Climate Change Health Protection and Promotion Act of 2021

Climate Change Health Protection and Promotion Act (H.R. 3271/S. 1702)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Climate Change Health Protection and Promotion Act (H.R. 3271/S. 1702)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to the health impacts of air pollution and climate change; Issues related to air pollution from stationary and mobile sources; Issues related to the Clean Air Act; Issues related to permitting and regulatory reforms; Issues related to infrastructure; Issues relating to the Presidents FY24 budget; H.R 8295 Labor HHS Appropriations bill; H.R. 8294 Interior, Environment and Related Agencies Appropriations bill; H.R. 8294 Transportation, Housing and Urban Development and Related Agencies Appropriations bill; S. 4659 Labor HHS Appropriations bill; S. 4659 Interior, Environment and Related Agencies Appropriations bill; S. 4670 Transportation, Housing and Urban Development and Related Agencies Appropriations bill; H.R.501 Climate Smart Ports Act; H.R.512 Green Bus Act of 2021; H.R.516 Environmental Justice Mapping and Data Collection Act of 2021; H.R.848 GREEN Act of 2021; H.R.957 Protecting Moms and Babies Against Climate Change Act; S. 423 Protecting Moms and Babies Against Climate Change; H.R.1221 Electric Vehicles for Underserved Communities Act of 2021; H.R.1344 Clean School Bus Act of 2021; H.R.1512 To build a clean and prosperous future by addressing the climate crisis, protecting the health and welfare of all Americans, and putting the Nation on the path to a net-zero greenhouse gas economy by 2050, and for other purposes; H.R.2307 To create a Carbon Dividend Trust Fund for the American people in order to encourage market-driven innovation of clean energy technologies and market efficiencies which will reduce harmful pollution and leave a healthier, more stable, and more prosperous nation for future generations; S.101 Environmental Justice Mapping and Data Collection Act of 2021; S.216 Climate Smart Ports Act of 2021; S.506 Clean School Bus Act of 2021; S.507 Electric Vehicles for Underserved Communities Act of 2021; H.R.959 Black Maternal Health Momnibus Act of 2021; S.975 A bill to amend the Internal Revenue Code of 1986 to extend and modify the credit for alternative fuel vehicle refueling property; S.985 A bill to amend the Internal Revenue Code of 1986 to provide direct payments of the renewable electricity production credit, the energy credit, and the carbon oxide sequestration credit; H.R.2721 Clean Commute for Kids Act; S.1271 Clean Commute for Kids Act of 2021; S.1345 Comprehensive National Mercury Monitoring Act; H.R.3271 Climate Change Health Protection and Promotion Act; S.1702 Climate Change Health Protection and Promotion Act of 2021; S.1931 Surface Transportation Reauthorization Act of 2021; S.2085 Save Our Future Act; S.1298 Clean Energy for America Act; H.R.3959 American Renewable Energy Act of 2021; H.R.5089 Next Generation Fuels Act; H.R.5376 Build Back Better Act/Inflation Reduction Act; S.Con.Res.14 A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2022 and setting forth the appropriate budgetary levels for fiscal years 2023 through 2031; S.674 Public Health Infrastructure Saves Lives Act; S.645 Methane Emissions Reduction Act; H.R.1915 Water Quality Protection and Job Creation Act; Environmental Justice Legacy Pollution Clean Up Act; S. 2887 Outdoors for All Act; S. 2810 Black Lung Benefits Disability Trust Fund Solvency Act; H.R. 6462 Black Lung Benefits Disability Trust Fund Solvency Act; S.1076 REGROW Act; H.R.6050 Aviation Noise and Emissions Mitigation Act; S.196 Nonprofit Energy Efficiency Act; Technology Assessment for Air Quality Management Act of 2022; H.R.6546 Wireless Electric Vehicle Charging Grant Program Act of 2022; H.R. 6662 EVs for All Act; H.R. 6759 Environmental Justice Air Quality Monitoring Act of 2022; H.R. 7267 Cabin Air Safety Act of 2022; S 3944 Cabin Air Safety Act of 2022; Issues related to FY23 appropriations bills; S.2476 - Environmental Justice Air Quality Monitoring Act of 2021; H.R.384 - Bicycle Commuter Act of 2021; H.R.1019 - E-BIKE Act; H.R.4966 - Healthier and Greener Schools Act of 2021; H.R.5781 - National Wildland Fire Risk Reduction Program Act; H.R. 8352 Public Health Air Quality Act; H.R. 7671 Airborne Act; H.R. 2021 Environmental Justice for All Act; S. 872 Environmental Justice for All Act; S. 4510 Public Health Air Quality Act; S. 2736 RPM Act of 2021; S. 2421 Smoke Planning and Research Act of 2021; S. 2661 Smoke-Ready Communities Act of 2021; S. 4815 START Act; H.R. 8966 Simplify Timeline and Assure Regulatory Transparency (START) Act; Energy Independence and Security Act of 2022; H.R. 6833 Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023;

Health impacts of climate change S. 1702 / H.R. 3271 - Climate Change Health Protection and Promotion Act H.Res. 975 - Expressing the mental health impacts of recurrent climate-related disasters on youth

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

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, SENATE

Health impacts of climate change S. 1702 / H.R. 3271 - Climate Change Health Protection and Promotion Act H.Res. 975 - Expressing the mental health impacts of recurrent climate-related disasters on youth

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

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, SENATE

Issues related to the health impacts of air pollution and climate change; Issues related to air pollution from stationary and mobile sources; Issues related to the Clean Air Act; Issues related to regulatory reforms; Issues related to infrastructure; Issues relating to the Presidents FY23 budget; House Labor HHS Appropriations bill; House Interior, Environment and Related Agencies Appropriations bill; House Transportation, Housing and Urban Development and Related Agencies Appropriations bill; Senate Labor HHS Appropriations bill; Senate Interior, Environment and Related Agencies Appropriations bill Senate Transportation, Housing and Urban Development and Related Agencies Appropriations bill; H.R.501 Climate Smart Ports Act; H.R.512 Green Bus Act of 2021; H.R.516 Environmental Justice Mapping and Data Collection Act of 2021; H.R.848 GREEN Act of 2021; H.R.957 Protecting Moms and Babies Against Climate Change Act; H.R.1221 Electric Vehicles for Underserved Communities Act of 2021; H.R.1344 Clean School Bus Act of 2021; H.R.1512 To build a clean and prosperous future by addressing the climate crisis, protecting the health and welfare of all Americans, and putting the Nation on the path to a net-zero greenhouse gas economy by 2050, and for other purposes; H.R.2307 To create a Carbon Dividend Trust Fund for the American people in order to encourage market-driven innovation of clean energy technologies and market efficiencies which will reduce harmful pollution and leave a healthier, more stable, and more prosperous nation for future generations; S.101 Environmental Justice Mapping and Data Collection Act of 2021; S.216 Climate Smart Ports Act of 2021; S.506 Clean School Bus Act of 2021; S.507 Electric Vehicles for Underserved Communities Act of 2021; H.R.959 Black Maternal Health Momnibus Act of 2021; S.975 A bill to amend the Internal Revenue Code of 1986 to extend and modify the credit for alternative fuel vehicle refueling property; S.985 A bill to amend the Internal Revenue Code of 1986 to provide direct payments of the renewable electricity production credit, the energy credit, and the carbon oxide sequestration credit; H.R.2721 Clean Commute for Kids Act; S.1271 Clean Commute for Kids Act of 2021; S.1345 Comprehensive National Mercury Monitoring Act; H.R.3271 Climate Change Health Protection and Promotion Act; S.1702 Climate Change Health Protection and Promotion Act of 2021; S.1931 Surface Transportation Reauthorization Act of 2021; S.2085 Save Our Future Act; S.1298 Clean Energy for America Act; H.R.3959 American Renewable Energy Act of 2021; H.R.5089 Next Generation Fuels Act; H.R.5376 Build Back Better Act; S.Con.Res.14 A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2022 and setting forth the appropriate budgetary levels for fiscal years 2023 through 2031; S.674 Public Health Infrastructure Saves Lives Act; S.645 Methane Emissions Reduction Act; H.R.1915 Water Quality Protection and Job Creation Act; Environmental Justice Legacy Pollution Clean Up Act; Outdoors for All Act; Black Lung Benefits Disability Trust Fund Solvency Act; S.1076 REGROW Act; H.R.6050 Aviation Noise and Emissions Mitigation Act; S.196 Nonprofit Energy Efficiency Act; Technology Assessment for Air Quality Management Act of 2022;; H.R.6546 Wireless Electric Vehicle Charging Grant Program Act of 2022;; H.R. 6662 EVs for All Act; H.R. 6759 Environmental Justice Air Quality Monitoring Act of 2022; H.R. 7267 Cabin Air Safety Act of 2022; S 3944 Cabin Air Safety Act of 2022; Issues related to FY23 appropriations bills; S.2476 - Environmental Justice Air Quality Monitoring Act of 2021; H.R.384 - Bicycle Commuter Act of 2021; H.R.1019 - E-BIKE Act; H.R.4966 - Healthier and Greener Schools Act of 2021; H.R.5781 - National Wildland Fire Risk Reduction Program Act; Public Health Air Quality Act

Health impacts of climate change S. 1702 / H.R. 3271 - Climate Change Health Protection and Promotion Act H.Res. 975 - Expressing the mental health impacts of recurrent climate-related disasters on youth

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

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, SENATE

Climate Change Health Protection and Promotion Act (H.R. 3271/S. 1702)

