Provider Relief Fund Deadline Extension Act

Issues related to prescription drug coverage and pharmacy benefits Regulatory and proposed legislative changes to Medicare Part D prescription drug benefits S.652 - Safe Step Act S.1038 - Drug Price Transparency in Medicaid Act S.1130 - Health Care PRICE Transparency Act S.1131 - Drug Price Transparency Act S.1217 - Ending the Prescription Drug Kickback Act S.1375 - HELP Copays Act S.1491 - Pharmacy and Medically Underserved Areas Enhancement Act S.1967 - Patients Before Middlemen (PBM) Act S.2052 - Protect Patient Access to Pharmacies Act S.2129 - Ensuring Access to Lower-Cost Medicines for Seniors Act S.2254 - Medicare PBM Accountability Act S.2405 - Strengthening Pharmacy Access for Seniors Act S.2406 - PBM Oversight Act S.2408 - IMPROVE Part D Regulations Act S.2436 - Neighborhood Options for Patients Buying Medicines (NO PBM) Act S.2456 - Protecting Seniors from High Drug Costs Act S.2474 - Share the Savings with Seniors Act S.2477 - Equitable Community Access to Pharmacist Services Act S.2493 - PBM Reporting Transparency Act S.2939 - Pharmacy Access Oversight and Reporting Act S.2973 - Modernizing and Ensuring PBM Accountability Act H.R.830 - HELP Copays Act H.R.1352 - Increasing Access to Biosimilars Act H.R.1613 - Drug Price Transparency in Medicaid Act H.R.1770 - Equitable Community Access to Pharmacists Act H.R.2630 - Safe Step Act H.R.2666 - Medicaid VBPs for Patients (MVP) Act H.R.2670 - PBM Accountability Act H.R.2691 - Transparent PRICE Act H.R.2880 - Protecting Patients Against PBM Abuses Act H.R.3262 - to amend title XI of the Social Security Act to increase transparency of certain health-related ownership information H.R.3281 - Transparent PRICE Act H.R.3282 - Promoting Transparency and Health Competition in Medicare Act H.R.3285 - Fairness for Patient Medications H.R.3561- Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act H.R.4011 - Timely Access to Clinical Treatment Act H.R.4881 - To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program H.R.4883 - Medicare Common Ownership Transparency Act H.R.5372 - Expanding Seniors Access to Lower Cost Medicines Act H.R.5376 - Share the Savings with Seniors Act H.R.5378 - Lower Costs More Transparency Act H.R.5384 - Advancing Enrollment and Reducing Drug Costs Act H.R.5385 - Medicare PBM Accountability Act H.R.5386 - Cutting Copays Act H.R.5393-Transparency and Fairness for Pharmacies Act H.R.5400 - Neighborhood Options for Patients Buying Medicines (NO PBM) Act H.R.5461 - Ensuring Access to Lower-Cost Medicines for Seniors Act Implementation of the Inflation Reduction Act of 2022, P.L. 169- Provisions on Medicare Part D modernization and drug price negotiation

Client expense: $3,973,758 · Firm income: Not reported

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

340B Drug Reimbursement Program: to encourage Congress to pass a bill and/or work with the Administration to return the 340B program to its pre-2018 status. S. 773; H.R. 4390; H.R. 3203 (to recalibrate critical access hospitals' revenues due to PRF funds for the purpose of calculating reasonable 340b payments). Kansas Provider Assessment: to encourage CMS to approve the increase in Kansas' Medicaid provider assessment, and to encourage Congress to work with CMS to get it approved. PRF Period 1 reporting: individual hospital needs. S. 2493; H.R. 4735 S. 1893: encouraging Congress to pass this bill that will help add additional physicians in rural areas. S. 1024: encouraging Congress to pass this bill that would encourage physicians to work in rural and out migrating areas. Encouraging Congress to end sequestration and allow PAYGO rules to enact a 4% cut to hospital Medicare reimbursement rates at the end of the year. Encouraging Congress to pass a bill that allows critical access hospitals to also be eligible for telehealth flexibilities afforded to other types of providers.

Client expense: Not reported · Firm income: $16,000

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

Q4 Lobbying Report (October 1-December 31) HCR Provider Relief Fund Deadline Extension Act (S. 2493/H.R. 4735) Infrastructure Investment and Jobs Act Build Back Better Act (H.R. 5376) Dr. Lorna Breen Health Care Provider Protection Act (HR 1667) Provider Relief Fund Improvement Act (H.R. 5963 / S. 3611) Public Service Loan Forgiveness program/physician federal loan forgiveness Healthcare Workforce Resilience Act of 2021 Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Regulatory relief in light of coronavirus Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Resident Physician Shortage Act (S. 834/H.R. 2256) No Surprises Act regulations Public Health Emergency designation Blood shortages PREVENT Pandemics Act (S. 3799) CMS Region IX re: Guidance on California State Bill 311 The Compassionate Access to Medical Cannabis Act Meeting with OMB re: Physician Loan Forgiveness CMS Regional Office re: Admission, Discharge, and Transfer Patient Event Notification Conditions of Participation (42 CFR 482.24(d), 482.61(f), and 485.638(d)) Food and Drug Amendments of 2022 (H.R. 7667) Improving Seniors Timely Access to Care Act (H.R. 1587/S. 3018) Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 7961) Bipartisan Safer Communities Act (S. 2938) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R. 7666) Saving Access to Laboratory Services Act (SALSA Act) (H.R. 8188/S.4449) Assistance for Rural Community Hospitals (ARCH) Act (H.R. 8747) Meetings with FEMA re: COVID-19 related reimbursement Train More Doctors Act of 2022 (H.R. 9156) H.R. 2617 2023 Omnibus MMM Accelerated and Advance Payment Program repayment flexibility (H.R. 1349, The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021) Graduate Medical Education (GME) funding (Resident Physician Shortage Reduction Act of 2021 (S. 834/H.R. 2256) Telehealth flexibilities and payment (TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act -S. 368/H.R. 1332) Hospital Inpatient Services Modernization Act (H.R. 7053) Annual Prospective Payment System Rules Organ acquisition payment policies Clinical lab fee schedule BUD FY2022 Appropriations bills Consolidated Appropriations Act of 2022 (HR 2471) - omnibus Further Additional Extending Government Funding Act, HR 6617 Nursing and allied health workforce funding FY 2023 budget request Submitted Comments Subject: CMS-9900-NC, Request for Information; Advanced Explanation of Benefits and Good Faith Estimate for Covered Individuals, Federal Register (Vol. 87, No. 179), September 16, 2022 Request for Information on Healthcare Access, Provider Experience, Health Equity, and PHE Flexibilities, November 4, 2022

