Excellence in Mental Health and Addiction Treatment Expansion Act

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

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of funding for the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies related to health insurance market stabilization Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Human and child trafficking Palliative Care and Hospice Education and Training Act (H.R. 647/S. 2080) Title VIII Nursing Workforce Reauthorization Act of 2019 (H.R. 728/S. 1399) Coronavirus Aid, Relief, and Economic Security (CARES) Act (H.R. 748/S.3548) Emergency Medical Services for Children Program Reauthorization Act of 2019 (H.R. 776/S. 1173) End Surprise Billing Act of 2019 (H.R. 861) Fairness for Breastfeeding Mothers Act (H.R. 866/S. 528) Heroes Act (H.R. 925) Mental Health Access Improvement Act of 2019 (H.R. 945) Mental Health Services for Students Act of 2019 (H.R. 1109) Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 1309) Competitive Health Insurance Reform Act of 2020 (H.R. 1418) Patient Protection and Affordable Care Enhancement Act (H.R. 1425) Healthy Families Act (H.R. 1784/S. 840) Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act (H.R. 1897) School-Based Health Centers Reauthorization Act of 2019 (H.R. 2075/S. 1013) Scarlett's Sunshine on Sudden Unexpected Death Act (H.R. 2271/S. 1130) Easy MAT for Opioid Addiction Act (H.R. 2281) Community Health Investment, Modernization, and Excellence Act of 2019 (H.R. 2328) Newborn Screening Saves Lives Reauthorization Act of 2019 (H.R. 2507) Pregnant Workers Fairness Act (H.R. 2694) Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 (H.R. 2781) Vaccine Awareness Campaign to Champion Immunization Nationally and Enhance Safety (VACCINES) Act of 2019 (H.R. 2862) Physical Activities Recommendations for Americans Act of 2019 (H.R. 2891) Safe Cribs Act of 2019 (H.R. 3170) Safe Sleep for Babies Act of 2019 (H.R. 3172) Pathways to Health Careers Act (H.R. 3398) Chronic Care Management Improvement Act (H.R. 3436) No Surprises Act (H.R. 3630) Midwives for Maximizing Optimal Maternity Services (Midwives for MOMS) Act of 2019 (H.R. 3849) Social Determinants Accelerator Act of 2019 (H.R. 4004/S. 2986) Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms (DISARM) Act of 2019 (H.R. 3328/H.R. 4100/S. 1712) Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 (H.R. 4861/S. 3006) United States Public Health Service Modernization Act of 2019 (H.R. 4870/S. 2629) Medication Access and Training Expansion (MATE) Act of 2019 (H.R. 4974) Maternal Health Quality Improvement Act of 2019 (H.R. 4995) Helping Medicaid Offer Maternity Services (MOMS) Act of 2019 (H.R. 4996) Protecting Seniors Through Immunization Act of 2019 (H.R. 5076/S. 1872) Pursuing Equity in Mental Health Act of 2019 (H.R. 5469) Primary and Behavioral Health Care Access Act (H.R. 5575) Ban Surprise Billing Act (H.R. 5800) Consumer Protections Against Surprise Medical Bills Act of 2020 (H.R. 5826) Black Maternal Health Momnibus Act of 2020 (H.R. 6142/S. 3424) Families First Coronavirus Response Act (H.R. 6201) Take Responsibility for Workers and Families Act (H.R. 6379) Health Care at Home Act (H.R. 6644) COVID-19 Mental Health Research Act (H.R. 6645) HEROES Act (H.R. 6800) Child Care Is Essential Act (H.R. 7027) Ensuring Children and Child Care Workers Are Safe Act of 2020 (H.R. 7079) Child Care for Economic Recovery Act (H.R. 7327) Protect Telehealth Access Act (H.R. 7391) Protecting Access to Post-COVID-19 Telehealth Act of 2020 (H.R. 7663) Community and Public Health Programs Extension Act (S. 192) National Nurse Act of 2019 (S. 696/H.R. 1597) Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/H.R. 1767) Nursing Where It's Needed Act (S. 1045) Promoting Physical Activity for Americans Act (S. 1608) Lower Health Care Costs Act (S. 1895) National Suicide Hotline Designation Act (S. 2661) Child Care Protection Improvement Act of 2019 (S. 2683) CONNECT for Health Act of 2019(S. 2741/H.R. 4932) CAPTA Reauthorization Act of 2019 (S. 2971) Suicide Prevention Act (S. 3198/H.R. 5619) Eliminating Abusive and Rampant Neglect of Interactive Technologies (EARN IT) Act of 2020 (S. 3398) Tele-Mental Health Improvement Act (S. 3792) Coronavirus Mental Health and Addiction Assistance Act of 2020 (S. 3825/H.R. 6999) Mental and Behavioral Health Connectivity Act (S. 3999) Future Advancement of Academic Nursing (FAAN) Act (S. 4396/H.R. 7945) Safe Authorization for Vaccines during Emergencies (SAVE) Act (S. 4427) Pioneering Antimicrobial Subscriptions to End Up surging Resistance (PASTEUR) Act of 2020 (S. 4760)

Client expense: Not reported · Firm income: $24,000

Government targets: Bureau of Alcohol Tobacco Firearms & Explosives, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), Vice President of the U.S., White House Office

Discussions on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussions about the work of Aligning for Health to address social determinants of health; Support HR 1041 / S 586,Critical Access Hospital Relief Act of 2019, a bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services; Support S 895, Rural Hospital Regulatory Relief Act of 2019, a bill to provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals; Support S 948,Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities, and for other purposes; Discussions in support of the Rural Emergency Medical Center Act (REACH) Act; Support for extension of the Rural Community Hospital Demonstration Program; Support for extension of the Frontier Community Health Integration Project Demonstration program; Discuss changes with House and Senate committees to Section 8122 of the SUPPORT for Patients and Communities Act; Letter of support to Energy and Commerce Committee for the hearing on legislation to strengthen our health care system and ACA market stability; Support HR 1781/ S 801, Payment Commission Data Act of 2019, a bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information; Support S 551 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 or the REFUND Act of 2019, a bill to amend title XVIII of the Social Security Act to require manufacturers of certain single-dose vial drugs payable under part B of the Medicare program to provide rebates with respect to amounts of such drugs discarded, and for other purposes; Support S 824/ HR 1767, Excellence in Mental Health and Addiction Treatment Expansion Act, a bill to increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services; Statement submitted to Senate Finance Committee on the implementation of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support HR 2552Protecting Local Access to Care for Everyone Act of 2019 or the PLACE Act of 2019, a bill to direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program; Support HR 3022, Patient Access Protection Act, a bill to amend title XIX of the Social Security Act to repeal the reductions in Medicaid DSH allotments, and for other purposes; Letter of support to the Ways and Means Committee in support of legislation to improve the quality of an access to services for Medicare beneficiaries, help train the physician workforce and reduce administrative burden on rural hospitals; Support HR 3431, HEARTS and Rural Relief Act, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2021; Support HR 3417,Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 or the BETTER Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for patient improvements and rural and quality improvements under the Medicare program; Oppose HR 1384, Medicare for All Act of 2019, a bill to establish an improved Medicare for All national health insurance program; Oppose S 1129, Medicare for All Act of 2019, a bill to establish a Medicare-for-all national health insurance program; Letter to House Committee on Ways and Means for the hearing on Pathways to Universal Health Coverage addressing concerns with Medicare for All and believe that the variety of proposals that often are used interchangeably under that name are not the solution; Oppose HR 2452, Medicare for America Act of 2019, a bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans; Letter to House Committee on Budget for the hearing on the Congressional Budget Offices (CBO) Key Design Components and Considerations for Establishing a Single-Payer Health Care System addressing concerns with Medicare for All; Oppose S 1261/ HR 2463, Choose Medicare Act, a bill to provide for the establishment of Medicare part E public health plans, and for other purposes; Oppose S 981/ HR 2000Medicare-X Choice Act of 2019A bill to establish a public health plan; Oppose S 1033/ HR 2085, CHOICE Act, a bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Oppose S 470, Medicare at 50 Act, a bill to amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare; Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes; Submitted Statement to the House Committee on Rules for the Hearing Medicare for All Act of 2019; Comment on provisions of HR 2328,Reauthorizing and Extending Americas Community Health (REACH) Act, support for the Medicaid disproportionate share hospital(DSH) program provisions included in Title III; comments on Title IV, which contains provisions of the No Surprises Act and concern with the legislations approach to determining reimbursement for out-of-network providers; Support HR 3107 Seniors Timely Access to Care Act of 2019, this legislation would establish requirements for the use of prior authorization under Medicare Advantage plans; Meeting with the Senate finance committee to discuss changes to drug bill; Meeting with CMS to discuss changes to prior authorization; Meeting with Department of Labor to discuss issues with ERISA health plans; Met with CMS staff on rural hospital issues; Regulatory burden related to new CMS guidance on documenting Crossover bad debt; Sent a Comment letter to CMS on a final rule on program integrity enhancements to the provider enrollment process for Medicare, Medicaid and Children's Health Insurance Programs; Oppose S. 2860 Patient Access to Higher Quality Health Care Act of 2019, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 4996, Helping MOMS Act of 2019, a bill amend title XIX of the Social Security Act to provide for a State option under the Medicaid program to provide for and extend continuous coverage for certain individuals, and for other purposes; Addressing hospital concerns about HR 3 Lower Drug Costs Now Act, a bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes; Sent comment letter requesting that CMS withdraw the proposed regulation related to Medicaid Program: Medicaid Fiscal Accountability Regulation ( MFAR) financing and supplemental payments. Given that the proposal would severely curtail the availability of health care services to millions of individuals and because many of its provisions are not legally permissible; Discussion with CMS for rural hospitals and critical access hospitals about the Medicare accelerated payment program, which is intended to provide necessary funds to providers, including rural hospitals and critical access hospitals, when there is a disruption in claims submission and/or claims processing; Submitted comments on CMSs proposed rule on Medicare Advantage and Part D prescription drug program for Contract Years 2021 and 2022. The letter focuses on several proposals addressing network adequacy; Letter sent to HHS, CDC, CMS, and SAMHSA requesting specialized guidance and assistance for providers who care for patients with behavioral health disorders; Support resetting the Improving Medicare Post- Acute Care Transformation (IMPACT) Act of 2014 in the next COVID-19 relief package. The IMPACT Acts implementation is behind schedule and does not take into account extensive payment reforms already underway in each post-acute care setting; Letter urging HHS to release substantial additional emergency funds to all hospitals in an expedited manner. This second wave of funding to all hospitals, targeted relief is necessary for hospitals in hot spots, hospitals with a high percentage of payments under Medicare Advantage, hospitals caring for high numbers of Medicaid patients, and rural hospitals; Support HR 6693 Critical Access Hospital Expansion Act of 2020, a bill to amend title XVIII of the Social Security Act to allow States to certify certain hospitals as necessary providers for purposes of designating such hospitals as critical access hospitals under the Medicare program; Support HR 6753/ S 3615 Rural Community Hospital Demonstration Extension Act of 2020, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the rural community hospital demonstration program; Letter urging CMS to use its authority to extend to LTCHs the existing 20% hospital add-on payment for Medicare beneficiaries diagnosed with COVID-19; Letter to CMS urging the agency to temporarily extend certain waivers and make others permanent beyond the COVID-19 public health emergency to allow hospitals to provide better and more cost effective care to their patients and communities; Sent comment letter to CMS about our concerns with the timeline proposed for implementation as well as the potential for penalties for noncompliance within this timeline on the Medicare Program: Electronic Prescribing of Controlled Substances; Sent comment letter on the FY 2021 Inpatient PPS proposed rule addressing CMS proposals related to payer-specific negotiated rate data collection, Medicare DSH payments, CAR T, bad debt, MS-DRG classifications, and quality programs, among other topics. Letter requesting that the CMS delay the implementation of the Appropriate Use Criteria for Advanced Diagnostic Imaging Services program to allow providers the opportunity to implement and test operational changes and acquire the education necessary to achieve compliance with the program; Sent comments to the CMS on the agencys long-term care hospital prospective payment system proposed policy changes and fiscal year 2021 rates; Letter to CMS asking for a delay in the start of repayments associated with the Medicare Accelerated and Advance Payment (AAP) Programs; Letter urging the CMS to continue its suspension of medical review activities throughout the ongoing COVID-19 public health emergency; Letter urging CMS to allow periodic interim payment (PIP) hospitals to carry out their accelerated payment repayment at cost settlement, as was initially communicated by the agency and also request that the agency make alternative repayment approaches available, such as direct payments to the Medicare Administrative Contractor (MAC), for all hospitals; Comment letter on CY 2021 Home Health Prospective Payment System Rate Update proposed rule. While we continue to support the PDGM objective of increasing HH PPS payment accuracy, we remain concerned that CY 2020s large behavioral offset, 4.36%, was implemented on a prospective basis; Letter urging the CMS to withdraw the condition of participation (CoP) that hospitals report daily COVID-19 data and request that CMS immediately release detailed interpretive guidance so hospitals can take the necessary steps to come into compliance; Urged CMS to withdraw its Medicaid fiscal accountability proposed rule from its regulatory agenda because it would "severely curtail the availability of health care services to millions of individuals" and "many of its provisions are not legally permissible;" Submitted comment letter that disagree with CMS interim APC assignments of COVID-19 vaccine administration services to these New Technology APCs because they are inconsistent with longstanding CMS policy; Submitted comments responding to a CMS request for information on regulatory relief to support economic recovery urging the agency to take additional action to remove certain regulatory barriers standing in the way of efficiency and innovation, thus allowing hospitals to provide better and more cost-effective care to our patients and communities. In order to achieve these objectives, we ask the agency to temporarily extend certain waivers and make others permanent beyond the duration of the COVID-19 public health emergency; Urged a delay implementation of CMS price transparency rule and also asked the Biden Transition team for enforcement discretion with the rule; Letter urging Congress to include in the year-end legislation an extension of the congressionally-enacted moratorium on the application of the Medicare sequester cuts into 2021 and through the duration of the public health emergency (PHE); Letter urging Congress to continue to support the movement to value by ensuring that clinicians in advanced alternative payment models (APMs) continue to receive incentives established under the bipartisan Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support S 5044, The Improving Seniors Timely Access to Care Act of 2020, a bill to amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans; Submitted a comment letter, urging CMS not to finalize proposals that would allow states to create a new type of direct enrollment marketplace in lieu of Healthcare.gov or a state-based marketplace. In addition, we do not support the codification in regulation of previous Section 1332 guidance that could allow states to pursue alternative approaches to coverage that would result in coverage losses; Support efforts to protect patients from surprise medical bills by including the No Surprises Act as part of the year-end legislative package; Submitted COVID-19 snapshot report for Congress to better understand the needs of hospitals and health systems during the public health emergency, which combines important data points with news articles and testimonials from the field to reiterate the dire circumstances hospitals and health systems face, and highlight why additional relief is necessary; Submitted comments in response to HRSAs proposal to include additional counties as eligible to receive Federal Office of Rural Health Policy (FORHP) grants, encouraged the agency to use a definition of rural that is inclusive and flexible, in order to broaden opportunities for providers in rural communities and urged HRSA to increase rural grant opportunities.