Client expense: $220,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Climate Change Health Protection and Promotion Act (H.R. 3271/S. 1702)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Supporting the Traveling Exotic Animal and Public Safety Protection Act (HR5999/ S3220), with outreach requesting cosponsorship, support, and committee hearing; all provisions related to and supporting ending the suffering of animals in US traveling acts, and to address the inherent health and safety risks such events pose to animals, workers, and the public. Support the following measures to the extent they protect animals from harm, end animal suffering, and promote conservation of wild populations (supporting ADI's overarching goal for longstanding change to end animal suffering and to promote conservation of wild populations): TEAPSPA (HR5999/ S3220); Alternative Pilot Protein Act (HR6193); Alternatives to Animals for Regulatory Fairness (AARF) Act (HR1905); AFTER (Animal Freedom from Testing, Experiments, and Research) Act (HR5244); Bear Poaching Elimination Act (S3472); Bear Protection Act (HR2325); Big Cat & Public Safety Act (HR263/ S1210); Break Free from Plastic Pollution Act (HR2238); Captive Primate Safety Act HR3135; Combating Online Wildlife Trafficking Act HB1546; Combating Wildlife Trafficking Financing and Proceeds Study Act (HR6477); Critically Endangered Animals Conservation Act (HR1569); Ejiao Act (HR5203); End Palm Oil Deforestation Act (HR5863); END Wildlife Trafficking Reauthorization Act; Extinction Crisis Emergency Act (HR4182); Federal fur action; FDA Modernization Act (HR2565/S2952); Global Amphibian Protection Act (HR2026); Global Pandemic Prevention & Biosecurity Act (HR3424); High Seas Driftnet Fishing Moratorium Protection Act; HRes69 (National Biodiversity Strategy); Humane Cosmetics Act (HR6207/ S3357); Humane Research & Testing Act (HR1744); Manatee Protection Act (HB4946); Marine Mammal Climate Change Protection Act (HR3692); Minks in Narrowly Kept Spaces (MINKS) are Superspreaders Act (HR4310); Multinational Species Conservation Fund (HR6023); Ocean-Based Climate Solutions Act HR3764; PAST (Preventing all soring tactics) Act (HR5441/ S2295); Preventing Future Pandemics Act (HR151/ S37); REDUCE Act S2645; Right Whale Coexistence Act (HR6785/ S3664); SAFE Act (HR3355); Shark Fin Sales Elimination Act (S1106); Tropical Forest and Coral Reef Conservation Reauthorization Act; Wildlife Conservation & Anti-Trafficking Act (HR6059); Wildlife Corridors Conservation Act. Opposing the following bills, which seek to reduce protections for animals, and/or their ecosystems and habitats: HR211 (apparently also named the Big Cat Public Safety Act); Listing Reform Act (HB4370); Science-based Grizzly Bear Management Act (HR6284). Monitoring, taking a neutral or no position on, the following bills: Advancing Human Rights-Centered International Conservation Act (HR7025); Climate Change Health Protection & Promotion Act (HR3271 /S1702); Farm System Reform Act; International Pandemic Preparedness and COVID-19 Response Act (S2297); Recovering Americas Wildlife Act (HR2773/ S2372).

Supporting the Traveling Exotic Animal and Public Safety Protection Act (HR5999/ S3220), with outreach requesting cosponsorship, support, and committee hearing; all provisions related to and supporting ending the suffering of animals in US traveling acts, and to address the inherent health and safety risks such events pose to animals, workers, and the public. Support the following measures to the extent they protect animals from harm, end animal suffering, and promote conservation of wild populations (supporting ADI's overarching goal for longstanding change to end animal suffering and to promote conservation of wild populations): TEAPSPA (HR5999/ S3220); Alternative Pilot Protein Act (HR6193); Alternatives to Animals for Regulatory Fairness (AARF) Act (HR1905); AFTER (Animal Freedom from Testing, Experiments, and Research) Act (HR5244); Bear Poaching Elimination Act (S3472); Bear Protection Act (HR2325); Big Cat & Public Safety Act (HR263/ S1210); Break Free from Plastic Pollution Act (HR2238); Captive Primate Safety Act HR3135; Combating Online Wildlife Trafficking Act HB1546; Combating Wildlife Trafficking Financing and Proceeds Study Act (HR6477); Critically Endangered Animals Conservation Act (HR1569); Ejiao Act (HR5203); End Palm Oil Deforestation Act (HR5863); END Wildlife Trafficking Reauthorization Act; Extinction Crisis Emergency Act (HR4182); Federal fur action; FDA Modernization Act (HR2565/S2952); Global Amphibian Protection Act (HR2026); Global Pandemic Prevention & Biosecurity Act (HR3424); High Seas Driftnet Fishing Moratorium Protection Act; HRes69 (National Biodiversity Strategy); Humane Cosmetics Act (HR6207/ S3357); Humane Research & Testing Act (HR1744); Manatee Protection Act (HB4946); Marine Mammal Climate Change Protection Act (HR3692); Minks in Narrowly Kept Spaces (MINKS) are Superspreaders Act (HR4310); Multinational Species Conservation Fund (HR6023); Ocean-Based Climate Solutions Act HR3764; PAST (Preventing all soring tactics) Act (HR5441/ S2295); Preventing Future Pandemics Act (HR151/ S37); REDUCE Act S2645; Right Whale Coexistence Act (HR6785/ S3664); SAFE Act (HR3355); Shark Fin Sales Elimination Act (S1106); Tropical Forest and Coral Reef Conservation Reauthorization Act; Wildlife Conservation & Anti-Trafficking Act (HR6059); Wildlife Corridors Conservation Act. Opposing the following bills, which seek to reduce protections for animals, and/or their ecosystems and habitats: HR211 (apparently also named the Big Cat Public Safety Act); Listing Reform Act (HB4370); Science-based Grizzly Bear Management Act (HR6284). Monitoring, taking a neutral or no position on, the following bills: Advancing Human Rights-Centered International Conservation Act (HR7025); Climate Change Health Protection & Promotion Act (HR3271 /S1702); Farm System Reform Act; International Pandemic Preparedness and COVID-19 Response Act (S2297); Recovering Americas Wildlife Act (HR2773/ S2372).

Issues related to the health impacts of air pollution and climate change; Issues related to air pollution from stationary and mobile sources; Issues related to the Clean Air Act; Issues related to regulatory reforms; Issues related to infrastructure; Issues relating to the Presidents FY23 budget; H.R.4502 House Labor HHS Appropriations bill; H.R.4372 House Interior, Environment and Related Agencies Appropriations bill; H.R.4550 House Transportation, Housing and Urban Development and Related Agencies Appropriations bill; S.3062 Senate Labor HHS Appropriations bill; S.3034 Senate Interior, Environment and Related Agencies Appropriations bill; S.3045 Senate Transportation, Housing and Urban Development and Related Agencies Appropriations bill; H.R.501 Climate Smart Ports Act; H.R.512 Green Bus Act of 2021; H.R.516 Environmental Justice Mapping and Data Collection Act of 2021; H.R.848 GREEN Act of 2021; H.R.957 Protecting Moms and Babies Against Climate Change Act; H.R.1221 Electric Vehicles for Underserved Communities Act of 2021; H.R.1344 Clean School Bus Act of 2021; H.R.1512 To build a clean and prosperous future by addressing the climate crisis, protecting the health and welfare of all Americans, and putting the Nation on the path to a net-zero greenhouse gas economy by 2050, and for other purposes; H.R.2307 To create a Carbon Dividend Trust Fund for the American people in order to encourage market-driven innovation of clean energy technologies and market efficiencies which will reduce harmful pollution and leave a healthier, more stable, and more prosperous nation for future generations; S.101 Environmental Justice Mapping and Data Collection Act of 2021; S.216 Climate Smart Ports Act of 2021; S.506 Clean School Bus Act of 2021; S.507 Electric Vehicles for Underserved Communities Act of 2021; H.R.959 Black Maternal Health Momnibus Act of 2021; S.975 A bill to amend the Internal Revenue Code of 1986 to extend and modify the credit for alternative fuel vehicle refueling property; S.985 A bill to amend the Internal Revenue Code of 1986 to provide direct payments of the renewable electricity production credit, the energy credit, and the carbon oxide sequestration credit; H.R.2721 Clean Commute for Kids Act; S.1271 Clean Commute for Kids Act of 2021; S.1345 Comprehensive National Mercury Monitoring Act; H.R.3271 Climate Change Health Protection and Promotion Act; S.1702 Climate Change Health Protection and Promotion Act of 2021; S.1931 Surface Transportation Reauthorization Act of 2021; S.2085 Save Our Future Act; S.1298 Clean Energy for America Act; H.R.3959 American Renewable Energy Act of 2021; H.R.5089 Next Generation Fuels Act;; H.R.5376 Build Back Better Act; S.Con.Res.14 A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2022 and setting forth the appropriate budgetary levels for fiscal years 2023 through 2031; S.674 Public Health Infrastructure Saves Lives Act; S.645 Methane Emissions Reduction Act; H.R.1915 Water Quality Protection and Job Creation Act; Environmental Justice Legacy Pollution Clean Up Act; Outdoors for All Act; Black Lung Benefits Disability Trust Fund Solvency Act; S.1076 REGROW Act; H.R.6050 Aviation Noise and Emissions Mitigation Act; S.196 Nonprofit Energy Efficiency Act; Technology Assessment for Air Quality Management Act of 2022; H.R.2471 FY22 Consolidated Appropriations Act, 2022; H.R.6546 Wireless Electric Vehicle Charging Grant Program Act of 2022; H.R.6617 Further Additional Extending Government Funding Act; H.R. 6662 EVs for All Act; H.R. 6759 Environmental Justice Air Quality Monitoring Act of 2022; H.R. 7267 Cabin Air Safety Act of 2022; S 3944 Cabin Air Safety Act of 2022; Issues related to FY23 appropriations bills

Health impacts of climate change S. 1702 / H.R. 3271 - Climate Change Health Protection and Promotion Act H.Res. 975 - Expressing the mental health impacts of recurrent climate-related disasters on youth

Client expense: $226,000 · Firm income: Not reported

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, SENATE

Climate Change Health Protection and Promotion Act (H.R. 3271/S. 1702)

