Violence Prevention for Health Care and Social Service Workers Act S.1199-Poison Center Network Enhancement Act of 2019 S.1266-Protecting Patients from Surprise Medical Bills Act S.1334-Improving Mental Health Access from the Emergency Department S.1350-Good Samaritan Health Professionals Act of 2019 S.1365-Comprehensive Addiction Resources Emergency Act of 2019 S.1531-Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 S.1895-Lower Health Care Costs Act S.2074-Mainstreaming Addiction Treatment Act of 2019 S.2661-National Suicide Hotline Designation Act of 2020 S.2741-Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019 S.3006-Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 S.3143-Magnet Injury Prevention Act S.3198-Suicide Prevention Act S.3346-Prevent Blood Loss with Emergency Equipment Devices Act of 2020 S.4349-Dr. Lorna Breen Health Care Provider Protection Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3502, Protecting People from Surprise Medical Bills Act, all provisions H.R. 5826, Consumer Protections Against Surprise Medical Bills Act of 2020, all provisions H.R. 3630, No Surprises Act, all provisions S. 1895, Lower Health Care Costs Act, provisions relating to surprise billing S. 1531, Stopping The Outrageous Practice of (STOP) Surprise Medical Bills Act of 2019, all provisions S. 4421, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions H.R. 6644, To require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for services furnished via telehealth if such services would be covered if furnished in-person during the COVID-19 emergency, all provisions S. 3741, Health Care at Home Act of 2020, all provisions S. 4666, National Coronavirus Commission Act of 2020, all provisions S. 4507, Getting Early Treatment and Comprehensive Assessments Reduces Emergencies (GET CARE) Act of 2020, all provisions H.R. 8441, Frontline Heroes Act, all provisions S. 4317, SAFE TO WORK Act, all provisions H.R. 925, The Heroes Act, all provisions S. 3749, Public Health Emergency Privacy Act, all provisions S. 3861, Exposure Notification Privacy Act, all provisions H.R. 6585, Equitable Data Collection and Disclosure on COVID-19 Act, all provisions H.R. 7510, Assimilating Health and Equity Assessments into Decision-making (AHEAD Act) of 2020, all provisions S. 4919, Assimilating Health and Equity Assessments into Decision-making (AHEAD Act) of 2020, all provisions H.R. 6808, Health Force and Resilience Force Act of 2020, all provisions S. 3606, Health Force and Resilience Force Act of 2020, all provisions H.R. 7255, Coronavirus Health Care Worker Wellness Act of 2020, all provisions H.R. 8094, Dr. Lorna Breen Health Care Provider Protection Act, all provisions S. 4349, Dr. Lorna Breen Health Care Provider Protection Act, all provisions H.R. 3884, Marijuana Opportunity Reinvestment and Expungement (MORE) Act of 2020, all provisions S. 2032, Cannabidiol and Marihuana Research Expansion Act, all provisions H.R. 1503, Orange Book Transparency Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 1520, Purple Book Continuity Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act, provisions related to PBM and prescription drug price transparency H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, provisions related to PBM and prescription drug price transparency H.R. 4995, Maternal Health Quality Improvement Act of 2020, all provisions H.R. 7120, George Floyd Justice in Policing Act of 2020, provisions relating to police reform Affordable Care Act stabilization Expansion of Paycheck Protection Program for 501(c)6s Public Health and Social Services Emergency Fund Marginalized and minoritized communities/COVID-19 disproportionate impact COVID-19 long haulers COVID-19 testing/vaccines/health care prior authorization COVID-19/treatment and prescribing flexibilities COVID-19/Expanded PPE/clearinghouses E/M services Surprise medical billing executive orders Surprise Medical Billing, generally Clinical and administrative data intersection State Medical Boards/Interstate Medical Licensure Compact Pharmacists and COVID-19 testing Mental health parity Digital therapeutics Physician practice financial impact 21st Century Cures Act/health data and privacy 42 CFR Part 2, HIPAA Patent reform CPT - digital Most favored nation drug pricing Drug pricing Health Information Technology/information blocking Dietary guidelines/alcohol consumption Data privacy Cyber security best practices Race and sex stereotyping executive order

Client expense: $3,870,000 · 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

Newborn Screening Saves Lives Reauthorization Act Urging inclusion of children in clinical trials for COVID-19 vaccines Urging action to address the sustained decline in childhood immunization rates during COVID-19 VACCINES Act Community Immunity During COVID-19 Act FY2021 Labor, Health and Human Services, and Education Appropriations Funding within COVID-19 relief legislation to help schools safely reopen and respond to COVID-19 Keeping All Students Safe Act FY 2021 National Defense Authorization Act Marijuana Opportunity Reinvestment and Expungement (MORE) Act (H.R. 3884) CLINICAL TREATMENT Act (H.R. 913/S. 4742) Quit Because of COVID-19 Act (H.R. 7286/S. 4524) 2020 Census Deadline Extensions Act (H.R. 8250/S. 4571) COVID-19 Relief Legislation FY 2021 Appropriations The Global Child Thrive Act HEROES Act Expansion of Protecting Life in Global Health Assistance (Global Gag Rule) Consolidated Appropriations Act COVID-19 Economic Relief Bill Regulation of air pollutants Food additive safety Paid family leave Climate change IHS funding Child Abuse Prevention and Treatment Act reauthorization CAPTA Plans of safe care grants Family First Prevention Services Act implementation Issues related to the COVID-19 pandemic and providing supports for the child welfare community Emergency Funding for Child Protection Act (S 3660) Child Welfare Emergency Funding Act (S 4172) Supporting Foster Youth and Families through the Pandemic Act Scarletts Sunshine on Sudden Unexpected Death Act (H.R. 2271/S. 1130) Gun violence prevention research funding Child product safety Child passenger safety COVID-19 pandemic response for AI/AN communities Child care supplemental funding Special Diabetes Program for Indians Reauthorization Act Maternal, Infant, and Early Childhood Home Visiting Program funding Infant sleep product safety Lead exposure prevention Standards in CBP Custody, S. 2135 Standards in ICE Family Detention Standards in ORR Custody Public Charge Child Nutrition Reauthorization/WIC SNAP Mental Health for Children H.R. 6, DREAM Act Family Separation and Detention CARE for Families Act HR 3107 WIC Act Keep Families Together Act Breastfeeding Peer Counseling Program Public Health Preparedness and Response Research for Pregnant and Lactating Women Palliative Care and Hospice Education and Training Act (S. 2080) Dietary Guidelines Child Poverty HEROES Act Senate 4.0 Coronavirus Response Legislation Asylum Child Poverty Reduction Act Suicide Prevention Dr Lorna Breen Health Care Provider Protection Act S. 4349 CBP Medical Services Contract Child Nutrition Waivers School Meal Standards Universal School Meals Eviction Moratorium 12-Month Continuous Medicaid/CHIP Eligibility Medicaid Work Requirements Medicaid Block Grants Medicaid Per Capita Caps Section 1115 Medicaid Waivers Medicaid Payment Parity Increase to Medicaid FMAP During COVID-19 Establish an automatic FMAP increase tied to state economic indicators HR 6159, the Kids Access to Primary Care Act The Ensuring Access for Womens and Childrens Act, S. 4088. Medicaid Maintenance of Effort (MOE) Protections Comprehensive Access to Robust Insurance Now Guaranteed (CARING) for Kids Act (H.R.6151) Medicaid Fiscal Accountability Rule Maternal Health H.R. 4996 Helping Moms Act H.R.4995 - Maternal Health Quality Improvement Act of 2020 Expanding Medicaid to 12 Months Post-Partum Medicaid Premiums and Cost Sharing Helping Families Access Pediatric Care Act of 2020 Medicaid Payment for Eligibility Workers Expanding the use of Telehealth in Medicaid/CHIP/Private Insurance Allow for the home and other secure locations as originating (patient) and distant (provider) sites in telehealth Waive telehealth cost-sharing for patients in telehealth Pay for telehealth care visits at parity with that of in-person visits Allow telehealth care for both new and established patients Expanding Capacity for Health Outcomes (ECHO) Act of 2019 (S 1618/HR 5199) Including Preventive Medicine Service Codes to be Eligible for Telehealth Increased Access To Broadband to Expand Telehealth Services Financial Relief to Medicaid Providers Financial Relief for Pediatricians Provider Relief Fund Expanding Provider Relief Fund Eligibility to Those Pediatricians Who Received a Small Medicare Allotment COVID-19 Response Targeted allocation of funds to primary care physician practices. Expand existing alternative payment models for primary care Fully implementing the 2021 outpatient E/M changes. Immediately implement the vaccine administration payment increases proposed in the 2021 MPFS. VACCINES Act, H.R. 2862 Expand VFC to separate CHIP Programs Providing incentive payments for VFC providers Allow VFC to pay for CPT code 90461 for administering a multiple-component vaccine Allowing underinsured and uninsured children in VFC to receive a vaccine from any participating VFC provider (not just FQHC or RHC)

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

Government targets: Administration for Children & Families (ACF), Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Product Safety Commission (CPSC), Environmental Protection Agency (EPA), Federal Aviation Administration (FAA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Indian Health Service, Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, State, Dept of (DOS), U.S. Agency for International Development (USAID), U.S. Customs & Border Protection, U.S. Immigration & Customs Enforcement (ICE)