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

Excellence in Mental Health and Addiction Treatment Expansion Act, HR 1767/S. 824. Labor, Health and Human Services, Education, Defense, State, Foreign Operations, and Energy and Water Development Appropriations Act, 2020, HR 2740. National Suicide Hotline Designation Act of 2019, HR 4194/S. 2661. CARES Act, HR 748. Families First Coronavirus Response Act, HR 6201. The Heroes Act, HR 6800. Continuing Appropriations Act, 2021 and Other Extensions Act, HR 8337. American Workers, Families, and Employers Assistance Act, S. 4318. Consolidated Appropriations Act, 2021, H.R. 133. Telemental Health Expansion Act of 2020, HR 5201. TREATS Act, S. 4103.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Excellence in Mental Health and Addiction Expansion Act, HR 1767/S. 824. Medicaid Services Investment and Accountability Act of 2019, HR 1839. Mental Health Access Improvement Act, HR 945/S. 286. National De-Escalation of Violence and Community Safety Training Act of 2019, HR 2457. Labor, Health and Human Services, Education, Defense, State, Foreign Operations, and Energy and Water Development Appropriations Act, 2020, HR 2740. A bill to provide for a 2-week extension of the Medicaid community mental health services demonstration program, and for other purposes, S. 2047. Sustaining Excellence in Medicaid Act of 2019, HR 3253. Continuing Appropriations Act, 2020, and Health Extenders Act of 2019, HR 4378. Further Continuing Appropriations Act, 2020, and Further Health Extenders Act of 2019, H.R.3055. FY2020 Further Consolidated Appropriations Act (LHHSED, AG, Energy Water, Interior, Leg. Branch, MCVA, State-For. Ops, T-HUD), H.R. 1865. Prescription Drug Pricing Reduction Act of 2019, S. 2543. CARES Act, HR 748. Families First Coronavirus Response Act, HR 6201.The Heroes Act, HR 6800. Continuing Appropriations Act, 2021 and Other Extensions Act, HR 8337. American Workers, Families, and Employers Assistance Act, S. 4318. Consolidated Appropriations Act, 2021, H.R. 133.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Repeal of the Affordable Care Act Development of legislation to protect essential hospitals Issues related to telehealth Mental Health Essential Health Benefits created by the Affordable Care Act Access to hospital emergency services Issues related to the 340B Drug Pricing Program 340B dug pricing program CMS OPPS 340B rule moratorium-related legislation 42 CFR Part 2 CREATES Act-H.R.965 Cassidy Surprise Billing Draft Protecting Patients from Surprise Medical Bills Excellence in Metal Health Act (S.824/H.R.1767) Patient Centered Outcomes Research Institute Funding No Surprises Act Lower Health Care Costs Act Surprise Medical Bills H.R.4004 - Social Determinants Accelerator Act of 2019 S.2986 - Social Determinants Accelerator Act of 2019 H.R.2328 - Reauthorizing and Extending America's Community Health Act S.2723 - Mitigating Emergency Drug Shortages Act H.R.4995 - Maternal Health Quality Improvement Act of 2019 H.R.2889 - Closing Loopholes for Orphan Drugs Act 340B drug pricing program eligibility (Matsui-Stewart Dear Colleague letter) Relief for Rural Providers During Emergencies Act (S. 3631) Improving Social Determinants of Health Act (H.R. 6561) Liability reform Issues related to COVID-19 regulatory and financial relief COVID-19 Provider Relief Fund Resolution recognizing racism as public health issue - S. Res. 655 COVID-19 Bias and Anti-Racism Training Act - S. 4248 Protecting 340B eligibility during the pandemic - S. 4160 and HR 7838 Protect Telehealth Access Act of 2020 (HR 7391) Improving Social Determinants of Health Act - S. 4440 Maternal health 340B contract pharmacies (McKinley-DeGette-Gianforte-Matsui-Johnson-Welch Dear Colleague letter) 340B contract pharmacies (Baldwin-Capito-Cardin-Portman-Stabenow-Thune Dear Colleague letter) Delivering Immediate Relief to Americas Families, Schools and Small Businesses Act Health disparities COVID-19 payroll tax credits 340B rebate Dear Colleague letter (Spanberger-McKinley-Axne-Johnson-Matsui-Katko)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, 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

Bill # H.R. 647 and S2080: Palliative Care and Hospice Education and Training Act. Establishes Palliative Care and Hospice Education Centers to increase access to palliative care Bill # H.R. 728: Title VIII Nursing Workforce Reauthorization Act.To amend title VIII of the Public Health Service Act to extend advanced education nursing grants to support clinical nurse specialist programs Bill # H.R. 1767 and S824: Excellence in Mental Health and Addiction Treatment Expansion Act. To increase the number of states that may conduct Medicaid demonstration programs to improve access to community mental health services Bill # H.R. 2062 and S1012: Overdose Prevention and Patient Safety Act.Amends the Public Health Service Act to protect the confidentiality of substance use disorder patient records Bill # H.R. 2431 and S2500: Mental Health Professionals Workforce Shortage Loan Repayment Act. Authorizes a loan repayment program for mental health professionals to relieve workforce shortages Bill #H.R. 2482 and S2074: Mainstreaming Addiction Treatment (MAT) Act. Loosens restrictions on doctors prescribing buprenorphine for addiction treatment Bill #H.R. 2895 and S948: Conrad State 30 and Physician Access Reauthorization Act. Reauthorizes the Conrad 30 program through FY 2021 Bill #H.R. 3165 and S1737: Mental Health Parity Compliance Act. To achieve complete implementation of the Mental Health Parity and Addiction Equity Act (federal parity law) Bill #H.R. 4004 and S2986: Social Determinants Accelerator Act. To direct the Secretary of Health and Human Services to establish an interagency council on social determinants of health Bill #H.R. 4468: Nursing Home Workforce Quality Act. To address the shortage of certified nursing assistants (CNAs) Bill #H.R. 4859: Protecting Older Americans from Social Isolation Act. To amend the Older Americans Act to reduce social isolation among older individuals Bill #H.R. 5242: Opioid Settlement Accountability Act. To ensure that opioid settlement funds are used to fight the opioid epidemic, including treatment, prevention, education and enforcement efforts. Bill # H.R. 945 and S286: Mental Health Access Improvement Act. To provide for the coverage of marriage and family therapist services and mental health counselor services under Medicare Bill # H.R. 986:Protecting Americans with Preexisting Conditions Act.To prevent the promotion of short-term, limited duration insurance plans and association health plans Bill #S1399:Title VIII Nursing Workforce Reauthorization Act.To amend title VIII of the Public Health Service Act to extend advanced education nursing grants to support clinical nurse specialist programs Bill #S1895 Lower Health Care Costs Act Bill # HR5640 and S3152:Data Mapping to Save Moms' Lives Act. To require the Federal Communications Commission to incorporate data on maternal health outcomes into its broadband health maps. Bill # S3374: Protecting Jessica Grubbs Legacy Act. Amends the Public Health Service Act to protect the confidentiality of substance use disorder patient records. Bill S3599 and HR6788 Healthcare Workforce Resilience Act to expand the number of immigrant visas available to nurses and physicians Bill # HR748 S3548: Coronavirus Aid, Relief, and Economic Security Act provides financial relief and resources to individuals, families, and businesses impacted by the COVID-19 public health emergency. Bill # 7010 Paycheck protection program flexibility Bill #HR7292 Advanced Accelerated Payment Program forgiveness Bill HR 7077 and S3877 Community Solutions for COVID-19 Act grants to reduce or eliminate disparities HR 8200 Ending health disparities during COVID-19 Bill HR7838 and S4160 To enable certain hospitals participating in 340B drug discount program prior to COVID-19 public health emergency to maintain eligibility

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

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

Excellence in Mental Health and Addiction Expansion Act (S. 824/H.R. 1767); The Mental Health Access Improvement Act (S. 286/H.R. 945).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/ H.R. 1767), all provisions related to expanding and extending the Certified Community Behavioral Health Clinic Medicaid demonstration program. Mental Health Access Improvement Act (S. 286/H.R. 945), all provisions related to allowing marriage and family therapists and mental health counselors to directly bill Medicare for their services. Medicaid Reentry Act (H.R. 1329), all provisions related to allowing Medicaid coverage for eligible incarcerated individuals to be re-established up to 30 days before their release from jail or prison. Medicare Mental Health Modernization Act of 2007 (H.R. 1663), all provisions related to eliminating the lifetime limit of inpatient mental health services, parity, and coverage of marriage and family therapist/counselor services under Medicare.