Client expense: $120,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Issues related to the health impacts of air pollution and climate change; Issues related to air pollution from stationary and mobile sources; Issues related to the Clean Air Act; Issues related to regulatory reforms; Issues related to infrastructure; Issues relating to the Presidents FY23 budget; H.R.4502 House Labor HHS Appropriations bill; H.R.4372 House Interior, Environment and Related Agencies Appropriations bill; H.R.4550 House Transportation, Housing and Urban Development and Related Agencies Appropriations bill; S.3062 Senate Labor HHS Appropriations bill; S.3034 Senate Interior, Environment and Related Agencies Appropriations bill; S.3045 Senate Transportation, Housing and Urban Development and Related Agencies Appropriations bill; H.R.501 Climate Smart Ports Act; H.R.512 Green Bus Act of 2021; H.R.516 Environmental Justice Mapping and Data Collection Act of 2021; H.R.848 GREEN Act of 2021; H.R.957 Protecting Moms and Babies Against Climate Change Act; H.R.1221 Electric Vehicles for Underserved Communities Act of 2021; H.R.1344 Clean School Bus Act of 2021; H.R.1512 To build a clean and prosperous future by addressing the climate crisis, protecting the health and welfare of all Americans, and putting the Nation on the path to a net-zero greenhouse gas economy by 2050, and for other purposes; H.R.2307 To create a Carbon Dividend Trust Fund for the American people in order to encourage market-driven innovation of clean energy technologies and market efficiencies which will reduce harmful pollution and leave a healthier, more stable, and more prosperous nation for future generations; S.101 Environmental Justice Mapping and Data Collection Act of 2021; S.216 Climate Smart Ports Act of 2021; S.506 Clean School Bus Act of 2021; S.507 Electric Vehicles for Underserved Communities Act of 2021; H.R.959 Black Maternal Health Momnibus Act of 2021; S.975 A bill to amend the Internal Revenue Code of 1986 to extend and modify the credit for alternative fuel vehicle refueling property; S.985 A bill to amend the Internal Revenue Code of 1986 to provide direct payments of the renewable electricity production credit, the energy credit, and the carbon oxide sequestration credit; H.R.2721 Clean Commute for Kids Act; S.1271 Clean Commute for Kids Act of 2021; S.1345 Comprehensive National Mercury Monitoring Act; H.R.3271 Climate Change Health Protection and Promotion Act; S.1702 Climate Change Health Protection and Promotion Act of 2021; S.1931 Surface Transportation Reauthorization Act of 2021; S.2085 Save Our Future Act; S.1298 Clean Energy for America Act; H.R.3959 American Renewable Energy Act of 2021; H.R.5089 Next Generation Fuels Act; H.R.3684 Infrastructure Investment and Jobs Act; H.R.5376 Build Back Better Act; S.Con.Res.14 A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2022 and setting forth the appropriate budgetary levels for fiscal years 2023 through 2031; S.674 Public Health Infrastructure Saves Lives Act; S.645 Methane Emissions Reduction Act; H.R.1915 Water Quality Protection and Job Creation Act; Environmental Justice Legacy Pollution Clean Up Act; Outdoors for All Act; Black Lung Benefits Disability Trust Fund Solvency Act; S.1076 REGROW Act; H.R.6050 Aviation Noise and Emissions Mitigation Act; S.196 Nonprofit Energy Efficiency Act; Technology Assessment for Air Quality Management Act of 2022

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.Tax Cuts and Jobs Act (Public Law 115-97) 7.Pandemic and All-Hazards Preparedness Advancing Innovation Act (P.L. 116-22) 8.Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136) 9.Implementation of the Amer 10.Strengthening the Vaccines for Children Program Act (H.R. 2347) 11.The Healthy Families Act (S. 1195/H.R. 2465) 12.FAMILY Act (H.R. 804/S. 248) 13.American Rescue Plan Act of 2021 (P.L. 117-2) 14.Pursuing Equity in Mental Health Act (H.R. 1475) 15.Public Health Infrastructure Saves Lives Act (S. 674) 16.Summer Meals Act of 2021 (H.R. 783) 17.The Mental Health Services for Students Act (H.R. 721) 18.Black Maternal Health Momnibus (H.R. 959/S. 346) 19.Immunization Information System Modernization Act (H.R. 550) 20.Protecting Seniors through Immunization Act (H.R. 1978) 21.Community Immunity During COVID-19 Act (H.R. 736/S. 167) 22.Parity Enforcement Act (H.R. 1364) 23.Improving Social Determinants of Health Act (S. 104/H.R 379) 24.FY 2022 Labor, HHS, Education and Related Agencies Appropriations 25.WIC Act of 2021 (S. 853) 26.Environmental Justice Legacy Pollution Cleanup Act (Bill number not yet available) 27.Transportation Alternatives Enhancement Act (H.R. 463/S. 614) 28.SAFE Streets Act (H.R. 508) 29.Safe Routes to School Expansion Act (H.R. 386) 30.Social Determinants Accelerator Act (H.R. 2503) 31.Strengthening the Vaccines for Children Act (H.R. 2347) 32.Tracking COVID-19 Variants Act (S. 236) 33.Tobacco Tax Equity Act (S. 1314/H.R. 2786) 34.NURSE Act (S. 1602) 35.Maternal Immunization Enhancement Act (S. 1114) 36.Maternal Immunization Coverage Act (S. 1117) 37.Equality Act (H.R. 5) 38.Climate Change Health Protection and Promotion Act (S. 1702/H.R. 3271) 39.RISE from Trauma Act (S. 2086) 40.Improving Data Collection for Adverse Childhood Experiences Act (H.R. 3467) 41.FY2022 Agriculture-FDA Appropriations Bill 42.Honoring the Centers for Disease Control and Prevention on the 75th anniversary of its establishment and expressing deep gratitude on behalf of the people of the United States to the scientists, disease detectives, career civil servants, and support staff at the Centers for Disease Control and Prevention for their dedication to protecting the health, safety, and security of the United States and to strengthening public health in the United States and abroad. (S Res. 332/H. Res. 618) 43.Build Back Better Act (H.R. 5376) 44.Behavioral Health Crisis Services Expansion Act (S. 1902) 45.Ensuring Understanding of COVID-19 to Protect Public Health Act (S. 176) 46.Protecting the Health of Americas Older Adults Act (H.R. 6302) 47.Cures 2.0 Act (H.R. 6000) 48.Helping Adults Protect Immunity Act (H.R. 2170) 49.Early Childhood Nutrition Improvement Act (H.R. 5919) 50.Public Health Workforce Loan Repayment Act (H.R. 3297) 51.Campus Prevention and Recovery Services for Students Act 52.Universal School Meals Program Act of 2021 (S. 1530) 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, ACF, Education, USDA, DHS, FEMA, and SAMHSA.

Support including $45 billion in federal funding to fully replace all lead service lines in the nation. Support H.R. 3721/S. 1702, the Climate Change Health Protection and Promotion Act of 2021. Support climate, clean energy and environmental justice provisions in the Build Back Better Act.

Client expense: $24,921 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), SENATE, Vice President of the U.S., 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.Tax Cuts and Jobs Act (Public Law 115-97) 7.Pandemic and All-Hazards Preparedness Advancing Innovation Act (P.L. 116-22) 8.Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136) 9.Implementation of the Amer 10.Strengthening the Vaccines for Children Program Act (H.R. 2347) 11.The Healthy Families Act (S. 1195/H.R. 2465) 12.FAMILY Act (H.R. 804/S. 248) 13.American Rescue Plan Act of 2021 (P.L. 117-2) 14.Pursuing Equity in Mental Health Act (H.R. 1475) 15.Public Health Infrastructure Saves Lives Act (S. 674) 16.Summer Meals Act of 2021 (H.R. 783) 17.The Mental Health Services for Students Act (H.R. 721) 18.Black Maternal Health Momnibus (H.R. 959/S. 346) 19.Immunization Information System Modernization Act (H.R. 550) 20.Protecting Seniors through Immunization Act (H.R. 1978) 21.Community Immunity During COVID-19 Act (H.R. 736/S. 167) 22.Parity Enforcement Act (H.R. 1364) 23.Improving Social Determinants of Health Act (S. 104/H.R 379) 24.FY 2022 Labor, HHS, Education and Related Agencies Appropriations 25.WIC Act of 2021 (S. 853) 26.Environmental Justice Legacy Pollution Cleanup Act (Bill number not yet available) 27.Transportation Alternatives Enhancement Act (H.R. 463/S. 614) 28.SAFE Streets Act (H.R. 508) 29.Safe Routes to School Expansion Act (H.R. 386) 30.Social Determinants Accelerator Act (H.R. 2503) 31.Strengthening the Vaccines for Children Act (H.R. 2347) 32.Tracking COVID-19 Variants Act (S. 236) 33.Tobacco Tax Equity Act (S. 1314/H.R. 2786) 34.NURSE Act (S. 1602) 35.Maternal Immunization Enhancement Act (S. 1114) 36.Maternal Immunization Coverage Act (S. 1117) 37.Equality Act (H.R. 5) 38.Climate Change Health Protection and Promotion Act (S. 1702/H.R. 3271) 39.RISE from Trauma Act (S. 2086) 40.Improving Data Collection for Adverse Childhood Experiences Act (H.R. 3467) 41.FY2022 Agriculture-FDA Appropriations Bill 42.Honoring the Centers for Disease Control and Prevention on the 75th anniversary of its establishment and expressing deep gratitude on behalf of the people of the United States to the scientists, disease detectives, career civil servants, and support staff at the Centers for Disease Control and Prevention for their dedication to protecting the health, safety, and security of the United States and to strengthening public health in the United States and abroad. (S Res. 332/H. Res. 618) 43.Build Back Better Act (H.R. 5376) 44.Behavioral Health Crisis Services Expansion Act (S. 1902) 45.Ensuring Understanding of COVID-19 to Protect Public Health Act (S. 176) 46.Protecting the Health of Americas Older Adults Act (H.R. 6302) 47.Cures 2.0 Act (H.R. 6000) 48.Helping Adults Protect Immunity Act (H.R. 2170) 49.Early Childhood Nutrition Improvement Act (H.R. 5919) 50.Public Health Workforce Loan Repayment Act (H.R. 3297) 51.Campus Prevention and Recovery Services for Students Act 52.Universal School Meals Program Act of 2021 (S. 1530) 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, ACF, Education, USDA, DHS, FEMA, and SAMHSA.