Support HR 1763/ S 348, Resident Physician Shortage Reduction Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose HR 506,Hospital Competition Act of 2019, a bill to amend title XVIII of the Social Security Act to increase hospital competition; Statement submitted to the House Judiciary on the hearing "Diagnosing the Problem: Exploring the Effects of Consolidation and Anticompetitive Conduct in Health Care Markets"; Support HR 965/ S340, Creating and Restoring Equal Access to Equivalent Samples Act of 2019 or the CREATES Act of 2019, a bill to promote competition in the market for drugs and biological products by facilitating the timely entry of lower-cost generic and biosimilar versions of those drugs and biological products; Support HR 986/ S466 Protecting Americans with Preexisting Conditions Act of 2019, a bill provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect; Support HR 987 Strengthening Health Care and Lowering Prescription Drug Costs Act, a bill to amend the Patient Protection and Affordable Care Act to provide for Federal Exchange outreach and educational activities; Support HR 938 Bringing Low-cost Options and Competition while Keeping Incentives for New Generics Act of 2019 or the BLOCKING Act of 2019, a bill to amend the Federal Food, Drug, and Cosmetic Act, with respect to eligibility for approval of a subsequent generic drug, to remove the barrier to that approval posed by the 180-day exclusivity period afforded to a first generic applicant that has not yet received final approval, and for other purposes; Support HR 1010, a bill to provide that the rule entitled Short-Term, Limited Duration Insurance shall have no force or effect; Support HR 1499 Protecting Consumer Access to Generic Drugs Act of 2019, a bill to prohibit brand name drug manufacturers from compensating generic drug manufacturers to delay the entry of a generic drug into the market, and to prohibit biological product manufacturers from compensating biosimilar and interchangeable product manufacturers to delay entry of biosimilar and interchangeable products, and for other purposes; Support HR 1425 State Health Care Premium Reduction Act, a bill to amend the Patient Protection and Affordable Care Act to provide for a Improve Health Insurance Affordability Fund to provide for certain reinsurance payments to lower premiums in the individual health insurance market; Support HR 1386/ S 1905 Expand Navigators Resources for Outreach, Learning, and Longevity Act of 2019 or the ENROLL Act of 2019,a bill to amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes; Support HR 1520 Purple Book Continuity Act of 2019, a bill to amend the Public Health Service Act to provide for the publication of a list of licensed biological products, and for other purposes; Support HR 1503 Orange Book Transparency Act of 2019A bill that would increase transparency for the patent status of both approved biological products and approved drugs; Support HR 2439/ HR 3414 Opioid Workforce Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Submitted statement to the House Committee on Ways and Means Overcoming Racial Disparities and Social Determinants in the Maternal Mortality Crisis sharing information regarding hospitals and health systems efforts to address maternal morbidity and mortality, as we seek ways to improve outcomes and reduce health inequities for expectant and new mothers, and give their children the best possible start in life; Submitted oral and written testimony to the House Committee on Ways and Means Subcommittee on Health Hearing on Protecting Patients from Surprise Medical Bills. Protecting patients from surprise medical bills is a top priority and we have adopted a set of guiding principles to use as we evaluate legislative proposals: Define surprise bills, Protect the patient financially, Ensure patient access to emergency care, Preserve the role of private negotiation, Remove the patient from health plan/provider negotiations, Educate patients about their health care coverage, Ensure patients have access to comprehensive provider networks and accurate network information, and Support state laws that work; Letters submitted to the Energy & Commerce Committee in response to the request for comments on their surprise billing discussion draft. Concerned with the Committees draft legislations approach to determining reimbursement for out-of-network providers. Once the patient is protected from surprise bills, providers and insurers should then be permitted to negotiate payment rates for services provided. We strongly oppose approaches that would impose arbitrary rates on providers. We look forward to continuing to work with the Committee on solutions to stop surprise medical bills; Letter sent to the HELP Committee in response to the Lower Health Care Costs Act of 2019 discussion draft about our concerns about several of the proposals that would allow the government to intrude into private commercial contracts between providers and insurers. For example, several of the provisions could undermine value-based purchasing arrangements aimed directly at improving the quality of care while reducing costs. We strongly urge the Committee to remove these provisions; Submitted oral and written testimony to the House Committee on Energy and Commerce, Subcommittee on Health Hearing on No More Surprises: Protecting Patients from Surprise Medical Bills asking that the Committee preserve the ability of providers and insurers to negotiate private contracts and not establish a fixed payment amount for out-of-network services; Oppose HR 1309 Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan, and for other purposes; Concerns about S.1531, Stopping The Outrageous Practice of Surprise Medical Bills Act of 2019 or the STOP Surprise Medical Bills Act of 2019, to amend the Public Health Service Act to provide protections for health insurance consumers from surprise billing; Concerns about S. 1895 Lower Health Care Costs Act Letter addressed concerns about the legislative provision that sets a benchmark rate in statute for the out-of-network payments, as well as provisions that seek to change privately negotiated contracting arrangements between hospitals and insurance companies; Support HR 3425, Advancing Medical Resident Training in Community Hospitals Act of 2019, to amend title XVIII of the Social Security Act to establish rules for payment for graduate medical education (GME) costs for hospitals that establish a new medical residency training program after hosting resident rotators for short durations; Expressed concerns regarding the provisions that reduce reimbursements to providers and hospitals that administer drugs the Prescription Drug Pricing Reduction Act (PDPRA) of 2019: including about Section 107, Medicare Part B Rebate by Manufacturers for Drugs or Biologicals with Prices Increasing Faster than Inflation, Section 110, Establishment of Maximum Add-on Payment for Drugs, Biologicals, and Biosimilars, this provision would establish $1,000 as the maximum add-on amount that a provider can be paid for a separately payable drug, biological or biosimilar, Section 111, Treatment of Drug Administration Services Furnished by an Off-Campus Outpatient Department of a Provider, the site neutral payment reduction would cut aggregate hospital payments; Support S. 2091, Backlog Elimination, Legal Immigration, and Employment Visa Enhancement Act, this legislation would increase the total number of employment-based visas from 140,000 to 270,000 and ensure that critical health care workers needed in the U.S. have access to employment-based visas by carving out health care workers in designated shortage occupations from the limit; Support S 350, The Competitive Health Insurance Reform Act of 2019, a bill to restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers; Submitted statement to Subcommittee on Health of the Committee on Energy and Commerce for the hearing on Improving Maternal Health: Legislation to Advance Prevention Efforts and Access to Care; Concerns with S. 386 and HR 1044, Fairness for High-Skilled Immigrants Act of 2019, this bill increases the per-country cap on family-based immigrant visas from 7% of the total number of such visas available that year to 15%, and eliminates the 7% cap for employment-based immigrant visas. It also removes an offset that reduced the number of visas for individuals from China; Support H.R. 4538, Closing Loopholes for Orphan Drugs Act, a bill to amend title III of the Public Health Service Act to limit the orphan drug exclusion under the drug discount program under section 340B of such title; Discussions of provisions we support and those we recommend be changes in a draft bill called the Mitigating Existing Drug Shortages (MEDS) Act; Discussions in support of the allowing states to designate hospitals as necessary providers for purposes of waiving the critical access hospital mileage requirements; Provided comments to W&M on legislation to expand Health Profession Opportunity Grants; Support S. 2723, The Mitigating Emergency Drug Shortages (MEDS) Act, a bill to amend Sec. 506C of the Federal Food, Drug, and Cosmetic Act which strengthens requirements for drug manufacturers to disclose the root causes and expected duration of shortages, extends reporting requirements to active pharmaceutical ingredients manufacturers, requires manufacturers have contingency plans to ensure ongoing supply, develops recommendations to incentivize manufacturers to enter the market for drugs in shortage and examines the national security risks of shortages; Discuss DEA reductions in annual quotas for opioid products used by hospitals for sedation and pain management; Meeting with the Office of the Assistant Secretary of Preparedness and Response (ASPR) to discuss developments in the hospital preparedness program, the pilot projects for the Regional Disaster Healthcare System and other issues; Rural access to health care, including identifying core services needed in rural communities, outlining approaches and considerations for delivering those services, and examining access and quality in the rural context; ONCs proposed rule to implement the 21st Century Cures provision on information blocking; Supported members serving on the HHS Quality Summit panel, which was convened by the Deputy Secretary to gather input regarding how to improve and energize quality and safety improvement activities across health care system; Discussion with HHS on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussion with HHS about the work of Aligning for Health to address social determinants of health; Support S 2902, Strengthening Our Rural Health Workforce Act of 2019, a bill to enhance the rural health workforce; Meetings and correspondence with staff members of Senate Financing Committee on a proposal to support rural health care access (REH, re-opening necessary provider CAH, infrastructure funding); Letter to Ways & Means committee Rural and Underserved Communities Health Task Force in response to RFI on factors that contribute to health outcomes in these areas, examples of successful models and lessons from the field that address access and outcomes, and considerations for the unique circumstances of rural and underserved communities; Letter to Energy and Commerce Members regarding health information technology priorities; Letter of Support to Senate Appropriations on funding for the Centers for Disease Control and Prevention and the National Institutes of Health to study gun violence; Support S.2741 and H.R. 4932,Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services, and for other purposes; Support S 2603, Resolving Extended Limbo for Immigrant Employees and Families (RELIEF) Act, a bill to amend the Immigration and Nationality Act to end the immigrant visa backlog, and for other purposes; Support HR 4995, Maternal Health Quality Improvement Act of 2019, a bill to amend the Public Health Service Act to improve obstetric care and maternal health outcomes, and for other purposes; Concerns with HR 5800,Ban Surprise Billing Act, a bill to address surprise medical bills that relies on a median in-network rate to resolve out-of-network payments and allows for an independent dispute resolution process to determine the final payment. Concerned with the Committee's legislative approach to determining reimbursement for out-of-network providers. Oppose approaches that would impose arbitrary rates on providers, which could have significant consequences far beyond the scope of surprise medical bills. It is the insurers' responsibility to maintain comprehensive provider networks, and a default payment rate would remove incentives for health plans to contract with providers or to offer fair terms; Support HR 5826, Consumer Protections Against Surprise Medical Bills Act, a bill that prohibits providers from balance billing patients for emergency services or medical care the patient reasonably could have expected to be in-network, and from charging patients more than the in-network cost-sharing amount. Rather than rely on a benchmark payment rate to determine out-of-network reimbursement, the legislation provides a period for health plans and providers to negotiate out-of-network reimbursement, followed by a mediated dispute resolution process if necessary; Letter urging HHS to take regulatory actions to help hospitals and health systems prepare and respond to COVID-19; Letter requesting $100 billion to prepare and respond to COVID-19; Letter urging the Department of Labor to accurately define health care provider when promulgating regulations implementing key sections of the Families First Coronavirus Response Act; Letter sent to the President asking for the use of the Defense Production Act to increase the production of medical supplies and equipment; Letter to HHS regarding $100 billion emergency fund, asking HHS and CMS to directly and expediently distribute to rural and urban hospitals and health systems funds from the Public Health and Social Services Emergency Fund that were designated for providers in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act increased funding by $100 billion in order to reimburse eligible health care providers for health care-related expenses or lost revenues that are attributable to COVID-19. In the letter, we urged HHS and CMS to immediately distribute funding to all hospital types in the US - with additional funding going to COVID-19 hotspots; Letter urging Congress to modernize the Stafford Act as part of its next COVID-19 legislative package to allow all hospitals to recoup financial losses from this pandemic and future disasters; Letter to the Federal Reserve System, the Federal Deposit Insurance Corporation and the Office of the Comptroller of the Currency requesting they, as primary federal regulators for insured depository institutions, take prompt action to assist health care providers on the front line of the COVID-19 pandemic should the need to do so arise; Letter to the Secretary of the Treasury and the Federal Reserve Chair of the Board of Governors urging a supplement to the New Main Street Loan Facility term sheet with prompt guidance to ensure that access to this critically-necessary loan facility will be attainable for hospitals without delay; Letter was sent to the SBA urging it to ensure that small- and mid-size public hospitals, including those that have both nonprofit and public designations, are allowed to apply for and receive loans under the newly-authorized SBA Paycheck Protection Program; Letter in response to FEMAs request for input on establishing a voluntary agreement, under the Defense Production Act, of key private sector stakeholders relevant to responding to COVID-19, urging that such an agreement account for the full breadth of COVID-19 medical supply and equipment needs; Support H.R. 6474/S.3838 Healthcare Broadband Expansion During COVID-19 Act, a bill that would provide an additional $2 billion in funding for the FCC Rural Health Care program and increase the subsidy for health care providers from 65 to 85 percent. This legislation also simplifies the program to allow for more efficient application processes and disbursement of much needed funding; Support HR 6654 Emergency COVID-19 Telehealth Response Act, a bill that would codify an expanded list of providers to deliver and bill for telehealth services during the PHE; Support HR 7233Knowing the Efficiency and Efficacy of Permanent (KEEP) Telehealth Options Act of 2020, a bill that would require the Department of Health and Human Services and the Government Accountability Office (GAO) to conduct studies to provide information about the expanded use of telehealth during the COVID-19 pandemic; Letter to Senate HELP Committee in response to request for feedback on preparing for next pandemic; Discussion about telehealth waivers and flexibilities with HHS; Discussion about CARES provider relief fund distributions with HHS; Oppose HR 6559/ S 3677 COVID-19 Every Worker Protection Act of 2020, a bill to require the Occupational Safety and Health Administration to promulgate an emergency temporary standard to protect employees from occupational exposure to SARS-CoV-2, and for other purposes; Joint letter with ANA urging Congress to act quickly to get needed resources into the health care system, so that hospitals, nurses and physicians responding to COVID-19 are able to continue to provide treatments, front-line health care personnel are able to provide care and patients are able access health care services; Statement to Committee on Ways and Means for the hearing on The Disproportionate Impact of COVID-19 on Communities of Color urging Congress to employ the resources of the National Institute on Minority Health and Health Disparities - which is congressionally-mandated to coordinate the research of the other National Institutes of Healths centers and institutes related to minority health - to research and develop approaches to specifically address the COVID-19 needs of minority populations; Advocate with Congress for full forgiveness of COVID-19 related accelerated payments received by hospitals; Support S 3781Pharmaceutical Accountability, Responsibility, and Transparency (PART) Act, a bill to increase reporting of, help mitigate potential shortages related to, and promote, accountability and transparency for pharmaceuticals and medical devices; Support S 3780 Help Onshore Manufacturing Efficiencies (HOME) for Drugs and Devices Act, a bill to encourage domestic advanced manufacturing of critical drugs and devices in order to address economic, health, and security concerns, combat shortages of critical drugs and devices, and promote increased domestic diversification of, and independence from foreign reliance on, pharmaceutical and medical device supply chains; Support S.3763 Pandemic Responder Service Award Act, a bill to establish the Pandemic Responder Service Award program to express our gratitude to front-line health care workers; Support HR 6788/ S 3599 Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Urged support for joint House and Senate letter to the Administration asking for flexibility for hospitals with respect to J-1 and H-1B visa programs; Letter to Senate Finance Committee to address the important issue of maternal health and the opportunity to provide suggestions regarding how to improve maternal health in this country; Support the Temporary Reciprocity to Ensure Access to Treatment Act, a bill that allows for the temporary reciprocity for treatment by medical professionals licensed in one state to patients in other states; Letter urging the Senate to include in the next COVID-19 relief bill provisions to strengthen the federal response for racial and ethnic minority and marginalized communities, which are disproportionately affected by the pandemic;Letter asking Congress to allocate as part of the next COVID-19 relief package at least an additional $100 billion to the emergency relief fund to provide direct funding to front line health care personnel and providers to continue to respond to this pandemic; Letter sent to HHS urging them to direct HRSA to take action to stop three drug manufacturers from limiting the distribution of 340B drugs to 340B covered entities. These drug manufacturers have taken separate actions to either limit the distribution of 340B drugs or require 340B covered entities provide claims level data for investigatory purposes if that 340B covered entity uses a contract pharmacy arrangement; Letter to the Congressional Leadership asking them to not to include in the next COVID-19 relief package any surprise medical billing legislation - such as a reimbursement rate set in statute - that would further destabilize hospitals finances during the pandemic; Support S 4507, Getting Early Treatment and Comprehensive Assessments Reduces Emergencies Act of 2020 or the GET CARE Act of 2020, a bill to amend the Public Health Service Act to provide for a national campaign to raise awareness of the importance of seeking preventive health services and the utilization of such services; Comment letter addressing concerns on the proposed rule from the Departments of the Treasury, Labor and Health and Human Services that would allow certain grandfathered health plans to increase patient cost-sharing beyond current limits, without losing their grandfathered status; Letter urging the Administration to work with the AHA and Congress to create a future for telehealth that allows not only clinicians, but also hospitals and health systems, to code and bill for virtual services. We further urge CMS and HHS to continue to provide hospitals with the flexibility for annual beneficiary consent to telehealth treatment to be obtained at the same time, and not necessarily before, services are furnished; Support HR 8061,Community Immunity During COVID-19 Act of 2020, a bill that would provide funding to state and local health departments to work with community providers and organizations to increase immunization rates for Advisory Committee on Immunization Practices (ACIP)-recommended vaccines during the COVID-19 public health emergency; Letter again expressing concern with recent actions taken by several major drug manufacturers to limit the distribution of certain 340B drugs to our hospital members. While we understand that the HRSA is further investigating these actions, we urge swift and decisive action to halt these pernicious tactics so as to prevent other manufacturers from following suit; Comment letter outlining our concerns about the ability of hospital systems to distribute provider relief funds among the parent and subsidiaries. HHS published certain FAQs that place problematic restrictions on the use of CARES Act provider relief fund dollars. Specifically, the FAQs restrict the ability of a hospital system to allocate the funds throughout its system where COVID-19 related expenses and lost revenues are occurring; Submitted comments in response to HRSAs RFI on Health Professional Shortage Area (HPSA) scoring. HPSA scores are important for rural hospitals and clinics ability to recruit physicians and other clinicians, namely from the National Health Service Corps (NHSC) program. Letter asking HHS to reinstate the COVID-19 Provider Relief Fund reporting requirements; Support S 4349, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 3595Ensuring Understanding of COVID-19 to Protect Public Health Act, a bill that directs the NIH to conduct a longitudinal study on mild, moderate, and severe cases of COVID-19 on a diverse patient population.

