Protecting Access to Ground Ambulance Medical Services Act of 2021

Medicare and Medicaid policies relating to ground and air ambulance services, including workforce shortage issues, and supplemental relief for ambulance providers; implementation of H.R.5376, Inflation Reduction Act of 2022 (P.L.117-169); S.2037/H.R.2454, Protecting Access to Ground Ambulance Medical Services Act of 2021; H.R.2617, Consolidated Appropriations Act, 2023.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid policies relating to ground and air ambulance services, including workforce shortage issues, and supplemental relief for ambulance providers; implementation of H.R.5376, Inflation Reduction Act of 2022 (P.L.117-169); S.2037/H.R.2454, Protecting Access to Ground Ambulance Medical Services Act of 2021; H.R.2617, Consolidated Appropriations Act, 2023.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid policies relating to ground and air ambulance services, including workforce shortage issues, and supplemental relief for ambulance providers; implementation of H.R.5376, Inflation Reduction Act of 2022 (P.L.117-169); S.2037/H.R.2454, Protecting Access to Ground Ambulance Medical Services Act of 2021; H.R.2617, Consolidated Appropriations Act, 2023.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2617, FY23 Consolidated Appropriations Act H.R. 7776, James M. Inhofe National Defense Authorization Act for Fiscal Year 2023 H.R. 7900, National Defense Authorization Act for Fiscal Year 2023 H.R. 1946/S. 1873, Medicare Multi-Cancer Early Detection Screening Coverage Act H.R. 4148/S. 2236, Expanding Health Care Options for Early Retirees Act H.R. 2454/S. 2037, Protecting Access to Ground Ambulance Medical Services Act of 2021 S. 2700/H.R. 1480, HERO Act H.R. 4965/S. 2683, 9/11 Responder and Survivor Health Funding Correction Act Issues pertaining to reimbursements for ambulance service Issues pertaining to implementation of the No Surprises Act COVID Resources for fire fighters. Enforcement of the Ryan White Act. Supporting the National Fire fighter Cancer Registry Issues related to cancer screenings for fire fighters

Client expense: $126,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), SENATE

Protecting Access to Ground Ambulance Medical Services Act (H.R. 2454, S. 2037); 2023 Consolidated Appropriations Act (H.R. 2617); specifically, extension of add-on payments for ambulance services.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Protecting Access to Ground Ambulance Medical Services Act (H.R. 2454, S. 2037); 2023 Consolidated Appropriations Act (H.R. 2617); specifically, extension of add-on payments for ambulance services.

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

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

Fiscal Year (FY) 2023 Consolidated Appropriations Act (P.L. 117-328), provisions relating to funding of the: - Rural EMS Training and Equipment Assistance (also known as the SIREN grant program). - National Firefighter Registry for cancer research. Also, provisions in P.L. 117-328 to allow health care providers to prescribe buprenorphine to prevent drug overdosed. In addition, a provision to extend ambulance add-on payments through 2024. The EMS Counts Act (H.R. 2354/S. 2971), provisions to obtain a more accurate count of the EMS workforce in the U.S. Issues relating to the fire & EMS departments needs for health and safety standards, testing, vaccinations, supplies and funding to respond to the COVID-19 pandemic. The Protecting Access to Ground Ambulance Medical Services Act (H.R. 2454/S. 2037), provisions to extend Medicare add-on payments for the transportation of patients by fire & EMS departments to hospitals. Funding for the SIREN grant program at the Substance Abuse & Mental Health Services Administration. Issues related to the cost accounting of EMS services for Medicare patients. Issues relating to the EMS workforce shortage issues. Issues relating to sequestration and its effects on Medicare reimbursement for ambulance transport. H.R. 1480/S. 2700, the HERO Act, legislation to provide mental health support to first responders. H.R. 8994, the Supporting Our First Responders Act, provisions to support grants for EMS agencies. Issues relating to supply chain shortages and the delivery of EMS vehicles and equipment.