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

H.R. 5487 - Value in Health Care Act of 2021 S. 2652 / H.R. 5067 - Preserving Patient Access to Home Infusion Act S.308 / H.R.1436 - PPE in America Act S.1260 - United States Innovation and Competition Act of 2021 S. 936 / H.R. 5502 - INFORM Consumers Act S. 2648 - Rural ACO Improvement Act S. 1574 / H.R.5632 - Long-Term Care Pharmacy Definition Act S. 834 / H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R.3173 / S 3018 - Improving Seniors Timely Access to Care Act of 2021 H.R. 3746 - Accountable Care in Rural America Act H.R. 959 / S. 364 - Black Maternal Health Momnibus Act of 2021 H.R. 4387 / S. 1675 - Maternal Health Quality Improvement Act of 2021 S. 168 / H.R. 708 - Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act S. 150 - Ensuring Parity in MA for Audio Only-Telehealth Act S. 3146 - The Protecting Patients from Counterfeit Medical Devices Act S. 3799 - The PREVENT Pandemics Act H.R. 6520 - The Medical and Health Stockpile Accountability Act of 2022, automated data collection infrastructure for healthcare supply chain S. 3416 - The Protecting Patients from Counterfeit Medical Devices Act S. 3493 - Drug Shortages Shelf Life Extension Act H.R. 4521 - America COMPETES Act of 2022 S.610 - Protecting Medicare and American Farmers from Sequester Cuts Act H.R.3684 - Infrastructure Investment and Jobs Act H.R. 4735 / S. 2493 - The Provider Relief Extension Act H.R. 3589 - Better Way for Providers To Repay Act of 2021 H.R. 3203 / S. 773 - To allow hospitals that were participating in or applied for the 340B drug discount program before the public health emergency to temporarily maintain eligibility H.R. 7961 - Safety from Violence for Healthcare Employees (SAVE) Act H.R. 7410 - The American Made Medicine Act H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act H.R. 8747 - Assistance for Rural Community Hospitals (ARCH) Act H.R. 8800 - Supporting Medicare Providers Act of 2022 H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act FY 2022 Omnibus Appropriations Bill S. 5249 - Preserving Patient Access to Value-Based Care Act 340B Drug Discount Program eligbility Incentivize Domestic Manufacturing Hospital Infrastructure Support FDA User Fee Reauthorization Bills Healthcare workforce (Graduate medical education , health professional training programs, recruitment and retension incentives) Medicare provider payment cuts (Medicare sequestration cuts, physician fee schedule 3.75% reduction due to evaluation & management code increases/budget neturality adjustment, Pay-as-You-Go reductions due to American Rescue Plan) Climate change healthcare impact HHS FY 2023 appropriations - Removal of a ban on using federal funds for implementing a unique patient identification system (Section 510) and fuding for Childrens Hospitals Graduate Medical Education (CHGME) Program ACO Assignment Bill NQF/Quality Measurement funding authorization Preparing for the next pandemic and supply chain resiliency

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

340B Drug Reimbursement Program: to encourage Congress to pass a bill and/or work with the Administration to return the 340B program to its pre-2018 status. S. 773; H.R. 4390; H.R. 3203 (to recalibrate critical access hospitals' revenues due to PRF funds for the purpose of calculating reasonable 340b payments). Kansas Provider Assessment: to encourage CMS to approve the increase in Kansas' Medicaid provider assessment, and to encourage Congress to work with CMS to get it approved. PRF Period 1 reporting: individual hospital needs. S. 2493; H.R. 4735 S. 1893: encouraging Congress to pass this bill that will help add additional physicians in rural areas. S. 1024: encouraging Congress to pass this bill that would encourage physicians to work in rural and out migrating areas. Encouraging Congress to end sequestration and allow PAYGO rules to enact a 4% cut to hospital Medicare reimbursement rates at the end of the year. Encouraging Congress to pass a bill that allows critical access hospitals to also be eligible for telehealth flexibilities afforded to other types of providers.

Client expense: Not reported · Firm income: $16,000

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

Issues related to COVID relief and the provider relief fund. Issues related to health care workforce, maternal health, and behavioral health. S. 2493/H.R. 4735, the Provider Relief Fund Deadline Extension Act. H.R. 5376, the Build Back Better Act, as it relates to hospitals. Monitored H.R. 4944, Helping Kids Cope Act of 2021. Monitored H.R. 1384, Mainstreaming Addiction Treatment Act of 2021.

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

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

Provider Relief Fund Deadline Extension Act (S. 2493/H.R. 4735) Public Health and Social Services Emergency Fund Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Resident Physician Shortage Act (S. 834/H.R. 2256) No Surprises Act regulations Rural health care innovation (PA Rural Health Model and Community Health Access and Rural Transformation Model (CHART) Public Health Emergency designation COVID Data Reporting Dr. Lorna Breen Health Care Provider Protection Act (HR 1667) Provider Relief Fund Improvement Act (H.R. 5963 / S. 3611) Public Service Loan Forgiveness program/physician federal loan forgiveness Healthcare Workforce Resilience Act of 2021 Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Conrad State 30 & Physician Access Act H.R. Res. 909 condemning violence against health care workers PREVENT Pandemics Act (S. 3799)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Q3 Lobbying Report (July 1- September 30) HCR Provider Relief Fund Deadline Extension Act (S. 2493/H.R. 4735) Infrastructure Investment and Jobs Act Build Back Better Act (H.R. 5376) Dr. Lorna Breen Health Care Provider Protection Act (HR 1667) Provider Relief Fund Improvement Act (H.R. 5963 / S. 3611) Public Service Loan Forgiveness program/physician federal loan forgiveness Healthcare Workforce Resilience Act of 2021 Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Regulatory relief in light of coronavirus Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Resident Physician Shortage Act (S. 834/H.R. 2256) No Surprises Act regulations Public Health Emergency designation Blood shortages PREVENT Pandemics Act (S. 3799) CMS Region IX re: Guidance on California State Bill 311 The Compassionate Access to Medical Cannabis Act Meeting with OMB re: Physician Loan Forgiveness CMS Regional Office re: Admission, Discharge, and Transfer Patient Event Notification Conditions of Participation (42 CFR 482.24(d), 482.61(f), and 485.638(d)) Food and Drug Amendments of 2022 (H.R. 7667) Improving Seniors Timely Access to Care Act (H.R. 1587/S. 3018) Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 7961) Bipartisan Safer Communities Act (S. 2938) Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R. 7666) Saving Access to Laboratory Services Act (SALSA Act) (H.R. 8188/S.4449) Assistance for Rural Community Hospitals (ARCH) Act (H.R. 8747) Meetings with FEMA re: COVID-19 related reimbursement MMM Accelerated and Advance Payment Program repayment flexibility (H.R. 1349, The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021) Graduate Medical Education (GME) funding (Resident Physician Shortage Reduction Act of 2021 (S. 834/H.R. 2256) Telehealth flexibilities and payment (TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act -S. 368/H.R. 1332) Hospital Inpatient Services Modernization Act (H.R. 7053) Annual Prospective Payment System Rules Organ acquisition payment policies Clinical lab fee schedule BUD FY2022 Appropriations bills Consolidated Appropriations Act of 2022 (HR 2471) - omnibus Further Additional Extending Government Funding Act, HR 6617 Nursing and allied health workforce funding FY 2023 budget request Submitted Comments Methodology for Preventing Duplication of FEMA Benefits SUBJECT: Forthcoming Guidance on Discharge Planning Requirements; August 4, 2022 RE: Public Service Loan Forgiveness Regulations Docket ID ED-2021-OPE-0077: Student Assistance General Provisions, Federal Perkins Loan Program, Federal Family Ed Loan Program, and William D. Ford Federal Direct Loan Program SUBJECT: CMS-4203-NC, Medicare Program; Request for Information on Medicare; Vol. 87, No. 146, August 1, 2022 SUBJECT: CMS-3419-P, Medicare and Medicaid Programs; Conditions of Participation (CoPs) for rural emergency hospitals and critical access hospital CoPs Updates (Vol 87, No 128), July 6, 2022 SUBJECT: CMS-1772-P, Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating, (Vol 87, No 142), July 26, 2022 SUBJECT: CMS-1770-P, Medicare and Medicaid Programs; CY 2023 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicare and Medicaid Provider Enrollment Policies, Including for Skilled Nursing Facilities; Conditions of Payment for Suppliers of Durable Medicaid Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS); and Implementing Requirements for Manufacturers of Certain Single-Dose Container or Single-Use Package Drugs To Provide Refunds With Respect to Discarded Amounts (Vol 87, No 145), July 29, 2022 SUBJECT: CMS1766P Medicare Program; Calendar Year 2023 Home Health Prospective Payment System Rate Update; Home Health Quality Reporting Program Requirements; Home Health Value Based Purchasing Expanded Model Requirements; and Home Infusion Therapy Services Requirement; Federal Register (Vol. 87, No. 120) June 23, 2022