Client expense: $104,240 · Firm income: Not reported

Government targets: Drug Enforcement Administration (DEA), Federal Communications Commission (FCC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

H.R. 1528, the Comprehensive Opioid Program Extension (COPE) Act, which would reauthorize the comprehensive opioid abuse program to provide more resources for communities; H.R. 1767/S. 824, the Excellence in Mental Health and Addiction Treatment Expansion Act, which would renew and expand the critical, community-based treatment program, the Certified Community Behavioral Health Clinic (CCBHC), which would otherwise expire on 22 May 2020; H.R. 2698, the "Law Enforcement Training for Mental Health Crisis Response Act," which would address an urgent need to provide our nations law enforcement officers with training to recognize and appropriately respond to behavioral crises caused, not by criminal activity, but by mental illness and substance abuse; H.R. 6008, the "Traumatic Brain Injury and Post-Traumatic Stress Disorder Law Enforcement Training Act," which would direct the Attorney General to develop crisis intervention training tools for use by law enforcement and other public safety officers when interacting with community members who have traumatic brain injury (TBI), another form of acquired brain injury, or Post-Traumatic Stress Disorder (PTSD); H.R. 6694/S. 3434, the Confidentiality Opportunities for Peer Support (COPS) Counseling Act," which would reduce the barriers for law enforcement officers when trying to access mental health resources; and S. 1464, the "Law Enforcement Training for Mental Health Crisis Response Act," which would address an urgent need to provide our nations law enforcement officers with training to recognize and appropriately respond to behavioral crises caused, not by criminal activity, but by mental illness and substance abuse.

Client expense: $55,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, White House Office

Lobbying Issues Description: Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; community-based public health interventions, and substance misuse/behavioral health issues. Specific Legislation: 1.Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2.Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act and Pandemic and All-Hazards Preparedness and Advancing Innovation Act (Public Law 113-5, 116-22) 3.Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296) 4.Implementation of Every Student Succeeds Act (Public Law 114-95) 5.Implementation of the Comprehensive Addition and Recovery Act (Public Law 114-98) 6.Midnight Rules Relief Act (S.34/H.R. 21) 7.Regulations from the Executive in Need of Scrutiny Act (S. 21/H.R. 26) 8.Regulatory Accountability Act (S.951/H.R. 5/H.R. 45/H.Res.33) 9.Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act (H.R. 998) 10.Regulatory Integrity Act (H.R. 1004) 11.OIRA Insight, Reform, and Accountability Act (S. 676/H.R. 1009) 12.A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026 (S.Con.Res. 3) 13.American Health Care Act (H.R. 1628/H.Res. 228) 14.Ozone Standards Implementation Act (S. 263/H.R. 806) 15.Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule of the Bureau of Land Management relating to "Waste Prevention, Production Subject to Royalties, and Resource Conservation" (S.J. Res. 11/H.J.Res.36) 16.Common Sense Nutrition Disclosure Act (S. 261/H.R. 772) 17.Reinvigorating Antibiotic and Diagnostic Innovation (READI) Act (H.R. 1840) 18.Preservation of Antibiotics for Medical Treatment Act (H.R. 1587) 19.Preventing Antibiotic Resistance Act (S. 629) 20.Better Care Reconciliation Act (H.R. 1628) and related amendments 21.Public Health Emergency Response Act (S. 196) 22.Recognizing the importance of vaccinations and immunizations in the United States (H.Res.327) 23.Treat and Reduce Obesity Act (S. 830/H.R. 1953) 24.Community Health and Medical Professionals Improve Our Nation (CHAMPION) Act (H.R. 3922) 25.Community Health Investment, Modernization, and Excellence Act of 2017 (S. 1899) 26.Tobacco Tax Equity Act (S. 1837) 27.Healthy Kids Act (S. 1821/H.R. 3921) 28.Implementation of the Drug Quality and Security Act (P.S. 113-54) 29.Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017 (Public Law 115-56) 30.Friendly Airports for Mothers Act (S. 1110/H.R. 2375) 31.Lead-Safe Housing for Kids Act (S. 1845) 32.Supporting Working Moms Act (S. 2122/H.R. 3255) 33.Championing Healthy Kids Act (H.R. 3922) 34.Making further continuing appropriations for fiscal year 2018, and for other purposes (Public Law 115-90) 35.An Act to amend the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign, and for other purposes (Public Law 115-96) 36.Tax Cuts and Jobs Act (Public Law 115-97) 37.Pandemic and All-Hazards Preparedness Advancing Innovation Act (S. 2852/H.R. 6378/H.R. 7328/S. 1379/H.R. 269) 38.Vaccine Access Improvement Act (H.R. 4993) 39.Relief from New Source Performance Standards Act (H.R. 453) 40.Strategies to Address Antimicrobial Resistance (S. 2469) 41.Opioid Quota Reform Act (S. 2535) 42.Hospital Preparedness Program Reauthorization Act (H.R. 4776) 43.Blocking Regulatory Interference from Closing Kilns Act (H.R. 1917) 44.Opioid Crisis Response Act of 2018 (S. 2680) 45.Agriculture and Nutrition Act (H.R. 2) 46.Agriculture Improvement Act (S. 3042) 47.SECURE Act (H.R. 5998) 48.Trauma-Informed Care for Children and Families Act (S. 774) 49.SUPPORT for Patients and Communities Act (H.R. 6) 50.Centers for Disease Control Emergency Response Act (S. 3161) 51.LABEL Opioids Act (S. 3428) 52.Relief from New Source Performance Standards Act (S. 1857) 53.Outdoors for All Act (S. 3499) 54.The MOMMA Act (H.R. 5977) 55.Preventing Maternal Deaths Act (H.R. 1318) 56.Medicare Access to Vaccines Equity Act (not yet introduced) 57.The Support Act (H.R. 6) 58.Climate Change Health Protection and Promotion Act (S. 529) 59.NURSE Act (H.R. 1597) 60.Investing for the People Act (H.R. 2021) 61.Child Care for Working Families Act (H.R. 365/S. 568) 62.FAMILY Act (H.R. 1185/S. 463) 63.Transportation Alternatives Enhancement Act (S. 1098) 64.Lower Health Care Costs Act (S. 1895) 65.LIFT America Act (H.R 2479) 66.Public Health Funding Restoration Act (H.R. 3447/S. 1944) 67.Supporting Older Americans Act of 2020 (HR 4334) 68.Campus Prevention and Recovery Services for Students Act (H.R. 3591) 69.Healthier Students for Stronger Campuses Act (S. 1281) 70.Saving Lives Through Better Data Act (S. 1793) 71.VACCINES Act (H.R. 2862) 72.DISARM Act (H.R. 4100/S. 1712) 73.Community Access, Resources, and Education for Families Act (H.R. 3117) 74.Protecting Seniors Through Immunization Act (S. 1872) 75.Tobacco-Free Youth Act (S. 1541) 76.Tobacco to 21 Act (H.R. 2411/S. 1258) 77.Investing for People Act (H.R. 2021) 78.School Based Health Centers Reauthorization Act (H.R.2075/S.1013) 79.Reversing the Youth Tobacco Epidemic Act of 2019 (H.R. 2339) 80.Social Determinants Accelerator Act (H.R. 4004/S. 2986) 81.Mental Health Professionals Workforce Shortage Loan Repayment Act (H.R. 2431) 82.The UNDERSTAND Act (S. 1323) 83.Americas Transportation Infrastructure Act (S. 2302) 84.Barriers to Suicide Act of 2019 (H.R. 4309) 85.Promoting Physical Activity for Americans Act (S. 1608/H.R. 2891) 86.Public Health Infrastructure Modernization Act of 2019 (H.R. 5321) 87.Supporting Healthy Mothers and Infants Act (H.R. 5249) 88.Lead-Free Future Act (H.R. 4416) 89.Home Visiting to Reduce Maternal Mortality and Morbidity Act (H.R. 4768) 90.Recognizing the anniversary of the eradication of smallpox and the importance of vaccination in the United States and worldwide (H. Res. 592) 91.Coronavirus Preparedness and Response Supplemental Appropriations Act (H.R. 6074) 92.Families First Coronavirus Response Act (H.R. 6201) 93.Coronavirus Aid, Relief, and Economic Security (CARES) Act (H.R. 748) 94.Connecting Americas Transportation Infrastructure Act (H.R. 5696/S. 3391)) 95.Improving Access to Remote Behavioral Health Treatment Act (S. 2244/H.R. 4131) 96.National Suicide Hotline Designation Act (S. 2661/H.R. 4194) 97.Suicide Prevention Lifeline Improvement Act (H.R. 4564) 98.Campaign to Prevent Suicide Act (H.R. 4585) 99.Medicaid Reentry Act (H.R. 1329) 100.Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/H.R. 1767) 101.Mental Health Services for Students Act (S. 1122/H.R. 1109) 102.Suicide Training and Awareness Nationally Delivered for Universal Prevention (STANDUP) Act (S. 2492/H.R. 2599) 103.Mental Health Parity Compliance Act (S. 1737/H.R. 3165) 104.Behavioral Health Transparency Act (S. 1576/H.R. 2874) 105.Medicare Mental Health Access Act (S. 2772/H.R. 884) 106.Public Health Emergency Response and Accountability Act (S. 3309) 107.Family Violence Prevention and Services Improvement Act (H.R. 5041) 108.Protecting the Health of Americas Older Adults During COVID-19 and Beyond Act (H.R. 6935) 109.Improving Social Determinants Act (H.R. 6561/S. 4440) 110.Urging the establishment of a United States Commission on Truth, Racial Healing, and Transformation (H.Con.Res.100) 111.FY 2021 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (TBD) 112.Better Tools for Healthy Living Act (S. 1805) 113.The WIC Act (H.R. 6811/S. 2358) 114.Health Equity and Accountability Act (H.R. 6637) 115.Paycheck Protection Program and Health Care Enhancement Act (H.R. 266) 116.The HEROES Act (H.R.6800) 117.Community Solutions for COVID-19 Act (H.R.7077/S.3877) 118.The Black Maternal Health Momnibus Act of 2020 (H.R. 6142) 119.COVID-19 Bias and Anti-Racism Training Act (H.R. 7618/S. 4248) 120.Urging the establishment of a United States Commission on Truth, Racial Healing, and Transformation (H. Con. Res. 100) 121.Community Immunity During COVID-19 Act of 2020 (H.R. 8061) 122.Public Safety Officer Support Act (H.R. 7568) 123.COVID-19 Behavioral Health Support Act (S. 4059) 124.Public Health Workforce Loan Repayment Act (H.R. 6578) 125.Strengthening the Public Health Workforce Act (S. 3737) 126.A resolution declaring racism a public health crisis (S. Res. 655) 127.Pandemic Child Hunger Prevention Act (H.R.7887) 128.Public Health Infrastructure Saves Lives Act (S. 4740) 129.CARE for Families Act (H.R. 3117/S. 3354) 130.Improving Data Collection for Adverse Childhood Experiences Act (H.R. 7689) 131.The STANDUP Act of 2020 (H.R. 7293) 132.The Effective Suicide Screening and Assessment in the Emergency Department Act (H.R. 4861) 133.The Pursuing Equity in Mental Health Act of 2019 (H.R. 5469) 134.The Improving Mental Health Access from the Emergency Department Act (H.R. 2519/S. 1334) 135.The Suicide Prevention Act (H.R. 5619/S. 3198) 136.The Helping Emergency Responders Overcome (HERO) Act (H.R. 1646/S. 3244) 137.The Campaign to Prevent Suicide Act (H.R. 4585) 138.The Maternal Health Immunization Enhancement Act (S. 4690) 139.Pandemic Vaccine Access Improvement Act (Not yet introduced) 140.Moving Forward Act (H.R. 2) 141.Continuing Appropriations Act, 2021 and Other Extensions Act (HR 8319) Coronavirus Response Additional Supplemental Appropriations Act (S. 4320). 142.ETHIC Act (H.R. 8205) 143.Safely Back to School and Work Act (S. 4322) 144.Supporting the goals and ideals of BIPOC Mental Health Awareness Month (H.Res. 1064) 145.COVID-19 Health Disparities Action Act (S. 4262) 146.Protecting American Heroes Act of 2020 (S. 4368) 147.Health STATISTICS Act (H.R. 8080) House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, HHS, CDC, FDA, CMS, OMB, DOT, HUD, EPA, NIMH, Education, USDA, DHS, FEMA, and SAMHSA.