Client expense: $4,460,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), 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. Draft Bipartisan Emergency COVID Relief Act of 2020 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: 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, imposing user fees, changing the program from an up-front discount to a post-sale rebate, and not providing 340B discounts on covered drugs purchased at community pharmacies. Issue: Oppose efforts to create new requirements for FQHC grantees that participate in the 340B program. Issue: Oppose efforts to reduce OPPS reimbursements to hospitals for drugs acquired under the 340B program. Issue: Oppose efforts to allow certain grandfathered health care plans to increase consumer cost sharing without losing their grandfathered status. Issue: Oppose State relief and empowerment waivers that allow states to offer insurance plans that do not meet the requirements set forth under the Affordable Care Act. Issue: Oppose efforts to expand the availability of Association Health Plans. Issue: Oppose efforts to direct HHS to update the Medicare.gov Hospital Compare website. Issue: Support increased interoperability and exchange of electronic health information and delayed enforcement of information blocking rule until comprehensive guidance is issued. Issue: Oppose efforts to finalize two new mandatory alternative payment models, the Radiation Oncology Model and the End-stage Renal Disease Treatment Choices Model 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 or 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 Issue: Prescription drug pricing, public health, maternal mortality, and health information technology. Issue: Oppose restrictions on diversity training for federal grantees and employees. 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. Issue: Support initiatives of hospitals to promote affordable housing in local communities and eliminate other social determinants of health to improve health equity. P.L. 116-260, Consolidated Appropriations Act, 2021 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. H.R. 4995 Maternal Health Quality Improvement Act of 2020 H.R. 4996 Helping MOMS Act of 2020 Issue: Support maternal health initiatives to expand coverage for postpartum women and expand demonstration project grants. 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. 116-260, Consolidated Appropriations Act, 2021 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 Draft Emergency Coronavirus Relief Act of 2020 Draft Bipartisan State and Local Support and Small Business Protection Act of 2020 Issues: Support emergency supplemental funding and policies for federal agencies to support coronavirus preparedness, response, relief, vaccine development and distribution, and testing and contact tracing. 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 fixes to Medicare GME Rural Training Track programs. Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Support an increase in the Federal Medicaid Assistance Program. Support for current telehealth waivers to be made permanent. Support for extension of Medicare sequester moratorium. Support changes to CY 2021 Physician Fee Schedule evaluation and management payments. 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. Support public health infrastructure. 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: Support establishment of regional pandemic response centers, stronger linkages between public health and academic medicine, and the role of medical students in administering covid vaccines. 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 and EPA 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. Issue: Support the rescission of the Department of Homeland Securitys Public Charge rule. Issue: Participate in Resilient American Communities initiative S. 4740 Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Rescind the Executive Order on Creating Schedule F in the Excepted Service. Issue: Rescind Executive Orders 13771 and 13777, and support re-implementation of directives under Executive Order 13563, Improving Regulation and Regulatory Review. Issue: Support establishment of a Presidential Bioethics Commission. Issue: Support ensuring patients are put first and that conscience protections align with medical professionalism standards. Issue: Support prompt establishment of the Research Policy Board and implementation of the additional reform efforts required by Section 2034 of the 21st Century Cures Act (P.L. 114-255). Issue: Support increased interoperability and exchange of electronic health information. Support delay of enforcement beyond April 2021. Issue: Support identification of specific federal regulations for review for disproportionate administrative impacts. Issue: Support independence of the US Food and Drug Administration. Issue: Support FDA rulemaking to harmonize protection of human research subjects. Issue: Support promotion of data sharing and clinical trials results reporting.