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

Issues related to the implementation of H.R. 1319, the American Rescue Plan Act of 2021. Issues related to H.R. 1609 / S.149, the Treatment in Place Act. Issues related to H.R. 3635 / S. 1974, the Strengthening America's Strategic National Stockpile Act of 2021. Issues related to S. 3910, the EMS Staffing and Support Act. Issues related to S. 2037, the Protecting Access to Ground Ambulance Medical Services Act of 2021. Issues related to H.R. 7850 / S. 4269, the Prevent BLEEDing Act of 2022. Issues related to EMS funding. Issues related to H.R. 8994, the Supporting Our First Responders Act. Issues related to the Congressional EMS Caucus. Issues related to the Bipartisan Pandemic Preparedness Caucus.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied on improvements to policies and increased reimbursement under the Medicare ambulance fee schedule. Advocated on the Protecting Access to Ground Ambulance Medical Services Act (H.R. 2454, S. 2037) to extend temporary Medicare ambulance increases and retain certain rural zip code designations. Lobbied on changes to the Medicare ambulance data collection system. Lobbied on extension of moratorium of sequestration cuts and 4% PAYGO sequestration cut stemming from American Rescue Plan. Advocated for inclusion of extension of Medicare ambulance relief and waiver of 4% PAYGO cuts in FY2023 Omnibus Appropriations Bill (H.R. 2617).

Client expense: $275,000 · Firm income: Not reported

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

Support funding the SIREN Grant program for FY23; Educate lawmakers and staff on the need to count EMS workforce correctly. Support S. 2971/H.R. 2354, a bill that would count EMS workforce correctly under the BLS. Urge for a Senate companion bill; Support S. 2037/H.R. 2453, ambulance Medicare extenders legislation to extend for another five years the temporary 2% urban, 3% rural and super rural bonus increases that expire at the end of 2022 and allow for the preservation of more zip codes as being rural. Ambulance transports that originate in rural zip codes get not only the 1% temporary increase but a 50% increase on the first 17 miles of a transport; Educate lawmakers and staff on shortage of EMS supply chain issues, specifically ambulance chassis and parts to fix existing chassis; Support participation in the Congressional EMS Caucus.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3630 No Surprises Act Pub. L. No 116-260 implementation, Data cost collection for ground ambulance; extending the ground ambulance add-ons and addressing rural ZIP code issues; S. 2037/H.R. 4938 Protecting Access to Ground Ambulance Medical Services Act of 2021; FY 2023 Labor-HHS appropriations; HR 3172/S 2981, the HELPER Act.

Client expense: Not reported · Firm income: $51,000

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

Discussions regarding solutions to address balance billing and to preserve access to emergency air ambulance services, particularly in rural areas with relation to No Surprises Act rulemaking (no specific bills); Issues related to emergency response staffing (no specific bills); Discussions regarding the introduction and support for the extension of Medicare add-on payments for ground ambulance services (no specific bills); Issues related to H.R. 2454/S. 2037 - Protecting Access to Ground Ambulance Medical Services Act of 2021; Issues related to PREVENT Pandemics Act - S. 3799; Discussions around support for increased Medicare reimbursement for air ambulance services (no specific bills). Protecting Access to Ground Ambulance Medical Services Act of 2021; Issues related to the need for additional funding to address increased expenses and decreases in reimbursement (no specific bills); Issues related to funding needed for workforce grants for training and employment retention and onboarding (no specific bills); Discussions related to upcoming ground ambulance patient advisory committee (no specific bills); Issues related to gathering data to support funding and increased reimbursement (no specific bills).

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

Addressing the effects of COVID-19 and other health issues affecting the fire and emergency services. H.R.1480 - HERO Act H.R.2454/S.2037 - Protecting Access to Ground Ambulance Medical Services Act H.R.2499/S.1116 - Federal Firefighters Fairness Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 7900, National Defense Authorization Act for Fiscal Year 2023 H.R. 1946/S. 1873, Medicare Multi-Cancer Early Detection Screening Coverage Act H.R. 4148/S. 2236, Expanding Health Care Options for Early Retirees Act H.R. 2454/S. 2037, Protecting Access to Ground Ambulance Medical Services Act of 2021 S. 2700/H.R. 1480, HERO Act H.R. 4965/S. 2683, 9/11 Responder and Survivor Health Funding Correction Act COVID Resources for fire fighters. Enforcement of the Ryan White Act. Supporting the National Fire fighter Cancer Registry Issues related to cancer screenings for fire fighters

Client expense: $81,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Occupational Safety & Health Administration (OSHA), SENATE