Client expense: $36,974 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of funding for the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies related to health insurance market stabilization Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Human and child trafficking Palliative Care and Hospice Education and Training Act (H.R. 647/S. 2080) Title VIII Nursing Workforce Reauthorization Act of 2019 (H.R. 728/S. 1399) Coronavirus Aid, Relief, and Economic Security (CARES) Act (H.R. 748/S.3548) Emergency Medical Services for Children Program Reauthorization Act of 2019 (H.R. 776/S. 1173) End Surprise Billing Act of 2019 (H.R. 861) Fairness for Breastfeeding Mothers Act (H.R. 866/S. 528) Mental Health Access Improvement Act of 2019 (H.R. 945) Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 1309) Patient Protection and Affordable Care Enhancement Act (H.R. 1425) Healthy Families Act (H.R. 1784/S. 840) Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act (H.R. 1897) School-Based Health Centers Reauthorization Act of 2019 (H.R. 2075/S. 1013) Scarlett's Sunshine on Sudden Unexpected Death Act (H.R. 2271/S. 1130) Community Health Investment, Modernization, and Excellence Act of 2019 (H.R. 2328) Newborn Screening Saves Lives Reauthorization Act of 2019 (H.R. 2507) Pregnant Workers Fairness Act (H.R. 2694) Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 (H.R. 2781) Vaccine Awareness Campaign to Champion Immunization Nationally and Enhance Safety (VACCINES) Act of 2019 (H.R. 2862) Physical Activities Recommendations for Americans Act of 2019 (H.R. 2891) Safe Cribs Act of 2019 (H.R. 3170) Safe Sleep for Babies Act of 2019 (H.R. 3172) Pathways to Health Careers Act (H.R. 3398) Chronic Care Management Improvement Act (H.R. 3436) No Surprises Act (H.R. 3630) Midwives for Maximizing Optimal Maternity Services (Midwives for MOMS) Act of 2019 (H.R. 3849) Social Determinants Accelerator Act of 2019 (H.R. 4004/S. 2986) Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms (DISARM) Act of 2019 (H.R. 3328/H.R. 4100/S. 1712) Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 (H.R. 4861/S. 3006) United States Public Health Service Modernization Act of 2019 (H.R. 4870/S. 2629) Medication Access and Training Expansion (MATE) Act of 2019 (H.R. 4974) Maternal Health Quality Improvement Act of 2019 (H.R. 4995) Helping Medicaid Offer Maternity Services (MOMS) Act of 2019 (H.R. 4996) Protecting Seniors Through Immunization Act of 2019 (H.R. 5076/S. 1872) Pursuing Equity in Mental Health Act of 2019 (H.R. 5469) Primary and Behavioral Health Care Access Act (H.R. 5575) Ban Surprise Billing Act (H.R. 5800) Consumer Protections Against Surprise Medical Bills Act of 2020 (H.R. 5826) Black Maternal Health Momnibus Act of 2020 (H.R. 6142/S. 3424) Families First Coronavirus Response Act (H.R. 6201) Take Responsibility for Workers and Families Act (H.R. 6379) Health Care at Home Act (H.R. 6644) COVID-19 Mental Health Research Act (H.R. 6645) HEROES Act (H.R. 6800) Child Care Is Essential Act (H.R. 7027) Ensuring Children and Child Care Workers Are Safe Act of 2020 (H.R. 7079) Child Care for Economic Recovery Act (H.R. 7327) Protect Telehealth Access Act (H.R. 7391) Protecting Access to Post-COVID-19 Telehealth Act of 2020 (H.R. 7663) Community and Public Health Programs Extension Act (S. 192) National Nurse Act of 2019 (S. 696/H.R. 1597) Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/H.R. 1767) Nursing Where It's Needed Act (S. 1045) Promoting Physical Activity for Americans Act (S. 1608) Lower Health Care Costs Act (S. 1895) National Suicide Hotline Designation Act (S. 2661) Child Care Protection Improvement Act of 2019 (S. 2683) CONNECT for Health Act of 2019(S. 2741/H.R. 4932) CAPTA Reauthorization Act of 2019 (S. 2971) Suicide Prevention Act (S. 3198/H.R. 5619) Eliminating Abusive and Rampant Neglect of Interactive Technologies (EARN IT) Act of 2020 (S. 3398) Tele-Mental Health Improvement Act (S. 3792) Coronavirus Mental Health and Addiction Assistance Act of 2020 (S. 3825/H.R. 6999) Future Advancement of Academic Nursing (FAAN) Act (S. 4396/H.R. 7945) Safe Authorization for Vaccines during Emergencies (SAVE) Act (S. 4427)

Client expense: Not reported · Firm income: $24,000

Government targets: Bureau of Alcohol Tobacco Firearms & Explosives, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), Vice President of the U.S., White House Office

Bill # H.R. 647 and S2080: Palliative Care and Hospice Education and Training Act. Establishes Palliative Care and Hospice Education Centers to increase access to palliative care Bill # H.R. 728: Title VIII Nursing Workforce Reauthorization Act.To amend title VIII of the Public Health Service Act to extend advanced education nursing grants to support clinical nurse specialist programs Bill # H.R. 1767 and S824: Excellence in Mental Health and Addiction Treatment Expansion Act. To increase the number of states that may conduct Medicaid demonstration programs to improve access to community mental health services Bill # H.R. 2062 and S1012: Overdose Prevention and Patient Safety Act.Amends the Public Health Service Act to protect the confidentiality of substance use disorder patient records Bill # H.R. 2431 and S2500: Mental Health Professionals Workforce Shortage Loan Repayment Act. Authorizes a loan repayment program for mental health professionals to relieve workforce shortages Bill #H.R. 2482 and S2074: Mainstreaming Addiction Treatment (MAT) Act. Loosens restrictions on doctors prescribing buprenorphine for addiction treatment Bill #H.R. 2895 and S948: Conrad State 30 and Physician Access Reauthorization Act. Reauthorizes the Conrad 30 program through FY 2021 Bill #H.R. 3165 and S1737: Mental Health Parity Compliance Act. To achieve complete implementation of the Mental Health Parity and Addiction Equity Act (federal parity law) Bill #H.R. 4004 and S2986: Social Determinants Accelerator Act. To direct the Secretary of Health and Human Services to establish an interagency council on social determinants of health Bill #H.R. 4468: Nursing Home Workforce Quality Act. To address the shortage of certified nursing assistants (CNAs) Bill #H.R. 4859: Protecting Older Americans from Social Isolation Act. To amend the Older Americans Act to reduce social isolation among older individuals Bill #H.R. 5242: Opioid Settlement Accountability Act. To ensure that opioid settlement funds are used to fight the opioid epidemic, including treatment, prevention, education and enforcement efforts. Bill # H.R. 945 and S286: Mental Health Access Improvement Act. To provide for the coverage of marriage and family therapist services and mental health counselor services under Medicare Bill # H.R. 986:Protecting Americans with Preexisting Conditions Act.To prevent the promotion of short-term, limited duration insurance plans and association health plans Bill #S1399:Title VIII Nursing Workforce Reauthorization Act.To amend title VIII of the Public Health Service Act to extend advanced education nursing grants to support clinical nurse specialist programs Bill #S1895 Lower Health Care Costs Act Bill # HR5640 and S3152:Data Mapping to Save Moms' Lives Act. To require the Federal Communications Commission to incorporate data on maternal health outcomes into its broadband health maps. Bill # S3374: Protecting Jessica Grubbs Legacy Act. Amends the Public Health Service Act to protect the confidentiality of substance use disorder patient records. Bill S3599 and HR6788 Healthcare Workforce Resilience Act to expand the number of immigrant visas available to nurses and physicians Bill # HR748 S3548: Coronavirus Aid, Relief, and Economic Security Act provides financial relief and resources to individuals, families, and businesses impacted by the COVID-19 public health emergency. Bill # 7010 Paycheck protection program flexibility Bill #HR7292 Advanced Accelerated Payment Program forgiveness Bill HR 7077 and S3877 Community Solutions for COVID-19 Act grants to reduce or eliminate disparities HR 8200 Ending health disparities during COVID-19 Bill HR7838 and S4160 To enable certain hospitals participating in 340B drug discount program prior to COVID-19 public health emergency to maintain eligibility

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Navy, Dept of, SENATE

Discussions on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussions about the work of Aligning for Health to address social determinants of health; Support HR 1041 / S 586,Critical Access Hospital Relief Act of 2019, a bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services; Support S 895, Rural Hospital Regulatory Relief Act of 2019, a bill to provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals; Support S 948,Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities, and for other purposes; Discussions in support of the Rural Emergency Medical Center Act (REACH) Act; Support for extension of the Rural Community Hospital Demonstration Program; Support for extension of the Frontier Community Health Integration Project Demonstration program; Discuss changes with House and Senate committees to Section 8122 of the SUPPORT for Patients and Communities Act; Letter of support to Energy and Commerce Committee for the hearing on legislation to strengthen our health care system and ACA market stability; Support HR 1781/ S 801, Payment Commission Data Act of 2019, a bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information; Support S 551 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 or the REFUND Act of 2019, a bill to amend title XVIII of the Social Security Act to require manufacturers of certain single-dose vial drugs payable under part B of the Medicare program to provide rebates with respect to amounts of such drugs discarded, and for other purposes; Support S 824/ HR 1767, Excellence in Mental Health and Addiction Treatment Expansion Act, a bill to increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services; Statement submitted to Senate Finance Committee on the implementation of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support HR 2552Protecting Local Access to Care for Everyone Act of 2019 or the PLACE Act of 2019, a bill to direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program; Support HR 3022, Patient Access Protection Act, a bill to amend title XIX of the Social Security Act to repeal the reductions in Medicaid DSH allotments, and for other purposes; Letter of support to the Ways and Means Committee in support of legislation to improve the quality of an access to services for Medicare beneficiaries, help train the physician workforce and reduce administrative burden on rural hospitals; Support HR 3431, HEARTS and Rural Relief Act, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2021; Support HR 3417,Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 or the BETTER Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for patient improvements and rural and quality improvements under the Medicare program; Oppose HR 1384, Medicare for All Act of 2019, a bill to establish an improved Medicare for All national health insurance program; Oppose S 1129, Medicare for All Act of 2019, a bill to establish a Medicare-for-all national health insurance program; Letter to House Committee on Ways and Means for the hearing on Pathways to Universal Health Coverage addressing concerns with Medicare for All and believe that the variety of proposals that often are used interchangeably under that name are not the solution; Oppose HR 2452, Medicare for America Act of 2019, a bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans; Letter to House Committee on Budget for the hearing on the Congressional Budget Offices (CBO) Key Design Components and Considerations for Establishing a Single-Payer Health Care System addressing concerns with Medicare for All; Oppose S 1261/ HR 2463, Choose Medicare Act, a bill to provide for the establishment of Medicare part E public health plans, and for other purposes; Oppose S 981/ HR 2000Medicare-X Choice Act of 2019A bill to establish a public health plan; Oppose S 1033/ HR 2085, CHOICE Act, a bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Oppose S 470, Medicare at 50 Act, a bill to amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare; Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes; Submitted Statement to the House Committee on Rules for the Hearing Medicare for All Act of 2019; Comment on provisions of HR 2328,Reauthorizing and Extending Americas Community Health (REACH) Act, support for the Medicaid disproportionate share hospital(DSH) program provisions included in Title III; comments on Title IV, which contains provisions of the No Surprises Act and concern with the legislations approach to determining reimbursement for out-of-network providers; Support HR 3107 Seniors Timely Access to Care Act of 2019, this legislation would establish requirements for the use of prior authorization under Medicare Advantage plans; Meeting with the Senate finance committee to discuss changes to drug bill; Meeting with CMS to discuss changes to prior authorization; Meeting with Department of Labor to discuss issues with ERISA health plans; Met with CMS staff on rural hospital issues; Regulatory burden related to new CMS guidance on documenting Crossover bad debt; Sent a Comment letter to CMS on a final rule on program integrity enhancements to the provider enrollment process for Medicare, Medicaid and Children's Health Insurance Programs; Oppose S. 2860 Patient Access to Higher Quality Health Care Act of 2019, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 4996, Helping MOMS Act of 2019, a bill amend title XIX of the Social Security Act to provide for a State option under the Medicaid program to provide for and extend continuous coverage for certain individuals, and for other purposes; Addressing hospital concerns about HR 3 Lower Drug Costs Now Act, a bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes; Sent comment letter requesting that CMS withdraw the proposed regulation related to Medicaid Program: Medicaid Fiscal Accountability Regulation ( MFAR) financing and supplemental payments. Given that the proposal would severely curtail the availability of health care services to millions of individuals and because many of its provisions are not legally permissible; Discussion with CMS for rural hospitals and critical access hospitals about the Medicare accelerated payment program, which is intended to provide necessary funds to providers, including rural hospitals and critical access hospitals, when there is a disruption in claims submission and/or claims processing; Submitted comments on CMSs proposed rule on Medicare Advantage and Part D prescription drug program for Contract Years 2021 and 2022. The letter focuses on several proposals addressing network adequacy; Letter sent to HHS, CDC, CMS, and SAMHSA requesting specialized guidance and assistance for providers who care for patients with behavioral health disorders; Support resetting the Improving Medicare Post- Acute Care Transformation (IMPACT) Act of 2014 in the next COVID-19 relief package. The IMPACT Acts implementation is behind schedule and does not take into account extensive payment reforms already underway in each post-acute care setting; Letter urging HHS to release substantial additional emergency funds to all hospitals in an expedited manner. This second wave of funding to all hospitals, targeted relief is necessary for hospitals in hot spots, hospitals with a high percentage of payments under Medicare Advantage, hospitals caring for high numbers of Medicaid patients, and rural hospitals; Support HR 6693 Critical Access Hospital Expansion Act of 2020, a bill to amend title XVIII of the Social Security Act to allow States to certify certain hospitals as necessary providers for purposes of designating such hospitals as critical access hospitals under the Medicare program; Support HR 6753/ S 3615 Rural Community Hospital Demonstration Extension Act of 2020, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the rural community hospital demonstration program; Letter urging CMS to use its authority to extend to LTCHs the existing 20% hospital add-on payment for Medicare beneficiaries diagnosed with COVID-19; Letter to CMS urging the agency to temporarily extend certain waivers and make others permanent beyond the COVID-19 public health emergency to allow hospitals to provide better and more cost effective care to their patients and communities; Sent comment letter to CMS about our concerns with the timeline proposed for implementation as well as the potential for penalties for noncompliance within this timeline on the Medicare Program: Electronic Prescribing of Controlled Substances; Sent comment letter on the FY 2021 Inpatient PPS proposed rule addressing CMS proposals related to payer-specific negotiated rate data collection, Medicare DSH payments, CAR T, bad debt, MS-DRG classifications, and quality programs, among other topics. Letter requesting that the CMS delay the implementation of the Appropriate Use Criteria for Advanced Diagnostic Imaging Services program to allow providers the opportunity to implement and test operational changes and acquire the education necessary to achieve compliance with the program; Sent comments to the CMS on the agencys long-term care hospital prospective payment system proposed policy changes and fiscal year 2021 rates; Letter to CMS asking for a delay in the start of repayments associated with the Medicare Accelerated and Advance Payment (AAP) Programs; Letter urging the CMS to continue its suspension of medical review activities throughout the ongoing COVID-19 public health emergency; Letter urging CMS to allow periodic interim payment (PIP) hospitals to carry out their accelerated payment repayment at cost settlement, as was initially communicated by the agency and also request that the agency make alternative repayment approaches available, such as direct payments to the Medicare Administrative Contractor (MAC), for all hospitals; Comment letter on CY 2021 Home Health Prospective Payment System Rate Update proposed rule. While we continue to support the PDGM objective of increasing HH PPS payment accuracy, we remain concerned that CY 2020s large behavioral offset, 4.36%, was implemented on a prospective basis; Letter urging the CMS to withdraw the condition of participation (CoP) that hospitals report daily COVID-19 data and request that CMS immediately release detailed interpretive guidance so hospitals can take the necessary steps to come into compliance; Urged CMS to withdraw its Medicaid fiscal accountability proposed rule from its regulatory agenda because it would "severely curtail the availability of health care services to millions of individuals" and "many of its provisions are not legally permissible."