Health impacts of climate change S. 1702 / H.R. 3271 - Climate Change Health Protection and Promotion Act

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Justice, Dept of (DOJ), Natl Science Foundation (NSF), Office of Management & Budget (OMB), Office of Science & Technology Policy (OSTP), SENATE, Veterans Affairs, Dept of (VA), 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.Tax Cuts and Jobs Act (Public Law 115-97) 7.Pandemic and All-Hazards Preparedness Advancing Innovation Act (P.L. 116-22) 8.Strengthening the Vaccines for Children Program Act (H.R. 2347) 9.The Healthy Families Act (S. 1195/H.R. 2465) 10.FAMILY Act (H.R. 804/S. 248) 11.American Rescue Plan Act of 2021 (P.L. 117-2) 12.Pursuing Equity in Mental Health Act (H.R. 1475) 13.Public Health Infrastructure Saves Lives Act (S. 674) 14.Summer Meals Act of 2021 (H.R. 783) 15.The Mental Health Services for Students Act (H.R. 721) 16.Black Maternal Health Momnibus (H.R. 959/S. 346) 17.Immunization Information System Modernization Act (H.R. 550) 18.Protecting Seniors through Immunization Act (H.R. 1978) 19.Community Immunity During COVID-19 Act (H.R. 736/S. 167) 20.Parity Enforcement Act (H.R. 1364) 21.Improving Social Determinants of Health Act (S. 104/H.R 379) 22.FY 2022 LHHS Appropriations 23.WIC Act of 2021 (S. 853) 24.Environmental Justice Legacy Pollution Cleanup Act (Bill number not yet available) 25.Transportation Alternatives Enhancement Act (H.R. 463/S. 614) 26.SAFE Streets Act (H.R. 508) 27.Safe Routes to School Expansion Act (H.R. 386) 28.Social Determinants Accelerator Act (H.R. 2503) 29.Strengthening the Vaccines for Children Act (H.R. 2347) 30.Tracking COVID-19 Variants Act (S. 236) 31.Tobacco Tax Equity Act (S. 1314/H.R. 2786) 32.NURSE Act (S. 1602) 33.Maternal Immunization Enhancement Act (S. 1114) 34.Maternal Immunization Coverage Act (S. 1117) 35.Equality Act (H.R. 5) 36.Climate Change Health Protection and Promotion Act (S. 1702/H.R. 3271) 37.RISE from Trauma Act (S. 2086) 38.Improving Data Collection for Adverse Childhood Experiences Act (H.R. 3467) 39.FY2022 Agriculture-FDA Appropriations Bill 40.Honoring the Centers for Disease Control and Prevention on the 75th anniversary of its establishment and expressing deep gratitude on behalf of the people of the United States to the scientists, disease detectives, career civil servants, and support staff at the Centers for Disease Control and Prevention for their dedication to protecting the health, safety, and security of the United States and to strengthening public health in the United States and abroad. (S Res. 332/H. Res. 618) 41.Build Back Better Act (H.R. 5376) 42.Behavioral Health Crisis Services Expansion Act (S. 1902) 43.Ensuring Understanding of COVID-19 to Protect Public Health Act (S. 176) 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, ACF, Education, USDA, DHS, FEMA, and SAMHSA.

Climate Change Health Protection and Promotion Act (H.R. 3271/S. 1702)

Client expense: $140,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Issues related to the health impacts of air pollution and climate change; Issues related to air pollution from stationary and mobile sources; Issues related to the Clean Air Act; Issues related to regulatory reforms; Issues related to infrastructure; Issues relating to the Presidents FY23 budget; H.R.4502 House Labor HHS Appropriations bill; H.R.4372 House Interior, Environment and Related Agencies Appropriations bill; H.R.4550 House Transportation, Housing and Urban Development and Related Agencies Appropriations bill; Senate Labor HHS Appropriations bill; Senate Interior, Environment and Related Agencies Appropriations bill; Senate Transportation, Housing and Urban Development and Related Agencies Appropriations bill; H.R.501 Climate Smart Ports Act; H.R.512 Green Bus Act of 2021; H.R.516 Environmental Justice Mapping and Data Collection Act of 2021; H.R.848 GREEN Act of 2021; H.R.957 Protecting Moms and Babies Against Climate Change Act; H.R.1221 Electric Vehicles for Underserved Communities Act of 2021; H.R.1344 Clean School Bus Act of 2021; H.R.1512 To build a clean and prosperous future by addressing the climate crisis, protecting the health and welfare of all Americans, and putting the Nation on the path to a net-zero greenhouse gas economy by 2050, and for other purposes; H.R.2307 To create a Carbon Dividend Trust Fund for the American people in order to encourage market-driven innovation of clean energy technologies and market efficiencies which will reduce harmful pollution and leave a healthier, more stable, and more prosperous nation for future generations; S.101 Environmental Justice Mapping and Data Collection Act of 2021;; S.216 Climate Smart Ports Act of 2021; S.506 Clean School Bus Act of 2021; S.507 Electric Vehicles for Underserved Communities Act of 2021; H.R.959 Black Maternal Health Momnibus Act of 2021; S.975 A bill to amend the Internal Revenue Code of 1986 to extend and modify the credit for alternative fuel vehicle refueling property; S.985 A bill to amend the Internal Revenue Code of 1986 to provide direct payments of the renewable electricity production credit, the energy credit, and the carbon oxide sequestration credit; H.R. 2721 Clean Commute for Kids Act; S.1271 Clean Commute for Kids Act of 2021; S.1345 Comprehensive National Mercury Monitoring Act; H.R. 3271 Climate Change Health Protection and Promotion Act; S.1702 Climate Change Health Protection and Promotion Act of 2021; S.1931 Surface Transportation Reauthorization Act of 2021; S.2085 Save Our Future Act; S.1298 Clean Energy for America Act; H.R. 3959 American Renewable Energy Act of 2021; H.R. 5089 Next Generation Fuels Act; H.R.3684 Infrastructure Investment and Jobs Act; H.R.5376 Build Back Better Act; S.Con.Res.14 A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2022 and setting forth the appropriate budgetary levels for fiscal years 2023 through 2031; S.674 Public Health Infrastructure Saves Lives Act; S.645 Methane Emissions Reduction Act; H.R.1915 Water Quality Protection and Job Creation Act; Environmental Justice Legacy Pollution Clean Up Act; Outdoors for All Act; Black Lung Benefits Disability Trust Fund Solvency Act; S.1076 REGROW Act

Support including $45 billion in federal funding in infrastructure legislation to fully replace all lead service lines in the nation. Support for the inclusion of strong climate change, clean energy and environmental justice provisions in budget reconciliation legislation. Support H.R. 3721/S. 1702, the Climate Change Health Protection and Promotion Act of 2021. Support for maximizing funding for zero-emission school buses in infrastructure legislation.

Client expense: $28,008 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of the Vice President of the United States, SENATE, Vice President of the U.S., White House Office