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

H.R. 5487 - Value in Health Care Act of 2021 S. 2652/H.R. 5067 - Preserving Patient Access to Home Infusion Act H.R. 6520 - The Medical and Health Stockpile Accountability Act of 2022, automated data collection infrastructure for healthcare supply chain S.308 / H.R.1436 - PPE in America Act S.1260 - United States Innovation and Competition Act of 2021 S. 936 / H.R. 5502 - INFORM Consumers Act S. 2648 - Rural ACO Improvement Act S. 1574/H.R.5632 - Long-Term Care Pharmacy Definition Act H.R. 7053/S. 3792 - Hospital Inpatient Services Modernization Act S. 834 / H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R.3173 / S 3018 - Improving Seniors Timely Access to Care Act of 2021 H.R. 3746 - Accountable Care in Rural America Act H.R. 959 / S. 364 - Black Maternal Health Momnibus Act of 2021 H.R. 4387 / S. 1675 - Maternal Health Quality Improvement Act of 2021 S. 168 / H.R. 708 - Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act S. 150 - Ensuring Parity in MA for Audio Only-Telehealth Act S. 3799 - The PREVENT Pandemics Act S. 3416 - The Protecting Patients from Counterfeit Medical Devices Act S. 3493 - Drug Shortages Shelf Life Extension Act H.R. 4521 - America COMPETES Act of 2022 S.610 - Protecting Medicare and American Farmers from Sequester Cuts Act H.R.3684 - Infrastructure Investment and Jobs Act H.R. 4735/S. 2493 - The Provider Relief Extension Act H.R. 3589 - Better Way for Providers To Repay Act of 2021 H.R. 3203 / S. 773 - To allow hospitals that were participating in or applied for the 340B drug discount program before the public health emergency to temporarily maintain eligibility H.R. 7961 - Safety from Violence for Healthcare Employees (SAVE) Act H.R. 7410 - The American Made Medicine Act Hospital Infrastructure Support FDA User Fee Reauthorization Bills Healthcare workforce (Graduate medical education , health professional training programs, recruitment and retention incentives) Medicare provider payment cuts (Medicare sequestration cuts, physician fee schedule 3% reduction due to evaluation & management code increases/budget neutrality adjustment, Pay-as-You-Go reductions due to American Rescue Plan) HHS FY 2023 appropriations - Removal of a ban on using federal funds for implementing a unique patient identification system (Section 510) and funding for Childrens Hospitals Graduate Medical Education (CHGME) Program NQF/Quality Measurement funding authorization

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Monitored issues related to drug shortages. Monitored implementation of P.L. 117-2, the American Rescue Plan, as it relates to COVID relief funding. Issues concerning COVID relief and future pandemic preparedness. Issues involving workforce shortages. Issues regarding the provider relief fund. Monitored S. 2493 / H.R. 4735, the Provider Relief Fund Deadline Extension Act. S. 3799, PREVENT Pandemics Act. Issues related to mental health. Monitored issues related to the World Trade Center Health Program. Monitored the FDA User Fee Agreements as it relates to the VALID Act. Issues regarding ARPA-H.

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, SENATE, White House Office

Issues related to COVID relief and the provider relief fund. Issues related to health care workforce, maternal health, and behavioral health. S. 2493/H.R. 4735, the Provider Relief Fund Deadline Extension Act. H.R. 5376, the Build Back Better Act, as it relates to hospitals. Monitored H.R. 4944, Helping Kids Cope Act of 2021. Monitored H.R. 1384, Mainstreaming Addiction Treatment Act of 2021.

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

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

Provider Relief Fund Deadline Extension Act (S. 2493/H.R. 4735) Build Back Better Act (H.R. 5376) Public Health and Social Services Emergency Fund Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Resident Physician Shortage Act (S. 834/H.R. 2256) OSHA rule on COVID-19 Healthcare Workplace Safety No Surprises Act regulations Rural health care innovation (PA Rural Health Model and Community Health Access and Rural Transformation Model (CHART) Public Health Emergency designation COVID Data Reporting H.R.7961 - the SAVE Act Restoring Hope for Mental Health and Well-being Act Infrastructure Investment and Jobs Act Dr. Lorna Breen Health Care Provider Protection Act (HR 1667) Provider Relief Fund Improvement Act (H.R. 5963 / S. 3611) Public Service Loan Forgiveness program/physician federal loan forgiveness Healthcare Workforce Resilience Act of 2021 Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Conrad State 30 & Physician Access Act Regulatory relief in light of coronavirus Vaccine mandate policy Healthcare Cybersecurity Act (S.3904) - collaboration between the CISA and HHS Blood shortages H. Res. 909 condemning violence against health care workers PREVENT Pandemics Act (S. 3799) Bipartisan Safer Communities Act (S. 2938)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues regarding access to dental services. Monitored S. 2493/H.R. 4735 The Provider Relief Fund Deadline Extension Act. Issues concerning provider relief fund disbursements. Monitored implementation of P.L. 117-2, the American Rescue Plan, as it relates to the provider relief fund. Monitored implementation of P.L.116-20, the Consolidated Appropriations Act of 2021, as it relates to surprise billing. Issues concerning workforce shortages. H.R. 1916 / S. 754, Ensuring Lasting Smiles Act.

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

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

Issues related to COVID relief and the provider relief fund. Monitored the implementation of P.L. 116-260, the Consolidated Appropriations Act of 2021, as it relates to surprise billing. Issues involving workforce shortages. Monitored S. 2493/H.R. 4735, the Provider Relief Fund Deadline Extension Act. Issues related to mental health. Issues related to the False Claims Act.

Client expense: Not reported · Firm income: $90,000

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

Q2 Lobbying Report (April 1 - June 30) HCR Provider Relief Fund Deadline Extension Act (S. 2493/H.R. 4735) Infrastructure Investment and Jobs Act Build Back Better Act (H.R. 5376) Dr. Lorna Breen Health Care Provider Protection Act (HR 1667) Provider Relief Fund Improvement Act (H.R. 5963 / S. 3611) Public Service Loan Forgiveness program/physician federal loan forgiveness Healthcare Workforce Resilience Act of 2021 Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Regulatory relief in light of coronavirus Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Resident Physician Shortage Act (S. 834/H.R. 2256) No Surprises Act regulations Public Health Emergency designation Blood shortages PREVENT Pandemics Act (S. 3799) CMS Region IX re: Guidance on California State Bill 311 The Compassionate Access to Medical Cannabis Act Meeting with OMB re: Physician Loan Forgiveness CMS Regional Office re: Admission, Discharge, and Transfer Patient Event Notification Conditions of Participation (42 CFR 482.24(d), 482.61(f), and 485.638(d)) Food and Drug Amendments of 2022 (H.R. 7667) Improving Seniors Timely Access to Care Act (H.R. 1587/S. 3018) Safety from Violence for Healthcare Employees (SAVE) Act (HR 7961) Bipartisan Safer Communities Act (S. 2938) Restoring Hope for Mental Health and Well-Being Act of 2022 (HR 7666) MMM Accelerated and Advance Payment Program repayment flexibility (H.R. 1349, The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021) Graduate Medical Education (GME) funding (Resident Physician Shortage Reduction Act of 2021 (S. 834/H.R. 2256) Telehealth flexibilities and payment (TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act -S. 368/H.R. 1332) Hospital Inpatient Services Modernization Act (H.R. 7053) Annual Prospective Payment System Rules Organ acquisition payment policies Clinical lab fee schedule BUD FY2022 Appropriations bills Consolidated Appropriations Act of 2022 (HR 2471) - omnibus Further Additional Extending Government Funding Act, HR 6617 Nursing and allied health workforce funding FY 2023 budget request Submitted Comments SUBJECT: [CIS No. 2715-22; DHS Docket No. USCIS-2021-0013]; Public Charge Ground of Inadmissibility; Notice of Proposed Rulemaking (Federal Register Vol. 87, No. 37), February 24, 2022 SUBJECT: CMS-1769-P, Medicare Program; FFY 2023 Inpatient Psychiatric Facilities Prospective Payment System-Rate Update and Quality Reporting-Request for Information Proposed Rule, Federal Register (Vol. 87, No. 64), April 4, 2022 SUBJECT: CMS-1767-P, Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2023 and Updates to the IRF Quality Reporting Program, Proposed Rule, Federal Register (Vol. 87, No. 66), April 6, 2022 Drug Enforcement Administration re: California Senate Bill 311, April 7, 2022 SUBJECT: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2023; Request for Information on Revising the Requirements for Long-Term Care Facilities To Establish Mandatory Minimum Staffing Levels (Vol 87, No 73), April 15, 2022 Centers for Medicare & Medicaid Services Request for Information on improving access to care and coverage for individuals enrolled in Medicaid and the Childrens Health Insurance Program, April 18, 2022 SUBJECT: CMS-1771-P, Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2023 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Costs Incurred for Qualified and Non-qualified Deferred Compensation Plans; and Changes to Hospital and Critical Access Hospital Conditions of Participation (Vol 87, No 90), May 10, 2022