Client expense: $4,860,000 · 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

Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/ H.R. 1767), all provisions related to expanding and extending the Certified Community Behavioral Health Clinic Medicaid demonstration program. Mental Health Access Improvement Act (S. 286/H.R. 945), all provisions related to allowing marriage and family therapists and mental health counselors to directly bill Medicare for their services. Medicaid Reentry Act (H.R. 1329), all provisions related to allowing Medicaid coverage for eligible incarcerated individuals to be re-established up to 30 days before their release from jail or prison. Medicare Mental Health Modernization Act of 2007 (H.R. 1663), all provisions related to eliminating the lifetime limit of inpatient mental health services, parity, and coverage of marriage and family therapist/counselor services under Medicare.

Client expense: $174,990 · Firm income: Not reported

Government targets: Drug Enforcement Administration (DEA), Federal Communications Commission (FCC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

Repeal of the Affordable Care Act Development of legislation to protect essential hospitals Issues related to telehealth Mental Health Essential Health Benefits created by the Affordable Care Act Access to hospital emergency services Issues related to the 340B Drug Pricing Program 340B dug pricing program CMS OPPS 340B rule moratorium-related legislation 42 CFR Part 2 CREATES Act-H.R.965 Cassidy Surprise Billing Draft Protecting Patients from Surprise Medical Bills Excellence in Metal Health Act (S.824/H.R.1767) Patient Centered Outcomes Research Institute Funding No Surprises Act Lower Health Care Costs Act Surprise Medical Bills H.R.4004 - Social Determinants Accelerator Act of 2019 S.2986 - Social Determinants Accelerator Act of 2019 H.R.2328 - Reauthorizing and Extending America's Community Health Act S.2723 - Mitigating Emergency Drug Shortages Act H.R.4995 - Maternal Health Quality Improvement Act of 2019 H.R.2889 - Closing Loopholes for Orphan Drugs Act 340B drug pricing program eligibility (Matsui-Stewart Dear Colleague letter) Relief for Rural Providers During Emergencies Act (S. 3631) Improving Social Determinants of Health Act (H.R. 6561) Liability reform Issues related to COVID-19 regulatory and financial relief COVID-19 Provider Relief Fund Resolution recognizing racism as public health issue - S. Res. 655 COVID-19 Bias and Anti-Racism Training Act - S. 4248 Protecting 340B eligibility during the pandemic - S. 4160 and HR 7838 Protect Telehealth Access Act of 2020 (HR 7391) Improving Social Determinants of Health Act - S. 4440 Maternal health 340B contract pharmacies (McKinley-DeGette-Gianforte-Matsui-Johnson-Welch Dear Colleague letter) 340B contract pharmacies (Baldwin-Capito-Cardin-Portman-Stabenow-Thune Dear Colleague letter) Delivering Immediate Relief to Americas Families, Schools and Small Businesses Act Health disparities COVID-19 payroll tax credits

Client expense: $290,000 · Firm income: Not reported

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

Excellence in Mental Health and Addiction Expansion Act (S. 824/H.R. 1767); The Mental Health Access Improvement Act (S. 286/H.R. 945).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Excellence in Mental Health and Addiction Treatment Expansion Act, HR 1767/S. 824. Labor, Health and Human Services, Education, Defense, State, Foreign Operations, and Energy and Water Development Appropriations Act, 2020, HR 2740. National Suicide Hotline Designation Act of 2019, HR 4194/S. 2661. CARES Act, HR 748. Families First Coronavirus Response Act, HR 6201. The Heroes Act, HR 6800. Continuing Appropriations Act, 2021 and Other Extensions Act, HR 8337. American Workers, Families, and Employers Assistance Act, S. 4318.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Excellence in Mental Health and Addiction Expansion Act, HR 1767/S. 824. Medicaid Services Investment and Accountability Act of 2019, HR 1839. Mental Health Access Improvement Act, HR 945/S. 286. National De-Escalation of Violence and Community Safety Training Act of 2019, HR 2457. Labor, Health and Human Services, Education, Defense, State, Foreign Operations, and Energy and Water Development Appropriations Act, 2020, HR 2740. A bill to provide for a 2-week extension of the Medicaid community mental health services demonstration program, and for other purposes, S. 2047. Sustaining Excellence in Medicaid Act of 2019, HR 3253. Continuing Appropriations Act, 2020, and Health Extenders Act of 2019, HR 4378. Further Continuing Appropriations Act, 2020, and Further Health Extenders Act of 2019, H.R.3055. FY2020 Further Consolidated Appropriations Act (LHHSED, AG, Energy Water, Interior, Leg. Branch, MCVA, State-For. Ops, T-HUD), H.R. 1865. Prescription Drug Pricing Reduction Act of 2019, S. 2543. CARES Act, HR 748. Families First Coronavirus Response Act, HR 6201.The Heroes Act, HR 6800. Continuing Appropriations Act, 2021 and Other Extensions Act, HR 8337. American Workers, Families, and Employers Assistance Act, S. 4318.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of funding for the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies related to health insurance market stabilization Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Human and child trafficking Palliative Care and Hospice Education and Training Act (H.R. 647/S. 2080) Title VIII Nursing Workforce Reauthorization Act of 2019 (H.R. 728/S. 1399) Coronavirus Aid, Relief, and Economic Security (CARES) Act (H.R. 748/S.3548) Emergency Medical Services for Children Program Reauthorization Act of 2019 (H.R. 776/S. 1173) End Surprise Billing Act of 2019 (H.R. 861) Fairness for Breastfeeding Mothers Act (H.R. 866/S. 528) Mental Health Access Improvement Act of 2019 (H.R. 945) Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 1309) Patient Protection and Affordable Care Enhancement Act (H.R. 1425) Healthy Families Act (H.R. 1784/S. 840) Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act (H.R. 1897) Community Health Investment, Modernization, and Excellence Act of 2019 (H.R. 2328) Newborn Screening Saves Lives Reauthorization Act of 2019 (H.R. 2507) Pregnant Workers Fairness Act (H.R. 2694) Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 (H.R. 2781) Vaccine Awareness Campaign to Champion Immunization Nationally and Enhance Safety (VACCINES) Act of 2019 (H.R. 2862) Physical Activities Recommendations for Americans Act of 2019 (H.R. 2891) Safe Cribs Act of 2019 (H.R. 3170) Safe Sleep for Babies Act of 2019 (H.R. 3172) Pathways to Health Careers Act (H.R. 3398) Chronic Care Management Improvement Act (H.R. 3436) No Surprises Act (H.R. 3630) Social Determinants Accelerator Act of 2019 (H.R. 4004/S. 2986) United States Public Health Service Modernization Act of 2019 (H.R. 4870/S. 2629) Maternal Health Quality Improvement Act of 2019 (H.R. 4995) Helping Medicaid Offer Maternity Services (MOMS) Act of 2019 (H.R. 4996) Protecting Seniors Through Immunization Act of 2019 (H.R. 5076/S. 1872) Pursuing Equity in Mental Health Act of 2019 (H.R. 5469) Primary and Behavioral Health Care Access Act (H.R. 5575) Ban Surprise Billing Act (H.R. 5800) Consumer Protections Against Surprise Medical Bills Act of 2020 (H.R. 5826) Black Maternal Health Momnibus Act of 2020 (H.R. 6142/S. 3424) Families First Coronavirus Response Act (H.R. 6201) Take Responsibility for Workers and Families Act (H.R. 6379) Health Care at Home Act (H.R. 6644) COVID-19 Mental Health Research Act (H.R. 6645) HEROES Act (H.R. 6800) Protect Telehealth Access Act (H.R. 7391) Community and Public Health Programs Extension Act (S. 192) National Nurse Act of 2019 (S. 696/H.R. 1597) Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/H.R. 1767) Nursing Where It's Needed Act (S. 1045) Promoting Physical Activity for Americans Act (S. 1608) Lower Health Care Costs Act (S. 1895) Child Care Improvement Act of 2019 (S. 2683) CONNECT for Health Act of 2019(S. 2741/H.R. 4932) CAPTA Reauthorization Act of 2019 (S. 2971) Suicide Prevention Act (S. 3198/H.R. 5619) Eliminating Abusive and Rampant Neglect of Interactive Technologies (EARN IT) Act of 2020 (S. 3398) Tele-Mental Health Improvement Act (S. 3792) Coronavirus Mental Health and Addiction Assistance Act of 2020 (S. 3825/H.R. 6999)

Client expense: Not reported · Firm income: $24,000

Government targets: Bureau of Alcohol Tobacco Firearms & Explosives, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), Vice President of the U.S., White House Office

H.R. 1528, the Comprehensive Opioid Program Extension (COPE) Act, which would reauthorize the comprehensive opioid abuse program to provide more resources for communities; H.R. 1767/S. 824, the Excellence in Mental Health and Addiction Treatment Expansion Act, which would renew and expand the critical, community-based treatment program, the Certified Community Behavioral Health Clinic (CCBHC), which would otherwise expire on 22 May 2020; H.R. 2698, the "Law Enforcement Training for Mental Health Crisis Response Act," which would address an urgent need to provide our nations law enforcement officers with training to recognize and appropriately respond to behavioral crises caused, not by criminal activity, but by mental illness and substance abuse; H.R. 6008, the "Traumatic Brain Injury and Post-Traumatic Stress Disorder Law Enforcement Training Act," which would direct the Attorney General to develop crisis intervention training tools for use by law enforcement and other public safety officers when interacting with community members who have traumatic brain injury (TBI), another form of acquired brain injury, or Post-Traumatic Stress Disorder (PTSD); H.R. 6694/S. 3434, the Confidentiality Opportunities for Peer Support (COPS) Counseling Act," which would reduce the barriers for law enforcement officers when trying to access mental health resources; and S. 1464, the "Law Enforcement Training for Mental Health Crisis Response Act," which would address an urgent need to provide our nations law enforcement officers with training to recognize and appropriately respond to behavioral crises caused, not by criminal activity, but by mental illness and substance abuse.