Medicare and Medicaid policies relating to ground and air ambulance services, including workforce shortage issues, and supplemental relief for ambulance providers; H.R.5376, Inflation Reduction Act of 2022 (P.L.117-169); S.2037/H.R.2454, Protecting Access to Ground Ambulance Medical Services Act of 2021.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid policies relating to ground and air ambulance services, including workforce shortage issues, and supplemental relief for ambulance providers; H.R.5376, Inflation Reduction Act of 2022 (P.L.117-169); S.2037/H.R.2454, Protecting Access to Ground Ambulance Medical Services Act of 2021.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare and Medicaid policies relating to ground and air ambulance services, including workforce shortage issues, and supplemental relief for ambulance providers; H.R.5376, Inflation Reduction Act of 2022 (P.L.117-169); S.2037/H.R.2454, Protecting Access to Ground Ambulance Medical Services Act of 2021.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 8295, the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2023, provisions relating to funding for: - Rural EMS Training and Equipment Assistance - National Firefighter Registry for cancer research The EMS Counts Act (H.R. 2354/S. 2971), provisions to obtain a more accurate count of the EMS workforce in the U.S. Issues relating to the fire & EMS departments needs for health and safety standards, testing, vaccinations, supplies and funding to respond to the COVID-19 pandemic. The Protecting Access to Ground Ambulance Medical Services Act (H.R. 2454/S. 2037), provisions to extend Medicare add-on payments for the transportation of patients by fire & EMS departments to hospitals. Funding for the SIREN grant program at the Substance Abuse & Mental Health Services Administration. Issues related to the assessment of EMS quality and medical director compensation. Issues related to the cost accounting of EMS services for Medicare patients. Issues relating to regulation of costs incurred during interfacility transport. Issues relating to COVID-19 vaccination of fire and EMS personnel. Issues relating to the EMS workforce shortage issues. Issues relating to sequestration and its effects on Medicare reimbursement for ambulance transport. H.R. 1480/S. 2700, the HERO Act, legislation to provide mental health support to first responders. S. 1873/H.R. 1946, the Medicare Multi-Cancer Early Detection Screening Coverage Act of 2021, provisions to promote Medicare payment of medical cancer screening technology. The Fighting Post-Traumatic Stress Disorder Act (S. 4007/H.R. 8058), provisions to request input from the Attorney General re: public safety officer health and wellmess. H.R. 8994, the Supporting Our First Responders Act, provisions to support grants for EMS agencies. Issues relating to supply chain shortages and the delivery of EMS vehicles and equipment.

Issues related to the implementation of H.R. 1319, the American Rescue Plan Act of 2021. Issues related to H.R. 1609 / S.149, the Treatment in Place Act. Issues related to H.R. 3635 / S. 1974, the Strengthening America's Strategic National Stockpile Act of 2021. Issues related to S. 3910, the EMS Staffing and Support Act. Issues related to S. 2037, the Protecting Access to Ground Ambulance Medical Services Act of 2021. Issues related to H.R. 7850 / S. 4269, the Prevent BLEEDing Act of 2022. Issues related to EMS funding. Issues related to H.R. 8994, the Supporting Our First Responders Act. Issues related to the Congressional EMS Caucus. Issues related to the Bipartisan Pandemic Preparedness Caucus.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied on improvements to policies and increased reimbursement under the Medicare ambulance fee schedule. Advocated on the Protecting Access to Ground Ambulance Medical Services Act (H.R. 2454, S. 2037) to extend temporary Medicare ambulance increases and retain certain rural zip code designations. Lobbied on changes to the Medicare ambulance data collection system. Lobbied on extension of moratorium of sequestration cuts and 4% Paygo sequestration cut stemming from American Rescue Plan.

Client expense: $275,000 · Firm income: Not reported

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

Support funding the SIREN Grant program for FY23; Educate lawmakers and staff on the need to count EMS workforce correctly. Support S. 2971/H.R. 2354, a bill that would count EMS workforce correctly under the BLS. Urge for a Senate companion bill; Support S. 2037/H.R. 2453, ambulance Medicare extenders legislation to extend for another five years the temporary 2% urban, 3% rural and super rural bonus increases that expire at the end of 2022 and allow for the preservation of more zip codes as being rural. Ambulance transports that originate in rural zip codes get not only the 1% temporary increase but a 50% increase on the first 17 miles of a transport; Support the re-introduction and participation in the Congressional EMS Caucus.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 3630 No Surprises Act Pub. L. No 116-260 implementation, Data cost collection for ground ambulance; extending the ground ambulance add-ons and addressing rural ZIP code issues; S. 2037/H.R. 4938 Protecting Access to Ground Ambulance Medical Services Act of 2021; FY 2023 Labor-HHS appropriations; HR 3172/S 2981, the HELPER Act.