Client expense: $390,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Provider Relief Fund Deadline Extension Act (S. 2493/H.R. 4735) Infrastructure Investment and Jobs Act Build Back Better Act (H.R. 5376) Dr. Lorna Breen Health Care Provider Protection Act (HR 1667) Provider Relief Fund Improvement Act (H.R. 5963 / S. 3611) Public Service Loan Forgiveness program/physician federal loan forgiveness Healthcare Workforce Resilience Act of 2021 Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Conrad State 30 & Physician Access Act Public Health and Social Services Emergency Fund Regulatory relief in light of coronavirus Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Resident Physician Shortage Act (S. 834/H.R. 2256) OSHA rule on COVID-19 Healthcare Workplace Safety No Surprises Act regulations Rural health care innovation (PA Rural Health Model and Community Health Access and Rural Transformation Model (CHART) Public Health Emergency designation PREVENT Pandemics Act (S. 3799)

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 5487 - Value in Health Care Act of 2021 S. 2652/H.R. 5067 - Preserving Patient Access to Home Infusion Act S.308 / H.R.1436 - PPE in America Act S.1260 - United States Innovation and Competition Act of 2021 S. 936 / H.R. 5502 - INFORM Consumers Act S. 2648 - Rural ACO Improvement Act S. 1574/H.R.5632 - Long-Term Care Pharmacy Definition Act S. 834 / H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 H.R.3173 / S 3018 - Improving Seniors Timely Access to Care Act of 2021 H.R. 3746 - Accountable Care in Rural America Act H.R. 959 / S. 364 - Black Maternal Health Momnibus Act of 2021 H.R. 4387 / S. 1675 - Maternal Health Quality Improvement Act of 2021 S. 168 / H.R. 708 - Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act S. 150 - Ensuring Parity in MA for Audio Only-Telehealth Act S. 3146 - The Protecting Patients from Counterfeit Medical Devices Act S. 3799 - The PREVENT Pandemics Act H.R. 6520 - The Medical and Health Stockpile Accountability Act of 2022, automated data collection infrastructure for healthcare supply chain S. 3416 - The Protecting Patients from Counterfeit Medical Devices Act S. 3493 - Drug Shortages Shelf Life Extension Act H.R. 4521 - America COMPETES Act of 2022 S.610 - Protecting Medicare and American Farmers from Sequester Cuts Act H.R.3684 - Infrastructure Investment and Jobs Act H.R. 4735/S. 2493 - The Provider Relief Extension Act H.R. 3589 - Better Way for Providers To Repay Act of 2021 H.R. 3203 / S. 773 - To allow hospitals that were participating in or applied for the 340B drug discount program before the public health emergency to temporarily maintain eligibility HHS FY 2023 appropriations - Removal of a ban on using federal funds for implementing a unique patient identification system (Section 510) and funding for Childrens Hospitals Graduate Medical Education (CHGME) Program 340B Drug Discount Program eligibility Incentivize Domestic Manufacturing Hospital Infrastructure Support FDA User Fee Reauthorization Bills Healthcare workforce (Graduate medical education , health professional training programs, recruitment and retention incentives) Medicare provider payment cuts (Medicare sequestration cuts, physician fee schedule 3.75% reduction due to evaluation & management code increases/budget neutrality adjustment, Pay-as-You-Go reductions due to American Rescue Plan)

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

340B Drug Reimbursement Program: to encourage Congress to pass a bill and/or work with the Administration to return the 340B program to its pre-2018 status. S. 773; H.R. 4390; H.R. 3203 (to recalibrate critical access hospitals' revenues due to PRF funds for the purpose of calculating reasonable 340b payments). Kansas Provider Assessment: to encourage CMS to approve the increase in Kansas' Medicaid provider assessment, and to encourage Congress to work with CMS to get it approved. PRF Period 1 reporting: individual hospital needs. S. 2493; H.R. 4735 S. 1893: encouraging Congress to pass this bill that will help add additional physicians in rural areas. S. 1024: encouraging Congress to pass this bill that would encourage physicians to work in rural and out migrating areas. Encouraging Congress to end sequestration and allow PAYGO rules to enact a 4% cut to hospital Medicare reimbursement rates at the end of the year. Encouraging Congress to pass a bill that allows critical access hospitals to also be eligible for telehealth flexibilities afforded to other types of providers.

Client expense: Not reported · Firm income: $16,000

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

Monitored the implementation of P.L. 117-2, the American Rescue Plan, as it relates to the provider relief fund. Monitored the implementation of P.L. 116-260, the Consolidated Appropriations Act of 2021, as it relates to surprise billing. Issues involving workforce shortages. S. 2493/H.R. 4735, the Provider Relief Fund Deadline Extension Act. H.R. 2471, the Consolidated Appropriations Act, 2022, and issues related to the provider relief fund. Issues related to mental health. Issues related to the False Claims Act.

Client expense: Not reported · Firm income: $90,000

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

Build Back Better Act (H.R. 5376) - Supported policies to encourage health care coverage and close the Medicaid coverage gap. Urged additional pandemic financial support for hospitals. Advocated for investments for hospitals and health care providers, including physical structure improvements, workforce and graduate medical education support. Public Health Emergency - Advocated for HHS to further extend the declared Public Health Emergency. Telehealth -Supported provisions in the Consolidated Appropriations Act, 2022 (H.R. 2471) to temporarily extend certain flexibilities after the end of the public health emergency. Supported passage of the CONNECT for Health Act (S. 1512/H.R. 2903) to make telehealth flexibilities permanent. Encouraged reimbursement parity for certain telehealth services and support for audio-only telehealth services. Health Care Workforce - Urged passage of the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708; S. 168); The Health Care Workforce Resilience Act (S. 1024/H.R. 2255); The Dr. Lorna Breen Health Care Provider Protection Act (S.610/H.R. 1667); The Resident Physician Shortage Reduction Act (S.834/H.R. 2256). The Opioid Workforce Act (S. 1438/H.R. 3441). Urged administration to examine practices of health care staffing agencies. Health Care Supply Chain - Advocated for the importance of hospital group purchasing organizations, and highlighted role in supporting supply chain resiliency to secure essential, authentic medical supplies for hospitals throughout the course of the COVID-19 pandemic. Engaged to support policies to limit shortages of prescription drugs. Advocated for greater transparency in the health care supply chain for drugs and medical devices. Prepare for and Respond to Existing Viruses, Emerging New Threats, and (PREVENT) Pandemics Act (S. 3799) - monitored introduction of PREVENT Pandemics Act. Supported inclusion of provisions to improve supply chain transparency and extend shelf life of prescription drugs. Supported passage of the Integrity, Notification, Fairness in Online Retail Marketplaces (INFORM) Consumers Act (S. 963/H.R. 5502). Provider Relief Fund - Urged HHS and Congress to offer greater flexibility and extend deadlines for hospitals to utilize PRF funding and provide clear guidance on reporting expectations. Supported Provider Relief Deadline Extension Act (S. 2493) and Provider Relief Fund Improvement Act (H.R. 5963/S.3611). Drug Pricing - Reviewed options to further support modifications to the unapproved drugs initiative that would prevent or limit price increases for older, unapproved drugs. Supported changes to the 340B program and urged HHS to enforce guidance that would allow 340B Covered Entities to utilize contract pharmacies. Advocated for HHS to offer additional 340B Drug Pricing Program eligibility flexibility for hospitals that have had patient mix changed during the COVID-19 public health emergency (S. 773). Supported inclusion of provisions in Consolidated Appropriations Act, 2022 (H.R. 2471) that would extend eligibility for covered entities that may have lost eligibility during the public health emergency. Medical Device User Fee Amendments - Urged greater authorities for the FDA to promote supply chain transparency. Generic Drug User Fee Amendments - Supported rapid adoption of generic drug user fee amendments, and urged inclusion of clarifying language related to the Unapproved Drugs Initiative and the PASTUER Act (S.2076). Social Determinants of Health and Health Equity - Shared insights and offered suggestions to CMS regarding health equity measurement, indices and data collection. Supported the Social Determinants Accelerator Act (H.R. 2503; S. 3039); The LINC to Address Social Needs Act (S. 509). Antimicrobial resistance (S. 2076) - Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act. Supported passage of Opioid Treatment Access Act (S. 3629/H.R. 6279). Supported passage of Drug Shortage Shelf Life Extension Act (S. 3493).