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

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

Medical liability issues; continuing medical education; graduate medical education; Physician Due Process Rights; General practice issues. H.R. 1554. Corporate practice of medicine. H.R. 748. H.R. 6910, the ER Hero and Patient Safety Act. Restrictive Clauses. H.R. 6800. H.R. 133, Consolidated Appropriations Act, 2021, Public Law No: 116-260. S. 4349 and H.R. 8094

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

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

Health Insurance Coverage (general); Health Disparities (general); Breastfeeding (general); Assisted Reproductive Technology (general); Smoking Cessation (general); Substance Use Disorder (general); Gynecologic Cancer (general); Gynecologic Devices (general); Reproductive Health (general); Intimate Partner Violence (general); Gun Violence (general); Immunization (general); Breast Cancer (general); Medical Liability Reform (general); Health IT (general); Patient-Physician Relationship (general); Child Welfare (general); Prematurity (general); Maternal Mortality and Morbidity (general); Graduate Medical Education (general); Contraception (general); Abortion (general); Indian Health (general); Teaching Health Centers Graduate Medical Education (general); Community Health Centers (general); National Health Service Corps (general); Special Diabetes Program (general); Special Diabetes Program for Indians (general); Sexuality Education (general); Teen Pregnancy Prevention Program (general); Personal Responsibility Education Program (general); Research in Pregnant and Breastfeeding Women (general); Health Care Reform (general); Title X Family Planning Program (general); Womens Preventive Services (general); Administrative Burden (general); Surprise Billing (general); Pediatric Loan Repayment Program (general); COVID-19 Response (general); Personal Protective Equipment (general); Risk Evaluation and Mitigation Strategies (general); Data Collection (general); Health Equity (general); Pregnancy Risk Assessment Monitoring System (CDC); Provider Relief Fund (general); Maternal Mental Health (general); Violence Against Women Act (general); Secretarys Advisory Committee on Infant Mortality (general); COVID-19 Vaccine (general); H.R. 2975/S. 1645, Womens Health Protection Act; S. 1895, Lower Health Care Costs Act; H.R. 2862/S. 1619, VACCINES Act; implementation of P.L. 115-344, Preventing Maternal Deaths Act; implementation of P.L. 115-320, Improving Access to Maternity Care Act; S. 2586, Maternal Outcomes Matter Act; HR 3630, No Surprises Act; HR 3502, Protecting People From Surprise Medical Bills Act; H.R. 4495, Maternal Health Quality Improvement Act of 2019; H.R. 5640/S. 3152, the Data Mapping to Save Moms Lives Act; H.R. 6142/ S. 3424, the Black Maternal Health Momnibus Act of 2020 implementation of P.L. 116-123, the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020; implementation of P.L. 116-127, the Families First Coronavirus Response Act; implementation of P.L. 116-136, the Coronavirus Aid, Relief, and Economic Security Act; implementation of P.L. 116-139, Paycheck Protection Program and Health Care Enhancement Act; H.R. 7059 the Coronavirus Provider Protection Act; H.R. 6953/ S. 3763 the Pandemic Responder Service Award Act; H.R. 6697, the Local Chamber, Tourism, and 501(c)(6) Protection Act; S.___, the Health, Economic Assistance, Liability Protection, and Schools Act; H.R. 2694, the Pregnant Workers Fairness Act; H.R. 8027, the Maternal Health Pandemic Response Act; HRes 1069/ SRes 655, Declaring racism a public health crisis; S. 4269 the Mothers and Newborns Success Act; S. 4349, Lorna Breen Health Care Provider Protection Act; H.R. 6701/S. 3595, Ensuring Understanding of COVID-19 to Protect Public Health Act; H.R. 8061/S. 4737, Community Immunity During COVID-19 Act; H.R. 8958/ S.4949, Supporting Best Practices for Healthy Moms Act; S.4863, HEALTH for MOM Act of 2020; H.R. 6383, Uterine Fibroid Research and Education Act; S.4859, Connected MOM Act.

Client expense: $147,955 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Indian Health Service, Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), U.S. Agency for International Development (USAID), Veterans Affairs, Dept of (VA), White House Office

