MATE Act of 2021

Mainstreaming Addiction Treatment Act (HR 2067, HR 7667); Drug Enforcement Administration regulation of buprenorphine under the Controlled Substances Act. Food and Drug Administration Safety and Landmark Advancement act FDASLA / FDA user fee reauthorization (HR 7667, S 4348, PL 117-70, Further Extending Government Funding Act) ; Restoring Hope for Mental Health and Well-Being Act (HR 7666); Medication Access and Training Expansion Act (HR 2067, S 2235; the Consolidated Appropriations Act PL 117-328).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Authority for dental-related programs to operate, caries prevention and oral health promotion, access to dental care, dental research, oral and craniofacial defects, filling Chief Dental Officer positions at CMS, prescribing practices (e.g., opioid prescribing), etc. Affordable Care Act Notice of Benefit and Payment Parameters S. 754/H.R. 1916, Ensuring Lasting Smiles Act (ELSA) S. 1793/H.R. 3461, Dental and Optometric Care Access Act of 2021 (DOC Access Act) Dental care coverage during pandemic H.R. 4510 Health Enterprise Zones Act Oral health initiatives Allowing dental practices to apply for Telehealth Program Funds regardless of size, location, or non-profit status Action for Dental Health Implementation CDC COVID-19 reopening guidance Health Profession Shortage Areas Access to personal protective equipment for dental offices Provider Relief Fund Including dental benefits in child support orders S. 54 Strengthening Americas Health Care Readiness Act House Energy and Commerce Committee Investigation into Dental Insurers NTP fluoride monograph Dentists and Dental Team Members Getting COVID Vaccine HHS PREP Act declaration for dentists, dental assistants to administer COVID-19 vaccines Public Option S. 958/H.R.5141, the Maximizing Outcomes through Better Investments in Lifesaving Equipment for Health Care Act (MOBILE Health Care Act) H.R. 379, Improving Social Determinants of Health Act H.R. 1550, PREVENT HPV Cancers Act S. 560, Oral Health for Moms Act H.R. 4555 Oral Health Literacy and Awareness Act Interoperability VA Community Care Program OSHA ETS on Vaccine Mandate CMS Vaccine Mandate Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids National Toxicology Program state-of-the-science report on fluoride H.R. 6000 Cures 2.0 Act H.R. 1667 Dr. Lorna Breen Health Care Provider Protection Act H.R. 2067, MATE Act of 2021 S. 2235, MATE Act of 2021 H.R. 7666, the Restoring Hope For Mental Health and Well-Being Act of 2022 2023 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies. ERISA reform Access to dental care for people with disabilities Provider directories

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Federal Communications Commission (FCC), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), SENATE

H.R.851/S.246 - Future Advancement of Academic Nursing (FAAN) Act H.R.9200 - Stop Nurse Shortages Act S.2114/H.R. 5699- Student Assisted Vaccination Effort (SAVE) Act H.R.8481/S. 3913-Improving DATA in Public Health Act H.R.8817/S.4844- National Nursing Workforce Center Act of 2022 H.R. 6087- Improving Access to Workers Compensation for Injured Federal Workers Act H.R. 7565- NIH IMPROVE Act H.R. 5721 VIPER Act S.4764/H.R.9040 - Reproductive Health Care Accessibility Act of 2022 H.R. 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 S.104/H.R.379 - Improving the Social Determinants of Health Act S.167/H.R.736 - Community Immunity During COVID-19 Act S.289/H.R.869- RISE Act S.346/H.R.959 - Black Maternal Health Momnibus Act of 2021 S.586/H.R. 3259 - NOPAIN Act S.1697/H.R.3352- Midwives for Maximizing Optimal Maternity Services (MOMS) Act H.R. 3337/S.1716- The Birth Access Benefiting Improved Essential Facility Services Act (BABIES) Act S.2235/H.R. 2067 - Medication Access and Training Expansion (MATE) Act S.1568/H.R.4407 - The Technical Reset to Advance the Instruction of Nurses (TRAIN) Act H.R. 8812/S.5212- Improving Care and Access to Nurses (I CAN) Act S.4182 - Workplace Violence Prevention for Health Care and Social Service Workers Act S.674- Public Health Infrastructure Saves Lives Act S.2187/H.R.4124- National Biomedical Research Act S.467/H.R.1324- Effective Suicide Screening and Assessment in the Emergency Department Act S.3799 - PREVENT Pandemics Act H.R. 831 - Health STATISTICS Act of 2021 H.R.1195 - Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 3550/S. 4905- Primary and Behavioral Health Care Access Act Support for clinical education, including graduate nursing education, and faculty Ensuring a Sustainable Public Health Workforce Title VIII Nursing Workforce Development Programs Nursing Education, Workforce, Research, and Public Health Infrastructure Needs Nursing faculty shortage Support Mental Health Programs for Nursing Students and the Workforce PPE, telehealth, mental health, and other resources and services to support Nursing Education, Practice, and the Workforce Safety and health of nurse educators and nursing students Public Health Emergency Waivers Ensure equity in COVID-19 efforts and health care Federal monkeypox response Comments on provider nondiscrimination Comments on the establishment of a National Directory of Healthcare Providers and Services

Client expense: $69,000 · 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), Natl Institutes of Health (NIH), Office of Natl Drug Control Policy (NDCP), SENATE, Treasury, Dept of

H.R. 2067/S.2235 - Medication Access and Training Expansion (MATE) Act H.R. 1384/S.445 - Mainstreaming Addiction Treatment (MAT) Act Reducing regulatory and legislative barriers for Nurse Practitioners Include nurses, APRNs, and nursing students in all National Public Health Plans Issues surrounding nurse faculty shortages H.R. 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Rural health care access Issues pertaining to White House Hunger, Nutrition, and Health Conference Public Law No: 117-215 - Medical Marijuana and Cannabidiol Research Expansion Act (H.R. 8454) S. 5212/H.R. 8812 - Improving Care and Access to Nurses (ICAN) Act Issues surrounding federal Monkeypox response H.R.2617 - Consolidated Appropriations Act, 2023

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1916, Ensuring Lasting Smiles Act (all sections of full text)(support). S. 754, Ensuring Lasting Smiles Act (all sections of full text)(support). HR 3461 DOC Access Act of 2021 (all sections of full text)(support). S 1793 DOC Access Act of 2021 (all sections of full text)(support). S. 3166, Medicaid Dental Benefit Act of 2021 (all sectionsof full text) Discussions pertaining to the cost of dental care in America. Discussions pertaining to proposals for expansion of Medicare benefits. Monitored HR 3173, Improving Seniors' Timely Access to Care Act. Monitored S. 3018, Improving Seniors' Timely Access to Care Act. Monitored HR 2607, Medication Access and Training Expansion (MATE) Act. Monitored S. 2235, Medication Access and Training Expansion (MATE) Act. Monitored surprise billing rulemaking process. Monitored executive branch nominations to federal agencies and commissions.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S.2697/H.R.6636 - the Due Process Continuity of Care Act: This legislation would amend the Medicaid Inmate Exclusion Policy to allow these otherwise eligible individuals to receive their full Medicaid benefits while incarcerated at the option of the state. Advocated for the DEA and SAMHSA to grant continued telehealth flexibilities for buprenorphine for OUD during the national public health emergency declared in response to the opioid crisis and work to make those telehealth flexibilities permanent, as appropriate, based on findings of further studies. Advocated for the Office of National Drug Control Policy (ONDCP) to clear policy barriers to sustainable implementation of contingency management (CM) interventions. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for issuance of a NPRM regarding further alignment of 42 CFR Part 2 with HIPAA, as called for by the CARES Act. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements and inclusion of S. 1927, the Child Abuse Prevention and Treatment (CAPTA) Reauthorization Act of 2021, in an end-of-the-year legislative package. ASAM joined a letter addressed to the Chairs and Ranking Members of the Labor, Health and Human Services, Education, and Related Agencies Subcommittees of the U.S. Senate and House Committees on Appropriations, urging the committees to fund the Centers for Disease Control and Preventions (CDC) Office of Smoking and Health (OSH) at $261.5 million, as was delineated in the U.S. Senate Appropriations Committees Chairmans mark from July 2022 ASAM submitted comments in a letter to the U.S. Senators Patty Murray and Richard Burr, Chair and Ranking Member of the Committee on Health, Education, Labor and Pensions (HELP), containing policy recommendations for inclusion in a possible Senate mental health and substance use disorder (MH/SUD) legislative package. The comments were based on HR 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022, which has already passed the U.S. House on a bipartisan basis. The letter voices ASAM's support for many provisions of the Restoring Hope Act, that would, among other things, reauthorize key Substance Abuse and Mental Health Administration (SAMHSA) and Health Resources and Services Administration (HRSA) programs to address the national MH and SUD crisis. ASAM joined a letter to the U.S. Senate Finance Committee in response to the committees Enhancing the Mental Health Workforce discussion draft. The letter thanks the committee for its ongoing efforts to address the MH and SUD workforce crisis and makes several key recommendations. The letters recommendations focus on two key areas: (1) clarifications to the bills language to ensure that Medicare beneficiaries with a primary diagnosis of SUD or no co-occurring MH condition can access the critical services they need and (2) resolving other barriers that prevent the MH and SUD workforce from meeting its full potential. ASAM joined a letter to SAMHSA supporting continuation of the PCSS program

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S.2697/H.R.6636 - the Due Process Continuity of Care Act: This legislation would amend the Medicaid Inmate Exclusion Policy to allow these otherwise eligible individuals to receive their full Medicaid benefits while incarcerated at the option of the state. Advocated for the DEA and SAMHSA to grant continued telehealth flexibilities for buprenorphine for OUD during the national public health emergency declared in response to the opioid crisis and work to make those telehealth flexibilities permanent, as appropriate, based on findings of further studies. Advocated for the Office of National Drug Control Policy (ONDCP) to clear policy barriers to sustainable implementation of contingency management (CM) interventions. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for issuance of a NPRM regarding further alignment of 42 CFR Part 2 with HIPAA, as called for by the CARES Act. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements and inclusion of S. 1927, the Child Abuse Prevention and Treatment (CAPTA) Reauthorization Act of 2021, in an end-of-the-year legislative package. ASAM joined a letter addressed to the Chairs and Ranking Members of the Labor, Health and Human Services, Education, and Related Agencies Subcommittees of the U.S. Senate and House Committees on Appropriations, urging the committees to fund the Centers for Disease Control and Preventions (CDC) Office of Smoking and Health (OSH) at $261.5 million, as was delineated in the U.S. Senate Appropriations Committees Chairmans mark from July 2022 ASAM submitted comments in a letter to the U.S. Senators Patty Murray and Richard Burr, Chair and Ranking Member of the Committee on Health, Education, Labor and Pensions (HELP), containing policy recommendations for inclusion in a possible Senate mental health and substance use disorder (MH/SUD) legislative package. The comments were based on HR 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022, which has already passed the U.S. House on a bipartisan basis. The letter voices ASAM's support for many provisions of the Restoring Hope Act, that would, among other things, reauthorize key Substance Abuse and Mental Health Administration (SAMHSA) and Health Resources and Services Administration (HRSA) programs to address the national MH and SUD crisis. ASAM joined a letter to the U.S. Senate Finance Committee in response to the committees Enhancing the Mental Health Workforce discussion draft. The letter thanks the committee for its ongoing efforts to address the MH and SUD workforce crisis and makes several key recommendations. The letters recommendations focus on two key areas: (1) clarifications to the bills language to ensure that Medicare beneficiaries with a primary diagnosis of SUD or no co-occurring MH condition can access the critical services they need and (2) resolving other barriers that prevent the MH and SUD workforce from meeting its full potential. ASAM joined a letter to SAMHSA supporting continuation of the PCSS program