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

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

Monitored issues related to drug shortages. Monitored implementation of P.L. 117-2, the American Rescue Plan, as it relates to COVID relief funding. Issues concerning COVID relief and future pandemic preparedness. Issues involving workforce shortages. Issues regarding the provider relief fund. S. 2493 / H.R. 4735, the Provider Relief Fund Deadline Extension Act. S. 3799, PREVENT Pandemics Act. Issues related to mental health. Monitored issues related to the World Trade Center Health Program.

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

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, SENATE

Q1 Lobbying Report (January 1 - March 31) HCR Provider Relief Fund Deadline Extension Act (S. 2493/H.R. 4735) Infrastructure Investment and Jobs Act Build Back Better Act (H.R. 5376) Dr. Lorna Breen Health Care Provider Protection Act (HR 1667) Provider Relief Fund Improvement Act (H.R. 5963 / S. 3611) Public Service Loan Forgiveness program/physician federal loan forgiveness Healthcare Workforce Resilience Act of 2021 Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Regulatory relief in light of coronavirus Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Resident Physician Shortage Act (S. 834/H.R. 2256) No Surprises Act regulations Public Health Emergency designation Blood shortages PREVENT Pandemics Act (S. 3799) CMS Region IX re: Guidance on California State Bill 311 The Compassionate Access to Medical Cannabis Act MMM Accelerated and Advance Payment Program repayment flexibility (H.R. 1349, The COVID-19 Hospital and Health Provider Loan Conversion Act of 2021) Graduate Medical Education (GME) funding (Resident Physician Shortage Reduction Act of 2021 (S. 834/H.R. 2256) Telehealth flexibilities and payment (TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act -S. 368/H.R. 1332) Hospital Inpatient Services Modernization Act (H.R. 7053) Annual Prospective Payment System Rules Organ acquisition payment policies Clinical lab fee schedule BUD FY2022 Appropriations bills Consolidated Appropriations Act of 2022 (HR 2471) - omnibus Further Additional Extending Government Funding Act, HR 6617 Nursing and allied health workforce funding FY 2023 budget request Submitted Comments California Department of Managed Health Care Draft All Plan Letter - No Surprises Act (NSA) Guidance Specified State Law for Payment for Out-of-Network Emergency Services, February 3, 2022 SUBJECT: CMS-4192-P, Medicare Program; Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (Vol 87, No 8), January 12, 2022 SUBJECT: CMS-1752-FC3, Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals; Changes to Medicare Graduate Medical Education Payments for Teaching Hospitals; Changes to Organ Acquisition Payment Policies (Vol 86, No 245), December 27, 2021

Client expense: $430,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

H.R. 2471, Consolidated Appropriations Act, 2022, issues related to COVID relief and the provider relief fund. Issues related to health care workforce, maternal health, and behavioral health. S. 2493/H.R. 4735, the Provider Relief Fund Deadline Extension Act. H.R. 5376, the Build Back Better Act, as it relates to hospitals. Monitored H.R. 4944, Helping Kids Cope Act of 2021. Monitored H.R. 1384, Mainstreaming Addiction Treatment Act of 2021. H.R. 1667, Dr. Lorra Breen Health Care Provider Act.

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

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

Provider Relief Fund Deadline Extension Act (S. 2493/H.R. 4735) Infrastructure Investment and Jobs Act Build Back Better Act (H.R. 5376) Dr. Lorna Breen Health Care Provider Protection Act (HR 1667) Provider Relief Fund Improvement Act (H.R. 5963 / S. 3611) Public Service Loan Forgiveness program/physician federal loan forgiveness Healthcare Workforce Resilience Act of 2021 Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Conrad State 30 & Physician Access Act Public Health and Social Services Emergency Fund Regulatory relief in light of coronavirus Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Resident Physician Shortage Act (S. 834/H.R. 2256) OSHA rule on COVID-19 Healthcare Workplace Safety No Surprises Act regulations Rural health care innovation (PA Rural Health Model and Community Health Access and Rural Transformation Model (CHART) Public Health Emergency designation COVID Data Reporting Vaccine mandate policy Healthcare Cybersecurity Act (S.3904) - collaboration between the CISA and HHS Blood shortages H. Res. 909 condemning violence against health care workers PREVENT Pandemics Act (S. 3799)

Client expense: $80,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Provider Relief Fund Deadline Extension Act (S. 2493/H.R. 4735) Dr. Lorna Breen Health Care Provider Protection Act (S. 4349/H.R. 8094) Provider Relief Fund Improvement Act (H.R. 5963) Public Service Loan Forgiveness program/physician federal loan forgiveness Healthcare Workforce Resilience Act of 2021 Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Conrad State 30 & Physician Access Act Regulatory relief in light of coronavirus Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 Strengthening Americas Health Care Readiness Act (S. 54) Resident Physician Shortage Act (S. 834/H.R. 2256) No Surprises Act regulations Rural health care innovation (PA Rural Health Model and Community Health Access and Rural Transformation Model (CHART) Public Health Emergency designation Executive Order on Promoting Competition in the American Economy COVID Data Reporting Vaccine mandate policy

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues regarding access to dental services. Monitored S. 2493/H.R. 4735 The Provider Relief Fund Deadline Extension Act. Issues concerning provider relief fund disbursements. Monitored implementation of P.L. 117-2, the American Rescue Plan, as it relates to the provider relief fund. Monitored implementation of P.L.116-20, the Consolidated Appropriations Act of 2021, as it relates to surprise billing. Issues concerning workforce shortages. H.R. 1916 / S. 754, Ensuring Lasting Smiles Act.