H. Res. 480, Acknowledging the racial disparities in diagnosing and treating mental health among youth in communities of color H.R. 1554, the Resident Education Deferred Interest Act H.R. 1763 / S. 348, the Resident Physician Shortage Reduction Act of 2019 H.R. 2734 / S. 1448, the Safer Prescribing of Controlled Substances Act H.R. 3180/ S. 1770, the RISE from Trauma Act H.R. 3239/ S. 2135, the Humanitarian Standards for Individuals in Customs and Border Protection Custody Act H.R. 3253, the Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act H.R. 3417, BETTER Act of 2019 H.R. 4194/S. 2661, the National Suicide Hotline Designation Act of 2019 H.R. 4309, the Barriers to Suicide Act H.R. 4327, the Enhancing Mental Health and Suicide Prevention Through Campus Planning Act H.R. 4861/ S. 3006, the Effective Suicide Screening and Assessment in the Emergency Department Act H.R. 4932 / S. 2741, the CONNECT for Health Act H.R. 4995, the Maternal Health Quality Improvement Act of 2019 H.R. 4996, the Helping Medicaid Offer Maternity Services Act of 2019 H.R. 5201, the Telemental Health Expansion Act of 2019 H.R. 5473, the Enhance Access to Support Essential Behavioral Health Services Act H.R.5469/ S.4388, the Pursuing Equity in Mental Health Act of 2019 H.R.5575, the Primary and Behavioral Health Care Access Act of 2020 Out of network billing legislation S. 1227, the Prescription Pricing for the People Act of 2019 S. 2443, the Investment in Tomorrow's Pediatric Health Care Workforce Act S. 824, the Excellence in Mental Health and Addiction Treatment Expansion Act S.1659, the Ensuring Childrens Access to Specialty Care Act of 2019 Title III Sec. 305 Timely Bills to Patients within the Lower Health Care Costs Act of 2019 (S. 1895) Cures 2.0 Title X Family Planning Program Administration Rule Efforts related to psychiatric bed shortages. H.R. 6074, the Coronavirus Preparedness and Response Supplemental Appropriations Act H.R. 6201, the Families First Coronavirus Response Act H.R. 4996, the Helping Medicaid Offer Maternity Services (MOMS) Act, and Senate efforts. S. 311, the Born-Alive Abortion Survivors Protection Act S. 3275, the Pain-Capable Unborn Child Protection Act H.R. 4056 and S. 2446, the Medicare Audiologist Access and Services Act of 2019 H.R. 5575, the Primary and Behavioral Health Care Access Act Telehealth provisions as related to Covid-19. H.R. 6644, the Health Care at Home Act Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 and related Medicare and Medicaid payment updates. Emergency financial relief and stability funding for 501(c)(6) tax-exempt medical and dental trade associations impacted by the pandemic H.R. 7078, the Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act of 2020 (EDOT Act of 2020) H.R. 7255, the Coronavirus Health Care Worker Wellness Act of 2020 S. 3919, the Military Suicide Prevention in the 21st Century Act H.R. 7608, the Legislative Vehicle for the Fiscal 2021 Four-Bill Appropriations Package H.R. 7539, the Strengthening Behavioral Health Parity Act H.R. 4564, the Suicide Prevention Lifeline Improvement Act of 2019 H.R. 5619/ S. 3198, the Suicide Prevention Act H.R. 4585, the Campaign to Prevent Suicide Act H.R. 1646/ S. 3244, the Helping Emergency Responders Overcome (HERO) Act of 2019 H.R. 2519/ S. 1334, the Improving Mental Health Access from the Emergency Department Act of 2019 H.R. 7147, the Creating Resources to Improve Situations of Inherent Severity Act (CRISIS Act) H.R. 7159/S. 4282, the Crisis Care Improvement and Suicide Prevention Act of 2020 H.R. 7689, the Improving Data Collection for Adverse Childhood Experiences Act H.R. 8094/S. 4349, the Dr. Lorna Breen Health Care Provider Protection Act H.R. 6561/S. 4440, the Improving Social Determinants of Health Act H.R. 7511/ S. 4211, the Facilitating Reforms that Offer Necessary Telehealth in Every Rural (FRONTIER) Community Act H.R. 884 / S. 2772, the Medicare Mental Health Access Act H.R. 3935, the Protecting Patients Transportation to Care Act H.R. 4564, the Suicide Prevention Lifeline Improvement Act of 2020 S. Res. 738, Recognizing suicide as a serious public health problem and expressing support for the designation of September as National Suicide Prevention Month S. 4113, the Broadband Reform and Investment to Drive Growth in the Economy Act of 2020 (BRIDGE Act) H.R. 7859, the Strengthening Behavioral Health Supports for Schools Act S. 4421, the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act H.R. 8141, the Strengthening Mental Health Supports for BIPOC Communities Act HR 7510, the Assimilating Health and Equity Assessments into Decision-making Act of 2020 or AHEAD Act H.R. 5469/S.4388, the Mental Health Equity Act of 2020 H.R. 7059, the Coronavirus Provider Protection Act, S. 3792, the Tele-Mental Health Improvement Act of 2020. HR 6810 to provide COBRA subsidies for unemployed and furloughed individuals during COVID H.R. 7593/S. 4103, the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act H.R. 6645, the Mental Health Research Act H.R. 5201, the Telemental Health Expansion Act of 2019 H.R. 6561/S. 3595, the Ensuring Understanding for COVID-19 to Protect Public Health Act S. 4524, the Quit Because of COVID-19 Act S. 4486, the Achieving Thorough Transparency & Accessibility for Information Navigation (ATTAIN) on Mental Health Act H.R. 6800/H.R. 8406, the HEROES Act S. 4230, the Telehealth Expansion Act of 2020 H.R. 7391, the Protect Telehealth Access Act of 2020 H.R. 7760, To make a supplemental appropriation for the COVID-19 Telehealth Program of the Federal Communications Commission for the fiscal year ending September 30, 2020 H.R.8067, the Addressing COVID-19 Health Disparities Act H.R. 2862, the VACCINES Act of 2019 (G6 letter for internal purposes) Efforts related to Collaborative Care Model S. 3197, the Improving Access to Health Care in Rural and Underserved Areas Act H.R. 6139, the COVID-19 Health Care Worker Protection Act of 2020 H.Res. 908 (S.Res. 580) Condemning all forms of Anti-Asian Sentiment as related to COVID-19 H.R. 6585, the Equitable Data Collection and Disclosure on COVID-19 Act H.R. 7078, the EDOT Act of 2020 HR 7077, the Community Solutions for COVID-19 Act H.R. 7780, the Virtual Community Support Act of 2020 H. R. 8016, the Peer Assisted Relief Through Empathetic Resources and Supports (PARTNERS) Act H. R. 8206, the Promoting Effective and Empowering Recovery Services in Medicare Act of 2020 (PEERS Medicare Act of 2020) 2021 Centers for Medicare and Medicaid Services (CMS), Medicare Physician Fee Schedule (MPFS) Final Rule, E/M (H.R. 8702; H.R. 8505; S. 4932) H.R. 9035, the Permanency for Audio Only Telehealth Act H.R. 7663, Protecting Access to Post-COVID-19 Telehealth Act of 2020 H.R. 8283/S. 4421 TREAT Act H.R. 2482/S. 2074 Mainstreaming Addiction Treatment Act of 2019 Misuse of race data within clinical algorithms.

Client expense: $238,000 · Firm income: Not reported

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

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

H.R. 3502, Protecting People from Surprise Medical Bills Act, all provisions H.R. 5826, Consumer Protections Against Surprise Medical Bills Act of 2020, all provisions H.R. 3630, No Surprises Act, all provisions S. 1895, Lower Health Care Costs Act, provisions relating to surprise billing S. 1531, Stopping The Outrageous Practice of (STOP) Surprise Medical Bills Act of 2019, all provisions S. 4421, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions H.R. 6644, To require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for services furnished via telehealth if such services would be covered if furnished in-person during the COVID-19 emergency, all provisions S. 3741, Health Care at Home Act of 2020, all provisions S. 4666, National Coronavirus Commission Act of 2020, all provisions S. 4507, Getting Early Treatment and Comprehensive Assessments Reduces Emergencies (GET CARE) Act of 2020, all provisions H.R. 8441, Frontline Heroes Act, all provisions S. 4317, SAFE TO WORK Act, all provisions H.R. 925, The Heroes Act, all provisions S. 3749, Public Health Emergency Privacy Act, all provisions S. 3861, Exposure Notification Privacy Act, all provisions H.R. 6585, Equitable Data Collection and Disclosure on COVID-19 Act, all provisions H.R. 7510, Assimilating Health and Equity Assessments into Decision-making (AHEAD Act) of 2020, all provisions S. 4919, Assimilating Health and Equity Assessments into Decision-making (AHEAD Act) of 2020, all provisions H.R. 6808, Health Force and Resilience Force Act of 2020, all provisions S. 3606, Health Force and Resilience Force Act of 2020, all provisions H.R. 7255, Coronavirus Health Care Worker Wellness Act of 2020, all provisions H.R. 8094, Dr. Lorna Breen Health Care Provider Protection Act, all provisions S. 4349, Dr. Lorna Breen Health Care Provider Protection Act, all provisions H.R. 3884, Marijuana Opportunity Reinvestment and Expungement (MORE) Act of 2020, all provisions S. 2032, Cannabidiol and Marihuana Research Expansion Act, all provisions H.R. 1503, Orange Book Transparency Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 1520, Purple Book Continuity Act of 2019, provisions related to PBM and prescription drug price transparency H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act, provisions related to PBM and prescription drug price transparency H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, provisions related to PBM and prescription drug price transparency H.R. 4995, Maternal Health Quality Improvement Act of 2020, all provisions H.R. 7120, George Floyd Justice in Policing Act of 2020, provisions relating to police reform Affordable Care Act stabilization Expansion of Paycheck Protection Program for 501(c)6s Public Health and Social Services Emergency Fund Marginalized and minoritized communities/COVID-19 disproportionate impact COVID-19 long haulers COVID-19 testing/vaccines/health care prior authorization COVID-19/treatment and prescribing flexibilities COVID-19/Expanded PPE/clearinghouses E/M services Surprise medical billing executive orders Surprise Medical Billing, generally Clinical and administrative data intersection State Medical Boards/Interstate Medical Licensure Compact Pharmacists and COVID-19 testing Mental health parity Digital therapeutics Physician practice financial impact 21st Century Cures Act/health data and privacy 42 CFR Part 2, HIPAA Patent reform CPT - digital Most favored nation drug pricing Drug pricing Health Information Technology/information blocking Dietary guidelines/alcohol consumption Data privacy Cyber security best practices Race and sex stereotyping executive order