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged support for H.R. 8505, a bill to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule; Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases, along with GPC1X codes to go into effect. Regarding CMS proposed 2022 Medicare Physician Fee Schedule and Quality Payment Program (QPP) rules, expressed support for extending some of the services and increased flexibility for telehealth through the end of 2023, namely some audio-only services that were allowed during the COVID-19 public health emergency (PHE), support for collecting additional data on health equity issues to analyze disparities that occur across their programs, support for including chronic care management as one of the seven MIPS Value Pathways (MVPs) for 2023. FY2022 Appropriations: Urged Congress to support $10 billion for the Centers for Disease Control and Preventions programs in the FY 2022 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as $50 million in funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for: Health Resources Services Administration (HRSA), $9.2 billion; Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA), $71 million; National Health Service Corps (NHSC), $860 million in total program funding; Agency for Healthcare Research and Quality (AHRQ), $500 million; Centers for Medicare and Medicaid Services (CMS), Program Operations for Federal Exchanges, $296.5 million. Also, urged support for the VA, Veterans Health Administration (VHA), $103.1 billion, which includes the following within the VHA -- VA, VHA, Medical Services, $66.2 billion, VA, VHA, Medical Community Care, $20.7 billion, VA, VHA, Medical and Prosthetic Research; $902 million. COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Urged the administration to explore regulatory and other actions that would make COVID-19 testing free-of-charge to patients covered by both public and private insurance plans, including ACA-compliant plans offered through the insurance exchanges, and to waive co-pays and deductibles for patients seeing physicians for symptoms that may be indicative of COVID-19 or who are hospitalized for treatment. Urged CMS to utilize a national disaster recovery program that would pay doctors 110% of Medicare rates for caring for uninsured patients who have been infected with SARS-CoV-2. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for the Student Loan Forgiveness for Frontline Health Workers Act, H.R. 6720, introduced May 5, 2020 by Representative Carolyn B. Maloney (D-NY) which would eliminate graduate school debt for healthcare workers, including physicians and medical students, who are providing direct patient care in response to the COVID-19 pandemic; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. This extension-either continued by CMS or mandated by Congress-should last at least through the end of 2021, or until such a time when effective vaccines and treatments are widely available, with an option to extend it even further, or consider making permanent, based on the experience and learnings of patients and physicians who are utilizing these visits. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP); urged support for administering COVID-19 vaccinations to all eligible immigrants in Customs and Border Protection (CBP) custody. American Rescue Plan (ARP) Act (H.R. 1319): Urged support for various provisions within the ARP to provide incentives for states to expand Medicaid by temporarily increasing the states base FMAP by five percentage points for two years for states that newly expand Medicaid. Urged support for allowing states, for five years, to extend Medicaid eligibility (and CHIP eligibility) to women for 12 months postpartum. Urged support to require Medicaid coverage of COVID-19 vaccines and treatment without beneficiary cost sharing with vaccines matched at a 100 percent federal medical assistance percentage (FMAP) through one year after the end of the PHE. Urged support for $46 billion to HHS to detect, diagnose, trace, and monitor COVID-19 infections, and for other activities necessary to mitigate the spread of COVID-19. Urged support to subsidize the health coverage of people earning up to 150 percent of the federal poverty level (FPL) under the ACA and those on unemployment insurance for a period of two years. Urged support for waiving VA cost sharing and copayments for medical treatment until September 30, 2021. Womens Health: Urged Congress to support, H.R. 958, the Protecting Moms Who Served Act, which would provide critical support for maternity care coordination programs to address the clinical and nonclinical perinatal needs of veterans and ensure effective coordination between VA and non-VA facilities in the delivery of maternity care and other health care services. Urged HHS to promptly finalize new Title X regulations that ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminates medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protects funding for and ensures consistent treatment of qualified service sites. Urged support for mandatory, permanent extension of postpartum Medicaid coverage, from 60 days to 12 months after delivery. Urged support for the Womens Health Protection Act of 2021 (H.R. 3755 and S. 1975), bills that would protect a persons ability to determine whether to continue or end a pregnancy and to protect the health care clinicians ability to provide abortion services free from medically unnecessary restrictions such as waiting periods, biased counselling and admitting privilege requirements for clinicians. Expand Health Coverage and Affordability: Urged Congress to support H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place. Introduce and pass the companion bill in the Senate and H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the ACA. Train and Support Frontline Physicians during and after COVID-19: Urged Congress to support H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots by at least 2,000 per year over seven years (14,000 slots) for specialties facing shortages, including internal medicine; H.R. 1554 (116th Congress), the Resident Education Deferred Interest Act, to allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program; S. 948, the Conrad State 30 and Physician Access Reauthorization Act (116th Congress) and S. 3599 (116th Congress), the Healthcare Workforce Resilience Act, to support the COVID-19 response workforce by expediting visas for international medical graduates (IMGs) to enter the U.S. for training and patient care, permanently authorizing the Conrad 30 Program, and providing a pathway for IMGs and their families already in the U.S to obtain permanent residency status; H.R. 2418, the Student Loan Forgiveness for Frontline Health Workers Act, to forgive student loans for physicians and other clinicians who are on the frontlines of providing care to COVID-19 patients or helping the health care system cope with the COVID-19 public health emergency; H.R. 1667/S. 610, the Dr. Lorna Breen Health Care Provider Protection Act, to address the behavioral health and well-being of physicians, including depression, suicides and burnout. Support the Value of Primary and Comprehensive Care: Urged Congress to Continue to fund the 3.75 percent increase to all physicians services that was approved by Congress at the end of last year to prevent CY2022 budget neutrality cuts for physician services, including primary care visits and other evaluation and management services; Ensure that any legislation that addresses budget neutrality treats all services fairly and equitably; Pass H.R. 1025, the Kids Access to Primary Care Act, to increase access to health coverage for Medicaid patients by achieving payment parity for primary care services under Medicaid and Medicare; Extend the five percent bonus that physicians receive if they meet performance expectations in Advanced APMs that is set to expire at the end of 2022; Act before the end of CY2021 to prevent scheduled cuts for physician services, including primary care, resulting from budget sequestration and pay-as-you go budget rules. Improve Access to Prescription Drugs and Reduce Costs: Urged Congress to support S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; S. 141, the End Taxpayer Subsidies for Drug Ads Act, to end the federal tax deduction that pharmaceutical companies use to pay for drug advertising; S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Support Essential Public Health and Research Initiatives: Urged Congress to support H.R. 8, the Bipartisan Background Checks Act that would establish new background check requirements for firearm transfers between private parties; H.R. 3076/S. 506, the Extreme Risk Protection Order Act from the 116th Congress, to establish a grant program to help states and Indian tribes implement extreme risk protection order laws and expands categories of individuals who are prohibited from receiving, possessing, shipping, or transporting a firearm; H.R. 3271/S. 1702, the Climate Change Health Protection and Promotion Act that would take important steps to mitigate the harmful impact of climate change on health. Promote Health Equity, Social Justice, and Eliminate Disparities: Urged Congress to support H.R. 1280, the George Floyd Justice in Policing Act of 2021, to overhaul qualified immunity for law enforcement, prohibit racial profiling on the part of law enforcement and ban no-knock warrants in federal drug cases and chokeholds and carotid holds at the federal level; H.R. 5, the Equality Act, to prohibit discrimination based on sex, sexual orientation and gender identity in public accommodations and facilities, education, federal housing credit and the jury system; H.R. 666/S. 162, the Anti-Racism in Public Health Act of 2021, to establish within the CDC a National Center on Anti-racism and Health for data collection and research and a law enforcement violence prevention program; H.R. 959/S. 346, the Black Maternal Health Momnibus Act of 2021, to reduce preventable maternal mortality and severe maternal morbidity in the U.S. and close disparities in maternal health outcomes, particularly among pregnant minority women. Expand Access to Telehealth Services and Promote Patient Safety/Privacy; Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends; Urged appropriators to include adequate funding in FY2022 to support expansion of broadband capabilities nationwide, especially to rural and underserved communities, and to remove the ban on adoption of a national unique health identifier standard. Veterans Administration: Expressed concerns to the VA about its efforts to develop National Standards of Practice for physicians and other health professionals that supersede state scope of practice and licensure laws; expressed that the VA has not provided a transparent process by which public stakeholders are provided an adequate opportunity to review and provide meaningful input into the standards of practice. Infrastructure Investment: Expressed support with Congress for several provisions in the bipartisan Infrastructure Investment and Jobs Act, legislation that makes sweeping and historic investments in this nations infrastructure; Applauded provisions that would improve public health specifically to ensure all Americans have access to safe drinking water, broadband services that provide vital access to telehealth services, as well as investment in clean energy to reverse the negative health effects associated with climate change. Surprise Medical Billing: Voiced support for the decision of CMS to provide protections for patients from surprise bills in situations where they need an ambulance, especially in a perceived emergency; voiced support for CMS approach that emergency services provided by out-of-network emergency facilities and out-of-network provider organizations, and certain non-emergency services furnished by out-of-network provider organizations at certain in-network facilities, must be calculated based on a recognized amount which is generally the lesser of the Qualifying Payment Amount (QPA) - the plans median in-network rate for the item or service, or an all-payer model agreement between CMS and the state; urged CMS to include in the Independent Dispute Resolution process described in future sub-regulatory guidance that health plans have an affirmative obligation to pay fairly and appropriately for services provided in and out of network.