Client expense: $55,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, White House Office

Discussions on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussions about the work of Aligning for Health to address social determinants of health; Support HR 1041 / S 586,Critical Access Hospital Relief Act of 2019, a bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services; Support S 895, Rural Hospital Regulatory Relief Act of 2019, a bill to provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals; Support S 948,Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities, and for other purposes; Discussions in support of the Rural Emergency Medical Center Act (REACH) Act; Support for extension of the Rural Community Hospital Demonstration Program; Support for extension of the Frontier Community Health Integration Project Demonstration program; Discuss changes with House and Senate committees to Section 8122 of the SUPPORT for Patients and Communities Act; Letter of support to Energy and Commerce Committee for the hearing on legislation to strengthen our health care system and ACA market stability; Support HR 1781/ S 801, Payment Commission Data Act of 2019, a bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information; Support S 551 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 or the REFUND Act of 2019, a bill to amend title XVIII of the Social Security Act to require manufacturers of certain single-dose vial drugs payable under part B of the Medicare program to provide rebates with respect to amounts of such drugs discarded, and for other purposes; Support S 824/ HR 1767, Excellence in Mental Health and Addiction Treatment Expansion Act, a bill to increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services; Statement submitted to Senate Finance Committee on the implementation of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support HR 2552Protecting Local Access to Care for Everyone Act of 2019 or the PLACE Act of 2019, a bill to direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program; Support HR 3022, Patient Access Protection Act, a bill to amend title XIX of the Social Security Act to repeal the reductions in Medicaid DSH allotments, and for other purposes; Letter of support to the Ways and Means Committee in support of legislation to improve the quality of an access to services for Medicare beneficiaries, help train the physician workforce and reduce administrative burden on rural hospitals; Support HR 3431, HEARTS and Rural Relief Act, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2021; Support HR 3417,Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 or the BETTER Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for patient improvements and rural and quality improvements under the Medicare program; Oppose HR 1384, Medicare for All Act of 2019, a bill to establish an improved Medicare for All national health insurance program; Oppose S 1129, Medicare for All Act of 2019, a bill to establish a Medicare-for-all national health insurance program; Letter to House Committee on Ways and Means for the hearing on Pathways to Universal Health Coverage addressing concerns with Medicare for All and believe that the variety of proposals that often are used interchangeably under that name are not the solution; Oppose HR 2452, Medicare for America Act of 2019, a bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans; Letter to House Committee on Budget for the hearing on the Congressional Budget Offices (CBO) Key Design Components and Considerations for Establishing a Single-Payer Health Care System addressing concerns with Medicare for All; Oppose S 1261/ HR 2463, Choose Medicare Act, a bill to provide for the establishment of Medicare part E public health plans, and for other purposes; Oppose S 981/ HR 2000Medicare-X Choice Act of 2019A bill to establish a public health plan; Oppose S 1033/ HR 2085, CHOICE Act, a bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Oppose S 470, Medicare at 50 Act, a bill to amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare; Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes; Submitted Statement to the House Committee on Rules for the Hearing Medicare for All Act of 2019; Comment on provisions of HR 2328,Reauthorizing and Extending Americas Community Health (REACH) Act, support for the Medicaid disproportionate share hospital(DSH) program provisions included in Title III; comments on Title IV, which contains provisions of the No Surprises Act and concern with the legislations approach to determining reimbursement for out-of-network providers; Support HR 3107 Seniors Timely Access to Care Act of 2019, this legislation would establish requirements for the use of prior authorization under Medicare Advantage plans; Meeting with the Senate finance committee to discuss changes to drug bill; Meeting with CMS to discuss changes to prior authorization; Meeting with Department of Labor to discuss issues with ERISA health plans; Met with CMS staff on rural hospital issues; Regulatory burden related to new CMS guidance on documenting Crossover bad debt; Sent a Comment letter to CMS on a final rule on program integrity enhancements to the provider enrollment process for Medicare, Medicaid and Children's Health Insurance Programs; Oppose S. 2860 Patient Access to Higher Quality Health Care Act of 2019, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 4996, Helping MOMS Act of 2019, a bill amend title XIX of the Social Security Act to provide for a State option under the Medicaid program to provide for and extend continuous coverage for certain individuals, and for other purposes; Addressing hospital concerns about HR 3 Lower Drug Costs Now Act, a bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes; Sent comment letter requesting that CMS withdraw the proposed regulation related to Medicaid Program: Medicaid Fiscal Accountability Regulation ( MFAR) financing and supplemental payments. Given that the proposal would severely curtail the availability of health care services to millions of individuals and because many of its provisions are not legally permissible; Discussion with CMS for rural hospitals and critical access hospitals about the Medicare accelerated payment program, which is intended to provide necessary funds to providers, including rural hospitals and critical access hospitals, when there is a disruption in claims submission and/or claims processing; Submitted comments on CMSs proposed rule on Medicare Advantage and Part D prescription drug program for Contract Years 2021 and 2022. The letter focuses on several proposals addressing network adequacy; Letter sent to HHS, CDC, CMS, and SAMHSA requesting specialized guidance and assistance for providers who care for patients with behavioral health disorders; Support resetting the Improving Medicare Post- Acute Care Transformation (IMPACT) Act of 2014 in the next COVID-19 relief package. The IMPACT Acts implementation is behind schedule and does not take into account extensive payment reforms already underway in each post-acute care setting; Letter urging HHS to release substantial additional emergency funds to all hospitals in an expedited manner. This second wave of funding to all hospitals, targeted relief is necessary for hospitals in hot spots, hospitals with a high percentage of payments under Medicare Advantage, hospitals caring for high numbers of Medicaid patients, and rural hospitals; Support HR 6693 Critical Access Hospital Expansion Act of 2020, a bill to amend title XVIII of the Social Security Act to allow States to certify certain hospitals as necessary providers for purposes of designating such hospitals as critical access hospitals under the Medicare program; Support HR 6753/ S 3615 Rural Community Hospital Demonstration Extension Act of 2020, a bill to amend the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend the rural community hospital demonstration program; Letter urging CMS to use its authority to extend to LTCHs the existing 20% hospital add-on payment for Medicare beneficiaries diagnosed with COVID-19; Letter to CMS urging the agency to temporarily extend certain waivers and make others permanent beyond the COVID-19 public health emergency to allow hospitals to provide better and more cost effective care to their patients and communities.

Client expense: $4,260,000 · 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), 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

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

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

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

Excellence in Mental Health and Addiction Treatment Expansion Act, HR 1767/S. 824. Labor, Health and Human Services, Education, Defense, State, Foreign Operations, and Energy and Water Development Appropriations Act, 2020, HR 2740. National Suicide Hotline Designation Act of 2019, HR 4194/S. 2661. CARES Act, HR 748. Families First Coronavirus Response Act, HR 6201. The Heroes Act, HR 6800.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Excellence in Mental Health and Addiction Expansion Act, HR 1767/S. 824. Medicaid Services Investment and Accountability Act of 2019, HR 1839. Mental Health Access Improvement Act, HR 945/S. 286. National De-Escalation of Violence and Community Safety Training Act of 2019, HR 2457. Labor, Health and Human Services, Education, Defense, State, Foreign Operations, and Energy and Water Development Appropriations Act, 2020, HR 2740. A bill to provide for a 2-week extension of the Medicaid community mental health services demonstration program, and for other purposes, S. 2047. Sustaining Excellence in Medicaid Act of 2019, HR 3253. Continuing Appropriations Act, 2020, and Health Extenders Act of 2019, HR 4378. Further Continuing Appropriations Act, 2020, and Further Health Extenders Act of 2019, H.R.3055. FY2020 Further Consolidated Appropriations Act (LHHSED, AG, Energy Water, Interior, Leg. Branch, MCVA, State-For. Ops, T-HUD), H.R. 1865. Prescription Drug Pricing Reduction Act of 2019, S. 2543. CARES Act, HR 748. Families First Coronavirus Response Act, HR 6201.The Heroes Act, HR 6800.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Repeal of the Affordable Care Act Development of legislation to protect essential hospitals Issues related to telehealth Mental Health Essential Health Benefits created by the Affordable Care Act Access to hospital emergency services Issues related to the 340B Drug Pricing Program 340B dug pricing program CMS OPPS 340B rule moratorium-related legislation 42 CFR Part 2 CREATES Act-H.R.965 Cassidy Surprise Billing Draft Protecting Patients from Surprise Medical Bills Excellence in Metal Health Act (S.824/H.R.1767) Patient Centered Outcomes Research Institute Funding No Surprises Act Lower Health Care Costs Act Surprise Medical Bills H.R.4004 - Social Determinants Accelerator Act of 2019 S.2986 - Social Determinants Accelerator Act of 2019 H.R.2328 - Reauthorizing and Extending America's Community Health Act S.2723 - Mitigating Emergency Drug Shortages Act H.R.4995 - Maternal Health Quality Improvement Act of 2019 H.R.2889 - Closing Loopholes for Orphan Drugs Act 340B drug pricing program eligibility (Matsui-Stewart Dear Colleague letter) Relief for Rural Providers During Emergencies Act (S. 3631) Improving Social Determinants of Health Act (H.R. 6561) Liability reform

Client expense: $310,000 · Firm income: Not reported

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

Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/ H.R. 1767), all provisions related to expanding and extending the Certified Community Behavioral Health Clinic Medicaid demonstration program. Mental Health Access Improvement Act (S. 286/H.R. 945), all provisions related to allowing marriage and family therapists and mental health counselors to directly bill Medicare for their services. Medicaid Reentry Act (H.R. 1329), all provisions related to allowing Medicaid coverage for eligible incarcerated individuals to be re-established up to 30 days before their release from jail or prison. Medicare Mental Health Modernization Act of 2007 (H.R. 1663), all provisions related to eliminating the lifetime limit of inpatient mental health services, parity, and coverage of marriage and family therapist/counselor services under Medicare.