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Childcare Issues related to childcare - no specific bill COVID-19 Pandemic H.R. 6800 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S. 3599/H.R.6788 - Healthcare Workforce Resilience Act H.R. 6793 - Pandemic Production Act H.R. 266 - Paycheck Protection Program and Health Care Enhancement Act H.R.7010 - Paycheck Protection Program Flexibility Act of 2020 H.R.6720 - Student Loan Forgiveness for Frontline Health Workers Act H.R. 7059 - Coronavirus Provider Protection Act H.R. 748 - The Coronavirus Aid, Relief, and Economic Security Act or the CARES Act Issues related to the COVID-19 Pandemic including: - no specific bill Financial assistance for health care providers Medicare Accelerated and Advance Payment Program Medicare and Medicaid payment rates Federal Medicaid Match Liability protection for health care providers Demographic data for the COVID-19 response Access to personal protective equipment (PPE) and medical supplies PPE supply chain improvements Access to testing for COVID-19 Telemedicine/telehealth Small Business Administration loans Support for contact tracing programs Mental and behavioral health Support for programs addressing domestic violence and child maltreatment Support for resident physicians and medical students Student loan forgiveness/debt relief State and local funding General advocacy on a COVID-19 stimulus/relief package FMAP increase in the Families First Coronavirus Response Act (P.L. 116-127) H.R.6793, the Pandemic Production Act (PPA) S.4349/ H.R.8094, the Dr. Lorna Breen Health Care Provider Protection Act H.R.7819 - Eliminating the Provider Relief Fund Tax Penalties Act of 2020 H.R. 8702 Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 S. 5082 - Expanding COVID-19 Testing Capacity Act of 2020 H.R. 133 - Consolidated Appropriations Act, 2021 Immigration Public Charge - no specific bill S. 948/H.R. 2895, Conrad State 30 and Physician Access Reauthorization Act S. 3599/H.R. 6788 - the Healthcare Workforce Resilience Act Interoperability/ONC Issues related to interoperability - no specific bill Medicare/Medicaid The Medicare Access and CHIP Reauthorization Act (MACRA) Medicaid Fiscal Accountability regulation Block Grants - no specific bill Issues related to Medicare Physician Payments H.R. 133 - Consolidated Appropriations Act, 2021 Prior Authorization - no specific bill Publications Open access to information based on publicly funded research OSTP Request for Information - FR Doc. 2020-06622 - Public Access to Peer-Reviewed Scholarly Publications, Data and Code Resulting From Federally Funded Research Issues related to scholarly and scientific publishing and public access H.R. 133 - Consolidated Appropriations Act, 2021 Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Scope of Practice - no specific bill Surprise Billing 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 Consumer Protections Against Surprise Medical Bills Act of 2020 - House Ways & Means Issues related to surprise medical billing/out-of-network medical billing No Surprises Act (compromise legislative proposal between House Ways & Means, Energy & Commerce, Education & Labor Committees and Senate HELP committee - no specific bill number) H.R. 133 - Consolidated Appropriations Act, 2021 Telehealth S. 4375, the Telehealth Modernization Act of 2020 Issues related to telehealth - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory Comments Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2021

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Science & Technology Policy (OSTP), SENATE

Childcare Issues related to childcare - no specific bill COVID-19 Pandemic H.R. 6800 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S. 3599/H.R.6788 - Healthcare Workforce Resilience Act H.R. 6793 - Pandemic Production Act H.R. 266 - Paycheck Protection Program and Health Care Enhancement Act H.R.7010 - Paycheck Protection Program Flexibility Act of 2020 H.R.6720 - Student Loan Forgiveness for Frontline Health Workers Act H.R. 7059 - Coronavirus Provider Protection Act H.R. 748 - The Coronavirus Aid, Relief, and Economic Security Act or the CARES Act Issues related to the COVID-19 Pandemic including: - no specific bill Financial assistance for health care providers Medicare Accelerated and Advance Payment Program Medicare and Medicaid payment rates Federal Medicaid Match Liability protection for health care providers Demographic data for the COVID-19 response Access to personal protective equipment (PPE) and medical supplies PPE supply chain improvements Access to testing for COVID-19 Telemedicine/telehealth Small Business Administration loans Support for contact tracing programs Mental and behavioral health Support for programs addressing domestic violence and child maltreatment Support for resident physicians and medical students Student loan forgiveness/debt relief State and local funding General advocacy on a COVID-19 stimulus/relief package FMAP increase in the Families First Coronavirus Response Act (P.L. 116-127) H.R.6793, the Pandemic Production Act (PPA) S.4349/ H.R.8094, the Dr. Lorna Breen Health Care Provider Protection Act H.R.7819 - Eliminating the Provider Relief Fund Tax Penalties Act of 2020 H.R. 8702 Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 S. 5082 - Expanding COVID-19 Testing Capacity Act of 2020 H.R. 133 - Consolidated Appropriations Act, 2021 Immigration Public Charge - no specific bill S. 948/H.R. 2895, Conrad State 30 and Physician Access Reauthorization Act S. 3599/H.R. 6788 - the Healthcare Workforce Resilience Act Interoperability/ONC Issues related to interoperability - no specific bill Medicare/Medicaid The Medicare Access and CHIP Reauthorization Act (MACRA) Medicaid Fiscal Accountability regulation Block Grants - no specific bill Issues related to Medicare Physician Payments H.R. 133 - Consolidated Appropriations Act, 2021 Prior Authorization - no specific bill Publications Open access to information based on publicly funded research OSTP Request for Information - FR Doc. 2020-06622 - Public Access to Peer-Reviewed Scholarly Publications, Data and Code Resulting From Federally Funded Research Issues related to scholarly and scientific publishing and public access H.R. 133 - Consolidated Appropriations Act, 2021 Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Scope of Practice - no specific bill Surprise Billing 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 Consumer Protections Against Surprise Medical Bills Act of 2020 - House Ways & Means Issues related to surprise medical billing/out-of-network medical billing No Surprises Act (compromise legislative proposal between House Ways & Means, Energy & Commerce, Education & Labor Committees and Senate HELP committee - no specific bill number) H.R. 133 - Consolidated Appropriations Act, 2021 Telehealth S. 4375, the Telehealth Modernization Act of 2020 Issues related to telehealth - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory Comments Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2021

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Science & Technology Policy (OSTP), SENATE

S.3548, CARES Act: To provide emergency assistance and health care response for individuals, families, and businesses affected by the 2020 coronavirus pandemic; Practice Support/Grants to Practice S.3599, Healthcare Workforce Resilience Act: Foreign physician immigration status H.R. 7059, Coronavirus Provider Protection Act: Liability protection for healthcare providers Public Law No: 116-142, Paycheck Protection Program Flexibility Act of 2020 S.3201, Temporary Reauthorization and Study of the Emergency Scheduling of Fentanyl Analogues Act: Letter to Congressional Leadership regarding Fentanyl S.2723, Mitigating Emergency Drug Shortages Act: reducing drug shortages H.R. 3502, Protecting People From Surprise Medical Bills Act: Surprise Medical Bills H.R. 2500, National Defense Authorization Act for Fiscal Year 2020: Krishnamoorthi amdt on drug shortages H.R. 3107, Improving Seniors' Timely Access to Care Act of 2019: pre-authorization S. 1895, Lower Health Care Costs Act H.R. 3692, Addiction Treatment Access Improvement Act of 2017: Medically assisted treatment; opioids H.R. 5761, Ending Maternal Mortality Act of 2018: Maternal mortality H.R. 5718, Perioperative Reduction of Opioids Act: Opioids H.R. 5197, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S. 2516, Alternatives to Opioids (ALTO) in the Emergency Department Act: Medically assisted treatment; opioids S.2680, Opioid Crisis Response Act of 2018: Medically assisted treatment; opioids S.2456, CARA 2.0 Act of 2018: Medically assisted treatment; opioids H.R. 1565, Saving Lives, Saving Costs S.1475, Saving Lives, Saving Costs S.4349, Dr. Lorna Breen Health Care Provider Protection Act: physician health Comprehensive Addiction and Recovery Act of 2016 (PL 114-198) FY 2021 LHHS Appropriations: Fiscal Year 2021 Appropriations for Subcommittee on Labor, Health and Human Services Outside Witness Testimony Affordable Care Act reform efforts H.R. 1628, American Health Care Act of 2017 S. Amdt. 1030 to H.R. 1628, "Graham-Cassidy" Better Care Reconciliation Act of 2017 H.R. 1492, Medical Controlled Substances Transportation Act of 2017 H.R. 1215, Protecting Access to Care Act of 2017 H.R. 3545, Overdose Prevention and Patient Safety Act H.R. 3446, Restoring Board Immunity Act of 2017: Professional Licensing S.2260, Opioids and STOP Pain Initiative ACT:opioids 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care H.R.3928, Truth in Healthcare Marketing Act of 2017 H.R. 1554, REDI Act: student loan debt repayment for residents 21st Century Cures Initiative Drug Shortages - FDA, DEA, HHS, CMS, GAO, House Energy and Commerce Committee, Senate HELP Committee DEA Scheduling Propofol Comparative Effectiveness Research - PCORI HITECH Implementation, Electronic Health Records, Final and Proposed Rules, HIT Meaningful Use HHS/OIG Anesthesia Practice Arrangements, Company Model FDA Safe Use Initiative Pain Management FTC Letters to States re: Interventional Pain Medicine & Advanced Practice Nurses & Competition in Healthcare Anesthesia Research Funding (Pediatric and others) Scope of Practice FDA Operating Room Fires Naloxone FDA Opioids Prescription Drug Abuse FDA Network of Experts NIH Interagency Pain Research Coordinating Committee FDA SMART TOTS - pediatric anesthesia research USP - US Pharmacopeia National Pain Strategy Nondiscrimination Compounding FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) Agency for Healthcare Research and Quality (AHRQ) funding Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Sequestration Opioids and opioid abuse; Brain health Certified Anesthesiologist Assistants Blood management COVID-19: Increased supply of PPE and ventilators, Funding for physician practices impacted by the cancellation of elective surgeries, unique role of anesthesiologists in responding to COVID-19 pandemic, medical liability, Scope of Practice (Waiver of federal supervision requirement under the Emergency Declaration), insurance moratorium; COVID Update Memorandum 4/21/20 Centre for Clinical and Applied Services Provision Research