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged support for H.R. 8505, a bill to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule; Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases, along with GPC1X codes to go into effect. Regarding CMS proposed 2022 Medicare Physician Fee Schedule and Quality Payment Program (QPP) rules, expressed support for extending some of the services and increased flexibility for telehealth through the end of 2023, namely some audio-only services that were allowed during the COVID-19 public health emergency (PHE), support for collecting additional data on health equity issues to analyze disparities that occur across their programs, support for including chronic care management as one of the seven MIPS Value Pathways (MVPs) for 2023. FY2022 Appropriations: Urged Congress to support $10 billion for the Centers for Disease Control and Preventions programs in the FY 2022 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as $50 million in funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for: Health Resources Services Administration (HRSA), $9.2 billion; Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA), $71 million; National Health Service Corps (NHSC), $860 million in total program funding; Agency for Healthcare Research and Quality (AHRQ), $500 million; Centers for Medicare and Medicaid Services (CMS), Program Operations for Federal Exchanges, $296.5 million. Also, urged support for the VA, Veterans Health Administration (VHA), $103.1 billion, which includes the following within the VHA -- VA, VHA, Medical Services, $66.2 billion, VA, VHA, Medical Community Care, $20.7 billion, VA, VHA, Medical and Prosthetic Research; $902 million. COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Urged the administration to explore regulatory and other actions that would make COVID-19 testing free-of-charge to patients covered by both public and private insurance plans, including ACA-compliant plans offered through the insurance exchanges, and to waive co-pays and deductibles for patients seeing physicians for symptoms that may be indicative of COVID-19 or who are hospitalized for treatment. Urged CMS to utilize a national disaster recovery program that would pay doctors 110% of Medicare rates for caring for uninsured patients who have been infected with SARS-CoV-2. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for the Student Loan Forgiveness for Frontline Health Workers Act, H.R. 6720, introduced May 5, 2020 by Representative Carolyn B. Maloney (D-NY) which would eliminate graduate school debt for healthcare workers, including physicians and medical students, who are providing direct patient care in response to the COVID-19 pandemic; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. This extension-either continued by CMS or mandated by Congress-should last at least through the end of 2021, or until such a time when effective vaccines and treatments are widely available, with an option to extend it even further, or consider making permanent, based on the experience and learnings of patients and physicians who are utilizing these visits. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP); urged support for administering COVID-19 vaccinations to all eligible immigrants in Customs and Border Protection (CBP) custody. American Rescue Plan (ARP) Act (H.R. 1319): Urged support for various provisions within the ARP to provide incentives for states to expand Medicaid by temporarily increasing the states base FMAP by five percentage points for two years for states that newly expand Medicaid. Urged support for allowing states, for five years, to extend Medicaid eligibility (and CHIP eligibility) to women for 12 months postpartum. Urged support to require Medicaid coverage of COVID-19 vaccines and treatment without beneficiary cost sharing with vaccines matched at a 100 percent federal medical assistance percentage (FMAP) through one year after the end of the PHE. Urged support for $46 billion to HHS to detect, diagnose, trace, and monitor COVID-19 infections, and for other activities necessary to mitigate the spread of COVID-19. Urged support to subsidize the health coverage of people earning up to 150 percent of the federal poverty level (FPL) under the ACA and those on unemployment insurance for a period of two years. Urged support for waiving VA cost sharing and copayments for medical treatment until September 30, 2021. Womens Health: Urged Congress to support, H.R. 958, the Protecting Moms Who Served Act, which would provide critical support for maternity care coordination programs to address the clinical and nonclinical perinatal needs of veterans and ensure effective coordination between VA and non-VA facilities in the delivery of maternity care and other health care services. Urged HHS to promptly finalize new Title X regulations that ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminates medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protects funding for and ensures consistent treatment of qualified service sites. Urged support for mandatory, permanent extension of postpartum Medicaid coverage, from 60 days to 12 months after delivery. Urged support for the Womens Health Protection Act of 2021 (H.R. 3755 and S. 1975), bills that would protect a persons ability to determine whether to continue or end a pregnancy and to protect the health care clinicians ability to provide abortion services free from medically unnecessary restrictions such as waiting periods, biased counselling and admitting privilege requirements for clinicians. Expand Health Coverage and Affordability: Urged Congress to support H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place. Introduce and pass the companion bill in the Senate and H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the ACA. Train and Support Frontline Physicians during and after COVID-19: Urged Congress to support H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots by at least 2,000 per year over seven years (14,000 slots) for specialties facing shortages, including internal medicine; H.R. 1554 (116th Congress), the Resident Education Deferred Interest Act, to allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program; S. 948, the Conrad State 30 and Physician Access Reauthorization Act (116th Congress) and S. 3599 (116th Congress), the Healthcare Workforce Resilience Act, to support the COVID-19 response workforce by expediting visas for international medical graduates (IMGs) to enter the U.S. for training and patient care, permanently authorizing the Conrad 30 Program, and providing a pathway for IMGs and their families already in the U.S to obtain permanent residency status; H.R. 2418, the Student Loan Forgiveness for Frontline Health Workers Act, to forgive student loans for physicians and other clinicians who are on the frontlines of providing care to COVID-19 patients or helping the health care system cope with the COVID-19 public health emergency; H.R. 1667/S. 610, the Dr. Lorna Breen Health Care Provider Protection Act, to address the behavioral health and well-being of physicians, including depression, suicides and burnout. Support the Value of Primary and Comprehensive Care: Urged Congress to Continue to fund the 3.75 percent increase to all physicians services that was approved by Congress at the end of last year to prevent CY2022 budget neutrality cuts for physician services, including primary care visits and other evaluation and management services; Ensure that any legislation that addresses budget neutrality treats all services fairly and equitably; Pass H.R. 1025, the Kids Access to Primary Care Act, to increase access to health coverage for Medicaid patients by achieving payment parity for primary care services under Medicaid and Medicare; Extend the five percent bonus that physicians receive if they meet performance expectations in Advanced APMs that is set to expire at the end of 2022; Act before the end of CY2021 to prevent scheduled cuts for physician services, including primary care, resulting from budget sequestration and pay-as-you go budget rules. Improve Access to Prescription Drugs and Reduce Costs: Urged Congress to support S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; S. 141, the End Taxpayer Subsidies for Drug Ads Act, to end the federal tax deduction that pharmaceutical companies use to pay for drug advertising; S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Support Essential Public Health and Research Initiatives: Urged Congress to support H.R. 8, the Bipartisan Background Checks Act that would establish new background check requirements for firearm transfers between private parties; H.R. 3076/S. 506, the Extreme Risk Protection Order Act from the 116th Congress, to establish a grant program to help states and Indian tribes implement extreme risk protection order laws and expands categories of individuals who are prohibited from receiving, possessing, shipping, or transporting a firearm; H.R. 3271/S. 1702, the Climate Change Health Protection and Promotion Act that would take important steps to mitigate the harmful impact of climate change on health. Promote Health Equity, Social Justice, and Eliminate Disparities: Urged Congress to support H.R. 1280, the George Floyd Justice in Policing Act of 2021, to overhaul qualified immunity for law enforcement, prohibit racial profiling on the part of law enforcement and ban no-knock warrants in federal drug cases and chokeholds and carotid holds at the federal level; H.R. 5, the Equality Act, to prohibit discrimination based on sex, sexual orientation and gender identity in public accommodations and facilities, education, federal housing credit and the jury system; H.R. 666/S. 162, the Anti-Racism in Public Health Act of 2021, to establish within the CDC a National Center on Anti-racism and Health for data collection and research and a law enforcement violence prevention program; H.R. 959/S. 346, the Black Maternal Health Momnibus Act of 2021, to reduce preventable maternal mortality and severe maternal morbidity in the U.S. and close disparities in maternal health outcomes, particularly among pregnant minority women. Expand Access to Telehealth Services and Promote Patient Safety/Privacy; Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends; Urged appropriators to include adequate funding in FY2022 to support expansion of broadband capabilities nationwide, especially to rural and underserved communities, and to remove the ban on adoption of a national unique health identifier standard. Veterans Administration: Expressed concerns to the VA about its efforts to develop National Standards of Practice for physicians and other health professionals that supersede state scope of practice and licensure laws; expressed that the VA has not provided a transparent process by which public stakeholders are provided an adequate opportunity to review and provide meaningful input into the standards of practice. Infrastructure Investment: Expressed support with Congress for several provisions in the bipartisan Infrastructure Investment and Jobs Act, legislation that makes sweeping and historic investments in this nations infrastructure; Applauded provisions that would improve public health specifically to ensure all Americans have access to safe drinking water, broadband services that provide vital access to telehealth services, as well as investment in clean energy to reverse the negative health effects associated with climate change. Surprise Medical Billing: Voiced support for the decision of CMS to provide protections for patients from surprise bills in situations where they need an ambulance, especially in a perceived emergency; voiced support for CMS approach that emergency services provided by out-of-network emergency facilities and out-of-network provider organizations, and certain non-emergency services furnished by out-of-network provider organizations at certain in-network facilities, must be calculated based on a recognized amount which is generally the lesser of the Qualifying Payment Amount (QPA) - the plans median in-network rate for the item or service, or an all-payer model agreement between CMS and the state; urged CMS to include in the Independent Dispute Resolution process described in future sub-regulatory guidance that health plans have an affirmative obligation to pay fairly and appropriately for services provided in and out of network.

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.Tax Cuts and Jobs Act (Public Law 115-97) 7.Pandemic and All-Hazards Preparedness Advancing Innovation Act (P.L. 116-22) 8.Strengthening the Vaccines for Children Program Act (H.R. 2347) 9.The Healthy Families Act (S. 1195/H.R. 2465) 10.FAMILY Act (H.R. 804/S. 248) 11.American Rescue Plan Act of 2021 (P.L. 117-2) 12.Pursuing Equity in Mental Health Act (H.R. 1475) 13.Public Health Infrastructure Saves Lives Act (S. 674) 14.Summer Meals Act of 2021 (H.R. 783) 15.The Mental Health Services for Students Act (H.R. 721) 16.Black Maternal Health Momnibus (H.R. 959/S. 346) 17.Immunization Information System Modernization Act (H.R. 550) 18.Protecting Seniors through Immunization Act (H.R. 1978) 19.Community Immunity During COVID-19 Act (H.R. 736/S. 167) 20.Parity Enforcement Act (H.R. 1364) 21.Improving Social Determinants of Health Act (S. 104/H.R 379) 22.FY 2022 LHHS Appropriations 23.WIC Act of 2021 (S. 853) 24.Environmental Justice Legacy Pollution Cleanup Act (Bill number not yet available) 25.Transportation Alternatives Enhancement Act (H.R. 463/S. 614) 26.SAFE Streets Act (H.R. 508) 27.Safe Routes to School Expansion Act (H.R. 386) 28.Social Determinants Accelerator Act (H.R. 2503) 29.Strengthening the Vaccines for Children Act (H.R. 2347) 30.Tracking COVID-19 Variants Act (S. 236) 31.Tobacco Tax Equity Act (S. 1314/H.R. 2786) 32.NURSE Act (S. 1602) 33.Maternal Immunization Enhancement Act (S. 1114) 34.Maternal Immunization Coverage Act (S. 1117) 35.Equality Act (H.R. 5) 36.Climate Change Health Protection and Promotion Act (S. 1702/H.R. 3271) 37.RISE from Trauma Act (S. 2086) 38.Improving Data Collection for Adverse Childhood Experiences Act (H.R. 3467) 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, ACF, Education, USDA, DHS, FEMA, and SAMHSA.

Climate Change Health Protection and Promotion Act (H.R. 3271/S. 1702)

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

Government targets: Agency for Healthcare Research & Quality (AHRQ), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Education, Dept of, Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Labor, Dept of (DOL), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Transportation, Dept of (DOT), Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

Issues related to the health impacts of air pollution and climate change; Issues related to air pollution from stationary and mobile sources; Issues related to the Clean Air Act; Issues related to regulatory reforms; Issues related to infrastructure; House Labor HHS Appropriations bill; H.R.4372 House Interior, Environment and Related Agencies Appropriations bill; House Transportation, Housing and Urban Development and Related Agencies Appropriations bill; Senate Labor HHS Appropriations bill; Senate Interior, Environment and Related Agencies Appropriations bill; Senate Transportation, Housing and Urban Development and Related Agencies Appropriations bill;; H.R.501 Climate Smart Ports Act; H.R.512 Green Bus Act of 2021; H.R.516 Environmental Justice Mapping and Data Collection Act of 2021; H.R.848 GREEN Act of 2021; H.R.957 Protecting Moms and Babies Against Climate Change Act; H.R.1221 Electric Vehicles for Underserved Communities Act of 2021; H.R.1344 Clean School Bus Act of 2021; H.R.1512 To build a clean and prosperous future by addressing the climate crisis, protecting the health and welfare of all Americans, and putting the Nation on the path to a net-zero greenhouse gas economy by 2050, and for other purposes; H.R.2307 To create a Carbon Dividend Trust Fund for the American people in order to encourage market-driven innovation of clean energy technologies and market efficiencies which will reduce harmful pollution and leave a healthier, more stable, and more prosperous nation for future generations; S.101 Environmental Justice Mapping and Data Collection Act of 2021; S.196 Nonprofit Energy Efficiency Act; S.216 Climate Smart Ports Act of 2021; S.506 Clean School Bus Act of 2021; S.507 Electric Vehicles for Underserved Communities Act of 2021; H.R.959 Black Maternal Health Momnibus Act of 2021; S.975 A bill to amend the Internal Revenue Code of 1986 to extend and modify the credit for alternative fuel vehicle refueling property; S.985 A bill to amend the Internal Revenue Code of 1986 to provide direct payments of the renewable electricity production credit, the energy credit, and the carbon oxide sequestration credit; H.R.3684 INVEST in America Act; H.R. 2721 Clean Commute for Kids Act; S.1271 Clean Commute for Kids Act of 2021; S.1345 Comprehensive National Mercury Monitoring Act; H.R. 3271 Climate Change Health Protection and Promotion Act; S.1702 Climate Change Health Protection and Promotion Act of 2021; S.1931 Surface Transportation Reauthorization Act of 2021; S.2085 Save Our Future Act; S.1298 Clean Energy for America Act

Support inclusion of $19 billion in upcoming infrastructure legislation to replace old, inefficient lead-contaminated windows and address other healthy housing hazards. Support the Environmental Justice Legacy Pollution Cleanup Act of 2021. Support for recovery legislation that invests in cleaning up air pollution, addressing climate change and ensuring environmental justice. Support H.R. 3721/S. 1702, the Climate Change Health Protection and Promotion Act of 2021.