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S.2697/H.R.6636 - the Due Process Continuity of Care Act: This legislation would amend the Medicaid Inmate Exclusion Policy to allow these otherwise eligible individuals to receive their full Medicaid benefits while incarcerated at the option of the state. Advocated for the DEA and SAMHSA to grant continued telehealth flexibilities for buprenorphine for OUD during the national public health emergency declared in response to the opioid crisis and work to make those telehealth flexibilities permanent, as appropriate, based on findings of further studies. Advocated for the Office of National Drug Control Policy (ONDCP) to clear policy barriers to sustainable implementation of contingency management (CM) interventions. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for issuance of a NPRM regarding further alignment of 42 CFR Part 2 with HIPAA, as called for by the CARES Act. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements and inclusion of S. 1927, the Child Abuse Prevention and Treatment (CAPTA) Reauthorization Act of 2021, in an end-of-the-year legislative package. ASAM joined a letter addressed to the Chairs and Ranking Members of the Labor, Health and Human Services, Education, and Related Agencies Subcommittees of the U.S. Senate and House Committees on Appropriations, urging the committees to fund the Centers for Disease Control and Preventions (CDC) Office of Smoking and Health (OSH) at $261.5 million, as was delineated in the U.S. Senate Appropriations Committees Chairmans mark from July 2022 ASAM submitted comments in a letter to the U.S. Senators Patty Murray and Richard Burr, Chair and Ranking Member of the Committee on Health, Education, Labor and Pensions (HELP), containing policy recommendations for inclusion in a possible Senate mental health and substance use disorder (MH/SUD) legislative package. The comments were based on HR 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022, which has already passed the U.S. House on a bipartisan basis. The letter voices ASAM's support for many provisions of the Restoring Hope Act, that would, among other things, reauthorize key Substance Abuse and Mental Health Administration (SAMHSA) and Health Resources and Services Administration (HRSA) programs to address the national MH and SUD crisis. ASAM joined a letter to the U.S. Senate Finance Committee in response to the committees Enhancing the Mental Health Workforce discussion draft. The letter thanks the committee for its ongoing efforts to address the MH and SUD workforce crisis and makes several key recommendations. The letters recommendations focus on two key areas: (1) clarifications to the bills language to ensure that Medicare beneficiaries with a primary diagnosis of SUD or no co-occurring MH condition can access the critical services they need and (2) resolving other barriers that prevent the MH and SUD workforce from meeting its full potential. ASAM joined a letter to SAMHSA supporting continuation of the PCSS program

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S.2697/H.R.6636 - the Due Process Continuity of Care Act: This legislation would amend the Medicaid Inmate Exclusion Policy to allow these otherwise eligible individuals to receive their full Medicaid benefits while incarcerated at the option of the state. Advocated for the DEA and SAMHSA to grant continued telehealth flexibilities for buprenorphine for OUD during the national public health emergency declared in response to the opioid crisis and work to make those telehealth flexibilities permanent, as appropriate, based on findings of further studies. Advocated for the Office of National Drug Control Policy (ONDCP) to clear policy barriers to sustainable implementation of contingency management (CM) interventions. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for issuance of a NPRM regarding further alignment of 42 CFR Part 2 with HIPAA, as called for by the CARES Act. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements and inclusion of S. 1927, the Child Abuse Prevention and Treatment (CAPTA) Reauthorization Act of 2021, in an end-of-the-year legislative package. ASAM joined a letter addressed to the Chairs and Ranking Members of the Labor, Health and Human Services, Education, and Related Agencies Subcommittees of the U.S. Senate and House Committees on Appropriations, urging the committees to fund the Centers for Disease Control and Preventions (CDC) Office of Smoking and Health (OSH) at $261.5 million, as was delineated in the U.S. Senate Appropriations Committees Chairmans mark from July 2022 ASAM submitted comments in a letter to the U.S. Senators Patty Murray and Richard Burr, Chair and Ranking Member of the Committee on Health, Education, Labor and Pensions (HELP), containing policy recommendations for inclusion in a possible Senate mental health and substance use disorder (MH/SUD) legislative package. The comments were based on HR 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022, which has already passed the U.S. House on a bipartisan basis. The letter voices ASAM's support for many provisions of the Restoring Hope Act, that would, among other things, reauthorize key Substance Abuse and Mental Health Administration (SAMHSA) and Health Resources and Services Administration (HRSA) programs to address the national MH and SUD crisis. ASAM joined a letter to the U.S. Senate Finance Committee in response to the committees Enhancing the Mental Health Workforce discussion draft. The letter thanks the committee for its ongoing efforts to address the MH and SUD workforce crisis and makes several key recommendations. The letters recommendations focus on two key areas: (1) clarifications to the bills language to ensure that Medicare beneficiaries with a primary diagnosis of SUD or no co-occurring MH condition can access the critical services they need and (2) resolving other barriers that prevent the MH and SUD workforce from meeting its full potential. ASAM joined a letter to SAMHSA supporting continuation of the PCSS program

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S.2697/H.R.6636 - the Due Process Continuity of Care Act: This legislation would amend the Medicaid Inmate Exclusion Policy to allow these otherwise eligible individuals to receive their full Medicaid benefits while incarcerated at the option of the state. Advocated for the DEA and SAMHSA to grant continued telehealth flexibilities for buprenorphine for OUD during the national public health emergency declared in response to the opioid crisis and work to make those telehealth flexibilities permanent, as appropriate, based on findings of further studies. Advocated for the Office of National Drug Control Policy (ONDCP) to clear policy barriers to sustainable implementation of contingency management (CM) interventions. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for issuance of a NPRM regarding further alignment of 42 CFR Part 2 with HIPAA, as called for by the CARES Act. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements and inclusion of S. 1927, the Child Abuse Prevention and Treatment (CAPTA) Reauthorization Act of 2021, in an end-of-the-year legislative package. ASAM joined a letter addressed to the Chairs and Ranking Members of the Labor, Health and Human Services, Education, and Related Agencies Subcommittees of the U.S. Senate and House Committees on Appropriations, urging the committees to fund the Centers for Disease Control and Preventions (CDC) Office of Smoking and Health (OSH) at $261.5 million, as was delineated in the U.S. Senate Appropriations Committees Chairmans mark from July 2022 ASAM submitted comments in a letter to the U.S. Senators Patty Murray and Richard Burr, Chair and Ranking Member of the Committee on Health, Education, Labor and Pensions (HELP), containing policy recommendations for inclusion in a possible Senate mental health and substance use disorder (MH/SUD) legislative package. The comments were based on HR 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022, which has already passed the U.S. House on a bipartisan basis. The letter voices ASAM's support for many provisions of the Restoring Hope Act, that would, among other things, reauthorize key Substance Abuse and Mental Health Administration (SAMHSA) and Health Resources and Services Administration (HRSA) programs to address the national MH and SUD crisis. ASAM joined a letter to the U.S. Senate Finance Committee in response to the committees Enhancing the Mental Health Workforce discussion draft. The letter thanks the committee for its ongoing efforts to address the MH and SUD workforce crisis and makes several key recommendations. The letters recommendations focus on two key areas: (1) clarifications to the bills language to ensure that Medicare beneficiaries with a primary diagnosis of SUD or no co-occurring MH condition can access the critical services they need and (2) resolving other barriers that prevent the MH and SUD workforce from meeting its full potential. ASAM joined a letter to SAMHSA supporting continuation of the PCSS program

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S.2697/H.R.6636 - the Due Process Continuity of Care Act: This legislation would amend the Medicaid Inmate Exclusion Policy to allow these otherwise eligible individuals to receive their full Medicaid benefits while incarcerated at the option of the state. Advocated for the DEA and SAMHSA to grant continued telehealth flexibilities for buprenorphine for OUD during the national public health emergency declared in response to the opioid crisis and work to make those telehealth flexibilities permanent, as appropriate, based on findings of further studies. Advocated for the Office of National Drug Control Policy (ONDCP) to clear policy barriers to sustainable implementation of contingency management (CM) interventions. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for issuance of a NPRM regarding further alignment of 42 CFR Part 2 with HIPAA, as called for by the CARES Act. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements and inclusion of S. 1927, the Child Abuse Prevention and Treatment (CAPTA) Reauthorization Act of 2021, in an end-of-the-year legislative package. ASAM joined a letter addressed to the Chairs and Ranking Members of the Labor, Health and Human Services, Education, and Related Agencies Subcommittees of the U.S. Senate and House Committees on Appropriations, urging the committees to fund the Centers for Disease Control and Preventions (CDC) Office of Smoking and Health (OSH) at $261.5 million, as was delineated in the U.S. Senate Appropriations Committees Chairmans mark from July 2022 ASAM submitted comments in a letter to the U.S. Senators Patty Murray and Richard Burr, Chair and Ranking Member of the Committee on Health, Education, Labor and Pensions (HELP), containing policy recommendations for inclusion in a possible Senate mental health and substance use disorder (MH/SUD) legislative package. The comments were based on HR 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022, which has already passed the U.S. House on a bipartisan basis. The letter voices ASAM's support for many provisions of the Restoring Hope Act, that would, among other things, reauthorize key Substance Abuse and Mental Health Administration (SAMHSA) and Health Resources and Services Administration (HRSA) programs to address the national MH and SUD crisis. ASAM joined a letter to the U.S. Senate Finance Committee in response to the committees Enhancing the Mental Health Workforce discussion draft. The letter thanks the committee for its ongoing efforts to address the MH and SUD workforce crisis and makes several key recommendations. The letters recommendations focus on two key areas: (1) clarifications to the bills language to ensure that Medicare beneficiaries with a primary diagnosis of SUD or no co-occurring MH condition can access the critical services they need and (2) resolving other barriers that prevent the MH and SUD workforce from meeting its full potential. ASAM joined a letter to SAMHSA supporting continuation of the PCSS program

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

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

Workforce development and clinical training site issues Issues surrounding opioid use disorders and medication-assisted treatment H.R. 2067/S.2235 - Medication Access and Training Expansion (MATE) Act H.R.945/S. 287 - Perinatal Workforce Act H.R. 959/S.346 - the Black Maternal Health Momnibus Act Telehealth issues, such as integrating students into telemedicine appointments H.R. 3890 - Physician Assistant Education Public Health Initiatives Act H.R. 5035/S. 2982 - Child Suicide Prevention and Lethal Means Safety Act H.R. 5602/S. 3244 - BIO Preparedness Workforce Act S. 4260 - Palliative Care and Hospice Education and Training Act S. 3799 - PREVENT Pandemics Act S. 4170 - Mental Health Reform Reauthorization Act of 2022