Client expense: Not reported · Firm income: $51,000

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

Discussions regarding solutions to address balance billing and to preserve access to emergency air ambulance services, particularly in rural areas and with relation to No Surprises Act rulemaking; Issues related to funding required to preserve emergency response staffing; Discussions regarding the introduction and support for the extension of Medicare add-on payments for ground ambulance services related to H.R. 2454/S. 2037 - Protecting Access to Ground Ambulance Medical Services Act of 2021; Issues related to PREVENT Pandemics Act - S. 3799; Issues related to the need for additional funding to address increased expenses and decreases in reimbursement; Issues related to funding needed for workforce grants for training and employment retention and onboarding; Discussions related to upcoming ground ambulance patient advisory committee; Issues related to gathering data to support funding and increased reimbursement.

Client expense: $240,000 · Firm income: Not reported

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

Addressing the effects of COVID-19 and other health issues affecting the fire and emergency services. H.R.1480 - HERO Act H.R.2454/S.2037 - Protecting Access to Ground Ambulance Medical Services Act H.R.2499/S.1116 - Federal Firefighters Fairness Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 8295, the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2023, provisions relating to funding for: - Rural EMS Training and Equipment Assistance - National Firefighter Registry for cancer research The EMS Counts Act (H.R. 2354/S. 2971), provisions to obtain a more accurate count of the EMS workforce in the U.S. Issues relating to the fire & EMS departments needs for health and safety standards, testing, vaccinations, supplies and funding to respond to the COVID-19 pandemic. The Protecting Access to Ground Ambulance Medical Services Act (H.R. 2454/S. 2037), provisions to extend Medicare add-on payments for the transportation of patients by fire & EMS departments to hospitals. Funding for the SIREN grant program at the Substance Abuse & Mental Health Services Administration. Issues related to the assessment of EMS quality and medical director compensation. Issues related to the cost accounting of EMS services for Medicare patients. Issues relating to regulation of costs incurred during interfacility transport. Issues relating to COVID-19 vaccination of fire and EMS personnel. Issues relating to the EMS workforce shortage issues. Issues relating to sequestration and its effects on Medicare reimbursement for ambulance transport. H.R. 1480/S. 2700, the HERO Act, legislation to provide mental health support to first responders. S. 1873/H.R. 1946, the Medicare Multi-Cancer Early Detection Screening Coverage Act of 2021, provisions to promote Medicare payment of medical cancer screening technology.

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

Lobbied on improvements to policies and increased reimbursement under the Medicare ambulance fee schedule. Advocated on the Protecting Access to Ground Ambulance Medical Services Act (H.R. 2454, S. 2037) to extend temporary Medicare ambulance increases and retain certain rural zip code designations. Lobbied on changes to the Medicare ambulance data collection system. Lobbied on extension of moratorium of sequestration cuts and 4% Paygo sequestration cut stemming from American Rescue Plan.

Client expense: $265,000 · Firm income: Not reported

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

Issues related to H.R. 8592, the EMS Counts Act of 2020. Issues related to the implementation of H.R. 1319, the American Rescue Plan Act of 2021. Issues related to H.R. 1609 / S.149, the Treatment in Place Act. Issues related to H.R. 3463 / S. 1693, the Medical Supplies for Pandemics Act of 2021. Issues related to H.R. 3635 / S. 1974, the Strengthening America's Strategic National Stockpile Act of 2021. Issues related to S. 3910, the EMS Staffing and Support Act. Issues related to S. 2037, the Protecting Access to Ground Ambulance Medical Services Act of 2021. Issues related to H.R. 7850 / S. 4269, the Prevent BLEEDing Act of 2022. Issues related to EMS funding.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support funding the SIREN Grant program for FY23; Educate lawmakers and staff on the need to count EMS workforce correctly. Support S. 2971/H.R. 2354, a bill that would count EMS workforce correctly under the BLS. Urge for a Senate companion bill; Support S. 2037/H.R. 2453, ambulance Medicare extenders legislation to extend for another five years the temporary 2% urban, 3% rural and super rural bonus increases that expire at the end of 2022 and allow for the preservation of more zip codes as being rural. Ambulance transports that originate in rural zip codes get not only the 1% temporary increase but a 50% increase on the first 17 miles of a transport; S. 3677/H.R. 5703, Post-Disaster Mental Health Response Act; Support letter to House and Senate leadership concerning EMS workforce shortage crisis. Educate lawmakers and staff about crisis and need for funding; Support letter to release and provide more provider relief funds as well as an extension of the moratorium on the 2% sequestration cut for Medicare providers and suppliers; Support letter to re-authorize FIRSTNET; Submitted Comment to Senate HELP hearings on the PREVENT Pandemics Bill and the EMS workforce shortage; Support the re-introduction and participation in the Congressional EMS Caucus.