Client expense: $21,976 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of the Vice President of the United States, SENATE, Vice President of the U.S., White House Office

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged support for H.R. 8505, a bill to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule; Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases, along with GPC1X codes to go into effect. FY2022 Appropriations: Urged Congress to support $10 billion for the Centers for Disease Control and Preventions programs in the FY 2022 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as $50 million in funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for: Health Resources Services Administration (HRSA), $9.2 billion; Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA), $71 million; National Health Service Corps (NHSC), $860 million in total program funding; Agency for Healthcare Research and Quality (AHRQ), $500 million; Centers for Medicare and Medicaid Services (CMS), Program Operations for Federal Exchanges, $296.5 million. Also, urged support for the VA, Veterans Health Administration (VHA), $103.1 billion, which includes the following within the VHA -- VA, VHA, Medical Services, $66.2 billion, VA, VHA, Medical Community Care, $20.7 billion, VA, VHA, Medical and Prosthetic Research; $902 million. COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Urged the administration to explore regulatory and other actions that would make COVID-19 testing free-of-charge to patients covered by both public and private insurance plans, including ACA-compliant plans offered through the insurance exchanges, and to waive co-pays and deductibles for patients seeing physicians for symptoms that may be indicative of COVID-19 or who are hospitalized for treatment. Urged CMS to utilize a national disaster recovery program that would pay doctors 110% of Medicare rates for caring for uninsured patients who have been infected with SARS-CoV-2. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for the Student Loan Forgiveness for Frontline Health Workers Act, H.R. 6720, introduced May 5, 2020 by Representative Carolyn B. Maloney (D-NY) which would eliminate graduate school debt for healthcare workers, including physicians and medical students, who are providing direct patient care in response to the COVID-19 pandemic; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. This extension-either continued by CMS or mandated by Congress-should last at least through the end of 2021, or until such a time when effective vaccines and treatments are widely available, with an option to extend it even further, or consider making permanent, based on the experience and learnings of patients and physicians who are utilizing these visits. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP). American Rescue Plan (ARP) Act (H.R. 1319): Urged support for various provisions within the ARP to provide incentives for states to expand Medicaid by temporarily increasing the states base FMAP by five percentage points for two years for states that newly expand Medicaid. Urged support for allowing states, for five years, to extend Medicaid eligibility (and CHIP eligibility) to women for 12 months postpartum. Urged support to require Medicaid coverage of COVID-19 vaccines and treatment without beneficiary cost sharing with vaccines matched at a 100 percent federal medical assistance percentage (FMAP) through one year after the end of the PHE. Urged support for $46 billion to HHS to detect, diagnose, trace, and monitor COVID-19 infections, and for other activities necessary to mitigate the spread of COVID-19. Urged support to subsidize the health coverage of people earning up to 150 percent of the federal poverty level (FPL) under the ACA and those on unemployment insurance for a period of two years. Urged support for waiving VA cost sharing and copayments for medical treatment until September 30, 2021. Patient Identifier: Urged Congress to reject the inclusion of outdated rider language in Section 510 of the Fiscal Year 2022 Labor, Health and Human Services, and Education and Related Agencies (Labor-HHS) Appropriations bill that prohibits the US Department of Health and Human Services (HHS) from spending any federal dollars to promulgate or adopt a national unique health identifier standard. Womens Health: Urged Congress to support, H.R. 958, the Protecting Moms Who Served Act, which would provide critical support for maternity care coordination programs to address the clinical and nonclinical perinatal needs of veterans and ensure effective coordination between VA and non-VA facilities in the delivery of maternity care and other health care services. Urged HHS to promptly finalize new Title X regulations that ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminates medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protects funding for and ensures consistent treatment of qualified service sites. Expand Health Coverage and Affordability: Urged Congress to support H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place. Introduce and pass the companion bill in the Senate and H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the ACA. Train and Support Frontline Physicians during and after COVID-19: Urged Congress to support H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots by at least 2,000 per year over seven years (14,000 slots) for specialties facing shortages, including internal medicine; H.R. 1554 (116th Congress), the Resident Education Deferred Interest Act, to allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program; S. 948, the Conrad State 30 and Physician Access Reauthorization Act (116th Congress) and S. 3599 (116th Congress), the Healthcare Workforce Resilience Act, to support the COVID-19 response workforce by expediting visas for international medical graduates (IMGs) to enter the U.S. for training and patient care, permanently authorizing the Conrad 30 Program, and providing a pathway for IMGs and their families already in the U.S to obtain permanent residency status; H.R. 2418, the Student Loan Forgiveness for Frontline Health Workers Act, to forgive student loans for physicians and other clinicians who are on the frontlines of providing care to COVID-19 patients or helping the health care system cope with the COVID-19 public health emergency; H.R. 1667/S. 610, the Dr. Lorna Breen Health Care Provider Protection Act, to address the behavioral health and well-being of physicians, including depression, suicides and burnout. Support the Value of Primary and Comprehensive Care: Urged Congress to Continue to fund the 3.75 percent increase to all physicians services that was approved by Congress at the end of last year to prevent CY2022 budget neutrality cuts for physician services, including primary care visits and other evaluation and management services; Ensure that any legislation that addresses budget neutrality treats all services fairly and equitably; Pass H.R. 1025, the Kids Access to Primary Care Act, to increase access to health coverage for Medicaid patients by achieving payment parity for primary care services under Medicaid and Medicare; Extend the five percent bonus that physicians receive if they meet performance expectations in Advanced APMs that is set to expire at the end of 2022; Act before the end of CY2021 to prevent scheduled cuts for physician services, including primary care, resulting from budget sequestration and pay-as-you go budget rules. Improve Access to Prescription Drugs and Reduce Costs: Urged Congress to support S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; S. 141, the End Taxpayer Subsidies for Drug Ads Act, to end the federal tax deduction that pharmaceutical companies use to pay for drug advertising; S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Support Essential Public Health and Research Initiatives: Urged Congress to support H.R. 8, the Bipartisan Background Checks Act that would establish new background check requirements for firearm transfers between private parties; H.R. 3076/S. 506, the Extreme Risk Protection Order Act from the 116th Congress, to establish a grant program to help states and Indian tribes implement extreme risk protection order laws and expands categories of individuals who are prohibited from receiving, possessing, shipping, or transporting a firearm; H.R. 3271/S. 1702, the Climate Change Health Protection and Promotion Act that would take important steps to mitigate the harmful impact of climate change on health. Promote Health Equity, Social Justice, and Eliminate Disparities: Urged Congress to support H.R. 1280, the George Floyd Justice in Policing Act of 2021, to overhaul qualified immunity for law enforcement, prohibit racial profiling on the part of law enforcement and ban no-knock warrants in federal drug cases and chokeholds and carotid holds at the federal level; H.R. 5, the Equality Act, to prohibit discrimination based on sex, sexual orientation and gender identity in public accommodations and facilities, education, federal housing credit and the jury system; H.R. 666/S. 162, the Anti-Racism in Public Health Act of 2021, to establish within the CDC a National Center on Anti-racism and Health for data collection and research and a law enforcement violence prevention program; H.R. 959/S. 346, the Black Maternal Health Momnibus Act of 2021, to reduce preventable maternal mortality and severe maternal morbidity in the U.S. and close disparities in maternal health outcomes, particularly among pregnant minority women. Expand Access to Telehealth Services and Promote Patient Safety/Privacy; Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends; Urged appropriators to include adequate funding in FY2022 to support expansion of broadband capabilities nationwide, especially to rural and underserved communities, and to remove the ban on adoption of a national unique health identifier standard.