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

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

Workforce development and clinical training site issues Issues surrounding opioid use disorders and medication-assisted treatment H.R. 2067/S.2235 - Medication Access and Training Expansion (MATE) Act H.R.945/S. 287 - Perinatal Workforce Act H.R. 959/S.346 - the Black Maternal Health Momnibus Act Telehealth issues, such as integrating students into telemedicine appointments H.R. 3890 - Physician Assistant Education Public Health Initiatives Act H.R. 5035/S. 2982 - Child Suicide Prevention and Lethal Means Safety Act H.R. 5602/S. 3244 - BIO Preparedness Workforce Act S. 4260 - Palliative Care and Hospice Education and Training Act S. 3799 - PREVENT Pandemics Act S. 4170 - Mental Health Reform Reauthorization Act of 2022

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

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

Authority for dental-related programs to operate, caries prevention and oral health promotion, access to dental care, dental research, oral and craniofacial defects, filling Chief Dental Officer positions at CMS, prescribing practices (e.g., opioid prescribing), etc. Affordable Care Act Notice of Benefit and Payment Parameters S. 754/H.R. 1916, Ensuring Lasting Smiles Act (ELSA) S. 1793/H.R. 3461, Dental and Optometric Care Access Act of 2021 (DOC Access Act) Dental care coverage during pandemic H.R. 4510 Health Enterprise Zones Act Oral health initiatives Allowing dental practices to apply for Telehealth Program Funds regardless of size, location, or non-profit status Action for Dental Health Implementation CDC COVID-19 reopening guidance Health Profession Shortage Areas Access to personal protective equipment for dental offices Provider Relief Fund Including dental benefits in child support orders S. 54 Strengthening Americas Health Care Readiness Act House Energy and Commerce Committee Investigation into Dental Insurers NTP fluoride monograph Dentists and Dental Team Members Getting COVID Vaccine HHS PREP Act declaration for dentists, dental assistants to administer COVID-19 vaccines Public Option S. 958/H.R.5141, the Maximizing Outcomes through Better Investments in Lifesaving Equipment for Health Care Act (MOBILE Health Care Act) H.R. 379, Improving Social Determinants of Health Act H.R. 1550, PREVENT HPV Cancers Act S. 560, Oral Health for Moms Act H.R. 4555 Oral Health Literacy and Awareness Act Interoperability VA Community Care Program OSHA ETS on Vaccine Mandate CMS Vaccine Mandate Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids National Toxicology Program state-of-the-science report on fluoride H.R. 6000 Cures 2.0 Act H.R. 1667 Dr. Lorna Breen Health Care Provider Protection Act H.R. 2067, MATE Act of 2021 S. 2235, MATE Act of 2021 H.R. 7666, the Restoring Hope For Mental Health and Well-Being Act of 2022 2023 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies. Section 1557 Access to dental care for people with disabilities

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Federal Communications Commission (FCC), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), SENATE

S.800/H.R. 4870 - Promoting Access to Diabetic Shoes Act H.R. 1956/S. 1986 - Increasing Access to Quality Cardiac Rehabilitation Care Act of 2021 H.R. 2067/S. 2235 - Medication Access and Training Expansion (MATE) Act S. 987 - Comprehensive Addiction and Recovery Act (CARA) 3.0 H.R. 1319 - American Rescue Plan Act [Public Law No: 117-2] H.R. 1716 - COVID-19 Mental Health Research Act H.R. 1195 - the Workplace Violence Prevention for Health Care and Social Service Workers Act S. 54 - Strengthening Americas Health Care Readiness Act H.R. 851/S. 246 - the Future Advancement of Academic Nursing (FAAN) Act H.R. 959/S.346 - Black Maternal Health Momnibus Act of 2021 H.R. 1384 - the Mainstreaming Addiction Treatment Act of 2021 H.R. 955 - the Medicaid Reentry Act of 2021 H.R. 1025 - the Kids Access to Primary Care Act of 2021 S. 1315/H.R. 3630 - the Lymphedema Treatment Act S. 1833 - the Ensuring Access to Primary Care for Women & Children Act H.R. 3550/S. 4905 - the Primary and Behavioral Health Care Access Act S. 1512/H.R. 2903 - the CONNECT for Health Act of 2021 S. 287/H.R. 945 - the Perinatal Workforce Act S. 1536/H.R. 3108 - the Medical Nutrition Therapy Act of 2021 H.R. 1667/S. 610 - the Dr. Lorna Breen Health Care Provider Protection Act H.R. 736 - the Community Immunity During COVID-19 Act of 2021 H.R. 3087/S. 2051 - Breast Cancer Patient Equity Act H.R. 6000 - the Cures 2.0 Act S. 2652/H.R. 5067 - the Preserving Patient Access to Home Infusion Act S. 3149/H.R. 5848 - the Rural Health Equity Act H.R. 6308 - the ACO Assignment Improvement Act of 2021 H.R. 5248 - the Temporary Responders for Immediate Aid in Grave Emergencies (TRIAGE) Act of 2021 H.R. 5376 - the Build Back Better Act H.R.3925 - the Reducing Barriers to Substance Use Treatment Act S. Res. 626 and H. Res. 1100 - honoring and recognizing May 6 through 12, 2022 as National Nurses Week S.3098/H.R. 7617 - Preventive Care Awareness Act S.4182 - the Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 7236 - the Strengthen Kids Mental Health Now Act of 2022 H.R. 2376 - the Excellence in Recovery Housing Act H.R. 4944 - the Helping Kids Cope Act of 2021 H.R. 5218 - the Collaborate in an Orderly and Cohesive Manner Act H.R. 7076 - the Supporting Childrens Mental Health Care Access Act of 2022 H.R. 7232 - the 9-8-8 and Parity Assistance Act of 2022 H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 S.4170 - the Mental Health Reform Reauthorization Act H.R. 8812 - Improving Care and Access to Nurses (ICAN) Act H.R. 8454 - Medical Marijuana and Cannabidiol Research Expansion Act H.R. 3352/S. 1697 - Midwives for MOMs Act Issues pertaining to White House Hunger, Nutrition, and Health Conference Issues surrounding federal Monkeypox response Clinical Laboratory Improvement Amendments (CLIA) Replenish the COVID-19 Uninsured Relief Fund Nursing faculty shortage Nursing Education Use of telehealth to prescribe controlled substances under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 [Public Law No: 110-425] Rural health care issues, including rural workforce, COVID-19 vaccination, and reimbursement Medicare sequestration Medicare restrictions pertaining to telehealth Include nurses, APRNs, and nursing students in all National Public Health Plans Provide resources to support nurses, APRNs, and nursing students mental health needs, especially for those responding to the pandemic Funding to ensure childcare coverage Increased Federal Medical Assistance Percentage (FMAP) funding to states Access to personal protective equipment Extension of CMS waivers beyond public health emergency Skilled Nursing Facility admitting examination and assessment requirements COVID-19 Pandemic relief: funding, removal of barriers, telehealth, mental health, personal protective equipment, and testing Telehealth, remote patient monitoring and other forms of health technology COVID-19 Pandemic Reducing Regulatory Burdens, including those relating to home infusion therapy, Medicare Conditions of Participation, and hospice certification Medication-Assisted Treatment (MATs) Opioid Abuse Epidemic Documentation of medical records Health plan coverage and program requirements including provider non-discrimination Issues relating to Mental and Substance Use Disorder Workforce Addressing Health Equity Medicare Provider Reimbursement Clinical labor pricing update Tobacco flavors and menthol Site specific restrictions on providers under DEA controlled substances policy

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), Nuclear Regulatory Commission (NRC), Office of Special Counsel, SENATE, Treasury, Dept of, Veterans Affairs, Dept of (VA), White House Office

H.R. 1916, Ensuring Lasting Smiles Act (all sections of full text)(support). S. 754, Ensuring Lasting Smiles Act (all sections of full text)(support). HR 3461 DOC Access Act of 2021 (all sections of full text)(support). S 1793 DOC Access Act of 2021 (all sections of full text)(support). Discussions pertaining to S. 3166, Medicaid Dental Benefit Act of 2021. Discussions pertaining to the cost of dental care in America. Discussions pertaining to proposals for expansion of Medicare benefits. Monitored HR 3173, Improving Seniors' Timely Access to Care Act. Monitored S. 3018, Improving Senior's Timely Access to Care Act. Monitored HR 2607, Medication Access and Training Expansion (MATE) Act. Monitored S. 2235, Medication Access and Training Expansion (MATE) Act. Monitored surprise billing rulemaking process. Monitored executive branch nominations to federal agencies and commissions.