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

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

a. Incentivize Domestic Manufacturing b. Hospital Infrastructure Support c. H.R. 5487 - Value in health Care Act of 2021 d. S. 2652/H.R. 5067 - Preserving Patient Access to Home Infusion Act e. S.308/H.R.1436 - PPE in America Act f. S.1260 - United States Innovation and Competition Act of 2021 g. S. 936 / H.R. 5502 - INFORM Consumers Act h. S. 2648 - Rural ACO Improvement Act i. S. 1574/H.R.5632 - Long-Term Care Pharmacy Definition Act j. S. 834 / H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 k. H.R.3173 S 3018 - Improving Seniors Timely Access to Care Act of 2021 l. H.R. 3746 - Accountable Care in Rural America Act m. H.R.1319 - American Rescue Plan Act of 2021 n. H.R. 959 / S. 364 - Black Maternal Health Momnibus Act of 2021 o. H.R. 4387 / S. 1675 - Maternal Health Quality Improvement Act of 2021 p. S. 168 / H.R. 708 - Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act q. S. 150 - Ensuring Parity in MA for Audio Only-Telehealth Act r. 340B Drug Discount Program eligbility t. Healthcare workforce (Graduate medical education , health professional training programs, recruitment and retension incentives) u. Medicare provider payment cuts (Medicare sequestration cuts, physician fee schedule 3.75% reduction due to evaluation & management code increases/budget neturality adjustment, Pay-as-You-Go reductions due to American Rescue Plan) v. Automated data collection infrastructure for healthcare supply chain w. S. 3146 - The Protecting Patients from Counterfeit Medical Devices Act x. S. 3799 - The PREVENT Pandemics Act y. H.R. 650 - The Medical and Health Stockpile Accountability Act of 2022 z. S. 3416 - The Protecting Patients from Counterfeit Medical Devices Act aa. S. 3493 - Drug Shortages Shelf Life Extension Act ab. H.R. 4521 - America COMPETES Act of 2022 ac. H.R.5376 - Build Back Better Act ad. S.610 - Protecting Medicare and American Farmers from Sequester Cuts Act ae. H.R.3684 - Infrastructure Investment and Jobs Act af. H.R. 4735/S. 2493 - The Provider Relief Extension Act ag. H.R. 3589 - Better Way for Providers To Repay Act of 2021 ah. H.R. 3203 / S. 773 - To allow hospitals that were participating in or applied for the 340B drug discount program before the public health emergency to temporarily maintain eligibility ai. HHS FY 2022 appropriations - Removal of a ban on using federal funds for implementing a unique patient identification system (Section 510) aj. ACO Assignment Bill ak. NQF/Quality Measurement funding authorization al. Preparing for the next pandemic and supply chain resiliency

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

340B Drug Reimbursement Program: to encourage Congress to pass a bill and/or work with the Administration to return the 340B program to its pre-2018 status. S. 773; H.R. 4390; H.R. 3203 (to recalibrate critical access hospitals' revenues due to PRF funds for the purpose of calculating reasonable 340b payments). Kansas Provider Assessment: to encourage CMS to approve the increase in Kansas' Medicaid provider assessment, and to encourage Congress to work with CMS to get it approved. PRF Period 1 reporting: individual hospital needs. S. 2493; H.R. 4735 S. 1893: encouraging Congress to pass this bill that will help add additional physicians in rural areas. S. 1024: encouraging Congress to pass this bill that would encourage physicians to work in rural and out migrating areas. Encouraging Congress to extend the sequestration holiday to the end of the Public Health Emergency. H.R. 2471: encouraging Congress to pass this bill that would fund the federal government for fiscal year 2022 which includes the provisions of H.R. 4390 and an extension of telehealth reimbursement flexibilities related to the covid pandemic. Encouraging Congress to pass a bill that allows critical access hospitals to also be eligible for telehealth flexibilities afforded to other types of providers per H.R. 2471.

Client expense: Not reported · Firm income: $16,000

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

340B Drug Reimbursement Program: to encourage Congress to pass a bill and/or work with the Administration to return the 340B program to its pre-2018 status. S. 773; H.R. 4390; H.R. 3203 (to recalibrate critical access hospitals' revenues due to PRF funds for the purpose of calculating reasonable 340b payments) Kansas Provider Assessment: to encourage CMS to approve the increase in Kansas' Medicaid provider assessment, and to encourage Congress to work with CMS to get it approved. PRF Period 1 reporting: individual hospital needs. S. 2493; H.R. 4735 S. 1893: encouraging Congress to pass this bill that will help add additional physicians in rural areas. S. 1024: encouraging Congress to pass this bill that would encourage physicians to work in rural and out migrating areas. H.R. 2547: discouraging Congress from passing this bill that would keep hospitals from attempting to collect debts owed to them for services provided. H.R. 3173: encouraging Congress to pass this bill which would provide greater access to care for seniors in rural areas. H. Res. 774: encouraging Congress to pay for premium tax credits for ACA applicants in non-expansion states by not making allotments to DSH allocations to non-expansion states. Encouraging Congress to extend the sequestration holiday to the end of the Public Health Emergency. Encouraging both Congress and the Administration to reconsider and provide certain exemptions for the vaccine mandate for health care workers. Against workplace vaccine mandates: S.J.Res. 29; H.J.Res. 65

Client expense: Not reported · Firm income: $15,000

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

oCDC funding for social determinants of health oCOVID-19 Provider Relief Fund oH.R. 133 Consolidated Appropriations Act, 2021 oH.R. 4735/S.2493 Provider Relief Deadline Extension Act oH.R. 5305 Extending Government Funding and Delivering Emergency Assistance Act oH.R. 5376 - Build Back Better Act oH.R. 6119 Further Extending Government Funding Act oH.R.1319 - American Rescue Plan Act of 2021 oH.R.1868 - To prevent across-the-board direct spending cuts, and for other purposes oHRSA Title VII and Title VIII programs in the FY 2022 Labor, Health and Human Services, Education and Related Agencies Appropriations oIssues related to hospital and public health infrastructure

Client expense: $340,000 · Firm income: Not reported

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

oCDC funding for social determinants of health oCOVID-19 Provider Relief Fund oH.R. 133 Consolidated Appropriations Act, 2021 oH.R. 4735/S.2493 Provider Relief Deadline Extension Act oH.R. 5305 Extending Government Funding and Delivering Emergency Assistance Act oH.R. 5376 - Build Back Better Act oH.R. 6119 Further Extending Government Funding Act oH.R.1319 - American Rescue Plan Act of 2021 oH.R.1868 - To prevent across-the-board direct spending cuts, and for other purposes oHRSA Title VII and Title VIII programs in the FY 2022 Labor, Health and Human Services, Education and Related Agencies Appropriations oIssues related to hospital and public health infrastructure

Client expense: $340,000 · Firm income: Not reported

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

Q4 Lobbying Report (October 1-December 31) Health Issues Provider Relief Fund Improvement Act (H.R. 5963) Provider Relief Fund Deadline Extension Act (S. 2493/H.R. 4735) Infrastructure Investment and Jobs Act (H.R. 3684) Build Back Better Act (H.R. 5376) FY 2022 Budget Resolution Public Service Loan Forgiveness program/physician federal loan forgiveness Coronavirus Provider Protection Act (H.R. 3021) Healthcare Workforce Resilience Act of 2021 Increasing Behavioral Health Treatment Act (H.R.2611) Rural America Health Corps Act (S.54) Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Conrad State 30 & Physician Access Act Public Health and Social Services Emergency Fund Regulatory relief in light of coronavirus Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 American Rescue Plan (H.R. 1319) American Jobs Plan Leading Infrastructure for Tomorrows America Act/LIFT America Act (H.R. 1848) Rural Hospital Closure Relief Act (H.R. 1639/S.644) National Coronavirus Commission Act (S. 412) Strengthening Mental Health Supports for BIPOC Communities Act (H.R. 1331) Rural and Underserved Small Hospital Protection Act/RUSH Act (H.R. 1885) Rural America Health Corps Act (S. 924/H.R. 2130), Strengthening Americas Health Care Readiness Act (S. 54) Resident Physician Shortage Act (S. 834/H.R. 2256) OSHA rule on COVID-19 Healthcare Workplace Safety No Surprises Act regulations Medicare/Medicaid Protecting Medicare and American Farmers from Sequester Cuts Act (S.610) Medicaid DSH Payment Adjustment Fairness Act of 2021 (H.R. 5015) Stopping Doctor Shortages Act (H.R. 1133/S. 311) Better Way for Providers to Repay Act of 2021 (H.R. 2407) Public Health Emergency designation Accelerated and Advance Payment Program repayment flexibility Rural hospital policies (Rural Health Clinic payment - H.R. 1868) Sequestration relief (H.R. 1868) Graduate Medical Education (GME) funding (Resident Physician Shortage Reduction Act of 2021 (S. 834) Disproportionate share hospital allotment increase (technical correction) Telehealth flexibilities and payment (TREAT Act - S. 168/H.R. 708; Telehealth Modernization Act -S. 368/H.R. 1332; TREATS Act - S. 340) Medicare for All (H.R. 1976) Resetting the Impact Act (TRIA) of 2021 (H.R. 2455) Submitted Comments SUBJECT: [Docket No. FDA-2016-D-0271], Hospital and Health System Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act; Revised Draft Guidance for Industry; (Vol 86, No 192), October 7, 2021 Subject: CMS-9908-IFC, Requirements Related to Surprise Billing; Part II; Interim Final Rule with Comment Period, Federal Register (Vol. 86, No. 192), October 7, 2021 SUBJECT: CMS-9907-P, Requirements Related to Air Ambulance Services, Agent and Broker Disclosures, and Provider Enforcement, Federal Register (Vol. 86, No. 177), September 16, 2021 SUBJECT: [IS No. 2696-21; DHS Docket No. USCIS- 2021-0013; Public Charge Ground of Inadmissibility; Advanced Notice of Proposed Rulemaking; Federal Register (Vol. 86, No. 160), August 23, 2021