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

Issues related to delayed payments and inappropriate denials for ground ambulance services provided to veterans; Issues related to the complexity of the VA claims processing system and specific claims payment problems related to inaccurate application of VA regulations and requirements; Issues related to implementation delays and challenges with VA Electronic Claims Submission program (eCAMS); Issues related to changes in payment authority on certain transports; Issues related to payment recoupments and inappropriate refund requests for services rendered. related to H.R. 2454/S. 2037 - Protecting Access to Ground Ambulance Medical Services of 2021.

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

Government targets: Veterans Affairs, Dept of (VA)

Discussions regarding solutions to address balance billing and to preserve access to emergency air ambulance services, particularly in rural areas; Issues related to funding required to preserve emergency response staffing; Discussions regarding the introduction and support for the extension of Medicare add-on payments for ground ambulance services related to H.R. 2454/S. 2037 - Protecting Access to Ground Ambulance Medical Services Act of 2021; Issues related to emergency first responder COVID-19 relief; Issues related to funding needed for workforce grants for training and employment retention and onboarding; Discussions related to upcoming ground ambulance patient advisory committee; Issues related to PREVENT Pandemics Act - S. 3799.

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

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

H.R. 3630 No Surprises Act Pub. L. No 116-260 implementation, Data cost collection for ground ambulance; extending the ground ambulance add-ons and addressing rural ZIP code issues; S. 2037/H.R. 4938 Protecting Access to Ground Ambulance Medical Services Act of 2021; FY 2023 Labor-HHS appropriations; HR 3172/S 2981, the HELPER Act.

Client expense: Not reported · Firm income: $51,000

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

P.L. 117-105, the Fiscal Year (FY) 2022 Consolidated Appropriations Act, funding for the following programs: - Rural EMS Training and Equipment Assistance. - National Firefighter Registry for cancer research. Funding for the above programs in FY 2023. The EMS Counts Act (H.R. 2354/S. 2971), provisions to more accurate count of the EMS workforce in the U.S. Issues relating to the fire & EMS departments needs for health and safety standards, testing, vaccinations, supplies and funding to respond to the COVID-19 pandemic. The Protecting Access to Ground Ambulance Medical Services Act (H.R. 2454/S. 2037), provisions to to the extension of Medicare add-on payments for the transportation of patients by fire & EMS departments to hospitals. Funding for the SIREN grant program at the Substance Abuse & Mental Health Services Administration. Issues related to the assessment of EMS quality and medical director compensation. Issues related to the implementation of provision in P.L. 117-2 that provides reimbursement for providing treatment in place services to patients. Issues related to the cost accounting of EMS services for Medicare patients. Issues relating to regulation of costs incurred during interfacility transport. Issues relating to COVID-19 vaccination of fire and EMS personnel.

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

Addressing the effects of COVID-19 and other health issues affecting the fire and emergency services. H.R.1480 - HERO Act H.R.2454/S.2037 - Protecting Access to Ground Ambulance Medical Services Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Lobbied on improvements to policies and increased reimbursement under the Medicare ambulance fee schedule. Advocated on the Protecting Access to Ground Ambulance Medical Services Act (H.R. 2454, S. 2037) to extend temporary Medicare ambulance increases and retain certain rural zip code designations. Lobbied to change the modified timeframe resulting from the COVID-19 PHE of ambulance data collection, and delay subsequent MedPAC report due date included in the FY2022 Consolidated Appropriations Act (H.R. 2471).