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

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

H.R. 6072, Leveraging Integrated Networks in Communities (LINC) to Address Social Needs Act of 2021, provisions relating to social determinants of health, mental health, and social services S. 509, LINC to Address Social Needs Act of 2021, provisions relating to social determinants of health, mental health, and social services H.R. 379, Improving Social Determinants of Health Act of 2021, all provisions S. 104, Improving Social Determinants of Health Act of 2021, all provisions S. 3799, Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act, all provisions H.R. 8, Bipartisan Background Checks Act of 2021, all provisions H.R. 1446, Enhanced Background Checks Act of 2021, all provisions H.R. 1218, Data Mapping to Save Moms Lives Act, all provisions S. 198, Data Mapping to Save Moms' Lives Act, all provisions S. 1675, Maternal Health Quality Improvement Act, all provisions H.R. 1384, Mainstreaming Addiction Treatment (MAT) Act of 2021, all provisions S. 445, MAT Act of 2021, all provisions H.R. 2163, Safe Step Act, all provisions S. 464, Safe Step Act, all provisions H.R. 666, Anti-Racism in Public Health Act of 2021, all provisions S. 162, Anti-Racism in Public Health Act of 2021, all provisions H.R. 5602, Bolstering Infectious Outbreaks (BIO) Preparedness Workforce Act of 2021, all provisions S. 3244, BIO Preparedness Workforce Act of 2021, all provisions H.R. 5248, Temporary Responders for Immediate Aid in Grave Emergencies (TRIAGE) Act of 2021, all provisions H.R. 6311, Comprehensive Addiction Resources Emergency Act of 2021, all provisions S. 3418, Comprehensive Addiction Resources Emergency Act of 2021, all provisions H.R. 1364, Parity Enforcement Act of 2021, all provisions H.R. 3753, Parity Implementation Assistance Act, all provisions S. 1962, Parity Implementation Assistance Act, all provisions H.R. 7232, 9-8-8 and Parity Assistance Act of 2022, all provisions H.R. 2067, Medication Access and Training Expansion (MATE) Act of 2021, all provisions S. 2235, MATE Act of 2021, all provisions S. 2938, Bipartisan Safer Communities Act, all provisions S. 4090, Dietary Supplement Listing Act of 2022, all provisions H.R. 8296, Womens Health Protection Act of 2022, all provisions H.R. 8373, Right to Contraception Act, all provisions H.R. 8318, To restrict limitations on the possession, sale, purchase, transportation or use of any contraceptive that relates to interstate commerce, all provisions H.R. 8454, Medical Marijuana and Cannabidiol Research Expansion Act S. 253, Cannabidiol and Marihuana Research Expansion Act, all provisions S. 2866, Treatment Restoration for Emergency Antibody Therapeutics (TREAT) Act, all provisions H.R. 6087, Improving Access to Workers Compensation for Injured Federal Workers Act of 2022, all provisions H.R. 3085, Equity in Neuroscience and Alzheimers Clinical Trials (ENACT) Act of 2021, all provisions H.R. 5030, Diversifying Investigations Via Equitable Research Studies for Everyone (DIVERSE) Trials Act, all provisions S. 1675, Maternal Health Quality Improvement Act, all provisions S. 3904, Healthcare Cybersecurity Act of 2022, all provisions H.R. 4128, Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021, all provisions S. 2209, VALID Act of 2021, all provisions H.R. 8152, American Data Privacy and Protection Act, all provisions H.R. 2377, Federal Extreme Risk Protection Order Act of 2022, all provisions H.R. 7910, Protecting Our Kids Act, all provisions S. 2938, Protecting Our Kids Act, all provisions H.R. 7667, Food and Drug Amendments of 2022, all provisions H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022, all provisions H.R. 8297, Ensuring Womens Right to Reproductive Freedom Act, all provisions H.R. 1235, Charlotte Woodward Organ Transplant Discrimination Prevention Act, all provisions S. 3301, Charlotte Woodward Organ Transplant Discrimination Prevention Act, all provisions H.R. 708, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions S. 168, TREAT Act, all provisions H.R. 4480, Telehealth Coverage and Payment Parity Act, all provisions H.R. 5541, Primary and Virtual Care Affordability Act, all provisions H.R. 1306, National Coronavirus Commission Act of 2021, all provisions S. 412, National Coronavirus Commission Act of 2021, all provisions H.R. 3778, Nullifying Opportunities for Variants to Infect and Decimate (NOVID) Act, all provisions S. 1976, NOVID Act, all provisions H.R. 6904, Patients Before Profits Act of 2022, all provisions H.R. 7116, 9-8-8 Implementation Act of 2022, all provisions H.R. 8890, Physician Wellness Program Act of 2022, all provisions H.R. 8908, Fighting Stimulant and other Substance Use Disorders Act, all provisions H.R. 8891, No Surprises for Survivors Act of 2022, all provisions H.R. 8885, Better Health Care Directories Act, all provisions H.R. 8886, Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act, all provisions H.R. 8892, To direct the Secretary of Health and Human Services to conduct a public outreach campaign to inform individuals covered under a group health plan or group or individual health insurance coverage of Federal requirements relating to mental health and substance use disorder crisis services, and for other purposes, all provisions H.R. 8881, To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require group health plans and health insurance issuers offering group or individual health insurance coverage to disclose the percentage of in-network participation for certain provider types, and for other purposes, all provisions H.R. 8889, Readable Insurance Coverage Explanations (RICE) Act, all provisions H.R. 7780, Mental Health Matters Act, all provisions H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, all provisions H.R. 5224, Preventing Overdoses and Saving Lives Act of 2021, all provisions H.R. 6279, Opioid Treatment Access Act of 2022, all provisions H.R. 925, Data to Save Moms Act, all provisions H.R. 3352, Midwives for MOMS Act of 2021, all provisions H.R. 847, Promoting Digital Privacy Technologies Act, all provisions S. 224, Promoting Digital Privacy Technologies Act, all provisions H.R. 3771, South Asian Heart Health Awareness and Research Act of 2022, all provisions H.R. 7559, Prescription Information Modernization Act of 2022, all provisions H.R. 8289, Banning Misleading Drug Ads Act of 2022, all provisions Emergency Room Hero and Patient Safety Act No Surprises Act/implementation Global health security/pandemics Digital Health/AI/Digital Therapeutics Privacy/non-HIPAA covered health apps Abortion/Dobbs decision Drug overdose epidemic Telehealth Scope of practice/patient safety Prior authorization Physician burnout/mental health stigma Health equity/COVID-19 COVID-19 Provider Relief Fund COVID-91/testing/misinformation/vaccine issues/therapeutics Section 1557/nondiscrimination/limited English proficiency Maternal Mortality Modifier 25, Impossible Day Hunger, Nutrition and Health WIC/SNAP/Nutrition Strengthening primary health care Data privacy Physician-led aerospace medicine teams Men who have sex with men/blood donations Federally qualified health centers and clinical trials

Client expense: $4,360,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Federal Aviation Administration (FAA), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, White House Office

Implementation of funding provided for in Consolidated Appropriations Act, 2021 (P.L. 116-260) to address substance use disorder; Mainstreaming Addiction Treatment Act (H.R. 1384/S. 445); Medication Access and Training Expansion Act (H.R. 2067/S. 2235); Medicaid Reentry Act of 2021 (H.R. 955/S. 285); Collaborate in an Orderly and Cohesive Manner Act (H.R.5218); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Synthetic Opioid Danger Awareness Act (H.R. 2364); FENTANYL Results Act (H.R. 2538/S. 1160); issues related to fentanyl.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Mainstreaming Addiction Treatment Act (HR 2067, HR 7667); Drug Enforcement Administration regulation of buprenorphine under the Controlled Substances Act. Food and Drug Administration Safety and Landmark Advancement act FDASLA / FDA user fee reauthorization (HR 7667, S 4348, PL 117-70, Further Extending Government Funding Act) ; Restoring Hope for Mental Health and Well-Being Act (HR 7666); Medication Access and Training Expansion Act (HR 2067, S 2235); the MOBILE Act, Maximizing Outcomes through Better Investment in Life Saving Equipment Act (PL 117-204).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2067/S.2235 - Medication Access and Training Expansion (MATE) Act H.R. 1384/S.445 - Mainstreaming Addiction Treatment (MAT) Act Reducing regulatory and legislative barriers for Nurse Practitioners Include nurses, APRNs, and nursing students in all National Public Health Plans Issues surrounding nurse faculty shortages H.R. 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Rural health care access Issues pertaining to White House Hunger, Nutrition, and Health Conference Medical Marijuana and Cannabidiol Research Expansion Act (H.R. 8454) H.R. 8812 - Improving Care and Access to Nurses (ICAN) Act Issues surrounding federal Monkeypox response

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for legislation that would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. ASAM wrote a letter to the U.S. House Ways and Means Committee regarding the Committees markup of worker and family support and health legislation aimed to expand access to mental health and substance use disorder (SUD) care under Medicare. ASAM requested several, specific clarifications to be made to ensure that Medicare beneficiaries with a primary diagnosis of SUD or with no co-occurring mental health condition can access critical SUD services under Medicare. ASAM wrote a comment letter to the Centers for Medicare and Medicaid Services (CMS) on the proposed 2023 Medicare Physician Fee Schedule (MPFS) covering revisions to opioid treatment program (OTP) services, a proposal to establish physician payment for the management of chronic pain, and a request for information on intensive outpatient (IOP) services, among other items. ASAM joined a coalition of public health, medical, and professional organizations in a letter to the Food and Drug Administration (FDA), supporting its intention to issue a proposed rule to reduce the nicotine level in cigarettes to non-addictive or minimally addictive levels. ASAM joined a letter addressed to Senator Schumer, requesting support of civil monetary penalty authority for the U.S. Department of Labor (USDOL) to enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). ASAM joined a letter to Congressional leadership regarding additional investments in the health care workforce, in particular Medicare-supported GME. ASAM joined a letter to Senate HELP leadership requesting support for funding to enhance the Collaborative Care Model (CoCM), which integrates behavioral health with primary care. Specifically, the letter recommended inclusion of bipartisan language found in Title III, Subtitle A, Section 301 of H.R. 7666 that provides grants to primary care to implement the CoCM. ASAM joined a letter to HHS, supporting the elevating of the Office of the Assistant Secretary for Preparedness and Response into a separate division, the Administration for Strategic Preparedness and Response (ASPR) and urging proactive steps to integrate mental health and substance use throughout the operations of ASPR. ASAM joined a letter to CMS, providing input on the Conditions of Participation for Rural Emergency Hospitals and recommending that CMS increase access to evidence-based treatment by clarifying in the Conditions of Participation that emergency departments operated by Rural Emergency Hospitals must meet the existing standard of care when treating patients with an opioid use disorder. ASAM joined a letter to bill sponsors supporting S. 4472, the Health Care Capacity for Pediatric Mental Health Act, which would make investments in mental health and substance use disorder care for kids and teens while providing support to the pediatric health professionals who serve. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for release of implementation rules regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements.

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for legislation that would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. ASAM wrote a letter to the U.S. House Ways and Means Committee regarding the Committees markup of worker and family support and health legislation aimed to expand access to mental health and substance use disorder (SUD) care under Medicare. ASAM requested several, specific clarifications to be made to ensure that Medicare beneficiaries with a primary diagnosis of SUD or with no co-occurring mental health condition can access critical SUD services under Medicare. ASAM wrote a comment letter to the Centers for Medicare and Medicaid Services (CMS) on the proposed 2023 Medicare Physician Fee Schedule (MPFS) covering revisions to opioid treatment program (OTP) services, a proposal to establish physician payment for the management of chronic pain, and a request for information on intensive outpatient (IOP) services, among other items. ASAM joined a coalition of public health, medical, and professional organizations in a letter to the Food and Drug Administration (FDA), supporting its intention to issue a proposed rule to reduce the nicotine level in cigarettes to non-addictive or minimally addictive levels. ASAM joined a letter addressed to Senator Schumer, requesting support of civil monetary penalty authority for the U.S. Department of Labor (USDOL) to enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). ASAM joined a letter to Congressional leadership regarding additional investments in the health care workforce, in particular Medicare-supported GME. ASAM joined a letter to Senate HELP leadership requesting support for funding to enhance the Collaborative Care Model (CoCM), which integrates behavioral health with primary care. Specifically, the letter recommended inclusion of bipartisan language found in Title III, Subtitle A, Section 301 of H.R. 7666 that provides grants to primary care to implement the CoCM. ASAM joined a letter to HHS, supporting the elevating of the Office of the Assistant Secretary for Preparedness and Response into a separate division, the Administration for Strategic Preparedness and Response (ASPR) and urging proactive steps to integrate mental health and substance use throughout the operations of ASPR. ASAM joined a letter to CMS, providing input on the Conditions of Participation for Rural Emergency Hospitals and recommending that CMS increase access to evidence-based treatment by clarifying in the Conditions of Participation that emergency departments operated by Rural Emergency Hospitals must meet the existing standard of care when treating patients with an opioid use disorder. ASAM joined a letter to bill sponsors supporting S. 4472, the Health Care Capacity for Pediatric Mental Health Act, which would make investments in mental health and substance use disorder care for kids and teens while providing support to the pediatric health professionals who serve. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for release of implementation rules regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements.