Client expense: $177,120 · Firm income: Not reported

Government targets: Drug Enforcement Administration (DEA), Federal Communications Commission (FCC), Federal Reserve System, HOUSE OF REPRESENTATIVES, SENATE

Excellence in Mental Health and Addiction Expansion Act (S. 824/H.R. 1767); The Mental Health Access Improvement Act (S. 286/H.R. 945).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Bill # H.R. 647 and S2080: Palliative Care and Hospice Education and Training Act. Establishes Palliative Care and Hospice Education Centers to increase access to palliative care Bill # H.R. 728: Title VIII Nursing Workforce Reauthorization Act.To amend title VIII of the Public Health Service Act to extend advanced education nursing grants to support clinical nurse specialist programs Bill # H.R. 1767 and S824: Excellence in Mental Health and Addiction Treatment Expansion Act. To increase the number of states that may conduct Medicaid demonstration programs to improve access to community mental health services Bill # H.R. 2062 and S1012: Overdose Prevention and Patient Safety Act.Amends the Public Health Service Act to protect the confidentiality of substance use disorder patient records Bill # H.R. 2431 and S2500: Mental Health Professionals Workforce Shortage Loan Repayment Act. Authorizes a loan repayment program for mental health professionals to relieve workforce shortages Bill #H.R. 2482 and S2074: Mainstreaming Addiction Treatment (MAT) Act. Loosens restrictions on doctors prescribing buprenorphine for addiction treatment Bill #H.R. 2895 and S948: Conrad State 30 and Physician Access Reauthorization Act. Reauthorizes the Conrad 30 program through FY 2021 Bill #H.R. 3165 and S1737: Mental Health Parity Compliance Act. To achieve complete implementation of the Mental Health Parity and Addiction Equity Act (federal parity law) Bill #H.R. 4004 and S2986: Social Determinants Accelerator Act. To direct the Secretary of Health and Human Services to establish an interagency council on social determinants of health Bill #H.R. 4468: Nursing Home Workforce Quality Act. To address the shortage of certified nursing assistants (CNAs) Bill #H.R. 4859: Protecting Older Americans from Social Isolation Act. To amend the Older Americans Act to reduce social isolation among older individuals Bill #H.R. 5242: Opioid Settlement Accountability Act. To ensure that opioid settlement funds are used to fight the opioid epidemic, including treatment, prevention, education and enforcement efforts. Bill # H.R. 945 and S286: Mental Health Access Improvement Act. To provide for the coverage of marriage and family therapist services and mental health counselor services under Medicare Bill # H.R. 986:Protecting Americans with Preexisting Conditions Act.To prevent the promotion of short-term, limited duration insurance plans and association health plans Bill #S1399:Title VIII Nursing Workforce Reauthorization Act.To amend title VIII of the Public Health Service Act to extend advanced education nursing grants to support clinical nurse specialist programs Bill #S1895 Lower Health Care Costs Act Bill # HR5640 and S3152:Data Mapping to Save Moms' Lives Act. To require the Federal Communications Commission to incorporate data on maternal health outcomes into its broadband health maps. Bill # S3374: Protecting Jessica Grubbs Legacy Act. Amends the Public Health Service Act to protect the confidentiality of substance use disorder patient records. Bill # HR748 S3548: Coronavirus Aid, Relief, and Economic Security Act provides financial relief and resources to individuals, families, and businesses impacted by the COVID-19 public health emergency. Bill # 7010 Paycheck protection program flexibility Bill #HR7292 Advanced Accelerated Payment Program forgiveness

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

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 1528, the Comprehensive Opioid Program Extension (COPE) Act, which would reauthorize the comprehensive opioid abuse program to provide more resources for communities; H.R. 1767/S. 824, the Excellence in Mental Health and Addiction Treatment Expansion Act, which would renew and expand the critical, community-based treatment program, the Certified Community Behavioral Health Clinic (CCBHC), which would otherwise expire on 22 May 2020; H.R. 2698, the "Law Enforcement Training for Mental Health Crisis Response Act," which would address an urgent need to provide our nations law enforcement officers with training to recognize and appropriately respond to behavioral crises caused, not by criminal activity, but by mental illness and substance abuse; and H.R. 6694/S. 3434, the Confidentiality Opportunities for Peer Support (COPS) Counseling Act," which would reduce the barriers for law enforcement officers when trying to access mental health resources.

Client expense: $55,000 · Firm income: Not reported

Government targets: Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), SENATE, White House Office

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Reauthorization of funding for the Childrens Health Insurance Program Reauthorization of the Child Nutrition Act Section 2706 of the ACA regarding provider non-discrimination Policies related to health insurance market stabilization Policies affecting nurse practitioner education and workforce Definition, evaluation and enforcement of essential health benefits and provider network adequacy Health information technology and electronic health records Mental health services and violence prevention Human and child trafficking Draft 21st Century Cures 2.0 legislation Palliative Care and Hospice Education and Training Act (H.R. 647/S. 2080) Title VIII Nursing Workforce Reauthorization Act of 2019 (H.R. 728/S. 1399) Coronavirus Aid, Relief, and Economic Security (CARES) Act (H.R. 748/S.3548) Emergency Medical Services for Children Program Reauthorization Act of 2019 (H.R. 776/S. 1173) End Surprise Billing Act of 2019 (H.R. 861) Fairness for Breastfeeding Mothers Act (H.R. 866/S. 528) Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 1309) Healthy Families Act (H.R. 1784/S. 840) Mothers and Offspring Mortality and Morbidity Awareness (MOMMAs) Act (H.R. 1897) Community Health Investment, Modernization, and Excellence Act of 2019 (H.R. 2328) Newborn Screening Saves Lives Reauthorization Act of 2019 (H.R. 2507) Pregnant Workers Fairness Act (H.R. 2694) Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 (H.R. 2781) VACCINES Act of 2019 (H.R. 2862) Physical Activities Recommendations for Americans Act of 2019 (H.R. 2891) Safe Cribs Act of 2019 (H.R. 3170) Safe Sleep for Babies Act of 2019 (H.R. 3172) Pathways to Health Careers Act (H.R. 3398) Chronic Care Management Improvement Act (H.R. 3436) No Surprises Act (H.R. 3630) Midwives for Maximizing Optimal Maternity Services (Midwives for MOMS) Act of 2019 (H.R. 3849) Social Determinants Accelerator Act of 2019 (H.R. 4004/S. 2986) Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms (DISARM) Act of 2019 (H.R. 3328/H.R. 4100/S. 1712) Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 (H.R. 4861/S. 3006) United States Public Health Service Modernization Act of 2019 (H.R. 4870/S. 2629) Medication Access and Training Expansion (MATE) Act (H.R. 4974) Maternal Health Quality Improvement Act of 2019 (H.R. 4995) Helping Medicaid Offer Maternity Services (MOMS) Act of 2019 (H.R. 4996) Protecting Seniors Through Immunization Act of 2019 (H.R. 5076/S. 1872) Pursuing Equity in Mental Health Act of 2019 (H.R. 5469) Primary and Behavioral Health Care Access Act (H.R. 5575) Ban Surprise Billing Act (H.R. 5800) Consumer Protections Against Surprise Medical Bills Act of 2020 (H.R. 5826) Black Maternal Health Momnibus Act of 2020 (H.R. 6142/S. 3424) Families First Coronavirus Response Act (H.R. 6201) Take Responsibility for Workers and Families Act (H.R. 6379) Community and Public Health Programs Extension Act (S. 192) National Nurse Act of 2019 (S. 696/H.R. 1597) Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/H.R. 1767) Nursing Where It's Needed Act (S. 1045) Promoting Physical Activity for Americans Act (S. 1608) Lower Health Care Costs Act (S. 1895) Child Care Improvement Act of 2019 (S. 2683) CAPTA Reauthorization Act of 2019 (S. 2971) Suicide Prevention Act (S. 3198/H.R. 5619)

Client expense: Not reported · Firm income: $24,000

Government targets: Bureau of Alcohol Tobacco Firearms & Explosives, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Justice, Dept of (DOJ), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA)

Discussions on drug pricing, 340b, and price transparency policies, as well as the International Pricing Index ANPRM; Discussions about the work of Aligning for Health to address social determinants of health; Support HR 1041 / S 586,Critical Access Hospital Relief Act of 2019, a bill to amend title XVIII of the Social Security Act to remove the 96-hour physician certification requirement for inpatient critical access hospital services; Support S 895, Rural Hospital Regulatory Relief Act of 2019, a bill to provide for a permanent extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals; Support S 948,Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities, and for other purposes; Discussions in support of the Rural Emergency Medical Center Act (REACH) Act; Support for extension of the Rural Community Hospital Demonstration Program; Support for extension of the Frontier Community Health Integration Project Demonstration program; Discuss changes with House and Senate committees to Section 8122 of the SUPPORT for Patients and Communities Act; Letter of support to Energy and Commerce Committee for the hearing on legislation to strengthen our health care system and ACA market stability; Support HR 1781/ S 801, Payment Commission Data Act of 2019, a bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information; Support S 551 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 or the REFUND Act of 2019, a bill to amend title XVIII of the Social Security Act to require manufacturers of certain single-dose vial drugs payable under part B of the Medicare program to provide rebates with respect to amounts of such drugs discarded, and for other purposes; Support S 824/ HR 1767, Excellence in Mental Health and Addiction Treatment Expansion Act, a bill to increase the number of States that may conduct Medicaid demonstration programs to improve access to community mental health services; Statement submitted to Senate Finance Committee on the implementation of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); Support HR 2552Protecting Local Access to Care for Everyone Act of 2019 or the PLACE Act of 2019, a bill to direct the Secretary of Health and Human Services to prevent certain payment reductions for clinic visit services furnished at excepted off-campus outpatient departments of a provider under the Medicare program; Support HR 3022, Patient Access Protection Act, a bill to amend title XIX of the Social Security Act to repeal the reductions in Medicaid DSH allotments, and for other purposes; Letter of support to the Ways and Means Committee in support of legislation to improve the quality of an access to services for Medicare beneficiaries, help train the physician workforce and reduce administrative burden on rural hospitals; Support HR 3431, HEARTS and Rural Relief Act, a bill to provide for the extension of the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals through 2021; Support HR 3417,Beneficiary Education Tools, Telehealth, and Extenders Reauthorization Act of 2019 or the BETTER Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for patient improvements and rural and quality improvements under the Medicare program; Oppose HR 1384, Medicare for All Act of 2019, a bill to establish an improved Medicare for All national health insurance program; Oppose S 1129, Medicare for All Act of 2019, a bill to establish a Medicare-for-all national health insurance program; Letter to House Committee on Ways and Means for the hearing on Pathways to Universal Health Coverage addressing concerns with Medicare for All and believe that the variety of proposals that often are used interchangeably under that name are not the solution; Oppose HR 2452, Medicare for America Act of 2019, a bill to amend the Social Security Act to establish a Medicare for America health program to provide for comprehensive health coverage for all Americans; Letter to House Committee on Budget for the hearing on the Congressional Budget Offices (CBO) Key Design Components and Considerations for Establishing a Single-Payer Health Care System addressing concerns with Medicare for All; Oppose S 1261/ HR 2463, Choose Medicare Act, a bill to provide for the establishment of Medicare part E public health plans, and for other purposes; Oppose S 981/ HR 2000Medicare-X Choice Act of 2019A bill to establish a public health plan; Oppose S 1033/ HR 2085, CHOICE Act, a bill to amend the Public Health Service Act to establish a public health insurance option, and for other purposes; Oppose S 470, Medicare at 50 Act, a bill to amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States age 50 to 64 to buy into Medicare; Oppose HR 1346, Medicare Buy-In and Health Care Stabilization Act of 2019, a bill to amend title XVIII of the Social Security Act to provide for an option for individuals who are ages 50 to 64 to buy into Medicare, to provide for health insurance market stabilization, and for other purposes; Submitted Statement to the House Committee on Rules for the Hearing Medicare for All Act of 2019; Comment on provisions of HR 2328,Reauthorizing and Extending Americas Community Health (REACH) Act, support for the Medicaid disproportionate share hospital(DSH) program provisions included in Title III; comments on Title IV, which contains provisions of the No Surprises Act and concern with the legislations approach to determining reimbursement for out-of-network providers; Support HR 3107 Seniors Timely Access to Care Act of 2019, this legislation would establish requirements for the use of prior authorization under Medicare Advantage plans; Meeting with the Senate finance committee to discuss changes to drug bill; Meeting with CMS to discuss changes to prior authorization; Meeting with Department of Labor to discuss issues with ERISA health plans; Met with CMS staff on rural hospital issues; Regulatory burden related to new CMS guidance on documenting Crossover bad debt; Sent a Comment letter to CMS on a final rule on program integrity enhancements to the provider enrollment process for Medicare, Medicaid and Children's Health Insurance Programs; Oppose S. 2860 Patient Access to Higher Quality Health Care Act of 2019, a bill to repeal changes made by health care reform laws to the Medicare exception to the prohibition on certain physician referrals for hospitals, and for other purposes; Support HR 4996, Helping MOMS Act of 2019, a bill amend title XIX of the Social Security Act to provide for a State option under the Medicaid program to provide for and extend continuous coverage for certain individuals, and for other purposes; Addressing hospital concerns about HR 3 Lower Drug Costs Now Act, a bill to establish a fair price negotiation program, protect the Medicare program from excessive price increases, and establish an out-of-pocket maximum for Medicare part D enrollees, and for other purposes; Sent comment letter requesting that CMS withdraw the proposed regulation related to Medicaid Program: Medicaid Fiscal Accountability Regulation ( MFAR) financing and supplemental payments. Given that the proposal would severely curtail the availability of health care services to millions of individuals and because many of its provisions are not legally permissible.