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 1082/ S. 402, Survivors' Access to Supportive Care Act; H.R. 728, Title VIII Nursing Workforce Reauthorization Act; H.R. 3593/ S. 1601 the Hot Cars Act of 2019; H.R 4861/ S. 3006 the Effective Suicide Screening and Assessment in the Emergency Department Act; H.R. 6390/S. 3568 Medical Supply Chain Emergency Act of 2020; H.R. 6711/S. 3627 the Medical Supply Transparency and Delivery Act; H.R. 7255 Coronavirus Health Care Worker Wellness Act; S. 4349/H.R. 8094 the Dr. Lorna Breen Health Care Provider Protection Act; various pieces of legislation in response to the COVID-19 pandemic, including H.R. 6800, the HEROES Act and S. 1624 the HEALS Act. Consolidated Omnibus Appropriations for FY2021, Including Coronavirus Relief Package (H.R. 133)

Client expense: $35,400 · Firm income: Not reported

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

H.R. 1082/ S. 402, Survivors' Access to Supportive Care Act; H.R. 728, Title VIII Nursing Workforce Reauthorization Act; H.R. 3593/ S. 1601 the Hot Cars Act of 2019; H.R 4861/ S. 3006 the Effective Suicide Screening and Assessment in the Emergency Department Act; H.R. 6390/S. 3568 Medical Supply Chain Emergency Act of 2020; H.R. 6711/S. 3627 the Medical Supply Transparency and Delivery Act; H.R. 7255 Coronavirus Health Care Worker Wellness Act; S. 4349/H.R. 8094 the Dr. Lorna Breen Health Care Provider Protection Act; various pieces of legislation in response to the COVID-19 pandemic, including H.R. 6800, the HEROES Act and S. 1624 the HEALS Act.

Client expense: $35,300 · Firm income: Not reported

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Gun violence prevention research funding Child product safety Child passenger safety COVID-19 pandemic response for AI/AN communities Child care supplemental funding Providing Americans Insured Days of Leave Act (HR 6442 / S 3513) Special Diabetes Program for Indians Reauthorization Act (S 3937) Maternal, Infant, and Early Childhood Home Visiting Program funding Sudden Unexpected Infant Death (HR 2271 / S 1130) Infant sleep product safety Lead exposure prevention Regulation of air pollutants Food additive safety Paid family leave Climate change IHS funding Tribal Health Data Improvement Act (HR 7948 / S 4562) Child Abuse Prevention and Treatment Act reauthorization CAPTA Plans of safe care grants Family First Prevention Services Act implementation Issues related to the COVID-19 pandemic and providing supports for the child welfare community Emergency Funding for Child Protection Act (S 3660) Child Welfare Emergency Funding Act (S 4172) Supporting Foster Youth and Families through the Pandemic Act (HR 7947) Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act (HR 6800) The Informing Grandfamilies Act Standards in CBP Custody, S. 2135 Standards in ICE Family Detention Standards in ORR Custody Public Charge Child Nutrition Reauthorization/WIC SNAP Mental Health for Children OTC Drug Reform H.R. 6, DREAM Act Family Separation and Detention CARE for Families Act HR 3107 WIC Act Keep Families Together Act Breastfeeding Peer Counseling Program Public Health Preparedness and Response Research for Pregnant and Lactating Women Palliative Care and Hospice Education and Training Act (S. 2080) Dietary Guidelines Child Poverty HEROES Act Senate 4.0 Coronavirus Response Legislation Asylum Child Poverty Reduction Act Suicide Prevention Dr Lorna Breen Health Care Provider Protection Act S. 4349 CBP Medical Services Contract Child Nutrition Waivers Eviction Moratorium Quit Because of COVID-19 Act (H.R. 7286/ S. 4524) Pediatric Subspecialty Loan Repayment Program FY 2021 Appropriations 2020 Census Deadline Extensions Act (S. 4571) COVID-19 Relief Legislation Mainstreaming Addiction Treatment Act (H.R. 2482/S. 2074) Regulation of Tobacco Products Research Investment to Spark the Economy (RISE) Act (H.R. 7308) Childhood immunizations, including an amendment by the Department of Health and Human Services (HHS) to the PREP Act to allow pharmacists to administer immunizations to children aged three to 18 years old COVID-19 vaccine, the importance of following safety and testing protocols, and the need to include children in clinical vaccine trials FY2021 National Defense Authorization Act (NDAA), including support for provisions to halt the reduction or realignment of military medical personnel billets and transformation of the Military Health System/military medical treatment facilities VACCINES Act and related issues around combatting vaccine hesitancy and misinformation Payment for vaccine administration and reform to the Vaccines for Children (VFC) Program Federal funding for K-12 education in response to COVID-19 FY 2021 appropriations Requesting the collection and regular reporting of data on race and ethnicity by the Social Security Administration (SSA) Addressing the needs of students with disabilities in light of COVID-19 12-Month Continuous Medicaid/CHIP Eligibility Medicaid Work Requirements Medicaid Block Grants Medicaid Per Capita Caps Section 1115 Medicaid Waivers Medicaid Payment Parity Increase to Medicaid FMAP During COVID-19 Establish an automatic FMAP increase tied to state economic indicators S. 4108, Coronavirus Medicaid Response Act HR 6159, the Kids Access to Primary Care Act The Ensuring Access for Womens and Childrens Act, S. 4088. Medicaid Maintenance of Effort (MOE) Protections Comprehensive Access to Robust Insurance Now Guaranteed (CARING) for Kids Act (H.R.6151) H.R.6098 to Expand State CHIP Eligibility Delaying the CHIP FMAP Decrease H.R.6797/S.3881 - CHIPPER Act Medicaid Fiscal Accountability Rule Maternal Health H.R. 4995 Helping Moms Act Expanding Medicaid to 12 Months Post-Partum Medicaid Premiums and Cost Sharing Helping Families Access Pediatric Care Act of 2020 Medicaid Payment for Eligibility Workers Expanding the use of Telehealth in Medicaid/CHIP/Private Insurance Allow for the home and other secure locations as originating (patient) and distant (provider) sites in telehealth Waive telehealth cost-sharing for patients in telehealth Pay for telehealth care visits at parity with that of in-person visits Allow telehealth care for both new and established patients Expanding Capacity for Health Outcomes (ECHO) Act of 2019 (S 1618/HR 5199) Including Preventive Medicine Service Codes to be Eligible for Telehealth Increased Access To Broadband to Expand Telehealth Services Financial Relief to Medicaid Providers Financial Relief for Pediatricians Provider Relief Fund Expanding Provider Relief Fund Eligibility to Those Pediatricians Who Received a Small Medicare Allotment COVID-19 Response Targeted allocation of funds to primary care physician practices. Expand existing alternative payment models for primary care Fully implementing the 2021 outpatient E/M changes. Immediately implement the vaccine administration payment increases proposed in the 2021 MPFS. VACCINES Act, H.R. 2862 Expand VFC to separate CHIP Programs

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

Government targets: Administration for Children & Families (ACF), Agriculture, Dept of (USDA), Bureau of Citizenship & Immigration Services (BCIS), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Product Safety Commission (CPSC), Environmental Protection Agency (EPA), Federal Aviation Administration (FAA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Indian Health Service, Natl Highway Traffic Safety Administration (NHTSA), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, U.S. Agency for International Development (USAID), U.S. Customs & Border Protection, U.S. Immigration & Customs Enforcement (ICE)

S. 4421, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, 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. 1503, Orange Book Transparency Act of 2019, all provisions H.R. 1520, Purple Book Continuity Act of 2019, all provisions H.R. 987, Strengthening Health Care and Lowering Prescription Drug Costs Act, all provisions H.R. 3, Elijah E. Cummings Lower Drug Costs Now Act, all provisions H.R. 3502, Protecting People From Surprise Medical Bills Act, all provisions S. 1895, Lower Health Care Costs Act, provisions related to surprise billing H.R. 5826, Consumer Protections Against Surprise Medical Bills Act of 2020, all provisions H.R. 3630, No Surprises Act, all provisions S. 1531, Stopping The Outrageous Practice of (STOP) Surprise Medical Bills Act of 2019, all provisions S. 4666, A bill to establish the Commission on the Coronavirus Pandemic in the United States, all provisions S. 44507, Getting Early Treatment and Comprehensive Assessments Reduces Emergencies (GET CARE) Act of 2020, all provisions H.R. 8441, To establish certain protections and benefits for front line workers, and for other purposes, all provisions H.R. 925, The Heroes Act, provisions related to COVID-19 H.R. 6644, Health Care at Home Act of 2020, all provisions S. 3741, Health Care at Home Act of 2020, all provisions S. 3749, Public Health Emergency Privacy Act, all provisions S. 3861, Exposure Notification Privacy Act, all provisions H.R. 6585, Equitable Data Collection and Disclosure on COVID-19 Act, all provisions H.R. 7510, Assimilating Health and Equity Assessments into Decision-making (AHEAD) Act of 2020, all provisions H.R. 7255, Coronavirus Health Care Worker Wellness Act of 2020, all provisions H.R. 8094, Dr. Lorna Breen Health Care Provider Protection Act, all provisions S. 4349, Dr. Lorna Breen Health Care Provider Protection Act, all provisions H.R. 4995, Maternal Health Quality Improvement Act of 2020, all provisions H.R. 7120, George Floyd Justice in Policing Act of 2020, all provisions H.R. 2279, Safe Step Act, all provisions S. 4055, Strengthening America's Health Care Readiness Act, all provisions S. 2032, Cannabidiol and Marihuana Research Expansion Act, all provisions Essential Workforce Parity Act Affordable Care Act (ACA) stabilization Georgia's ACA Section 1332 waiver Public Health Emergency Fund/physician financial assistance/healthcare workforce support 21st Century Cures Act/health data and privacy Surprise medical billing Expanded Personal Protective Equipment (PPE)/clearinghouses Health equity Maternal mortality Marginalized and minoritized communities/COVID-19 disproportionate impact COVID-19/serology testing supply chain COVID-19/response strategy COVID-19/social distancing COVID-19/data collection COVID-19/ PPE/federal funding COVID-19/Vaccines COVID-19/pediatric vaccines/pharmacists and pharmacy interns COVID-19/Coding Pharmacists and COVID-19 testing Mental health parity 42 CFR Part 2, HIPAA Funding for pandemic planning and preparedness Physician burnout/suicide Telehealth waivers Augmented Intelligence (AI) Drug pricing/Executive Orders Health Quality Roadmap Datablocking Health breach notification rule Electronic health record (EHR) certification