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

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

H.R. 1391: American Rescue Plan, H.R. 3630 No Surprises Act Pub. L. No 116-260 implementation, Data cost collection for ground ambulance; extending the ground ambulance add-ons and addressing rural ZIP code issues; S. 2037/H.R. 4938 Protecting Access to Ground Ambulance Medical Services Act of 2021.

Client expense: Not reported · Firm income: $51,000

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Transportation, Dept of (DOT)

Support funding the SIREN Grant program for FY22; Educate lawmakers and staff on the need to count EMS workforce correctly. Support S. 2971/H.R. 2354, a bill that would count EMS workforce correctly under the BLS. Urge for a Senate companion bill; Support S. 2037/H.R. 2453, ambulance Medicare extenders legislation to extend for another five years the temporary 2% urban, 3% rural and super rural bonus increases that expire at the end of 2022 and allow for the preservation of more zip codes as being rural. Ambulance transports that originate in rural zip codes get not only the 1% temporary increase but a 50% increase on the first 17 miles of a transport; H.R 4377, The Volunteer First Responder Housing Act; H.R. 5703, Post-Disaster Mental Health Response Act; S. 1902, Behavioral Health Crisis Services Expansion Act; Support $15 billion to build out 911 services nationwide; Urge Administration to keep ground ambulance out of balanced billing regulations; Support letter to House and Senate leadership to prevent the pending 4% sequestration cut triggered by the American Rescue Plan; Submitted comments on balanced billing and cost collection; Support letter to House and Senate leadership concerning EMS workforce shortage crisis. Educate lawmakers and staff about crisis; Support letter to release provider relief funds; Support the re-introduction of the Congressional EMS Caucus.

Client expense: Not reported · Firm income: $34,000

Discussions regarding solutions to address balance billing and to preserve access to emergency air ambulance services, particularly in rural areas; Issues regarding implementation of the Consolidated Appropriations Act, 2021 (Public Law 116-260), including the No Surprises Act (H.R. 3630 in the 116th Congress); Support for air ambulance cost and claims data reporting program; Issues regarding implementation of the CARES Act (Public Law 116-136) and the Paycheck Protection Program and Health Care Enhancement Act (Public Law 116-139); Issues related to emergency response staffing; Discussions regarding the introduction and support for the extension of Medicare add-on payments for ground ambulance services; Issues related to H.R. 2454/S. 2037 - Protecting Access to Ground Ambulance Medical Services Act of 2021; Issues related to emergency first responder COVID-19 relief; Issues related to treatment in place language for ground ambulance Medicare reimbursement; Issues related to the complexity of obtaining additional payor support to the ET3 program implemented by the Center for Medicare & Medicaid Innovation for ground ambulance services; Issues related to funding needed to preserve emergency response staffing; Issues related to funding needed for workforce grants for training and employment; Discussions related to upcoming ground ambulance patient advisory committee.

Client expense: $520,000 · Firm income: Not reported

Issues related to delayed payments and inappropriate denials for ground ambulance services provided to veterans; Issues related to the complexity of the VA claims processing system and specific claims payment problems related to inaccurate application of VA regulations and requirements; Issues related to H.R. 2454/S. 2037 - Protecting Access to Ground Ambulance Medical Services of 2021.

Client expense: $520,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

P.L. 117-71, the Protecting Medicare and American Farmers from Sequester Cuts Act, provisions to delay sequester cuts to Medicare reimbursement. FY 2022 Departments of Labor, Health and Human Services, Education and Related Agencies (H.R. 4502/S. 3062), funding for the following programs: - Rural EMS Training and Equipment Assistance - National Firefighter Registry for cancer research Issues relating to the fire & EMS departments needs for health and safety standards, testing, vaccinations, supplies and funding to respond to the COVID-19 pandemic. The Protecting Access to Ground Ambulance Medical Services Act (H.R. 2454/S. 2037), provisions to to the extension of Medicare add-on payments for the transportation of patients by fire & EMS departments to hospitals. Funding for the SIREN grant program at the Substance Abuse & Mental Health Services Administration. Issues related to the assessment of EMS quality and medical director compensation. Issues related to the implementation of provision in P.L. 117-2 that provide reimbursement for providing treatment in place services to patients. Issues related to the cost accounting of EMS services for Medicare patients. Issues relating to regulation of costs incurred during interfacility transport. Issues relating to COVID-19 vaccination of fire and EMS personnel. H.R. 4148/S. 2236, the Expanding Health Care Options for Early Retirees Act, provisions to extend Medicare benefits to firefighter retirees. H.R. 3876, the Ketamine Restriction Act, provisions to limit the use of ketamine in emergency situations.