The Affordable Care Act (P.L. 111-148, P.L. 111-152): Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; public and private health insurers should encourage preventive health care by providing full coverage, with no cost-sharing, for preventive services recommended by an expert advisory group, such as the U.S. Preventive Services Task Force; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act (ACA) to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Supporting the Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Supporting the Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Advocated against a December 2018 ruling by a federal judge in Texas that the entire Affordable Care Act (ACA) is unconstitutional. Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Medicare Payments to Physicians: Urged that Congress provide incentives to physicians who transform their practices into Advanced Alternative Payment Models and continue to provide stability for physicians in the MIPS program. Specifically, Congress should extend the five percent Qualified Alternative Payment Model participant bonus beyond the 2022 performance year, replace the zero percent baseline payment updates under Medicare with positive updates. Urged congressional committees with jurisdiction over Medicare to exercise their oversight authority and urge CMS to expedite approval of more Advanced APMS, particularly those that work for small and specialty practices and to simplify the scoring structure and reporting requirements under the Merit-Based Incentive Payment System (MIPS) in order to fulfill Congress intent of a more streamlined program that reduces burdens on physicians; Supported S.2648, the Rural ACO Improvement Act, amends title XVIII of the Social Security Act to improve the benchmarking process for the Medicare Shared Savings Program (MSSP) to ensure that all ACOs have an equal opportunity to share in savings regardless of their geographic location; Provided recommendations to CMS on the Merit-based Incentive Payment System Value Pathway (MVP), which aims to reduce reporting burden and complexity within MIPS while improving the accuracy and effectiveness of performance measurement. The College noted specifically that a robust, multi-year transition period will be critical to the success of the MVP, that it does not support making the MVP mandatory, that CMS should continue to support numerous reporting mechanisms, including qualified registries and clinical data registries, which have been instrumental in developing specialty-specific performance measures, among other things. Urged support for H.R. 8505, a bill to provide for a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule; Urged that any legislation to hold some Medicare physician payment codes harmless from budget neutrality do so for just one year and to allow evaluation and management increases, along with GPC1X codes to go into effect. FY2022 Appropriations: Urged Congress to support $10 billion for the Centers for Disease Control and Preventions programs in the FY 2022 Labor, Health and Human Services, Education and Related Agencies Appropriations bill as well as $50 million in funding shared evenly between the U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) to conduct public health research into firearm morbidity and mortality prevention. Advocated for: Health Resources Services Administration (HRSA), $9.2 billion; Title VII, Section 747, Primary Care Training and Enhancement (PCTE), Health Resources and Services Administration (HRSA), $71 million; National Health Service Corps (NHSC), $860 million in total program funding; Agency for Healthcare Research and Quality (AHRQ), $500 million; Centers for Medicare and Medicaid Services (CMS), Program Operations for Federal Exchanges, $296.5 million. Also, urged support for the VA, Veterans Health Administration (VHA), $103.1 billion, which includes the following within the VHA -- VA, VHA, Medical Services, $66.2 billion, VA, VHA, Medical Community Care, $20.7 billion, VA, VHA, Medical and Prosthetic Research; $902 million. COVID-19: Urged congressional appropriators to provide the highest possible funding level for research, prevention, control, and treatment of illnesses associated with the virus that is commensurate with the public health emergency that the virus represents. Urged the administration to explore regulatory and other actions that would make COVID-19 testing free-of-charge to patients covered by both public and private insurance plans, including ACA-compliant plans offered through the insurance exchanges, and to waive co-pays and deductibles for patients seeing physicians for symptoms that may be indicative of COVID-19 or who are hospitalized for treatment. Urged CMS to utilize a national disaster recovery program that would pay doctors 110% of Medicare rates for caring for uninsured patients who have been infected with SARS-CoV-2. Expressed support to Congress and the administration for a variety of COVID-related bills from the 116th Congress as follows: the Families First Coronavirus Response Act, H.R. 6201, and other stimulus reforms related to COVID-19 including: Emergency paid leave benefits, paid sick days for public health emergencies, coverage of testing for COVID-19, waiving of cost sharing under Medicare, Medicare Advantage, Medicaid, and CHIP, increasing the federal FMAP under Medicaid, providing reimbursement for CPT codes 99441 - 99443, which are telephone evaluation and management services, expediting entrance of international medical graduates who are citizens of other nations (non-US IMGs) into the country and ensuring that lawfully present non-U.S. IMGs are not negatively impacted by the COVID-19 pandemic, funding for physician practices under the Public Health and Social Service Emergency Fund (PHSSEF), providing tax relief, grants, and loans to small and medium size practices impacted by COVID-19, increasing funding for personal protective equipment (PPE), ensuring Medicaid pay parity with Medicare for primary care services; Urged support for the Student Loan Forgiveness for Frontline Health Workers Act, H.R. 6720, introduced May 5, 2020 by Representative Carolyn B. Maloney (D-NY) which would eliminate graduate school debt for healthcare workers, including physicians and medical students, who are providing direct patient care in response to the COVID-19 pandemic; Urged support for H.R. 7059, the Coronavirus Provider Protection Act, which extend liability protections to those who provide care in good faith during the COVID-19 public health emergency (plus a reasonable time, such as 60 days, after the emergency declaration ends), and not in situations of gross negligence or willful misconduct. The College also urged that pay parity between telephone claims and in-person visits and between all telehealth and in-person visits be maintained after the PHE is lifted. This extension-either continued by CMS or mandated by Congress-should last at least through the end of 2021, or until such a time when effective vaccines and treatments are widely available, with an option to extend it even further, or consider making permanent, based on the experience and learnings of patients and physicians who are utilizing these visits. Urged congress to mitigate the impact of covid across racial and ethnic minority populations by collect covid-19 and racial disparity data, equitably distribute covid-19 vaccines and treatments, protect essential workers, permanently expand access to family and medical leave, address environmental and social drivers of health, integrate primary care and behavioral health, improve mental health parity with increased federal oversight and enforcement, make naloxone more available to prevent overdose, expand medication-assisted treatment (mat) for physicians, establish a national prescription drug monitoring program (PDMP). American Rescue Plan (ARP) Act (H.R. 1319): Urged support for various provisions within the ARP to provide incentives for states to expand Medicaid by temporarily increasing the states base FMAP by five percentage points for two years for states that newly expand Medicaid. Urged support for allowing states, for five years, to extend Medicaid eligibility (and CHIP eligibility) to women for 12 months postpartum. Urged support to require Medicaid coverage of COVID-19 vaccines and treatment without beneficiary cost sharing with vaccines matched at a 100 percent federal medical assistance percentage (FMAP) through one year after the end of the PHE. Urged support for $46 billion to HHS to detect, diagnose, trace, and monitor COVID-19 infections, and for other activities necessary to mitigate the spread of COVID-19. Urged support to subsidize the health coverage of people earning up to 150 percent of the federal poverty level (FPL) under the ACA and those on unemployment insurance for a period of two years. Urged support for waiving VA cost sharing and copayments for medical treatment until September 30, 2021. Patient Identifier: Urged Congress to reject the inclusion of outdated rider language in Section 510 of the Fiscal Year 2022 Labor, Health and Human Services, and Education and Related Agencies (Labor-HHS) Appropriations bill that prohibits the US Department of Health and Human Services (HHS) from spending any federal dollars to promulgate or adopt a national unique health identifier standard. Womens Health: Urged Congress to support, H.R. 958, the Protecting Moms Who Served Act, which would provide critical support for maternity care coordination programs to address the clinical and nonclinical perinatal needs of veterans and ensure effective coordination between VA and non-VA facilities in the delivery of maternity care and other health care services. Urged HHS to promptly finalize new Title X regulations that ensure unencumbered access to affordable, comprehensive, evidence-based reproductive health care; eliminates medically unnecessary restrictions and inappropriate political interference in the patient-physician relationship; and protects funding for and ensures consistent treatment of qualified service sites. Expand Health Coverage and Affordability: Urged Congress to support H.R. 340, the Incentivizing Medicaid Expansion Act of 2021, to expand federal matching assistance for states that choose to expand Medicaid, regardless of when such expansion takes place. Introduce and pass the companion bill in the Senate and H.R. 369, the Health Care Affordability Act of 2021, to permanently expand eligibility for higher premium tax credits under the ACA. Train and Support Frontline Physicians during and after COVID-19: Urged Congress to support H.R. 2256/S. 834, the Resident Physician Reduction Shortage Act of 2021, to increase the number of GME slots by at least 2,000 per year over seven years (14,000 slots) for specialties facing shortages, including internal medicine; H.R. 1554 (116th Congress), the Resident Education Deferred Interest Act, to allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program; S. 948, the Conrad State 30 and Physician Access Reauthorization Act (116th Congress) and S. 3599 (116th Congress), the Healthcare Workforce Resilience Act, to support the COVID-19 response workforce by expediting visas for international medical graduates (IMGs) to enter the U.S. for training and patient care, permanently authorizing the Conrad 30 Program, and providing a pathway for IMGs and their families already in the U.S to obtain permanent residency status; H.R. 2418, the Student Loan Forgiveness for Frontline Health Workers Act, to forgive student loans for physicians and other clinicians who are on the frontlines of providing care to COVID-19 patients or helping the health care system cope with the COVID-19 public health emergency; H.R. 1667/S. 610, the Dr. Lorna Breen Health Care Provider Protection Act, to address the behavioral health and well-being of physicians, including depression, suicides and burnout. Support the Value of Primary and Comprehensive Care: Urged Congress to Continue to fund the 3.75 percent increase to all physicians services that was approved by Congress at the end of last year to prevent CY2022 budget neutrality cuts for physician services, including primary care visits and other evaluation and management services; Ensure that any legislation that addresses budget neutrality treats all services fairly and equitably; Pass H.R. 1025, the Kids Access to Primary Care Act, to increase access to health coverage for Medicaid patients by achieving payment parity for primary care services under Medicaid and Medicare; Extend the five percent bonus that physicians receive if they meet performance expectations in Advanced APMs that is set to expire at the end of 2022; Act before the end of CY2021 to prevent scheduled cuts for physician services, including primary care, resulting from budget sequestration and pay-as-you go budget rules. Improve Access to Prescription Drugs and Reduce Costs: Urged Congress to support S. 898, the Fair Drug Pricing Act, to require drug companies to disclose and provide more information about imminent drug-price increases, including data about research and development costs; S. 833, the Empowering Medicare Seniors to Negotiate Drug Prices Act of 2021, to help to reduce drug prices and out-of-pocket costs by allowing the federal government to negotiate lower drug prices on behalf of Medicare beneficiaries; S. 141, the End Taxpayer Subsidies for Drug Ads Act, to end the federal tax deduction that pharmaceutical companies use to pay for drug advertising; S. 464/H.R. 2163, the Safe Step Act, to ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. Support Essential Public Health and Research Initiatives: Urged Congress to support H.R. 8, the Bipartisan Background Checks Act that would establish new background check requirements for firearm transfers between private parties; H.R. 3076/S. 506, the Extreme Risk Protection Order Act from the 116th Congress, to establish a grant program to help states and Indian tribes implement extreme risk protection order laws and expands categories of individuals who are prohibited from receiving, possessing, shipping, or transporting a firearm; H.R. 3271/S. 1702, the Climate Change Health Protection and Promotion Act that would take important steps to mitigate the harmful impact of climate change on health. Promote Health Equity, Social Justice, and Eliminate Disparities: Urged Congress to support H.R. 1280, the George Floyd Justice in Policing Act of 2021, to overhaul qualified immunity for law enforcement, prohibit racial profiling on the part of law enforcement and ban no-knock warrants in federal drug cases and chokeholds and carotid holds at the federal level; H.R. 5, the Equality Act, to prohibit discrimination based on sex, sexual orientation and gender identity in public accommodations and facilities, education, federal housing credit and the jury system; H.R. 666/S. 162, the Anti-Racism in Public Health Act of 2021, to establish within the CDC a National Center on Anti-racism and Health for data collection and research and a law enforcement violence prevention program; H.R. 959/S. 346, the Black Maternal Health Momnibus Act of 2021, to reduce preventable maternal mortality and severe maternal morbidity in the U.S. and close disparities in maternal health outcomes, particularly among pregnant minority women. Expand Access to Telehealth Services and Promote Patient Safety/Privacy; Urged Congress to support H.R. 2903/S. 1512, the CONNECT for Health Act, to remove arbitrary barriers to telehealth services such as geographic and site of service restrictions; S. 168/H.R. 708, the Temporary Reciprocity to Ensure Access to Treatment Act or the TREAT Act, to ensure that telehealth services can be provided across states lines after the public health emergency ends; Urged appropriators to include adequate funding in FY2022 to support expansion of broadband capabilities nationwide, especially to rural and underserved communities, and to remove the ban on adoption of a national unique health identifier standard.