Client expense: $340,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Monitored issues related to drug shortages. Monitored implementation of P.L. 117-2, the American Rescue Plan, as it relates COVID relief funding. Monitored S. 168 / H.R. 708, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act. Issues concerning COVID relief and future pandemic preparedness. Issues involving workforce shortages. Issues regarding the provider relief fund. S. 2493 / H.R. 4735, the Provider Relief Fund Deadline Extension Act. H.R. 3684 (P.L. 117-58), The Infrastructure Investment and Jobs Act as it relates to hospitals.

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

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

Issues regarding access to dental services. Monitored S. 2493/H.R. 4735 The Provider Relief Fund Deadline Extension Act. Issues concerning provider relief fund disbursements. Monitored issues related to expansion of the Affordable Care Act; monitored implementation of P.L. 117-2, the American Rescue Plan, as it relates to the provider relief fund, PPE testing and vaccines. Monitored implementation of P.L.116-20, the Consolidated Appropriations Act of 2021, as it relates to surprise billing. Issues concerning workforce shortages.

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

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

Build Back Better Act (H.R. 5376) - Supported policies to encourage health care coverage and close the Medicaid coverage gap. Urged additional pandemic financial support for hospitals. Advocated for investments for hospitals and health care providers, including physical structure improvements, workforce and graduate medical education support. Infrastructure Investment and Jobs Act (H.R. 3684) - Supported inclusion of funding to support broadband deployment needed for greater access to telehealth services. Opposed using further extension of Medicare sequestration or repurposing unused provider relief funding as offsets for bipartisan infrastructure package. Telehealth - Supported passage of the CONNECT for Health Act (S. 1512/H.R. 2903) to make telehealth flexibilities permanent. Encouraged reimbursement parity for certain telehealth services and support for audio-only telehealth services. Health Care Workforce - Urged passage of the Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (H.R. 708; S. 168); The Health Care Workforce Resilience Act (S. 1024/H.R. 2255); The Dr. Lorna Breen Health Care Provider Protection Act (S.610/H.R. 1667); The Resident Physician Shortage Reduction Act (S.834/H.R. 2256). Urged administration to examine practices of health care staffing agencies. Surprise Bills - Urged changes to the Surprise Billing Interim Final Rule Part 2 to modify its reliance on a "Qualifying Payment Amount" in an Independent Dispute Resolution process. Hospital Group Purchasing Organizations - Advocated for the importance of hospital group purchasing organizations, and highlighted role in supporting supply chain resiliency to secure essential, authentic medical supplies for hospitals throughout the course of the COVID-19 pandemic. Engaged to support policies to limit shortages of prescription drugs. Engaged with U.S. DOT Port Envoy related to shipping delays for key medical products. Advocated for greater transparency in the health care supply chain for drugs and medical devices. Supported passage of the Integrity, Notification, Fairness in Online Retail Marketplaces (INFORM) Consumers Act (S. 963/H.R. 5502). Provider Relief Fund - Urged HHS and Congress to offer greater flexibility and extend deadlines for hospitals to utilize PRF funding and provide clear guidance on reporting expectations. Supported Provider Relief Deadline Extension Act (S. 2493) and Provider Relief Fund Improvement Act (H.R. 5963). Drug Pricing - Monitored drug pricing legislation (H.R. 3, H.R. 19, H.R. 5376) with support for policies that improve market competition and makes improvements to support hospital and patient access to needed medications. Reviewed options to further support modifications to the unapproved drugs initiative that would prevent or limit price increases for older, unapproved drugs. Monitored for potential changes to the 340B program and supported HHS to enforce guidance that would allow 340B Covered Entities to utilize contract pharmacies. Advocated for HHS to offer additional 340B Drug Pricing Program eligibility flexibility for hospitals that have had patient mix changed during the COVID-19 public health emergency (S. 773). Social Determinants of Health - Engaged to offer support for policies to improve social determinants of health. Offered feedback on legislation and activity from the CMS Innovation Center to improve access and reduce health care disparities. Supported the Social Determinants Accelerator Act (H.R. 2503; S. 3039); The LINC to Address Social Needs Act (S. 509). CURES 2.0 (H.R. 6000) - Monitored the introduction of CURES 2.0 Health Care Equity - Offered feedback on legislation to improve access to care and reduce health care disparities. Rural MOMS Act (H.R. 769); Black Maternal Health Momnibus Act (H.R. 959). Antimicrobial resistance (S. 2076) - Supported passage of the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act.

Client expense: $190,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Transportation, Dept of (DOT), U.S. Trade Representative (USTR)

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

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

- Distributed to the Centers for Medicare and Medicaid Services a copy of the talking points from the September 9 virtual meeting regarding Medicare Advantage Sepsis Down coding and Prior Authorization. - Corresponded with a member of the Missouri congressional delegation on questions regarding HHS distribution of CARES Act General Distribution Phase 4 funds. - Corresponded with Senate members of the Missouri congressional delegation regarding the pending House Amendment to S. 610. - Responded to a member of the Missouri congressional delegations questions regarding American Rescue Plan Act rural health funding and Medicare Accelerated and Advance Payments. - Corresponded with a member of the Missouri congressional delegation regarding HHS and HRSAs distribution of American Rescue Plan Act payments to providers and suppliers who serve rural Medicaid, Childrens Health Insurance Program (CHIP) and Medicare beneficiaries. - Corresponded with a member of the Missouri congressional delegation regarding the findings of the CMS survey on regulations mandating COVID-19 vaccination of employees and others in CMS-regulated settings. - Distributed to the House members of the Missouri congressional delegation a memorandum of support for H.R. 5963, the Provider Relief Fund Improvement Act. - Conversation via telephone with a member of Missouri congressional delegation regarding the expected effects of the vaccine mandate. - Distributed to the members of the Missouri congressional delegation a document concerning ARPA pandemic financial relief for hospitals in Missouri. - Distributed to the members of the Missouri congressional delegation a fact sheet prepared by the Missouri Hospital Association outlining the issues being faced by health care providers regarding the disruption caused using temporary staffing agencies and the inability of nursing schools to enroll all interested students. - Corresponded with a member of the Missouri congressional delegation regarding HRSA Resiliency Grants and related testimony from a House Energy and Commerce Committee hearing on health workforce shortages. - Convened a virtual meeting with a member of the Missouri congressional delegation regarding the potential legislation to relieve pandemic stresses on nurses. - Responded to a member of the Missouri congressional delegation regarding Missouri Hospital Associations position on HR 3165, the Nurse Staffing Standards for Hospital Patient Safety & Quality Care Act. - Corresponded with a member of the Missouri congressional delegation regarding an upcoming HRSA deadline to apply for funding from the Provider Relief Fund Phase 4 and ARPA rural distribution. - Corresponded with a member of the Missouri congressional delegation regarding legislative language regarding Medicare reimbursement reductions on services furnished by Physical Therapy Assistants and Occupational Therapy Assistants. - Corresponded with a member of the Missouri congressional delegation regarding issues from hospitals concerning workforce, provider relief funding expenditure deadlines and reporting concerns, 340B concerns and vaccination mandates. Also, discussed the impending Medicare cut from PAYGO and the expiration of the moratorium on the Medicare sequestration and support of H.R. 4735/S.2493. - Corresponded with a member of the Missouri congressional delegation regarding Medicare Sequestration Relief and prevention of the PAYGO cut. - Corresponded with members of the Missouri congressional delegation regarding Missouri Hospital Associations staff transitions at the end of 2021.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

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

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

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

Monitored the implementation of P.L. 117-2, the American Rescue Plan, as it relates to the provider relief fund. Monitored the implementation of P.L. 116-260, the Consolidated Appropriations Act of 2021, as it relates to surprise billing. Issues involving workforce shortages. S. 2493/H.R. 4735, the Provider Relief Fund Deadline Extension Act. H.R. 3684, The Infrastructure Investment and Jobs Act, as it relates to hospitals.