Client expense: $5,940,000 · 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), 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

Repeal of the Affordable Care Act Development of legislation to protect essential hospitals Issues related to telehealth Mental Health Essential Health Benefits created by the Affordable Care Act Access to hospital emergency services Issues related to the 340B Drug Pricing Program 340B dug pricing program CMS OPPS 340B rule moratorium-related legislation 42 CFR Part 2 CREATES Act-H.R.965 Cassidy Surprise Billing Draft Protecting Patients from Surprise Medical Bills Excellence in Metal Health Act (S.824/H.R.1767) Patient Centered Outcomes Research Institute Funding No Surprises Act Lower Health Care Costs Act Surprise Medical Bills H.R.4004 - Social Determinants Accelerator Act of 2019 S.2986 - Social Determinants Accelerator Act of 2019 H.R.2328 - Reauthorizing and Extending America's Community Health Act S.2723 - Mitigating Emergency Drug Shortages Act H.R.4995 - Maternal Health Quality Improvement Act of 2019 H.R.2889 - Closing Loopholes for Orphan Drugs Act

Client expense: $440,000 · Firm income: Not reported

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

Excellence in Mental Health and Addiction Expansion Act (S. 824/H.R. 1767); The Mental Health Access Improvement Act (S. 286/H.R. 945).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbying Issues Description: Budget and appropriations for disease and injury prevention, including obesity and related diseases; pandemic influenza and emerging infectious diseases; physical activity; public health bioterrorism preparedness; food safety, environmental health; paid sick days; womens and childrens health; community-based public health interventions, and substance misuse/behavioral health issues. Specific Legislation: 1. Implementation of the Patient Protection and Affordable Care Act (Public Law 111-148) 2. Implementation of the FDA Food Safety Modernization Act (Public Law 111353) 3. Implementation of Pandemic and All-Hazards Preparedness Reauthorization Act and Pandemic and All-Hazards Preparedness and Advancing Innovation Act (Public Law 113-5, 116-22) 4. Implementation of Healthy, Hunger-Free Kids Act of 2010 (Public Law 111296) 5. Implementation of Child Care and Development Block Grant Act of 2014 (Public Law 113-186) 6. Implementation of Every Student Succeeds Act (Public Law 114-95) 7. Implementation of the Comprehensive Addition and Recovery Act (Public Law 114-98) 8. FY 2020 Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations (H.R. 2740/Not Yet Introduced)) 9. FY 2020 Departments of Agriculture, Rural Development, Food and Drug Administration and Related Agencies Appropriations (H.R. 3164/Not yet introduced) 10. FY2020 Departments of Transportation, HUD and related agencies Appropriations (H.R. 3163/Not Yet Introduced) 11. FY2020 Further Consolidated Appropriations Act (H.R. 1865/P.L. 116-94) 12. Midnight Rules Relief Act (S.34/H.R. 21) 13. Regulations from the Executive in Need of Scrutiny Act (S. 21/H.R. 26) 14. Regulatory Accountability Act (S.951/H.R. 5/H.R. 45/H.Res.33) 15. Searching for and Cutting Regulations that are Unnecessarily Burdensome (SCRUB) Act (H.R. 998) 16. Regulatory Integrity Act (H.R. 1004) 17. OIRA Insight, Reform, and Accountability Act (S. 676/H.R. 1009) 18. A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2017 and setting forth the appropriate budgetary levels for fiscal years 2018 through 2026 (S.Con.Res. 3) 19. American Health Care Act (H.R. 1628/H.Res. 228) 20. Ozone Standards Implementation Act (S. 263/H.R. 806) 21. Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the final rule of the Bureau of Land Management relating to "Waste Prevention, Production Subject to Royalties, and Resource Conservation" (S.J. Res. 11/H.J.Res.36) 22. Common Sense Nutrition Disclosure Act (S. 261/H.R. 772) 23. Reinvigorating Antibiotic and Diagnostic Innovation (READI) Act (H.R. 1840) 24. Preservation of Antibiotics for Medical Treatment Act (H.R. 1587) 25. Preventing Antibiotic Resistance Act (S. 629) 26. Better Care Reconciliation Act (H.R. 1628) and related amendments 27. Public Health Emergency Response Act (S. 196) 28. Recognizing the importance of vaccinations and immunizations in the United States (H.Res.327) 29. Consolidated Appropriations Act, 2017 (Public Law 115-31) 30. Treat and Reduce Obesity Act (S. 830/H.R. 1953) 31. Community Health and Medical Professionals Improve Our Nation (CHAMPION) Act (H.R. 3922) 32. Community Health Investment, Modernization, and Excellence Act of 2017 (S. 1899) 33. Tobacco Tax Equity Act (S. 1837) 34. Healthy Kids Act (S. 1821/H.R. 3921) 35. Implementation of the Drug Quality and Security Act (P.S. 113-54) 36. Continuing Appropriations Act, 2018 and Supplemental Appropriations for Disaster Relief Requirements Act, 2017 (Public Law 115-56) 37. Friendly Airports for Mothers Act (S. 1110/H.R. 2375) 38. Lead-Safe Housing for Kids Act (S. 1845) 39. Supporting Working Moms Act (S. 2122/H.R. 3255) 40. Championing Healthy Kids Act (H.R. 3922) 41. Making further continuing appropriations for fiscal year 2018, and for other purposes (Public Law 115-90) 42. An Act to amend the Homeland Security Act of 2002 to require the Secretary of Homeland Security to issue Department of Homeland Security-wide guidance and develop training programs as part of the Department of Homeland Security Blue Campaign, and for other purposes (Public Law 11596) 43. Tax Cuts and Jobs Act (Public Law 115-97) 44. Pandemic and All-Hazards Preparedness Advancing Innovation Act (S. 2852/H.R. 6378/H.R. 7328/S. 1379/H.R. 269) 45. Vaccine Access Improvement Act (H.R. 4993) 46. Relief from New Source Performance Standards Act (H.R. 453) 47. Strategies to Address Antimicrobial Resistance (S. 2469) 48. Opioid Quota Reform Act (S. 2535) 49. Hospital Preparedness Program Reauthorization Act (H.R. 4776) 50. Blocking Regulatory Interference from Closing Kilns Act (H.R. 1917) 51. Opioid Crisis Response Act of 2018 (S. 2680) 52. Agriculture and Nutrition Act (H.R. 2) 53. Agriculture Improvement Act (S. 3042) 54. SECURE Act (H.R. 5998) 55. Trauma-Informed Care for Children and Families Act (S. 774) 56. SUPPORT for Patients and Communities Act (H.R. 6) 57. Centers for Disease Control Emergency Response Act (S. 3161) 58. LABEL Opioids Act (S. 3428) 59. Relief from New Source Performance Standards Act (S. 1857) 60. Outdoors for All Act (S. 3499) 61. The MOMMA Act (H.R. 5977) 62. Preventing Maternal Deaths Act (H.R. 1318) 63. Medicare Access to Vaccines Equity Act (note yet introduced) 64. The Support Act (H.R. 6) 65. Climate Change Health Protection and Promotion Act (S. 529) 66. FY 2020 Departments of the Interior, Environment, and Related Agencies Appropriations Act (H.R. 3052/Not Yet Introduced) 67. NURSE Act (H.R. 1597) 68. Investing for the People Act (H.R. 2021) 69. Child Care for Working Families Act (H.R. 365/S. 568) 70. FAMILY Act (H.R. 1185/S. 463) 71. Transportation Alternatives Enhancement Act (S. 1098) 72. Lower Health Care Costs Act (S. 1895) 73. LIFT America Act (H.R 2479) 74. Public Health Funding Restoration Act (H.R. 3447/S. 1944) 75. Older Americans Act reauthorization (not yet introduced) 76. Campus Prevention and Recovery Services for Students Act (H.R. 3591) 77. Healthier Students for Stronger Campuses Act (S. 1281) 78. Saving Lives Through Better Data Act (S. 1793) 79. VACCINES Act (H.R. 2862) 80. DISARM Act (H.R. 4100/S. 1712) 81. Community Access, Resources, and Education for Families Act (H.R. 3117) 82. Protecting Seniors Through Immunization Act (S. 1872) 83. Tobacco-Free Youth Act (S. 1541) 84. Tobacco to 21 Act (H.R. 2411/S. 1258) 85. Investing for People Act (H.R. 2021) 86. School Based Health Centers Reauthorization Act (H.R.2075/S.1013) 87. Reversing the Youth Tobacco Epidemic Act of 2019 (H.R. 2339) 88. Social Determinants Accelerator Act (H.R. 4004) 89. Mental Health Professionals Workforce Shortage Loan Repayment Act (H.R. 2431) 90. The UNDERSTAND Act (S. 1323) 91. Americas Transportation Infrastructure Act (S. 2302) 92. Health Equity and Accountability Act (Not yet introduced) 93. Barriers to Suicide Act of 2019 (H.R. 4309) 94. Promoting Physical Activity for Americans Act (S. 1608/H.R. 2891) 95. Public Health Infrastructure Modernization Act of 2019 (H.R. 5321) 96. Supporting Healthy Mothers and Infants Act (H.R. 5249) 97. Lead-Free Future Act (H.R. 4416) 98. Home Visiting to Reduce Maternal Mortality and Morbidity Act (H.R. 4768) 99. Recognizing the anniversary of the eradication of smallpox and the importance of vaccination in the United States and worldwide (H. Res. 592) 100. Coronavirus Preparedness and Response Supplemental Appropriations Act (H.R. 6074) 101. Families First Coronavirus Response Act (H.R. 6201) 102. Coronavirus Aid, Relief, and Economic Security (CARES) Act (H.R. 748) 103. Connecting Americas Transportation Infrastructure Act (S. 2302) 104. Improving Access to Remote Behavioral Health Treatment Act (S. 2244/H.R. 4131) 105. National Suicide Hotline Designation Act (S. 2661/H.R. 4194) 106. Suicide Prevention Lifeline Improvement Act (H.R. 4564) 107. Campaign to Prevent Suicide Act (H.R. 4585) 108. Medicaid Reentry Act (H.R. 1329) 109. Excellence in Mental Health and Addiction Treatment Expansion Act (S. 824/H.R. 1767) 110. Mental Health Services for Students Act (S. 1122/H.R. 1109) 111. Suicide Training and Awareness Nationally Delivered for Universal Prevention (STANDUP) Act (S. 2492/H.R. 2599) 112. Mental Health Parity Compliance Act (S. 1737/H.R. 3165) 113. Behavioral Health Transparency Act (S. 1576/H.R. 2874) 114. Medicare Mental Health Access Act (S. 2772/H.R. 884) 115. Public Health Emergency Response and Accountability Act (S. 3309) 116. Family Violence Prevention and Services Improvement Act (H.R. 5041) House(s) of Congress and Federal Agencies lobbied during the quarter: House, Senate, Exec Office of Pres, HHS, CDC, FDA, CMS, OMB, DOT, HUD, EPA, NIMH, Education, USDA, DHS, FEMA, and SAMHSA

Client expense: $35,610 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Environmental Protection Agency (EPA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Office of Management & Budget (OMB), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA), Transportation, Dept of (DOT)