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for legislation that would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. ASAM wrote a letter to the U.S. House Ways and Means Committee regarding the Committees markup of worker and family support and health legislation aimed to expand access to mental health and substance use disorder (SUD) care under Medicare. ASAM requested several, specific clarifications to be made to ensure that Medicare beneficiaries with a primary diagnosis of SUD or with no co-occurring mental health condition can access critical SUD services under Medicare. ASAM wrote a comment letter to the Centers for Medicare and Medicaid Services (CMS) on the proposed 2023 Medicare Physician Fee Schedule (MPFS) covering revisions to opioid treatment program (OTP) services, a proposal to establish physician payment for the management of chronic pain, and a request for information on intensive outpatient (IOP) services, among other items. ASAM joined a coalition of public health, medical, and professional organizations in a letter to the Food and Drug Administration (FDA), supporting its intention to issue a proposed rule to reduce the nicotine level in cigarettes to non-addictive or minimally addictive levels. ASAM joined a letter addressed to Senator Schumer, requesting support of civil monetary penalty authority for the U.S. Department of Labor (USDOL) to enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). ASAM joined a letter to Congressional leadership regarding additional investments in the health care workforce, in particular Medicare-supported GME. ASAM joined a letter to Senate HELP leadership requesting support for funding to enhance the Collaborative Care Model (CoCM), which integrates behavioral health with primary care. Specifically, the letter recommended inclusion of bipartisan language found in Title III, Subtitle A, Section 301 of H.R. 7666 that provides grants to primary care to implement the CoCM. ASAM joined a letter to HHS, supporting the elevating of the Office of the Assistant Secretary for Preparedness and Response into a separate division, the Administration for Strategic Preparedness and Response (ASPR) and urging proactive steps to integrate mental health and substance use throughout the operations of ASPR. ASAM joined a letter to CMS, providing input on the Conditions of Participation for Rural Emergency Hospitals and recommending that CMS increase access to evidence-based treatment by clarifying in the Conditions of Participation that emergency departments operated by Rural Emergency Hospitals must meet the existing standard of care when treating patients with an opioid use disorder. ASAM joined a letter to bill sponsors supporting S. 4472, the Health Care Capacity for Pediatric Mental Health Act, which would make investments in mental health and substance use disorder care for kids and teens while providing support to the pediatric health professionals who serve. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for release of implementation rules regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements.

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for legislation that would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. ASAM wrote a letter to the U.S. House Ways and Means Committee regarding the Committees markup of worker and family support and health legislation aimed to expand access to mental health and substance use disorder (SUD) care under Medicare. ASAM requested several, specific clarifications to be made to ensure that Medicare beneficiaries with a primary diagnosis of SUD or with no co-occurring mental health condition can access critical SUD services under Medicare. ASAM wrote a comment letter to the Centers for Medicare and Medicaid Services (CMS) on the proposed 2023 Medicare Physician Fee Schedule (MPFS) covering revisions to opioid treatment program (OTP) services, a proposal to establish physician payment for the management of chronic pain, and a request for information on intensive outpatient (IOP) services, among other items. ASAM joined a coalition of public health, medical, and professional organizations in a letter to the Food and Drug Administration (FDA), supporting its intention to issue a proposed rule to reduce the nicotine level in cigarettes to non-addictive or minimally addictive levels. ASAM joined a letter addressed to Senator Schumer, requesting support of civil monetary penalty authority for the U.S. Department of Labor (USDOL) to enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). ASAM joined a letter to Congressional leadership regarding additional investments in the health care workforce, in particular Medicare-supported GME. ASAM joined a letter to Senate HELP leadership requesting support for funding to enhance the Collaborative Care Model (CoCM), which integrates behavioral health with primary care. Specifically, the letter recommended inclusion of bipartisan language found in Title III, Subtitle A, Section 301 of H.R. 7666 that provides grants to primary care to implement the CoCM. ASAM joined a letter to HHS, supporting the elevating of the Office of the Assistant Secretary for Preparedness and Response into a separate division, the Administration for Strategic Preparedness and Response (ASPR) and urging proactive steps to integrate mental health and substance use throughout the operations of ASPR. ASAM joined a letter to CMS, providing input on the Conditions of Participation for Rural Emergency Hospitals and recommending that CMS increase access to evidence-based treatment by clarifying in the Conditions of Participation that emergency departments operated by Rural Emergency Hospitals must meet the existing standard of care when treating patients with an opioid use disorder. ASAM joined a letter to bill sponsors supporting S. 4472, the Health Care Capacity for Pediatric Mental Health Act, which would make investments in mental health and substance use disorder care for kids and teens while providing support to the pediatric health professionals who serve. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for release of implementation rules regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements.

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for legislation that would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. ASAM wrote a letter to the U.S. House Ways and Means Committee regarding the Committees markup of worker and family support and health legislation aimed to expand access to mental health and substance use disorder (SUD) care under Medicare. ASAM requested several, specific clarifications to be made to ensure that Medicare beneficiaries with a primary diagnosis of SUD or with no co-occurring mental health condition can access critical SUD services under Medicare. ASAM wrote a comment letter to the Centers for Medicare and Medicaid Services (CMS) on the proposed 2023 Medicare Physician Fee Schedule (MPFS) covering revisions to opioid treatment program (OTP) services, a proposal to establish physician payment for the management of chronic pain, and a request for information on intensive outpatient (IOP) services, among other items. ASAM joined a coalition of public health, medical, and professional organizations in a letter to the Food and Drug Administration (FDA), supporting its intention to issue a proposed rule to reduce the nicotine level in cigarettes to non-addictive or minimally addictive levels. ASAM joined a letter addressed to Senator Schumer, requesting support of civil monetary penalty authority for the U.S. Department of Labor (USDOL) to enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). ASAM joined a letter to Congressional leadership regarding additional investments in the health care workforce, in particular Medicare-supported GME. ASAM joined a letter to Senate HELP leadership requesting support for funding to enhance the Collaborative Care Model (CoCM), which integrates behavioral health with primary care. Specifically, the letter recommended inclusion of bipartisan language found in Title III, Subtitle A, Section 301 of H.R. 7666 that provides grants to primary care to implement the CoCM. ASAM joined a letter to HHS, supporting the elevating of the Office of the Assistant Secretary for Preparedness and Response into a separate division, the Administration for Strategic Preparedness and Response (ASPR) and urging proactive steps to integrate mental health and substance use throughout the operations of ASPR. ASAM joined a letter to CMS, providing input on the Conditions of Participation for Rural Emergency Hospitals and recommending that CMS increase access to evidence-based treatment by clarifying in the Conditions of Participation that emergency departments operated by Rural Emergency Hospitals must meet the existing standard of care when treating patients with an opioid use disorder. ASAM joined a letter to bill sponsors supporting S. 4472, the Health Care Capacity for Pediatric Mental Health Act, which would make investments in mental health and substance use disorder care for kids and teens while providing support to the pediatric health professionals who serve. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for release of implementation rules regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements.

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for HR 1364/S.4804 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. Advocated for legislation that would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. ASAM wrote a letter to the U.S. House Ways and Means Committee regarding the Committees markup of worker and family support and health legislation aimed to expand access to mental health and substance use disorder (SUD) care under Medicare. ASAM requested several, specific clarifications to be made to ensure that Medicare beneficiaries with a primary diagnosis of SUD or with no co-occurring mental health condition can access critical SUD services under Medicare. ASAM wrote a comment letter to the Centers for Medicare and Medicaid Services (CMS) on the proposed 2023 Medicare Physician Fee Schedule (MPFS) covering revisions to opioid treatment program (OTP) services, a proposal to establish physician payment for the management of chronic pain, and a request for information on intensive outpatient (IOP) services, among other items. ASAM joined a coalition of public health, medical, and professional organizations in a letter to the Food and Drug Administration (FDA), supporting its intention to issue a proposed rule to reduce the nicotine level in cigarettes to non-addictive or minimally addictive levels. ASAM joined a letter addressed to Senator Schumer, requesting support of civil monetary penalty authority for the U.S. Department of Labor (USDOL) to enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). ASAM joined a letter to Congressional leadership regarding additional investments in the health care workforce, in particular Medicare-supported GME. ASAM joined a letter to Senate HELP leadership requesting support for funding to enhance the Collaborative Care Model (CoCM), which integrates behavioral health with primary care. Specifically, the letter recommended inclusion of bipartisan language found in Title III, Subtitle A, Section 301 of H.R. 7666 that provides grants to primary care to implement the CoCM. ASAM joined a letter to HHS, supporting the elevating of the Office of the Assistant Secretary for Preparedness and Response into a separate division, the Administration for Strategic Preparedness and Response (ASPR) and urging proactive steps to integrate mental health and substance use throughout the operations of ASPR. ASAM joined a letter to CMS, providing input on the Conditions of Participation for Rural Emergency Hospitals and recommending that CMS increase access to evidence-based treatment by clarifying in the Conditions of Participation that emergency departments operated by Rural Emergency Hospitals must meet the existing standard of care when treating patients with an opioid use disorder. ASAM joined a letter to bill sponsors supporting S. 4472, the Health Care Capacity for Pediatric Mental Health Act, which would make investments in mental health and substance use disorder care for kids and teens while providing support to the pediatric health professionals who serve. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for release of implementation rules regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements.

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

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

H.R.851/S.246 - Future Advancement of Academic Nursing (FAAN) Act S.2114/H.R. 5699- Student Assisted Vaccination Effort (SAVE) Act H.R.8481/S. 3913-Improving DATA in Public Health Act H.R.8817/S.4844- National Nursing Workforce Center Act of 2022 H.R. 6087- Improving Access to Workers Compensation for Injured Federal Workers Act H.R. 7565- NIH IMPROVE Act S.4764/H.R.9040 - Reproductive Health Care Accessibility Act of 2022 H.R. 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 S.104/H.R.379 - Improving the Social Determinants of Health Act S.167/H.R.736 - Community Immunity During COVID-19 Act S.289/H.R.869- RISE Act S.346/H.R.959 - Black Maternal Health Momnibus Act of 2021 S.586/H.R. 3259 - NOPAIN Act S.1697/H.R.3352- Midwives for Maximizing Optimal Maternity Services (MOMS) Act H.R. 3337- The Birth Access Benefiting Improved Essential Facility Services Act (BABIES) Act S.2235/H.R. 2067 - Medication Access and Training Expansion (MATE) Act S.1568/H.R.4407 - The Technical Reset to Advance the Instruction of Nurses (TRAIN) Act S.674- Public Health Infrastructure Saves Lives Act S.2187- National Biomedical Research Act S.467- Effective Suicide Screening and Assessment in the Emergency Department Act S.3799 - PREVENT Pandemics Act H.R. 831 - Health STATISTICS Act of 2021 H.R.1195 - Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 3550/S. 4905- Primary and Behavioral Health Care Access Act Support for clinical education, including graduate nursing education, and faculty Ensuring a Sustainable Public Health Workforce Title VIII Nursing Workforce Development Programs Nursing Education, Workforce, Research, and Public Health Infrastructure Needs Nursing faculty shortage Support Mental Health Programs for Nursing Students and the Workforce PPE, telehealth, mental health, and other resources and services to support Nursing Education, Practice, and the Workforce Safety and health of nurse educators and nursing students Public Health Emergency Waivers Ensure equity in COVID-19 efforts and health care Comments on new Rural Emergency Hospital (REH) designation and the removal of physician supervision requirements for APRN's at such facilities Comments on the CY 2023 Physician Fee Schedule Comments on Clinical Laboratory Improvement Amendments of 1988 Fees; Histocompatibility, Personnel, and Alternative Sanctions for Certificate of Waiver Laboratories Comments on the Department of Health and Human Services Initiative to Strengthen Primary Health Care

Client expense: $69,000 · 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, White House Office

-Prescription drug abuse prevention - sharing the association's efforts to educate our members. - Discussed efforts to modify the MATE Act (HR 2067/S 2235) with House and Senate staff.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Workforce development and clinical training site issues Issues surrounding opioid use disorders and medication-assisted treatment H.R. 2067/S.2235 - Medication Access and Training Expansion (MATE) Act H.R.945/S. 287 - Perinatal Workforce Act H.R. 959/S.346 - the Black Maternal Health Momnibus Act Telehealth issues, such as integrating students into telemedicine appointments H.R. 3890 - Physician Assistant Education Public Health Initiatives Act H.R. 5035/S. 2982 - Child Suicide Prevention and Lethal Means Safety Act H.R. 5602/S. 3244 - BIO Preparedness Workforce Act S. 4260 - Palliative Care and Hospice Education and Training Act S. 3799 - PREVENT Pandemics Act S. 4170 - Mental Health Reform Reauthorization Act of 2022

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

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

Workforce development and clinical training site issues Issues surrounding opioid use disorders and medication-assisted treatment H.R. 2067/S.2235 - Medication Access and Training Expansion (MATE) Act H.R.945/S. 287 - Perinatal Workforce Act H.R. 959/S.346 - the Black Maternal Health Momnibus Act Telehealth issues, such as integrating students into telemedicine appointments H.R. 3890 - Physician Assistant Education Public Health Initiatives Act H.R. 5035/S. 2982 - Child Suicide Prevention and Lethal Means Safety Act H.R. 5602/S. 3244 - BIO Preparedness Workforce Act S. 3799 - PREVENT Pandemics Act S. 4170 - Mental Health Reform Reauthorization Act of 2022

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

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

Authority for dental-related programs to operate, caries prevention and oral health promotion, access to dental care, dental research, oral and craniofacial defects, filling Chief Dental Officer positions at CMS, prescribing practices (e.g., opioid prescribing), etc. Affordable Care Act Notice of Benefit and Payment Parameters S. 754/H.R. 1916, Ensuring Lasting Smiles Act (ELSA) S. 1793/H.R. 3461, Dental and Optometric Care Access Act of 2021 (DOC Access Act) Dental care coverage during pandemic H.R. 4510 Health Enterprise Zones Act Oral health initiatives Allowing dental practices to apply for Telehealth Program Funds regardless of size, location, or non-profit status Action for Dental Health Implementation CDC COVID-19 reopening guidance Health Profession Shortage Areas Access to personal protective equipment for dental offices Provider Relief Fund Including dental benefits in child support orders S. 54 Strengthening Americas Health Care Readiness Act House Energy and Commerce Committee Investigation into Dental Insurers NTP fluoride monograph Dentists and Dental Team Members Getting COVID Vaccine HHS PREP Act declaration for dentists, dental assistants to administer COVID-19 vaccines Public Option S. 958, the Maximizing Outcomes through Better Investments in Lifesaving Equipment for Health Care Act (MOBILE Health Care Act) H.R. 379, Improving Social Determinants of Health Act H.R. 1550, PREVENT HPV Cancers Act S. 560, Oral Health for Moms Act H.R. 4555 Oral Health Literacy and Awareness Act VA Community Care Program OSHA ETS on Vaccine Mandate CMS Vaccine Mandate Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids National Toxicology Program state-of-the-science report on fluoride H.R. 6000 Cures 2.0 Act H.R. 1667 Dr. Lorna Breen Health Care Provider Protection Act H.R. 2067, MATE Act of 2021 S. 2235, MATE Act of 2021 H.R. 7666, the Restoring Hope For Mental Health and Well-Being Act of 2022 2023 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies.

Client expense: $470,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Environmental Protection Agency (EPA), Federal Communications Commission (FCC), Federal Emergency Management Agency (FEMA), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Indian Health Service, Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), SENATE

S. 253, Cannabidiol and Marihuana Research Expansion Act, all provisions H.R. 6087, Improving Access to Workers Compensation for Injured Federal Workers Act of 2022, all provisions H.R. 3085, Equity in Neuroscience and Alzheimers Clinical Trials (ENACT) Act of 2021, all provisions H.R. 5030, Diversifying Investigations Via Equitable Research Studies for Everyone (DIVERSE) Trials Act, all provisions H.R. 1384, Mainstreaming Addiction Treatment (MAT) Act of 2021, all provisions S. 445, Mainstreaming Addiction Treatment (MAT) Act of 2021, all provisions H.R. 2067, Medication Access and Training Expansion (MATE) Act of 2021, all provisions S. 2235, Medication Access and Training Expansion (MATE) Act of 2021, all provisions H.R. 6072, Leveraging Integrated Networks in Communities (LINC) To Address Social Needs Act of 2021, provisions relating to social determinants of health, impact on mental health and social services S. 509, Leveraging Integrated Networks in Communities (LINC) To Address Social Needs Act of 2021, provisions relating to social determinants of health, impact on mental health and social services H.R. 379, Improving Social Determinants of Health Act of 2021, all provisions S. 104, Improving Social Determinants of Health Act of 2021, all provisions S. 3799, Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act, all provisions H.R. 8, Bipartisan Background Checks Act of 2021, all provisions H.R. 1446, Enhanced Background Checks Act of 2021, all provisions S. 1675, Maternal Health Quality Improvement Act, all provisions H.R. 2163, Safe Step Act, all provisions S. 464, Safe Step Act, all provisions H.R. 666, Anti-Racism in Public Health Act of 2021, all provisions S. 162, Anti-Racism in Public Health Act of 2021, all provisions H.R. 5248, Temporary Responders for Immediate Aid in Grave Emergencies (TRIAGE) Act of 2021, all provisions H.R. 6311, Comprehensive Addiction Resources Emergency Act of 2021, all provisions S. 3418, Comprehensive Addiction Resources Emergency Act of 2021, all provisions H.R. 1364, Parity Enforcement Act of 2021, all provisions H.R. 3735, Parity Implementation Assistance Act, all provisions H.R. 7232, 9-8-8 and Parity Assistance Act of 2022, all provisions H.R. 7116, 9-8-8 Implementation Act of 2022, all provisions S. 2938, Bipartisan Safer Communities Act, all provisions S. 4090, Dietary Supplement Listing Act of 2022, all provisions S. 1675, Maternal Health Quality Improvement Act, all provisions H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, all provisions S. 610, Dr. Lorna Breen Health Care Provider Protection Act, all provisions H.R. 3753, Parity Implementation Assistance Act, all provisions S. 1962, Parity Implementation Assistance Act, all provisions S. 3904, Healthcare Cybersecurity Act of 2022, all provisions H.R. 4128, Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021, all provisions S. 2209, Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021, all provisions H.R. 6000, Cures 2.0 Act, all provisions S. 2416, New Opportunities for Value that Extend Lives (NOVEL) Act of 2021, all provisions H.R. 8152, To provide consumers with foundational data privacy rights, create strong oversight mechanisms, and establish meaningful enforcement, all provisions H.R. 2377, Federal Extreme Risk Protection Order Act of 2022, all provisions H.R. 7910, Protecting Our Kids Act, all provisions S. 2938, Bipartisan Safer Communities Act, all provisions H.R. 7667, Food and Drug Amendments of 2022, all provisions H.R. 7666, Restoring Hope for Mental Health and Well-Being Act of 2022, all provisions H.R. 2503, Social Determinants Accelerator Act of 2021, all provisions S. 3039, Social Determinants Accelerator Act of 2021, all provisions H.R. 7192, Diagnostic Device Advisory Committee Act, all provisions H.R. 3085, Equity in Neuroscience and Alzheimers Clinical Trials (ENACT) Act of 2021, all provisions H.R. 5218, Collaborate in an Orderly and Cohesive Manner Act, all provisions H.R. 7845, NIH Clinical Trial Diversity Act of 2022, all provisions H.R. 708, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions H.R. 4480, Telehealth Coverage and Payment Parity Act, all provisions H.R. 7573, Telehealth Extension and Evaluation Act, all provisions S. 3593, Telehealth Extension and Evaluation Act, all provisions H.R. 5541, Primary and Virtual Care Affordability Act, all provisions H.R. 1306, National Coronavirus Commission Act of 2021, all provisions S. 412, National Coronavirus Commission Act of 2021, all provisions H.R. 1843, COVID-19 Hate Crimes Act, all provisions S. 937, COVID-19 Hate Crimes Act, all provisions H.R. 3778, Nullifying Opportunities for Variants to Infect and Decimate (NOVID) Act, all provisions S. 1976, Nullifying Opportunities for Variants to Infect and Decimate (NOVID) Act, all provisions H.R. 6904, Patients Before Profits Act of 2022, all provisions H.R. 7053, Hospital Inpatient Services Modernization Act, all provisions S. 3792, Hospital Inpatient Services Modernization Act, all provisions H.R. 1364, Parity Enforcement Act of 2021, all provisions H.R. 5224, Preventing Overdoses and Saving Lives Act of 2021, all provisions H.R. 6279, Opioid Treatment Access Act of 2022, all provisions H.R. 7234, Summer Barrow Prevention, Treatment, and Recovery Act, all provisions H.R. 3352, Midwives for MOMS Act of 2021, all provisions H.R. 847, Promoting Digital Privacy Technologies Act, all provisions S. 224, Promoting Digital Privacy Technologies Act, all provisions H.R. 3771, South Asian Heart Health Awareness and Research Act of 2021, all provisions H.R. 7559, Prescription Information Modernization Act of 2022, all provisions H.R. 8289, Banning Misleading Drug Ads Act of 2022, all provisions H.R. 3614, Menstrual Equity For All Act of 2021, all provisions No Surprises Act/implementation Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, all provisions 21st Century Cures Act/implementation Maternal mortality Maternal health and inequities/FY 2023 funding Prior Authorization AMA Recovery Plan for Americas Physicians/telehealth/prior authorization/physician burnout/scope Section 2527(b) of the U.S. Innovation and Competition Act (USICA)/Open Access Language Retired Physician Re-entry COVID-19 telehealth flexibilities COVID-19/Vaccine distribution/Vaccines in physician offices Physician burnout and suicide COVID-19/Health Equity/vaccines COVID-19 response/testing/misinformation/therapeutics/Paxlovid Public Health Emergency COVID-19 Health Equity/Men who have sex with men/3-month blood donation use deferral Health Equity/Federally qualified health centers and clinical trials Womens Reproductive Health Medication Abortion Access Diabetes Provider Relief Fund/COVID-19 Electronic Health Records (EHR) Certification Data Privacy Hunger, Nutrition, and Health Digital Health/AI/Digital Therapeutics Monkeypox/testing/vaccination

Client expense: $4,550,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), President of the U.S., SENATE, Vice President of the U.S., White House Office

Implementation of funding provided for in Consolidated Appropriations Act, 2021 (P.L. 116-260) to address substance use disorder; Mainstreaming Addiction Treatment Act (H.R. 1384/S. 445); Medication Access and Training Expansion Act (H.R. 2067/S. 2235); Fiscal Year 2022 appropriations report language regarding substance use disorder treatment; Medicaid Reentry Act of 2021 (H.R. 955/S. 285); Collaborate in an Orderly and Cohesive Manner Act (H.R.5218); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Synthetic Opioid Danger Awareness Act (H.R. 2364); FENTANYL Results Act (H.R. 2538/S. 1160).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S.800/H.R 4870 - Promoting Access to Diabetic Shoes Act H.R. 1956/S. 1986 - Increasing Access to Quality Cardiac Rehabilitation Care Act of 2021 H.R. 2067/S. 2235 - Medication Access and Training Expansion (MATE) Act S. 987 - Comprehensive Addiction and Recovery Act (CARA) 3.0 H.R. 1319 - American Rescue Plan Act [Public Law No: 117-2] H.R. 1716 - COVID-19 Mental Health Research Act H.R. 1195 - the Workplace Violence Prevention for Health Care and Social Service Workers Act S. 54 - Strengthening Americas Health Care Readiness Act H.R. 851/S. 246 - the Future Advancement of Academic Nursing (FAAN) Act H.R. 959/S.346 - Black Maternal Health Momnibus Act of 2021 H.R. 1384 - the Mainstreaming Addiction Treatment Act of 2021 H.R. 955 - the Medicaid Reentry Act of 2021 H.R. 1025 - the Kids Access to Primary Care Act of 2021 S. 1315/H.R. 3630 - the Lymphedema Treatment Act S. 1833 - the Ensuring Access to Primary Care for Women & Children Act H.R. 3550 - the Primary and Behavioral Health Care Access Act of 2021 S. 1512/H.R. 2903 - the CONNECT for Health Act of 2021 S. 287/H.R. 945 - the Perinatal Workforce Act S. 1536/H.R. 3108 - the Medical Nutrition Therapy Act of 2021 H.R. 1667/S. 610 - the Dr. Lorna Breen Health Care Provider Protection Act H.R. 736 - the Community Immunity During COVID-19 Act of 2021 H.R. 3087/S. 2051 - Breast Cancer Patient Equity Act H.R. 6000 - the Cures 2.0 Act S. 2652/H.R. 5067 - the Preserving Patient Access to Home Infusion Act S. 3149/H.R. 5848 - the Rural Health Equity Act H.R. 6308 - the ACO Assignment Improvement Act of 2021 H.R. 5248 - the Temporary Responders for Immediate Aid in Grave Emergencies (TRIAGE) Act of 2021 H.R. 5376 - the Build Back Better Act H.R.3925 - the Reducing Barriers to Substance Use Treatment Act S. Res. 626 and H. Res. 1100 - honoring and recognizing May 6 through 12, 2022 as National Nurses Week S.3098/H.R. 7617 - Preventive Care Awareness Act S.4182 - the Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 7236 - the Strengthen Kids Mental Health Now Act of 2022 H.R. 2376 - the Excellence in Recovery Housing Act H.R. 4944 - the Helping Kids Cope Act of 2021 H.R. 5218 - the Collaborate in an Orderly and Cohesive Manner Act H.R. 7076 - the Supporting Childrens Mental Health Care Access Act of 2022 H.R. 7232 - the 9-8-8 and Parity Assistance Act of 2022 H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 S.4170 - the Mental Health Reform Reauthorization Act Replenish the COVID-19 Uninsured Relief Fund Nursing faculty shortage Nursing Education Use of telehealth to prescribe controlled substances under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 [Public Law No: 110-425] Rural health care issues, including rural workforce, COVID-19 vaccination, and reimbursement Medicare sequestration Medicare restrictions pertaining to telehealth Include nurses, APRNs, and nursing students in all National Public Health Plans Provide resources to support nurses, APRNs, and nursing students mental health needs, especially for those responding to the pandemic Funding to ensure childcare coverage Increased Federal Medical Assistance Percentage (FMAP) funding to states Access to personal protective equipment Extension of CMS waivers beyond public health emergency Skilled Nursing Facility admitting examination and assessment requirements COVID-19 Pandemic relief: funding, removal of barriers, telehealth, mental health, personal protective equipment, and testing Telehealth, remote patient monitoring and other forms of health technology COVID-19 Pandemic Reducing Regulatory Burdens, including those relating to home infusion therapy, Medicare Conditions of Participation, and hospice certification Medication-Assisted Treatment (MATs) Opioid Abuse Epidemic Documentation of medical records Health plan coverage and program requirements including provider non-discrimination Issues relating to Mental and Substance Use Disorder Workforce Addressing Health Equity Medicare Provider Reimbursement Clinical labor pricing update

Client expense: $181,696 · Firm income: Not reported

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Advocated for closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Advocated for closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Advocated for closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Advocated for closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Advocated for closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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

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

Advocated for Increased appropriations for HRSAs Substance Use Disorder Treatment and Recovery Loan Repayment Program. This program provides student loan repayment for addiction treatment professionals who commit to working in underserved or high-risk communities. Advocated for increased appropriations for HRSAs Addiction Medicine Fellowship Program. This Program provides grants to institutions with training opportunities for fellows in addiction medicine and addiction psychiatry who have demonstrated interest in providing addiction treatment in underserved communities. Advocated for increased appropriations for HRSAs Integrated Substance Use Disorder Training Program. This program provides grants to expand the number of nurse practitioners, physician assistants, psychologists, and social workers trained to provide addiction and mental health services in underserved community-based settings that integrate primary care, mental health, and addiction services. Advocated for increased appropriations for federal initiatives that lead to a more diverse addiction treatment workforce, such as scholarships and loan repayment targeting underrepresented minority addiction medicine professionals, including SAMHSAs Minority Fellowship Program. Advocated for the alignment of coverage and payment policies in Medicare and Medicaid with evidence-based and nationally recognized addiction treatment and placement criteria and standards (e.g., The ASAM Criteria). This would include permanent modification to the Institutions for Mental Diseases (IMD) exclusion to allow federal Medicaid funds to serve individuals with SUDs in those residential and inpatient settings that are able to demonstrate that patient assessments, clinical services, level-of-care and length-of-stay recommendations are consistent with The ASAM Criteria and that evidence based medication management using Food and Drug Administration (FDA)-approved medications are available to patients in such settings. Advocated for H.R.7803 - Michelle Alyssa Go Act, which would amend title XIX of the Social Security Act to remove the exclusion from medical assistance under the Medicaid program of items and services for patients in an institution for mental diseases, and for other purposes. Advocated for use of evidence-based practices in the Substance Abuse Prevention and Treatment (SAPT) Block Grant and acceptance of Medicaid by treatment grantees. Advocated for S 2235/HR 2067 - Medication Access and Training Expansion (MATE) Act of 2021: This legislation would ensure most Drug Enforcement Agency (DEA) controlled medication prescribers have a baseline knowledge of how to identify, treat, and manage patients with SUD and would allow accredited health professional schools and residency programs to fulfill the training requirement through their own curricula, as well as provide them with resources to do so. Advocated for simultaneous passage of S 445/HR 1384 - Mainstreaming Addiction Treatment (MAT) Act, which would eliminate the requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for addiction and eliminate the patient limits on buprenorphine prescribers. Advocated for S 285/HR 955 - the Medicaid Reentry Act: This legislation would allow for reestablishment of health insurance coverage under Medicaid for eligible individuals who are incarcerated, during the 30-day period preceding their release from jail or prison. Advocated for S 1821/HR 3514 - the Humane Correctional Health Care Act, which would repeal the inmate exclusion that bars the use of federal Medicaid matching funds from covering health care services in jails and prisons. Advocated for S1727/HR 3450 - The Medicaid Bump Act of 2021: This legislation would provide an enhanced Medicaid Federal Medical Assistance Percentage rate of 90 percent for State Medicaid spending on mental health and substance use disorder services in excess of 2019 levels. It would also require states to use the additional federal funds as a supplement to rather than a replacement for state funding levels, and to use the funds to increase the capacity, efficiency, and quality of behavioral health services, including through increasing provider reimbursement rates. Advocated for Section 9 of S. 1010 - the Turn the Tide Act - These provisions would increase Medicaid fees for addiction treatment services to at least Medicare levels. Advocated for HR 1364 - the Parity Enforcement Act: This legislation would expand the U.S. Department of Labors authority to hold health insurers and plan sponsors accountable for offering health plans that violate the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 or for employing utilization review processes that prove more restrictive for mental health and addiction care than for other medical care in violation of the MHPAEA. Advocated for S 340/HR 1674 - TREATS Act: This legislation would make permanent a new, audio-video, telehealth evaluation exception to the Ryan Haight Acts in-person exam requirement, which would allow clinicians to prescribe certain addiction treatment medications, like buprenorphine, to new patients through telehealth. It would also clarify Medicares continued ability, beyond the COVID-19 public health emergency, to reimburse for audio-only, SUD and mental health telehealth services after an in-person or telehealth evaluation. Provided technical assistance regarding a possible audio-only exception to Ryan Haight for initiation of buprenorphine for OUD. Advocated for HR 3925 Reducing Barriers to Substance Use Treatment Act: This legislation would prohibit states receiving Federal funding for medication-assisted treatment under Medicaid from imposing utilization control policies or procedures (as defined by the Secretary of the Department of Health and Human Services), including prior authorization requirements, with respect to such treatment. Advocated for the Administration to support continuous collaboration and sharing of information between the Centers for Medicare & Medicaid Services (CMS) and SAMHSA, which should include new, strategic efforts to provide technical assistance funds to states to support their operation of CMS-approved Section 1115 SUD waivers related to the IMD exclusion and to enhance their care delivery systems for patients. Advocated for the Administration to support the following regulatory and administrative efforts that would reduce barriers to accessing addiction treatment: Creation of safe-harbor provisions to the Anti-Kickback Statute and Eliminating Kickbacks in Recovery Act Civil, as they may be applied to the implementation of contingency management (CM) for the treatment of addiction. Approval of a prescription to over the counter (OTC) switch for at least one naloxone product. This change would save lives and reduce existing barriers that prevent access to this critical medication; Regulatory changes that would allow Medicaid reimbursement for the room and board portion of SUD residential levels of care that meet level of care standards set forth in The ASAM Criteria; Regulatory (or legislative) changes that would allow pharmacy dispensing and/or administration of methadone that has been prescribed by a legally authorized prescriber of controlled medications who is affiliated with an OTP or is a board-certified addiction specialist physician; Regulatory (or legislative) changes that would make permanent the opioid treatment program (OTP) flexibilities, including the methadone unsupervised dosing flexibilities, implemented during the COVID-19 Public Health Emergency while continuing study of the impact of these flexibilities; Assessment of current opioid order systems and monitoring programs to more fully understand the potential negative implications for patient access to buprenorphine at pharmacies and other controlled substance medications used to treat OUD; Issuance of regulations relating to a special registration for telemedicine, as was directed in Section 3232 of the SUPPORT Act of 2018. Advocated for the S.834/H.R.2256 Resident Physician Shortage Reduction Act, which would increase the number of Medicare GME slots by 14,000 over 7 years, including its inclusion in the next reconciliation package. Advocated for the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021 (H.R. 2366 / S. 1457). This legislation would expand fentanyl research and education, enhance overdose prevention and access to substance use disorder (SUD) treatment, and provide critical public health data and additional training support for various stakeholders. Advocated for HR 6279/S 3629 - Opioid Treatment Access Act which would make permanent certain COVID-19 flexibilities allowed to states for unsupervised doses, as well as "time in treatment" regulatory changes and to permit pharmacy dispensing of methadone for opioid use disorder treatment for certain experienced cohorts of prescribers. Advocated for the Moms Matter Act (H.R. 909). The Moms Matter Act is a bipartisan bill that would increase federal funding for culturally congruent, community-based mental and behavior health programs. Advocated for H.R 1693 / S. 79, the Eliminating a Quantifiably Unjust Application of the Law Act. This legislation would eliminate the federal crack and powder cocaine sentencing disparity and apply it retroactively to those already convicted or sentenced. Supported implemented recommendations regarding the CARES Acts amendment of 42 CFR Part 2 to advance further alignment of 42 CFR Part 2 (Part 2) with the Health Insurance Portability and Accountability Act (HIPAA) for the purposes of treatment, payment, and health care operations (TPO). Supported H.R.4244 - STOP Stigma Act, which would make amendments to the names of certain agencies to help end the stigmatization of substance use disorder, and for other purposes. Joined advocacy efforts with Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Advocated for closer coordination among relevant federal agencies, greater integration between primary care and behavioral health reimbursement, and robust funding for the addiction treatment workforce-- such as the Addiction Medicine Fellowship Program. ASAM also expressed support for legislation to ensure state compliance with mental health and addiction parity law and codification of audio-video telehealth prescribing flexibilities for the treatment of substance use disorder. Finally, ASAM called on federal legislators to consider new and promising strategies like contingency management Urged inclusion of the field of addiction medicine in reauthorizations of several SAMHSA programs as well as conveyed ways to improve clinician access to relevant addiction medicine education Advocated for federal clarification of suspicious order rules to break down perceived and real barriers to buprenorphine access at pharmacies Advocated for passage of HR 3441/ S 1438 the Opioid Workforce Act/Substance Use Disorder Workforce Act to increase Medicare supported GME slots for addiction medicine, addiction psychiatry, and pain medicine. Advocated for draft legislative text that would close severe MH/SUD coverage gaps in Medicare. Advocated for federal agency guidance on CAPTA reporting vs. notification requirements. Advocated for stronger network adequacy requirements for OTPS and addiction specialist physicians under Medicare Advantage Plans On April 4, ASAM and stakeholders sent a letter to the House Energy & Commerce Committee in support the "Mental Health Justice and Parity Act of 2022," under consideration at the Committee's April 5 hearing. The organizations asked the Committee to support the legislation that phases out "parity opt-outs" among self-funded state and local health plans. On May 10th, ASAM sent a letter to leadership of the U.S. House Committee on Energy and Commerce on H.R. 7666 - the Restoring Hope for Mental Health and Well-Being Act of 2022 (the Act), in advance of the Subcommittee on Healths legislative mark-up session on May 11th. In its letter, ASAM advocates for reducing complex barriers to addiction treatment, including eliminating the one-year requirement that an individual have an addiction to opioids to begin methadone treatment at an opioid treatment program (OTP), supporting provisions inspired by the Opioid Treatment Access Act (OTAA) - including revising who can determine the stability of a patient for take-homes to include a medical practitioner appropriately licensed by the State to prescribe or dispense controlled medications, - and codifying recent mobile methadone regulations into law. In its letter, ASAM also advocates for increased funding to support HRSAs Addiction Medicine Fellowship Program; adding addiction medicine to SAMHSAs Minority Fellowship Program grants, and adding addiction specialists to HRSAs Pediatric Mental Health Care Access grants. The letter concludes with a call for adding the MATE and MAT Acts to the Act. The MATE Act would condition the federal DEA registration to prescribe controlled medications on a one-time, flexible education requirement on the treatment of patients with substance use disorder. The MAT Act would eliminate the DATA 2000-waiver, a barrier to broader uptake of treatment for OUD with buprenorphine, a life-saving medication. On April 1, ASAM joined a coalition letter to the Department of Labor and HHS expressing concern about a recent decision from a three-judge panel of the U.S. Ninth Circuit Court of Appeals that threatens to have devastating effects on Americans ability to access medically necessary mental health and substance use disorder (MH/SUD) services covered by commercial health plans and requesting that the Departments of Labor and Health and Human Services file an amicus brief in this case to support en banc review before the entire Ninth Circuit. On May 11th, ASAM and other stakeholders sent a letter to U.S. House Energy and Commerce Committee leadership praising Section 321 of the Restoring Hope for Mental Health and Well-Being Act of 2022, which would sunset the ability of self-funded, non-federal governmental health care plans to opt-out of protections provided by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. On June 3, ASAM joined a large coalition of public health, harm reduction, HIV, and hepatitis organizations in sending a letter urging Congress to appropriate $150 million in fiscal year 2023 towards the Centers for Disease Control and Preventions (CDC) Infectious Diseases and Opioid Epidemic Program. This letter garnered support from 334 organizations from all fifty states, DC, and Puerto Rico, and may be the largest display of support from community stakeholders for lifesaving harm reduction services and for ending the ban on the use of certain federal funding for syringes. On June 14th, ASAM joined a coalition letter regarding the FY 2023 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill, urging House appropriators not to include provisions that would weaken FDAs authority over tobacco products. On June 27th, ASAM joined a Coalition of Whole Health letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure and Deputy Administrator Dr. Meena Seshamani, supporting a proposed Medicare rule that would establish a special enrollment period (SEP) for individuals formerly incarcerated and exempt those who enroll under the SEP from a Late Enrollment Penalty (LEP) and urging CMS to revise its current definition of in custody for Medicare to be consistent with the definition CMS uses for Medicaid.