Client expense: Not reported · Firm income: $90,000

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

Issues related to COVID relief and the provider relief fund. Issues related to health care workforce, maternal health, and behavioral health. S. 2493/H.R. 4735, the Provider Relief Fund Deadline Extension Act. Monitored H.R. 3684 (P.L. 117-58), the Infrastructure Investment and Jobs Act, as it relates to hospitals. Monitored H.R. 5376, the Build Back Better Act, as it relates to hospitals. H.R. 4944, Helping Kids Cope Act of 2021. H.R. 1384, Mainstreaming Addiction Treatment Act of 2021. H.R. 1667, Dr. Lorra Breen Health Care Provider Act.

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

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

a. Incentivize Domestic Manufacturing b. Hospital Infrastructure Support c. H.R. 5487 - Value in health Care Act of 2021 d. S. 2652/H.R. 5067 - Preserving Patient Access to Home Infusion Act e. S.308/H.R.1436 - PPE in America Act f. S.1260 - United States Innovation and Competition Act of 2021 g. S. 936 / HR 5502 - INFORM Consumers Act h. S. 2648 - Rural ACO Improvement Act i. S. 1574/H.R.5632 - Long-Term Care Pharmacy Definition Act j. S. 834 / H.R. 2256 - Resident Physician Shortage Reduction Act of 2021 k. H.R.3173 S 3018 - Improving Seniors Timely Access to Care Act of 2021 l. H.R. 3746 - Accountable Care in Rural America Act m. H.R.1319 - American Rescue Plan Act of 2021 n. H.R. 959 / S. 364 - Black Maternal Health Momnibus Act of 2021 o. H.R. 4387 / S. 1675 - Maternal Health Quality Improvement Act of 2021 p. S. 168 / H.R. 708 - Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act q. S. 150 - Ensuring Parity in MA for Audio Only-Telehealth Act r. 340B Drug Discount Program eligbility s. Healthcare workforce (Graduate medical education , health professional training programs, recruitment and retension incentives) t. Medicare provider payment cuts (Medicare sequestration cuts, physician fee schedule 3.75% reduction due to evaluation & management code increases/budget neturality adjustment, Pay-as-You-Go reductions due to American Rescue Plan) u. Automated data collection infrastructure for healthcare supply chain v. The Protecting Patients from Counterfeit Medical Devices Act (S. 3416) w. Preparing for the next pandemic and supply chain resiliency x. H.R.5376 - Build Back Better Act y. S.610 - Protecting Medicare and American Farmers from Sequester Cuts Act z. H.R.3684 - Infrastructure Investment and Jobs Act aa. H.R. 4735/S. 2493 - The Provider Relief Extension Act ab. H.R. 3589 - Better Way for Providers To Repay Act of 2021 ac. H.R. 3203 / S. 773 - To allow hospitals that were participating in or applied for the 340B drug discount program before the public health emergency to temporarily maintain eligibility ad. HHS FY 2022 appropriations - Removal of a ban on using federal funds for implementing a unique patient identification system (Section 510) ae. ACO Assignment Bill af. NQF/Quality Measurement funding authorization

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

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Emergency Management Agency (FEMA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Provider Relief Fund Deadline Extension Act (S. 2493/H.R. 4735) Infrastructure Investment and Jobs Act (H.R. 3684) Build Back Better Act (H.R. 5376) FY 2022 Budget Resolution Public Service Loan Forgiveness program/physician federal loan forgiveness Healthcare Workforce Resilience Act of 2021 Black Maternal Health Momnibus Act of 2021 (S. 346/H.R. 959) Conrad State 30 & Physician Access Act Public Health and Social Services Emergency Fund Regulatory relief in light of coronavirus Transparency (surprise medical bills; public posting of hospital charges) 340B Drug Pricing Program, including S. 773/H.R. 3203 American Rescue Plan (H.R. 1319) American Jobs Plan Leading Infrastructure for Tomorrows America Act/LIFT America Act (H.R. 1848) Rural America Health Corps Act (S. 924/H.R. 2130), Strengthening Americas Health Care Readiness Act (S. 54) Resident Physician Shortage Act (S. 834/H.R. 2256) OSHA rule on COVID-19 Healthcare Workplace Safety No Surprises Act regulations Rural health care innovation (PA Rural Health Model and Community Health Access and Rural Transformation Model (CHART) Coverage policy (H.R. 1976, Medicare for All) Social Determinants Accelerator Act (H.R. 2503) Public Health Emergency designation Executive Order on Promoting Competition in the American Economy COVID Data Reporting Vaccine mandate policy

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

oConsolidated Appropriations Act, 2021 (H.R. 133) oH.R.1868 - To prevent across-the-board direct spending cuts, and for other purposes oCOVID-19 Provider Relief Fund oHR 1848 - LIFT America Act oHR 1846 - Hospital construction oH.R.1319 - American Rescue Plan Act of 2021 oHRSA Title VII and Title VIII programs in the FY 2022 Labor, Health and Human Services, Education and Related Agencies Appropriations oCDC funding for social determinants of health oIssues related to hospital and public health infrastructure oH.R. 5376 - Build Back Better Act oH.R. 4735/S.2493 Provider Relief Deadline Extension Act oH.R. 4846/S.2538 Alternatives to Opioids in the Emergency Department Reauthorization Act oH.R. 4970 Rural Medical Residency Expansion Act

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

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

CMS/HHS: Requirements Related to Surprise Billing; Part II (CMS-9908-IFC); Home Health Prospective Payment System Rate Update (CMS-1747-P); Hospital Inpatient Prospective Payment System rule (CMS-1752-F and CMS 1762-F); Hospital Outpatient Prospective Payment System rule (CMS-1753-P); Inpatient Rehabilitation Facility PPS rule (CMS-1748-F); Skilled Nursing Facility PPS rule (CMS-1746-F); Hospice Wage Index rule (CMS-1754-F); Physician Fee Schedule rule (CMS-1751-P); HOUSE/SENATE: Dr. Lorna Breen Health Care Provider Protection Act (S. 610); Maternal Health Quality Improvement Act of 2021 (H.R. 4387/S. 1675); Rural Telehealth Expansion Act (H.R. 4918); ALTO Reauthorization Act of 2021 (H.R. 4846/S. 2538); Provider Relief Fund Deadline Extension Act (H.R. 4735/S. 2493); Resident Physician Shortage Reduction Act of 2021 (S. 834); A concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2022 and setting forth the appropriate budgetary levels for fiscal years 2023 through 2031 (S. Con. Res. 14); Build Back Better Act (H.R. 5376); Infrastructure Investment and Jobs Act (H.R. 3684).

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

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

Monitored issues related to drug shortages. Monitored implementation of P.L. 117-2, the American Rescue Plan, as it relates to the provider relief fund and COVID relief funding. Monitored S. 168 / H.R. 708, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act. Issues concerning COVID relief and future pandemic preparedness. Issues involving workforce shortages. Issues regarding the provider relief fund. S. 2493 / H.R. 4735, the Provider Relief Fund Deadline Extension Act. H.R. 3684, The Infrastructure Investment and Jobs Act as it relates to provider relief funds.

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

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