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

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

Childcare Issues related to childcare - no specific bill COVID-19 Pandemic H.R. 6800 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S. 3599/H.R.6788 - Healthcare Workforce Resilience Act H.R. 6793 - Pandemic Production Act H.R. 266 - Paycheck Protection Program and Health Care Enhancement Act H.R.7010 - Paycheck Protection Program Flexibility Act of 2020 H.R.6720 - Student Loan Forgiveness for Frontline Health Workers Act H.R. 7059 - Coronavirus Provider Protection Act H.R. 748 - The Coronavirus Aid, Relief, and Economic Security Act or the CARES Act Issues related to the COVID-19 Pandemic including: - no specific bill Financial assistance for health care providers Medicare Accelerated and Advance Payment Program Medicare and Medicaid payment rates Federal Medicaid Match Liability protection for health care providers Demographic data for the COVID-19 response Access to personal protective equipment (PPE) and medical supplies PPE supply chain improvements Access to testing for COVID-19 Telemedicine/telehealth Small Business Administration loans Support for contact tracing programs Mental and behavioral health Support for programs addressing domestic violence and child maltreatment Support for resident physicians and medical students Student loan forgiveness/debt relief State and local funding General advocacy on a COVID-19 stimulus/relief package FMAP increase in the Families First Coronavirus Response Act (P.L. 116-127) H.R.6793, the Pandemic Production Act (PPA) S.4349/ H.R.8094, the Dr. Lorna Breen Health Care Provider Protection Act H.R.7819 - Eliminating the Provider Relief Fund Tax Penalties Act of 2020 Immigration Public Charge - no specific bill S. 948/H.R. 2895, Conrad State 30 and Physician Access Reauthorization Act Interoperability/ONC Issues related to interoperability - no specific bill Medicare/Medicaid The Medicare Access and CHIP Reauthorization Act (MACRA) Medicaid Fiscal Accountability regulation Block Grants - no specific bill Issues related to Medicare Payments Prior Authorization - no specific bill Publications Open access to information based on publicly funded research OSTP Request for Information - FR Doc. 2020-06622 - Public Access to Peer-Reviewed Scholarly Publications, Data and Code Resulting From Federally Funded Research Issues related to scholarly and scientific publishing and public access Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Scope of Practice - no specific bill Surprise Billing 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 Consumer Protections Against Surprise Medical Bills Act of 2020 - House Ways & Means Telehealth S. 4375, the Telehealth Modernization Act of 2020 Issues related to telehealth - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory Comments Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2021

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Science & Technology Policy (OSTP), SENATE

Childcare Issues related to childcare - no specific bill COVID-19 Pandemic H.R. 6800 - Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S. 3599/H.R.6788 - Healthcare Workforce Resilience Act H.R. 6793 - Pandemic Production Act H.R. 266 - Paycheck Protection Program and Health Care Enhancement Act H.R.7010 - Paycheck Protection Program Flexibility Act of 2020 H.R.6720 - Student Loan Forgiveness for Frontline Health Workers Act H.R. 7059 - Coronavirus Provider Protection Act H.R. 748 - The Coronavirus Aid, Relief, and Economic Security Act or the CARES Act Issues related to the COVID-19 Pandemic including: - no specific bill Financial assistance for health care providers Medicare Accelerated and Advance Payment Program Medicare and Medicaid payment rates Federal Medicaid Match Liability protection for health care providers Demographic data for the COVID-19 response Access to personal protective equipment (PPE) and medical supplies PPE supply chain improvements Access to testing for COVID-19 Telemedicine/telehealth Small Business Administration loans Support for contact tracing programs Mental and behavioral health Support for programs addressing domestic violence and child maltreatment Support for resident physicians and medical students Student loan forgiveness/debt relief State and local funding General advocacy on a COVID-19 stimulus/relief package FMAP increase in the Families First Coronavirus Response Act (P.L. 116-127) H.R.6793, the Pandemic Production Act (PPA) S.4349/ H.R.8094, the Dr. Lorna Breen Health Care Provider Protection Act H.R.7819 - Eliminating the Provider Relief Fund Tax Penalties Act of 2020 Immigration Public Charge - no specific bill S. 948/H.R. 2895, Conrad State 30 and Physician Access Reauthorization Act Interoperability/ONC Issues related to interoperability - no specific bill Medicare/Medicaid The Medicare Access and CHIP Reauthorization Act (MACRA) Medicaid Fiscal Accountability regulation Block Grants - no specific bill Issues related to Medicare Payments Prior Authorization - no specific bill Publications Open access to information based on publicly funded research OSTP Request for Information - FR Doc. 2020-06622 - Public Access to Peer-Reviewed Scholarly Publications, Data and Code Resulting From Federally Funded Research Issues related to scholarly and scientific publishing and public access Racial Justice/Health Equity Issues related to racial justice/health care equity - no specific bill Scope of Practice - no specific bill Surprise Billing 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 Consumer Protections Against Surprise Medical Bills Act of 2020 - House Ways & Means Telehealth S. 4375, the Telehealth Modernization Act of 2020 Issues related to telehealth - no specific bill Vaccines Issues related to vaccines - no specific bill Regulatory Comments Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2021

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Science & Technology Policy (OSTP), SENATE

Health Insurance Coverage (general); Health Disparities (general); Breastfeeding (general); Assisted Reproductive Technology (general); Smoking Cessation (general); Substance Use Disorder (general); Gynecologic Cancer (general); Gynecologic Devices (general); Reproductive Health (general); Intimate Partner Violence (general); Gun Violence (general); Immunization (general); Breast Cancer (general); Medical Liability Reform (general); Health IT (general); Patient-Physician Relationship (general); Child Welfare (general); Prematurity (general); Maternal Mortality and Morbidity (general); Graduate Medical Education (general); Contraception (general); Abortion (general); Indian Health (general); Teaching Health Centers Graduate Medical Education (general); Community Health Centers (general); National Health Service Corps (general); Special Diabetes Program (general); Special Diabetes Program for Indians (general); Sexuality Education (general); Teen Pregnancy Prevention Program (general); Personal Responsibility Education Program (general); Research in Pregnant and Breastfeeding Women (general); Health Care Reform (general); Title X Family Planning Program (general); Womens Preventive Services (general); Administrative Burden (general); Surprise Billing (general); Pediatric Loan Repayment Program (general); COVID-19 Response (general); Personal Protective Equipment (general); Risk Evaluation and Mitigation Strategies (general); Data Collection (general); Health Equity (general); Pregnancy Risk Assessment Monitoring System (CDC); Provider Relief Fund (general); Maternal Mental Health (general); Violence Against Women Act (general); Secretarys Advisory Committee on Infant Mortality (general); H.R. 2975/S. 1645, Womens Health Protection Act; S. 1895, Lower Health Care Costs Act; H.R. 2862/S. 1619, VACCINES Act; implementation of P.L. 115-344, Preventing Maternal Deaths Act; implementation of P.L. 115-320, Improving Access to Maternity Care Act; S. 2586, Maternal Outcomes Matter Act; HR 3630, No Surprises Act; HR 3502, Protecting People From Surprise Medical Bills Act; H.R. 4495, Maternal Health Quality Improvement Act of 2019; H.R. 5640/S. 3152, the Data Mapping to Save Moms Lives Act; H.R. 6142/ S. 3424, the Black Maternal Health Momnibus Act of 2020 implementation of P.L. 116-123, the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020; implementation of P.L. 116-127, the Families First Coronavirus Response Act; implementation of P.L. 116-136, the Coronavirus Aid, Relief, and Economic Security Act; implementation of P.L. 116-139, Paycheck Protection Program and Health Care Enhancement Act; H.R. 6800, the Heroes Act; H.R. 1425, the Affordable Care Act Enhancement Act; H.R. 7059 the Coronavirus Provider Protection Act; H.R. 6953/ S. 3763 the Pandemic Responder Service Award Act; H.R. 6697, the Local Chamber, Tourism, and 501(c)(6) Protection Act; S.___, the Health, Economic Assistance, Liability Protection, and Schools Act; H.R. 2694, the Pregnant Workers Fairness Act; H.R. 8027, the Maternal Health Pandemic Response Act; S. 4524, the Quit Because of COVID-19 Act; HRes 1069/ SRes 655, Declaring racism a public health crisis; S. 4269 the Mothers and Newborns Success Act; S. 4349, Lorna Breen Health Care Provider Protection Act.

Client expense: $404,940 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Executive Office of the President (EOP), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Indian Health Service, Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), State, Dept of (DOS), Substance Abuse & Mental Health Services Administration (SAMHSA), U.S. Agency for International Development (USAID), Veterans Affairs, Dept of (VA), White House Office

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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