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

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

-Prescription drug abuse prevention - sharing the association's efforts to educate our members. - Discussed efforts to modify the MATE Act (HR 2067/S 2235) with House and Senate staff. - Comments to the CDC regarding their draft updated opioid prescribing guideline. - Comments to the FDA regarding a proposal to require industry provide patients filling a controlled substance with mail back envelopes.

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), SENATE

Workforce development and clinical training site issues Issues surrounding opioid use disorders and medication-assisted treatment H.R. 2067/S.2235 - Medication Access and Training Expansion (MATE) Act H.R.945/ S. 287 - Perinatal Workforce Act H.R. 959/S.346 - the Black Maternal Health Momnibus Act S.54 - Strengthening Americas Health Care Readiness Act Telehealth issues, such as integrating students into telemedicine appointments Issues surrounding personal protective equipment availability S. 987 - Comprehensive Addiction and Recovery Act (CARA) 3.0 PA student involvement in vaccination efforts Solutions Not Stigmas Act H.R. 3890 - Physician Assistant Education Public Health Initiatives Act * S. 3799 PREVENT Pandemics Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 2067/S.2235 - Medication Access and Training Expansion (MATE) Act H.R. 1384/S.445 - Mainstreaming Addiction Treatment (MAT) Act Reducing regulatory and legislative barriers for Nurse Practitioners Include nurses, APRNs, and nursing students in all National Public Health Plans Issues surrounding nurse faculty shortages H.R. 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Rural health care access

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

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

H.R.851/S.246 - Future Advancement of Academic Nursing (FAAN) Act H.R. 6087- Improving Access to Workers Compensation for Injured Federal Workers Act Public Law No: 117-159- S.2938 - Bipartisan Safer Communities Act H.R. 7565- NIH IMPROVE Act H.R. 7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 S.Res.626/H.Res.1100 - Supporting the goals and ideals of National Nurses Week, to be observed from May 6 through May 12, 2022 S.104/H.R.379 - Improving the Social Determinants of Health Act S.167/H.R.736 - Community Immunity During COVID-19 Act S.289/H.R.869- RISE Act S.346/H.R.959 - Black Maternal Momnibus Act of 2021 S.586/H.R. 3259 - NOPAIN Act S.1697/H.R.3352- Midwives for Maximizing Optimal Maternity Services (MOMS) Act S.2235/H.R. 2067 - Medication Access and Training Expansion (MATE) Act S.1568/H.R.4407 - The Technical Reset to Advance the Instruction of Nurses (TRAIN) Act S.674- Public Health Infrastructure Saves Lives Act S.2114/H.R. 5699- Student Assisted Vaccination Effort (SAVE) Act S.2187- National Biomedical Research Act S.467- Effective Suicide Screening and Assessment in the Emergency Department Act S.3799 - PREVENT Pandemics Act H.R. 831 - Health STATISTICS Act of 2021 H.R.1195 - Workplace Violence Prevention for Health Care and Social Service Workers Act H.R. 3550- Primary and Behavioral Health Care Access Act H.R. 5035- Child Suicide Prevention and Lethal Means Safely Act H.R. 6735- Supporting Access to Nurse Exams (SANE) Act H.Res.909 - Expressing support for healthcare personnel and condemning assaults on healthcare personnel as the U.S. healthcare system faces unprecedented staffing shortages and increased workplace-related stressors. Public Law No: 117-105- H.R. 1667- Dr. Lorna Breen Health Care Provider Protection Act Support for clinical education, including graduate nursing education, and faculty Ensuring a Sustainable Public Health Workforce Title VIII Nursing Workforce Development Programs Nursing Education, Research, and Public Health Infrastructure Needs Nursing Workforce and Research Nursing faculty shortage Support Mental Health Programs for Nursing Students and the Workforce PPE, telehealth, mental health, and other resources and services to support Nursing Education, Practice, and the Workforce Nursing Workforce Centers Provider Nondiscrimination language Safety and health of nurse educators and nursing students Public Health Emergency Waivers Efforts to utilize nursing students and faculty to help with COVID-19 vaccination efforts Ensure equity in COVID-19 efforts and health care 2022 National Drug Control Strategy

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

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Natl Drug Control Policy (NDCP), SENATE, White House Office

Workforce development and clinical training site issues Issues surrounding opioid use disorders and medication-assisted treatment H.R. 2067/S.2235 - Medication Access and Training Expansion (MATE) Act H.R.945/S. 287 - Perinatal Workforce Act H.R. 959/S.346 - the Black Maternal Health Momnibus Act Telehealth issues, such as integrating students into telemedicine appointments PA student involvement in vaccination efforts H.R. 3890 - Physician Assistant Education Public Health Initiatives Act H.R. 5699/S. 2114 - Student Assisted Vaccination Effort Act H.R. 5035/S. 2982 - Child Suicide Prevention and Lethal Means Safety Act H.R. 5602/S. 3244 - BIO Preparedness Workforce Act S. 3799 - PREVENT Pandemics Act S. 4170 - Mental Health Reform Reauthorization Act of 2022 S. 2938 - Bipartisan Safer Communities Act H.R. 6087 - Improving Access to Workers' Compensation for Injured Federal Workers Act

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

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