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

Addressing the effects of COVID-19 and other health issues affecting the fire and emergency services. H.R.1480 - HERO Act H.R.2454/S.2037 - Protecting Access to Ground Ambulance Medical Services Act

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

Government targets: HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE

Lobbied on improvements to policies and increased reimbursement under the Medicare ambulance fee schedule. Advocated on the Protecting Access to Ground Ambulance Medical Services Act (H.R. 2454, S. 2037) to extend temporary Medicare ambulance increases and retain certain rural zip code designations. Lobbied to change the modified timeframe resulting from the COVID-19 PHE of ambulance data collection and delay subsequent MedPAC report due date. Advocated in support of the Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610) for an extension of the freeze on the 2% Medicare sequestration cut and to prevent the 4% cut for Medicare providers and suppliers resulting from the American Rescue Plan.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Veterans Affairs, Dept of (VA)

Support funding the SIREN Grant program for FY22; Educate lawmakers and staff on Treatment in Place (TIP) and make permanent as well as other waivers- telehealth and alternate destination for EMS. Educate lawmakers and staff on the need to count EMS workforce correctly. Support H.R. 2354, a bill that would count EMS workforce correctly under the BLS. Urge for a Senate companion bill; Support S. 2037/H.R. 2453, ambulance Medicare extenders legislation to extend for another five years the temporary 2% urban, 3% rural and super rural bonus increases that expire at the end of 2022 and allow for the preservation of more zip codes as being rural. Ambulance transports that originate in rural zip codes get not only the 1% temporary increase but a 50% increase on the first 17 miles of a transport; Support $15 billion to build out 911 services nationwide; Urge Administration to keep ground ambulance out of balanced billing regulations; Support letter to House and Senate leadership to prevent the pending 4% sequestration cut triggered by the American Rescue Plan; Submitted comments on balanced billing and cost collection; Support letter to House and Senate leadership concerning EMS workforce shortage crisis. Educate lawmakers and staff about crisis; Support letter to release provider relief funds; Support the re-introduction of the Congressional EMS Caucus.

Client expense: Not reported · Firm income: $26,000

H.R. 1391: American Rescue Plan, H.R. 3630 No Surprises Act Pub. L. No 116-260 implementation, Data cost collection for ground ambulance; extending the ground ambulance add-ons and addressing rural ZIP code issues; S. 2037/H.R. 4938 Protecting Access to Ground Ambulance Medical Serv- ices Act of 2021.

Client expense: Not reported · Firm income: $51,000

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Transportation, Dept of (DOT)

Issues related to delayed payments and inappropriate denials for ground ambulance services provided to veterans; Issues related to the complexity of the VA claims processing system and specific claims payment problems related to inaccurate application of VA regulations and requirements; Issues related to H.R. 2454/S. 2037 - Protecting Access to Ground Ambulance Medical Services of 2021.

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

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

Discussions regarding solutions to address balance billing and to preserve access to emergency air ambulance services, particularly in rural areas; Issues regarding implementation of the Consolidated Appropriations Act, 2021 (Public Law 116-260), including the No Surprises Act (H.R. 3630 in the 116th Congress); Support for air ambulance cost and claims data reporting program; Issues regarding implementation of the CARES Act (Public Law 116-136) and the Paycheck Protection Program and Health Care Enhancement Act (Public Law 116-139); Issues related to emergency response staffing; Discussions regarding the introduction and support for the extension of Medicare add-on payments for ground ambulance services; Issues related to H.R. 2454/S. 2037 - Protecting Access to Ground Ambulance Medical Services Act of 2021; Issues related to emergency first responder COVID-19 relief; Issues related to treatment in place language for ground ambulance Medicare reimbursement; Issues related to the complexity of obtaining additional payor support to the ET3 program implemented by the Center for Medicare & Medicaid Innovation for ground ambulance services.

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

Addressing the effects of COVID-19 and other health issues affecting the fire and emergency services. H.R.1480 - HERO Act H.R.2454/S.2037 - Protecting Access to Ground Ambulance Medical Services Act

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

Government targets: HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE