Child Suicide Prevention and Lethal Means Safety Act

S.2982 / HR 5035 - Child Suicide and Lethal Means Safety Act S.4003 / HR 8637 - Law Enforcement De-Escalation Act S..3635 / HR 3071 - Public Safety Officer Support Act HR 8361 - Preventing Suicide Through Voluntary Firearm Purchase Delay Act S.4007/ HR 8058 - Fighting Post Traumatic Stress Disorder Act of 2022

Client expense: $480,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), Office of Justice Program, SENATE

S.2982 / HR 5035 - Child Suicide and Lethal Means Safety Act S.4003 / HR 8637 - Law Enforcement De-Escalation Act S..3635 / HR 3071 - Public Safety Officer Support Act HR 8361 - Preventing Suicide Through Voluntary Firearm Purchase Delay Act S.4007/ HR 8058 - Fighting Post Traumatic Stress Disorder Act of 2022

Client expense: $480,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), Office of Justice Program, SENATE

Support H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021, a bill to provide for special enrollment periods during public health emergencies; Letter urging Congress to provide additional funds to the Provider Relief Fund and for vaccine distribution and administration, which will allow for continued support of hospitals' COVID-19-related lost revenues, as well as additional expenses incurred due to purchasing supplies and equipment, staffing, establishing emergency testing and vaccination centers and constructing and retrofitting facilities; Support H.R. 708 and S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, a bill to provide temporary licensing reciprocity for telehealth and interstate health care treatment; Support H.R. 1306 and S. 412, National Coronavirus Commission Act of 2021, a bill to establish the Commission on the Coronavirus Pandemic in the United States; Support S. 610/ H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 773 a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; Support S.834, Resident Physician Shortage Reduction Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan and urge the Committee on Education and Labor not to report it favorably; Support S.924 and H.R. 2130, Rural America Health Corps Act, a bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Discussions with ASPR about COVID-19 related medical supply and personnel shortages; Discussions with FEMA about COVID-19 public assistance funding policies; Letter asking Congress to consider an infrastructure proposal that you prioritize hospital and health system needs to ensure our nations health care system is well positioned to meet the opportunities and challenges that lie ahead; Support S.1512/H.R. 2903, CONNECT for Health Act of 2021, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services; Support H.R. 2255/ S 1024, Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Support S.1568, Technical Reset to Advance the Instruction of Nurses (TRAIN) Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Support H.R. 3203, a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Statement to Senate Committee on Homeland Security and Governmental Affairs hearing on "COVID-19 Part II: Evaluating the Medical Supply Chain and Pandemic Response Gaps" urges Congress to take steps to strengthen the nations medical supply chain; Statement to Senate Committee on Finance hearing on COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned stating that these flexibilities can continue to drive significant improvements in patient care long after the public health emergency (PHE) ends and given the beneficial impact of those specific flexibilities urges Congress and the Administration to make them permanent. In addition, a second group of flexibilities will remain critically important for some time following the PHE and will require a carefully crafted phase-out plan to ensure enough time is provided for a necessary transition. Without action from Congress and the Administration prior to the termination of the PHE, we are concerned that much of the progress made because of the implementation of many of these flexibilities may be unnecessarily halted or even lost; Letter urges Senate HELP Committee to consider recommendations and prioritize programs that support the health care workforce needs of the country in the wake of the COVID-19 pandemic and into the future; Support H.R. 769/S. 1491, Rural Maternal and Obstetric Modernization of Services Act or the Rural MOMS Act, a bill to amend the Public Health Service Act to improve obstetric care in rural areas; Support for S.1675/ H.R. 4387, Maternal Health Quality Improvement Act, a bill to improve maternal health; Support 1438, Opioid Workforce Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Support HR 3441,Substance Use Disorder Workforce Act, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the substance use disorder crisis; Support S.1810 / H.R.3541, Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; Statement to the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights for the hearing on Antitrust Applied: Hospital Consolidation Concerns and Solutions expressing that integration helps to ensure every community, whether rural, urban or suburban, has access to the same high standard of affordable, evidenced based care; discussions to ensure that H.R. 2547s limits on unfair practice under FDCPA for debt collectors does not inappropriately interfere with or restrict the ability of hospitals to be able to obtain payment for care provided; Support for revising/repealing changes to the Rural Health Clinic (RHC) Program that reduced reimbursement for provider-based RHCs; Hill outreach expressing concerns with United Healths retroactive denial of coverage for emergency-level care in facilities; Hill outreach expressing concern about CMS mid-build audit denials; Senate outreach on prior authorization legislation; Urge support for legislation/administrative action to extend the deadline to use PRF money; Urged HRSA to ensure that the drug companies that denied 340B Statute appropriate discounts make the impacted hospitals whole for the benefit of the vulnerable communities they serve; Support S. 2304 Drug-Price Transparency for Competition Act of 2021 (DTC Act of 2021), a bill to amend title XI of the Social Security Act to require that direct-to-consumer advertisements for prescription drugs and biological products include an appropriate disclosure of pricing information; Support S.246/H.R.851 Future Advancement of Academic Nursing Act or the FAAN Act, a bill to amend the Public Health Service Act to authorize grants to support schools of nursing in program enhancement and infrastructure modernization, increasing the number of nursing faculty and students, and for other purposes; Support S. 1568/HR 4407Technical Reset to Advance the Instruction of Nurses Act or the TRAIN Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Comment letter to the Occupational Safety and Health Administration (OSHA) recommending the withdrawal of the COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Meeting with Department of Labor staff to discuss our concerns about the OSHA COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Discussion with ASPR staff overseeing the Strategic National Stockpile about their intent to procure supplies of surgical masks; Call with Senator Cassidys staff to discuss concerns about impact of FEMA COVID-19 funding of traveling nurse agencies on hospital nursing shortages; Oppose S 2428, False Claims Amendments Act of 2021A bill to amend title 31, United States Code, to modify False Claims Act procedures, and for other purposes; Discussions about Provider Relief Fund - reporting on past disbursements and urging HHS to disburse remaining PRF money; Discussions about the challenges that teaching hospitals have with training the physician workforce, residency caps that limit funding for training programs, a shortage of residents pursuing primary care specialties, a growing patient pool due to the newly insured and aging of the population; Discussions about the hospital and health system priorities for infrastructure and reconciliation bills; Letter urging Congress to maintain the current legal and regulatory framework for evaluating mergers and acquisitions; Hill outreach to discuss the benefits of health care integration; Hill outreach about the negative impact of potentially anticompetitive conduct by nurse-staffing agencies; Support HR 5035/ S 2982 Child Suicide Prevention and Lethal Means Safety Act, a bill to authorize the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes; Support H.R.5376 Build Back Better Act, this bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment; Discussions with members of congress about the implementation of Rural Emergency Hospital payment designation; Discussions on the No Surprises Act Implementation (surprise billing) and urging federal regulators to restore the independence of the independent dispute resolution process in the No Surprises Act Part 2 regulations; Support HR 5699 Student Assisted Vaccination Effort (SAVE) Act, a bill to expand the definition of qualified persons for purposes of the Public Readiness and Emergency Preparedness Act to include health professional students; Support S 2873 Preventing and Addressing Trauma with Health Services Act (PATHS Act), a bill to require the Secretary of Health and Human Services to award grants to establish or expand programs and activities to increase access to high-quality culturally competent trauma support and mental health care; Letter urging HRSA to delay proposals to withdraw certain HPSAs; Support S 3497 and HR 6397, Medical Student Education Authorization Act of 2022, a bill to amend the Public Health Service Act to establish a grant program to award grants to public institutions of higher education located in a covered State; Support HR 6279 and S 3629, Opioid Treatment Access Act of 2022, a bill to authorize a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs during the COVID-19 public health emergency; Support HR 5703 and S 3677, Post-Disaster Mental Health Response Act, a bill to amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to authorize the President to provide professional counseling services to victims of emergencies declared under such Act; Submitted a statement on the hearing for Pandemic Profiteers: Legislation to Stop Corporate Price Gouging regarding concerns about anticompetitive conduct on the part of health care staffing agencies, some of which have been exploiting the severe shortage of health care providers during the COVID-19 pandemic; Submitted a statement on the hearing for Americas Mental Health Crisis and supports additional approaches to help ensure improved access to needed comprehensive, affordable and quality behavioral health services; Provide comments to the Affordability Subcommittee of the Healthy Future Task Force expressing our shared focus with Congress on providing relief from the pandemic, ensuring a smooth recovery and rebuilding a better health care system for the future, all while continuing to support efforts to promote greater affordability and value to patients and the health care system; Submitted statement on the hearing for Recruiting, Revitalizing & Diversifying: Examining the Health Care Workforce Shortage about the challenges ahead and the need to examine Americas health care workforce shortage. We must work together to solve these issues so that our nations hospitals and health systems can continue to care for the patients and communities they serve; Submitted statement on the hearing for Protecting Youth Mental Health: Part II - Identifying and Addressing Barriers to Care examines ways to protect the mental health of our nations youth; Submitted statement on the hearing for Exploring Pathways to Affordable, Universal Health Coverage Care expressing the need to build upon and improve our existing system to increase access to coverage of comprehensive health benefits; Submitted a letter to provide information regarding the challenges facing Americas health care workforce as the country enters the third year of the COVID-19 pandemic; Provided comments to the Modernization Subcommittee of the Healthy Future Task Force urging Congress to consider how to ensure the telehealth flexibilities could remain in place for patients and health care providers beyond the PHE; Support HR 7053 and S 3792, Hospital Inpatient Services Modernization Act, a bill to amend title XVIII of the Social Security Act to extend acute hospital care at home waiver flexibilities; Support resolution, 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; Letter urges Congress to provide immediate additional support for hospitals and health systems serving their communities during this unprecedented public health crisis. While the support Congress has provided during the last two years of the COVID-19 pandemic has helped hospitals care for their patients and communities, there is still a significant need for financial support and relief as COVID-19 challenges persist; Support S 3904, Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Letter urging OSHA to extend the comment deadline for the rule making on the occupational exposure to COVID-19 in healthcare settings by at least an additional 30 days, through May 23; Meeting with the Office of the Assistant Secretary of Health (OASH) at HHS to discuss the widespread blood shortages in the U.S. and next steps; Stakeholder calls with HHS ASPR regarding the distribution/administration of COVID-19 therapeutics; Discussions on S 571, Public Health Funding Prevents Pandemics Act, a bill to fully fund the Prevention and Public Health Fund and reaffirm the importance of prevention in the United States healthcare system; Regular calls with ASPR and other stakeholders participating in the Health Care and Public Health (HPH) Sector Joint Supply Chain Resilience Working Group (Joint SCRWG), a formal Working Group under the authority of the Critical Infrastructure Partnership Advisory Council (CIPAC) to support the Presidents vision for a resilient public health supply chain; Monthly calls with ASPRs Hospital Preparedness Program (HPP) to discuss updates on the hospital association COVID-19 funding program; Call with ASPR Healthcare and Public Health Government Coordinating Council leadership and other hospital associations to provide feedback on the COVID-19 hospital data guidance update; Provide comment letter to OSHA on the re-opening of comments on the Occupational Exposure to COVID-19 Rulemaking in which we urge OSHA not to finalize its rule for occupational exposure to COVID-19. In our comments, we indicate that we continue to oppose establishing new regulations that are not fully aligned with the Centers for Disease Control and Preventions evolving evidence-based guidance. With the constantly evolving, science-based CDC guidance and recommendations, CMS vaccination requirement and existing OSHA general standards, we strongly believe that an inconsistent and overly strict OSHA COVID-19 health care standard is not necessary, would cause confusion and will ultimately lower hospital employees morale and worsen unprecedented personnel shortages in hospitals. It is essential to a well-functioning health care system that only one set of science-based standards be applied to health care providers, and that these standards be aligned across federal agencies; Letter urging Congress to make the expanded tax credits permanent, ensuring millions of low- and middle-income families continue to have access to affordable coverage in 2023 and beyond; Express concerns with the letter to CMS from Congressman Murphy that makes a number of requests for data surrounding the COVID-19 add on payments for hospitals. We are concerned about the questions as they do not take into account the continued needs of the nations hospitals and health systems. Hospitals continue to face numerous challenges, including increased labor and supply costs and workforce shortages. These additional payments have helped to address some but not all of the high costs associated with COVID-19 patient care. The complexity of care is still higher than pre-pandemic levels as measured by length of stay, which further indicates that its still more resource intensive to treat COVID inpatients. In addition, the high costs associated personal protective equipment, isolation measures, and other additional resources are necessary when treating all patients, unless and until it is determined they do not have COVID-19; Submitted a letter to Ways and Means per their request for information on the health care industry and climate change. We support the sustainability efforts while acknowledging that for a variety of reasons, many hospitals and health systems face challenges and barriers to implementing this work, especially while responding to a pandemic; Letter urging HHS to maintain the COVID-19 public health emergency (PHE) until it is clear that the global pandemic has receded and the capabilities authorized by the PHE are no longer necessary. This will help prevent any future surges from threatening the health and safety of patients and the ability of health care professionals to care for them; Long COVID Best Clinical Practices Discussion with the White House Policy Advisor, Office of the COVID-19 Response; Submitted comment letter to the Federal Trade Commission outlining the impact pharmacy benefit managers (PBMs) practices have on the field. Specifically, urging the FTC to increase scrutiny on insured-mandated white bagging policies, as well as the impact of PBM-negotiated rebates and other business practices on the 340B drug discount pricing program and overall drug prices and drug price increases; Submit a comment letter to the Internal Revenue Service for their proposed rule amending how employer coverage affordability would be measured for family members of employees. We advocated for a fix to the current methodology for assessing affordability of employer coverage for family members, often referred to as the family glitch, which is estimated to affect about 5 million individuals. We commend the IRS on proposing to revise the regulation and improve access to health insurance coverage for millions of American families; Concerns S.4348, Food and Drug Administration Safety and Landmark Advancements Act of 2022 or the FDASLA Act of 2022, a bill to amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological product; Comment letter on CMS Radiation Oncology (RO) Model proposed rule. We strongly supports CMS efforts to transform the delivery of cancer care. We also support the original intent of the RO Model, which was to protect access to care by ensuring fair, predictable payment for radiation oncologists. However, this important goal of the original RO Model has been marred by the incorporation of significant payment cuts and substantial administrative burdens for those participating in this mandatory model. As such, the AHA supports CMSs proposal to delay the start date of the RO model from Jan. 1, 2023 to a date to be determined through future rulemaking; Support S. 4352,Travel Nursing Agency Transparency Study Act, a bill to require a study on the effects of travel nurse agencies on the health industry during the COVID-19 pandemic; Letter in response to CMS request for guidance on implementing the regulatory requirement for convening providers and facilities exchange information with co-providers and co-facilities to create a comprehensive good faith estimate as part of the implementation of the No Surprises Act. Due to the lack of currently available automated solutions, this process would require a significant manual effort by providers, which would undoubtedly result in the convening provider being unable to meet the short statutory timeframes for delivering good faith estimates to the patients and could also lead to inadvertent errors. AHA has requested an extension in enforcement direction until a technical solution has been identified and implemented; Support HR 7691, Safety From Violence for Healthcare Employees Act or the SAVE Act, a bill to protect hospital personnel from violence, and for other purposes; Letter requesting that HHS, HRSA, and OIG take immediate enforcement action against the now 17 companies that are refusing to honor their obligations under the 340B program; Letter sent to HHS Secretary to discuss how best to ensure prompt repayment to 340B hospitals without penalizing the rest of the hospital field after the U.S. Supreme Court unanimously agreed that HHS outpatient payment cuts to hospitals in the 340B Drug Pricing Program were unlawful. The Courts decision did not determine a remedy for the unlawful payment cuts, instead, it remanded the case to the lower courts to address the proper remedy; Support HR 7084/ S 3983, Protecting and Transforming Cyber Health Care Act of 2022 or the PATCH Act of 2022, a bill to amend the Federal Food, Drug, and Cosmetic Act to require, for purposes of ensuring cybersecurity, the inclusion in any premarket submission for a cyber device of information to demonstrate a reasonable assurance of safety and effectiveness throughout the lifecycle of the cyber device, and for other purposes; Submit Comment letter of support for CMS continued focus on strengthening health insurance coverage and ensuring ease of enrollment and limited gaps in coverage, including proposed updates to Medicare enrollment and eligibility rules; Submit letter for oversight hearing on Medicare Advantage (MA) plans expressing concerns about some MA plans inappropriate restrictions on beneficiary access to medically necessary care, including those highlighted in a recent report issued by the Department of Health and Human Services Office of Inspector General (HHS-OIG), and urge Congress to increase its oversight of these plans; Provided feedback on the Senate Finance Committees discussion draft addressing mental health care and telehealth. AHA supports allowing Medicare beneficiaries who seek treatment for mental health disorders to receive their care through audio-only services, removing the requirement for Medicare patients to receive an in-person visit prior to receiving mental health services through telehealth, and expanding beyond physicians and limited non-physician practitioners the types of providers who can deliver and bill for telehealth services; Support HR 8576/ S 4352 Travel Nursing Agency Transparency Study Act, a bill to require a study on the effects of travel nurse agencies on the health industry during the COVID-19 pandemic; Support HR 8806 Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Submitted a statement for the record for the Senate Judiciary Subcommittee hearing on Flatlining Care: Why Immigrants Are Crucial to Bolstering Our Health Care Workforce. This hearing examines the importance of improving the immigration process in order to help alleviate Americas health care workforce shortage. We encourage Congress to help address domestic health care workforce shortage.

Issue: Educate Congress and the administration on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. Draft Graduate Medical Education Reform Act Issue: Support increased funding for the National Health Service Corps, Teaching Health Center GME, and National Disaster Medical Service (NDMS) demonstration pilot. Support increased Medicare support for Graduate Medical Education/physician training. Issues: Educate Congress and the administration about the role of academic medicine in the provision of mental and behavioral health care, including initiatives to respond to the opioid epidemic. Support measures to expand access to mental health care and substance use disorder treatment, including funding for training on substance use disorders, pain management, and safe prescribing practices, enhance enforcement of mental health parity laws, increased financial support for integrated behavioral health models, and the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). Support Senate Finance Committee proposal to provide 400 additional Medicare-supported graduate medical education slots for psychiatry and psychiatry sub-specialties. H.R. 1384/ S.445 Mainstreaming Addiction Treatment (MAT) Act of 2021 Issue: Support suspension of waiver requirement for certain providers to prescribe buprenorphine. H.R. 2067 Medication Access and Training Expansion Act of 2021 Issue: Oppose legislative mandates dictating medical education curriculum on pain management and addiction. H.R. 7236 Strengthen Kids Mental Health Now Act Issue: Support increasing Medicaid reimbursement rates for pediatric mental health services through a 100% federal match. P.L. 116-22, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 Issues: Support the Hospital Preparedness Program and the reauthorization of the Pandemic and All-Hazards Preparedness Act. Support increased funding authorization levels. Issue: Educate Congress on how the 340B Drug Pricing Program helps safety-net providers to fulfill their missions and care for patients and communities. Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, including not providing 340B discounts on covered drugs purchased at community pharmacies. H.R. 4390 Preserving Rules Ordered for the Entities Covered Through 340B Act of 2021 (PROTECT 340B Act) Issue: Support measures to prevent pharmacy benefit managers and commercial insurers from discriminating against 340B covered entities. H.R. 3203/S. 773 Issue: Support policy to allow 340B DSH hospitals to remain eligible to participate in the program throughout the current public health emergency even if their DSH adjustment falls below the current threshold due to changes in payor mix as a result of the COVID-19 pandemic. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Support increased interoperability and exchange of electronic health information and delayed enforcement of information blocking rule until comprehensive guidance is issued. Issue: Support the ongoing refinement of the two new mandatory alternative payment models, the Radiation Oncology Model and End-stage Renal Disease Treatment Choices Model, to better incentivize high-quality care for all patients. H.R. 4128/ S. 2209 Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021 S. 4348, Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act of 2022 Issue: Educate Congress on development of Laboratory Developed Tests at academic medical centers and oppose policies that would increase burdensome regulations and negatively impact patients access to care by allowing Food and Drug Administration regulation of the development of Laboratory Developed Tests at academic medical centers. S. 4348, Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act of 2022 H.R. 7667, Food and Drug Amendments of 2022 (FDA22) Issue: Support promotion of data sharing and clinical trials results reporting. Support increased clinical trials diversity. Issue: Development of Enhanced Primary Care Pilot Act proposal Issue: Support initiatives of hospitals to promote affordable housing in local communities and eliminate other social determinants of health to improve health equity. H.R. 2503 Social Determinants Accelerator Act of 2021 Issue: Support grants to address social determinants of health H.R. 7585 / S. 4486, Health Equity and Accountability Act Issue: Support programs to improve health equity and address social determinants of health. Issue: Support incentives to encourage the inclusion of implicit bias training in medical education and residency training. Issue: Support congressional investment in the Centers for Medicare and Medicaid Innovation (CMMI) models to reduce maternal mortality and improve maternal health. Issue: Support maternal health initiatives to expand coverage for postpartum women and expand demonstration project grants. H.R. 959 Black Maternal Health Momnibus Act of 2021 S. 1695 / H.R. 4387 Maternal Health Quality Improvement Act S. 1491/ H.R. 769 Rural MOMs Act H.R. 4387 Maternal Health Quality Improvement Act of 2021 H.R. 5376, Build Back Better Act H.R. 925 / S. 347 Data to Save Moms Act Issue: Support legislative efforts to improve maternal health and reduce rates of maternal mortality, including the Momnibus. Support legislative initiatives to improve data collection to improve maternal health equity. P.L. 117-159, Bipartisan Safer Communities Act Issue: Support policies to promote firearm safety, universal background checks, violence prevention programs, extreme risk protection orders, child access safety laws, reinstating assault weapons ban, data infrastructure, hospital based and community violence intervention programs, and programs to address mental and behavioral health impact of gun violence. Issue: Support funding for Community Violence Interventions/ Hospital Based Violence Intervention Programs P.L. 117-105, Dr. Lorna Breen Health Care Provider Protection Act Issue: Support grants directed at improving clinician burnout and well-being. Issue: Provide feedback on implementation of the Provider Relief Fund. Support extension for use of PRF funds. Issue: Support improvements to the Medicare Accelerated and Advance Payment Programs, including delaying recoupment of MAAP loans. Issue: Support extension of public health emergency declaration. Issue: Provide feedback on COVID-19 and pandemic response. Provide feedback on monkeypox response including testing. S. 3799, PREVENT Pandemics Act Issue: Provide feedback on pandemic preparedness legislation, urge inclusion of provisions to support academic medical centers preparedness activities. Issue: Support establishment of regional pandemic response centers, stronger linkages between public health and academic medicine, and the role of medical students and academic medical centers in administering COVID vaccines. H.R. 8131 Increasing Competition for Medical Residency Act Issue: Educate Congress on the medical education and training continuum, the annual residency Match, and the role of the National Resident Matching Program (NRMP) in medical education and residency. Issue: Support efforts of academic medical centers to respond to public health threats such as monkeypox and COVID-19. Urge establishment and implementation of robust national testing strategy; functional, redundant, and transparent supply chain; improved federal coordination; investments in public health and health care human and other resources; data modernization initiatives; and other actions to improve current and future pandemic response. H.R. 708, S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act Issue: Support for a temporary uniform licensing standard for all practitioners in all states throughout the COVID-19 public health emergency S. 674 Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Support ensuring patients are put first, that conscience protections align with medical professionalism standards, and oppose interference in the patient-physician relationship. Issue: Support increased interoperability and exchange of electronic health information. Support delay of enforcement beyond April 2021. H.R. 6000, Cures 2.0 Act Issue: Provide feedback on provisions related to public health, patients and caregivers, FDA, CMS, and research, and ARPA-H. Issue: Promote strategies to strengthen the health, public health, and research workforces. H.R. 3671, Doctors of Community Act Issue: Discuss authorization of the Teaching Health Center Graduate Medical Education program. Issue: Provide guidance on the implementation of the No Surprises Act. Issue: Provide feedback on proposed modifications to the HIPAA privacy rule. H.R. 5035, S. 2982 Child Suicide Prevention and Lethal Means Safety Act Issue: Support legislation to provide grants to improve suicide prevention and lethal means safety. Issue: Inform Congress and Administration about medical education on caring for older adults, nutrition, climate change, stigma around addiction, reproductive health, and accelerated medical education training programs. Issue: Provide feedback on efforts of the academic medicine community to address climate change and decarbonization. H.R. 7152/ S.3534, The Tracking Pathogens Act Issue: Support expansion of CDC activities related to genomic sequencing of pathogens. Issue: Support reignition of Cancer Moonshot. H.R. 7961 - Safety from Violence for Healthcare Employees (SAVE) Act Issue: Support statutory protections against violence and intimidation for healthcare workers and provide grants for hospital programs aimed at preventing violence in healthcare settings. Issue: Support a one-year pause in military medical billet reductions in the Military Health System.

S.2982 / HR 5035 - Child Suicide and Lethal Means Safety Act S.4003 / HR 8637 - Law Enforcement De-Escalation Act S..3635 / HR 3071 - Public Safety Officer Support Act HR 8361 - Preventing Suicide Through Voluntary Firearm Purchase Delay Act S.4007/ HR 8058 - Fighting Post Traumatic Stress Disorder Act of 2022

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

Government targets: HOUSE OF REPRESENTATIVES, Justice, Dept of (DOJ), 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

Issues relating to the intersection of suicide and firearms; H.R. 2749 / S. 1277 Lethal Means Safety Training Act; H.R. 5035 / S. 2982 the Child Suicide Prevention and Lethal Means Safety Act; Representative Brownley's Gun Suicide Prevention Act; issues relating to community violence; H.R. 4118 Break the Cycle of Violence Act.

Client expense: Not reported · Firm income: Not reported

Issues relating to universal background checks; H.R. 8 Bipartisan Background Checks Act of 2021; S. 529 Background Check Expansion Act; H.R. 1446 Enhanced Background Checks Act of 2021; S. 591 Background Check Completion Act; issues relating to the intersection of health and firearms; H.R. 2749 / S. 1277 Lethal Means Safety Training Act; H.R. 5035 / S. 2982 the Child Suicide Prevention and Lethal Means Safety Act; Representative Brownley's Gun Suicide Prevention Act; H.R. 4118 Break the Cycle of Violence Act; H.R. 2377 / S. 1819 ERPO Act; issues relating to the intersection of policing and gun violence; H.R. 1280 George Floyd Justice in Policing Act of 2021; H.R. 1808 / S. 736 Assault Weapons Ban. H.R. 2377 / S. 1819 ERPO Act

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021, a bill to provide for special enrollment periods during public health emergencies; Letter urging Congress to provide additional funds to the Provider Relief Fund and for vaccine distribution and administration, which will allow for continued support of hospitals' COVID-19-related lost revenues, as well as additional expenses incurred due to purchasing supplies and equipment, staffing, establishing emergency testing and vaccination centers and constructing and retrofitting facilities; Support H.R. 708 and S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, a bill to provide temporary licensing reciprocity for telehealth and interstate health care treatment; Support H.R. 1306 and S. 412, National Coronavirus Commission Act of 2021, a bill to establish the Commission on the Coronavirus Pandemic in the United States; Support S. 610/ H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 773 a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; Support S.834, Resident Physician Shortage Reduction Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan and urge the Committee on Education and Labor not to report it favorably; Support S.924 and H.R. 2130, Rural America Health Corps Act, a bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Discussions with ASPR about COVID-19 related medical supply and personnel shortages; Discussions with FEMA about COVID-19 public assistance funding policies; Letter asking Congress to consider an infrastructure proposal that you prioritize hospital and health system needs to ensure our nations health care system is well positioned to meet the opportunities and challenges that lie ahead; Support S.1512/H.R. 2903, CONNECT for Health Act of 2021, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services; Support H.R. 2255/ S 1024, Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Support S.1568, Technical Reset to Advance the Instruction of Nurses (TRAIN) Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Support H.R. 3203, a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Statement to Senate Committee on Homeland Security and Governmental Affairs hearing on "COVID-19 Part II: Evaluating the Medical Supply Chain and Pandemic Response Gaps" urges Congress to take steps to strengthen the nations medical supply chain; Statement to Senate Committee on Finance hearing on COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned stating that these flexibilities can continue to drive significant improvements in patient care long after the public health emergency (PHE) ends and given the beneficial impact of those specific flexibilities urges Congress and the Administration to make them permanent. In addition, a second group of flexibilities will remain critically important for some time following the PHE and will require a carefully crafted phase-out plan to ensure enough time is provided for a necessary transition. Without action from Congress and the Administration prior to the termination of the PHE, we are concerned that much of the progress made because of the implementation of many of these flexibilities may be unnecessarily halted or even lost; Letter urges Senate HELP Committee to consider recommendations and prioritize programs that support the health care workforce needs of the country in the wake of the COVID-19 pandemic and into the future; Support H.R. 769/S. 1491, Rural Maternal and Obstetric Modernization of Services Act or the Rural MOMS Act, a bill to amend the Public Health Service Act to improve obstetric care in rural areas; Support for S.1675/ H.R. 4387, Maternal Health Quality Improvement Act, a bill to improve maternal health; Support 1438, Opioid Workforce Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Support HR 3441,Substance Use Disorder Workforce Act, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the substance use disorder crisis; Support S.1810 / H.R.3541, Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; Statement to the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights for the hearing on Antitrust Applied: Hospital Consolidation Concerns and Solutions expressing that integration helps to ensure every community, whether rural, urban or suburban, has access to the same high standard of affordable, evidenced based care; discussions to ensure that H.R. 2547s limits on unfair practice under FDCPA for debt collectors does not inappropriately interfere with or restrict the ability of hospitals to be able to obtain payment for care provided; Support for revising/repealing changes to the Rural Health Clinic (RHC) Program that reduced reimbursement for provider-based RHCs; Hill outreach expressing concerns with United Healths retroactive denial of coverage for emergency-level care in facilities; Hill outreach expressing concern about CMS mid-build audit denials; Senate outreach on prior authorization legislation; Urge support for legislation/administrative action to extend the deadline to use PRF money; Urged HRSA to ensure that the drug companies that denied 340B Statute appropriate discounts make the impacted hospitals whole for the benefit of the vulnerable communities they serve; Support S. 2304 Drug-Price Transparency for Competition Act of 2021 (DTC Act of 2021), a bill to amend title XI of the Social Security Act to require that direct-to-consumer advertisements for prescription drugs and biological products include an appropriate disclosure of pricing information; Support S.246/H.R.851 Future Advancement of Academic Nursing Act or the FAAN Act, a bill to amend the Public Health Service Act to authorize grants to support schools of nursing in program enhancement and infrastructure modernization, increasing the number of nursing faculty and students, and for other purposes; Support S. 1568/HR 4407Technical Reset to Advance the Instruction of Nurses Act or the TRAIN Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Comment letter to the Occupational Safety and Health Administration (OSHA) recommending the withdrawal of the COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Meeting with Department of Labor staff to discuss our concerns about the OSHA COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Discussion with ASPR staff overseeing the Strategic National Stockpile about their intent to procure supplies of surgical masks; Call with Senator Cassidys staff to discuss concerns about impact of FEMA COVID-19 funding of traveling nurse agencies on hospital nursing shortages; Oppose S 2428, False Claims Amendments Act of 2021A bill to amend title 31, United States Code, to modify False Claims Act procedures, and for other purposes; Discussions about Provider Relief Fund - reporting on past disbursements and urging HHS to disburse remaining PRF money; Discussions about the challenges that teaching hospitals have with training the physician workforce, residency caps that limit funding for training programs, a shortage of residents pursuing primary care specialties, a growing patient pool due to the newly insured and aging of the population; Discussions about the hospital and health system priorities for infrastructure and reconciliation bills; Letter urging Congress to maintain the current legal and regulatory framework for evaluating mergers and acquisitions; Hill outreach to discuss the benefits of health care integration; Hill outreach about the negative impact of potentially anticompetitive conduct by nurse-staffing agencies; Support HR 5035/ S 2982 Child Suicide Prevention and Lethal Means Safety Act, a bill to authorize the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes; Support H.R.5376 Build Back Better Act, this bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment; Discussions with members of congress about the implementation of Rural Emergency Hospital payment designation; Discussions on the No Surprises Act Implementation (surprise billing) and urging federal regulators to restore the independence of the independent dispute resolution process in the No Surprises Act Part 2 regulations; Support HR 5699 Student Assisted Vaccination Effort (SAVE) Act, a bill to expand the definition of qualified persons for purposes of the Public Readiness and Emergency Preparedness Act to include health professional students; Support S 2873 Preventing and Addressing Trauma with Health Services Act (PATHS Act), a bill to require the Secretary of Health and Human Services to award grants to establish or expand programs and activities to increase access to high-quality culturally competent trauma support and mental health care; Letter urging HRSA to delay proposals to withdraw certain HPSAs; Support S 3497 and HR 6397, Medical Student Education Authorization Act of 2022, a bill to amend the Public Health Service Act to establish a grant program to award grants to public institutions of higher education located in a covered State; Support HR 6279 and S 3629, Opioid Treatment Access Act of 2022, a bill to authorize a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs during the COVID-19 public health emergency; Support HR 5703 and S 3677, Post-Disaster Mental Health Response Act, a bill to amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to authorize the President to provide professional counseling services to victims of emergencies declared under such Act; Submitted a statement on the hearing for Pandemic Profiteers: Legislation to Stop Corporate Price Gouging regarding concerns about anticompetitive conduct on the part of health care staffing agencies, some of which have been exploiting the severe shortage of health care providers during the COVID-19 pandemic; Submitted a statement on the hearing for Americas Mental Health Crisis and supports additional approaches to help ensure improved access to needed comprehensive, affordable and quality behavioral health services; Provide comments to the Affordability Subcommittee of the Healthy Future Task Force expressing our shared focus with Congress on providing relief from the pandemic, ensuring a smooth recovery and rebuilding a better health care system for the future, all while continuing to support efforts to promote greater affordability and value to patients and the health care system; Submitted statement on the hearing for Recruiting, Revitalizing & Diversifying: Examining the Health Care Workforce Shortage about the challenges ahead and the need to examine Americas health care workforce shortage. We must work together to solve these issues so that our nations hospitals and health systems can continue to care for the patients and communities they serve; Submitted statement on the hearing for Protecting Youth Mental Health: Part II - Identifying and Addressing Barriers to Care examines ways to protect the mental health of our nations youth; Submitted statement on the hearing for Exploring Pathways to Affordable, Universal Health Coverage Care expressing the need to build upon and improve our existing system to increase access to coverage of comprehensive health benefits; Submitted a letter to provide information regarding the challenges facing Americas health care workforce as the country enters the third year of the COVID-19 pandemic; Provided comments to the Modernization Subcommittee of the Healthy Future Task Force urging Congress to consider how to ensure the telehealth flexibilities could remain in place for patients and health care providers beyond the PHE; Support HR 7053 and S 3792, Hospital Inpatient Services Modernization Act, a bill to amend title XVIII of the Social Security Act to extend acute hospital care at home waiver flexibilities; Support resolution, 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; Letter urges Congress to provide immediate additional support for hospitals and health systems serving their communities during this unprecedented public health crisis. While the support Congress has provided during the last two years of the COVID-19 pandemic has helped hospitals care for their patients and communities, there is still a significant need for financial support and relief as COVID-19 challenges persist; Support S 3904, Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Letter urging OSHA to extend the comment deadline for the rule making on the occupational exposure to COVID-19 in healthcare settings by at least an additional 30 days, through May 23; Meeting with the Office of the Assistant Secretary of Health (OASH) at HHS to discuss the widespread blood shortages in the U.S. and next steps; Stakeholder calls with HHS ASPR regarding the distribution/administration of COVID-19 therapeutics; Discussions on S 571, Public Health Funding Prevents Pandemics Act, a bill to fully fund the Prevention and Public Health Fund and reaffirm the importance of prevention in the United States healthcare system; Regular calls with ASPR and other stakeholders participating in the Health Care and Public Health (HPH) Sector Joint Supply Chain Resilience Working Group (Joint SCRWG), a formal Working Group under the authority of the Critical Infrastructure Partnership Advisory Council (CIPAC) to support the Presidents vision for a resilient public health supply chain; Monthly calls with ASPRs Hospital Preparedness Program (HPP) to discuss updates on the hospital association COVID-19 funding program; Call with ASPR Healthcare and Public Health Government Coordinating Council leadership and other hospital associations to provide feedback on the COVID-19 hospital data guidance update; Provide comment letter to OSHA on the re-opening of comments on the Occupational Exposure to COVID-19 Rulemaking in which we urge OSHA not to finalize its rule for occupational exposure to COVID-19. In our comments, we indicate that we continue to oppose establishing new regulations that are not fully aligned with the Centers for Disease Control and Preventions evolving evidence-based guidance. With the constantly evolving, science-based CDC guidance and recommendations, CMS vaccination requirement and existing OSHA general standards, we strongly believe that an inconsistent and overly strict OSHA COVID-19 health care standard is not necessary, would cause confusion and will ultimately lower hospital employees morale and worsen unprecedented personnel shortages in hospitals. It is essential to a well-functioning health care system that only one set of science-based standards be applied to health care providers, and that these standards be aligned across federal agencies; Letter urging Congress to make the expanded tax credits permanent, ensuring millions of low- and middle-income families continue to have access to affordable coverage in 2023 and beyond; Express concerns with the letter to CMS from Congressman Murphy that makes a number of requests for data surrounding the COVID-19 add on payments for hospitals. We are concerned about the questions as they do not take into account the continued needs of the nations hospitals and health systems. Hospitals continue to face numerous challenges, including increased labor and supply costs and workforce shortages. These additional payments have helped to address some but not all of the high costs associated with COVID-19 patient care. The complexity of care is still higher than pre-pandemic levels as measured by length of stay, which further indicates that its still more resource intensive to treat COVID inpatients. In addition, the high costs associated personal protective equipment, isolation measures, and other additional resources are necessary when treating all patients, unless and until it is determined they do not have COVID-19; Submitted a letter to Ways and Means per their request for information on the health care industry and climate change. We support the sustainability efforts while acknowledging that for a variety of reasons, many hospitals and health systems face challenges and barriers to implementing this work, especially while responding to a pandemic; Letter urging HHS to maintain the COVID-19 public health emergency (PHE) until it is clear that the global pandemic has receded and the capabilities authorized by the PHE are no longer necessary. This will help prevent any future surges from threatening the health and safety of patients and the ability of health care professionals to care for them; Long COVID Best Clinical Practices Discussion with the White House Policy Advisor, Office of the COVID-19 Response; Submitted comment letter to the Federal Trade Commission outlining the impact pharmacy benefit managers (PBMs) practices have on the field. Specifically, urging the FTC to increase scrutiny on insured-mandated white bagging policies, as well as the impact of PBM-negotiated rebates and other business practices on the 340B drug discount pricing program and overall drug prices and drug price increases; Submit a comment letter to the Internal Revenue Service for their proposed rule amending how employer coverage affordability would be measured for family members of employees. We advocated for a fix to the current methodology for assessing affordability of employer coverage for family members, often referred to as the family glitch, which is estimated to affect about 5 million individuals. We commend the IRS on proposing to revise the regulation and improve access to health insurance coverage for millions of American families; Concerns S.4348, Food and Drug Administration Safety and Landmark Advancements Act of 2022 or the FDASLA Act of 2022, a bill to amend the Federal Food, Drug, and Cosmetic Act to revise and extend the user-fee programs for prescription drugs, medical devices, generic drugs, and biosimilar biological product; Comment letter on CMS Radiation Oncology (RO) Model proposed rule. We strongly supports CMS efforts to transform the delivery of cancer care. We also support the original intent of the RO Model, which was to protect access to care by ensuring fair, predictable payment for radiation oncologists. However, this important goal of the original RO Model has been marred by the incorporation of significant payment cuts and substantial administrative burdens for those participating in this mandatory model. As such, the AHA supports CMSs proposal to delay the start date of the RO model from Jan. 1, 2023 to a date to be determined through future rulemaking; Support S. 4352,Travel Nursing Agency Transparency Study Act, a bill to require a study on the effects of travel nurse agencies on the health industry during the COVID-19 pandemic; Letter in response to CMS request for guidance on implementing the regulatory requirement for convening providers and facilities exchange information with co-providers and co-facilities to create a comprehensive good faith estimate as part of the implementation of the No Surprises Act. Due to the lack of currently available automated solutions, this process would require a significant manual effort by providers, which would undoubtedly result in the convening provider being unable to meet the short statutory timeframes for delivering good faith estimates to the patients and could also lead to inadvertent errors. AHA has requested an extension in enforcement direction until a technical solution has been identified and implemented; Support HR 7691, Safety From Violence for Healthcare Employees Act or the SAVE Act, a bill to protect hospital personnel from violence, and for other purposes; Letter requesting that HHS, HRSA, and OIG take immediate enforcement action against the now 17 companies that are refusing to honor their obligations under the 340B program; Letter sent to HHS Secretary to discuss how best to ensure prompt repayment to 340B hospitals without penalizing the rest of the hospital field after the U.S. Supreme Court unanimously agreed that HHS outpatient payment cuts to hospitals in the 340B Drug Pricing Program were unlawful. The Courts decision did not determine a remedy for the unlawful payment cuts, instead, it remanded the case to the lower courts to address the proper remedy; Support HR 7084/ S 3983, Protecting and Transforming Cyber Health Care Act of 2022 or the PATCH Act of 2022, a bill to amend the Federal Food, Drug, and Cosmetic Act to require, for purposes of ensuring cybersecurity, the inclusion in any premarket submission for a cyber device of information to demonstrate a reasonable assurance of safety and effectiveness throughout the lifecycle of the cyber device, and for other purposes; Submit Comment letter of support for CMS continued focus on strengthening health insurance coverage and ensuring ease of enrollment and limited gaps in coverage, including proposed updates to Medicare enrollment and eligibility rules; Submit letter for oversight hearing on Medicare Advantage (MA) plans expressing concerns about some MA plans inappropriate restrictions on beneficiary access to medically necessary care, including those highlighted in a recent report issued by the Department of Health and Human Services Office of Inspector General (HHS-OIG), and urge Congress to increase its oversight of these plans.

Issue: Educate Congress and the administration on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. Draft Graduate Medical Education Reform Act Issue: Support increased funding for the National Health Service Corps, Teaching Health Center GME, and National Disaster Medical Service (NDMS) demonstration pilot. Support increased Medicare support for Graduate Medical Education/physician training. Issues: Educate Congress and the administration about the role of academic medicine in the provision of mental and behavioral health care, including initiatives to respond to the opioid epidemic. Support measures to expand access to mental health care and substance use disorder treatment, including funding for training on substance use disorders, pain management, and safe prescribing practices, enhance enforcement of mental health parity laws, increased financial support for integrated behavioral health models, and the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). H.R. 1384/ S.445 Mainstreaming Addiction Treatment (MAT) Act of 2021 Issue: Support suspension of waiver requirement for certain providers to prescribe buprenorphine. H.R. 2067 Medication Access and Training Expansion Act of 2021 Issue: Oppose legislative mandates dictating medical education curriculum on pain management and addiction. H.R. 7236 Strengthen Kids Mental Health Now Act Issue: Support increasing Medicaid reimbursement rates for pediatric mental health services through a 100% federal match. P.L. 116-22, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 Issues: Support the Hospital Preparedness Program and the reauthorization of the Pandemic and All-Hazards Preparedness Act. Support increased funding authorization levels. Issue: Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, including not providing 340B discounts on covered drugs purchased at community pharmacies. H.R. 4390 Preserving Rules Ordered for the Entities Covered Through 340B Act of 2021 (PROTECT 340B Act) Issue: Support measures to prevent pharmacy benefit managers and commercial insurers from discriminating against 340B covered entities. H.R. 3203/S. 773 Issue: Support policy to allow 340B DSH hospitals to remain eligible to participate in the program throughout the current public health emergency even if their DSH adjustment falls below the current threshold due to changes in payor mix as a result of the COVID-19 pandemic. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Support increased interoperability and exchange of electronic health information and delayed enforcement of information blocking rule until comprehensive guidance is issued. Issue: Support the ongoing refinement of the two new mandatory alternative payment models, the Radiation Oncology Model and End-stage Renal Disease Treatment Choices Model, to better incentivize high-quality care for all patients. H.R. 4128/ S. 2209 Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021 S. 4348, Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act of 2022 Issue: Educate Congress on development of Laboratory Developed Tests at academic medical centers and oppose policies that would increase burdensome regulations and negatively impact patients access to care. Issue: Development of Enhanced Primary Care Pilot Act proposal H.R.7585, Health Equity and Accountability Act Issue: Support programs to improve health equity and address social determinants of health. Issue: Support initiatives of hospitals to promote affordable housing in local communities and eliminate other social determinants of health to improve health equity. H.R. 2503 Social Determinants Accelerator Act of 2021 Issue: Support grants to address social determinants of health Issue: Support congressional investment in the Centers for Medicare and Medicaid Innovation (CMMI) models to reduce maternal mortality and improve maternal health. Issue: Support maternal health initiatives to expand coverage for postpartum women and expand demonstration project grants. H.R. 959 Black Maternal Health Momnibus Act of 2021 S. 1695 / H.R. 4387 Maternal Health Quality Improvement Act S. 1491/ H.R. 769 Rural MOMs Act H.R. 4387 Maternal Health Quality Improvement Act of 2021 H.R. 5376, Build Back Better Act H.R. 925 / S. 347 Data to Save Moms Act Issue: Support legislative efforts to improve maternal health and reduce rates of maternal mortality, including the Momnibus. Support legislative initiatives to improve data collection to improve maternal health equity. P.L. 117-159, Bipartisan Safer Communities Act Issue: Support policies to promote firearm safety, universal background checks, violence prevention programs, extreme risk protection orders, child access safety laws, reinstating assault weapons ban, data infrastructure, hospital based and community violence intervention programs, and programs to address mental and behavioral health impact of gun violence. Issue: Support funding for Community Violence Interventions/ Hospital Based Violence Intervention Programs P.L. 117-105, Dr. Lorna Breen Health Care Provider Protection Act Issue: Support grants directed at improving clinician burnout and well-being. Issue: Provide feedback on implementation of the Provider Relief Fund. Support extension for use of PRF funds. Issue: Support improvements to the Medicare Accelerated and Advance Payment Programs, including delaying recoupment of MAAP loans. Issue: Support extension of public health emergency declaration. Issue: Provide feedback on COVID-19 and pandemic response. S. 3799, PREVENT Pandemics Act Issue: Provide feedback on pandemic preparedness legislation, urge inclusion of provisions to support academic medical centers preparedness activities. Issue: Support establishment of regional pandemic response centers, stronger linkages between public health and academic medicine, and the role of medical students and academic medical centers in administering COVID vaccines. Issue: Support efforts of academic medical centers to respond to public health threats such as monkeypox and COVID-19. Urge establishment and implementation of robust national testing strategy; functional, redundant, and transparent supply chain; improved federal coordination; investments in public health and health care human and other resources; data modernization initiatives; and other actions to improve current and future pandemic response. H.R. 708, S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act Issue: Support for a temporary uniform licensing standard for all practitioners in all states throughout the COVID-19 public health emergency S. 674 Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Support ensuring patients are put first, that conscience protections align with medical professionalism standards, and oppose interference in the patient-physician relationship. Issue: Support increased interoperability and exchange of electronic health information. Support delay of enforcement beyond April 2021. S. 4348, Food and Drug Administration Safety and Landmark Advancements (FDASLA) Act of 2022 H.R. 7667, Food and Drug Amendments of 2022 (FDA22) Issue: Support promotion of data sharing and clinical trials results reporting. Support increased clinical trials diversity. H.R. 6000, Cures 2.0 Act Issue: Provide feedback on provisions related to public health, patients and caregivers, FDA, CMS, and research, and ARPA-H. Issue: Promote strategies to strengthen the health, public health, and research workforces. H.R. 3671, Doctors of Community Act Issue: Discuss authorization of the Teaching Health Center Graduate Medical Education program. Issue: Provide guidance on the implementation of the No Surprises Act. Issue: Provide feedback on proposed modifications to the HIPAA privacy rule. H.R. 5035, S. 2982 Child Suicide Prevention and Lethal Means Safety Act Issue: Support legislation to provide grants to improve suicide prevention and lethal means safety. Issue: Inform Congress about medical education on caring for older adults, nutrition, climate change, and opportunities to accelerate training. Issue: Provide feedback on efforts of the academic medicine community to address climate change and decarbonization. H.R. 7152/ S.3534, The Tracking Pathogens Act Issue: Support expansion of CDC activities related to genomic sequencing of pathogens. Issue: Support reignition of Cancer Moonshot. Issue: Educate Congress on accelerated medical education programs. Issue: Educate Congress and the administration on AAMC member curriculum on climate change and nutrition.

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

Support H.R. 526, Ensuring Coverage in Public Health Emergencies Act of 2021, a bill to provide for special enrollment periods during public health emergencies; Letter urging Congress to provide additional funds to the Provider Relief Fund and for vaccine distribution and administration, which will allow for continued support of hospitals' COVID-19-related lost revenues, as well as additional expenses incurred due to purchasing supplies and equipment, staffing, establishing emergency testing and vaccination centers and constructing and retrofitting facilities; Support H.R. 708 and S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, a bill to provide temporary licensing reciprocity for telehealth and interstate health care treatment; Support H.R. 1306 and S. 412, National Coronavirus Commission Act of 2021, a bill to establish the Commission on the Coronavirus Pandemic in the United States; Support S. 610/ H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act, a bill to address behavioral health and well-being among health care professionals; Support S. 773 a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program; Support S.834, Resident Physician Shortage Reduction Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions; Oppose H.R. 1195, Workplace Violence Prevention for Health Care and Social Service Workers Act, a bill to direct the Secretary of Labor to issue an occupational safety and health standard that requires covered employers within the health care and social service industries to develop and implement a comprehensive workplace violence prevention plan and urge the Committee on Education and Labor not to report it favorably; Support S.924 and H.R. 2130, Rural America Health Corps Act, a bill to establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program; Discussions with ASPR about COVID-19 related medical supply and personnel shortages; Discussions with FEMA about COVID-19 public assistance funding policies; Letter asking Congress to consider an infrastructure proposal that you prioritize hospital and health system needs to ensure our nations health care system is well positioned to meet the opportunities and challenges that lie ahead; Support S.1512/H.R. 2903, CONNECT for Health Act of 2021, a bill to amend title XVIII of the Social Security Act to expand access to telehealth services; Support H.R. 2255/ S 1024, Healthcare Workforce Resilience Act, a bill to enhance our Nations nurse and physician workforce during the COVID-19 crisis by recapturing unused immigrant visas; Support S.1568, Technical Reset to Advance the Instruction of Nurses (TRAIN) Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Support H.R. 3203, a bill to enable certain hospitals that were participating in or applied for the drug discount program under section 340B of the Public Health Service Act prior to the COVID-19 public health emergency to temporarily maintain eligibility for such program, and for other purposes; Statement to Senate Committee on Homeland Security and Governmental Affairs hearing on "COVID-19 Part II: Evaluating the Medical Supply Chain and Pandemic Response Gaps" urges Congress to take steps to strengthen the nations medical supply chain; Statement to Senate Committee on Finance hearing on COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned stating that these flexibilities can continue to drive significant improvements in patient care long after the public health emergency (PHE) ends and given the beneficial impact of those specific flexibilities urges Congress and the Administration to make them permanent. In addition, a second group of flexibilities will remain critically important for some time following the PHE and will require a carefully crafted phase-out plan to ensure enough time is provided for a necessary transition. Without action from Congress and the Administration prior to the termination of the PHE, we are concerned that much of the progress made because of the implementation of many of these flexibilities may be unnecessarily halted or even lost; Letter urges Senate HELP Committee to consider recommendations and prioritize programs that support the health care workforce needs of the country in the wake of the COVID-19 pandemic and into the future; Support H.R. 769/S. 1491, Rural Maternal and Obstetric Modernization of Services Act or the Rural MOMS Act, a bill to amend the Public Health Service Act to improve obstetric care in rural areas; Support for S.1675/ H.R. 4387, Maternal Health Quality Improvement Act, a bill to improve maternal health; Support 1438, Opioid Workforce Act of 2021, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the opioid crisis; Support HR 3441,Substance Use Disorder Workforce Act, a bill to amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions to help combat the substance use disorder crisis; Support S.1810 / H.R.3541, Conrad State 30 and Physician Access Reauthorization Act, a bill to provide incentives to physicians to practice in rural and medically underserved communities; Statement to the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights for the hearing on Antitrust Applied: Hospital Consolidation Concerns and Solutions expressing that integration helps to ensure every community, whether rural, urban or suburban, has access to the same high standard of affordable, evidenced based care; discussions to ensure that H.R. 2547s limits on unfair practice under FDCPA for debt collectors does not inappropriately interfere with or restrict the ability of hospitals to be able to obtain payment for care provided; Support for revising/repealing changes to the Rural Health Clinic (RHC) Program that reduced reimbursement for provider-based RHCs; Hill outreach expressing concerns with United Healths retroactive denial of coverage for emergency-level care in facilities; Hill outreach expressing concern about CMS mid-build audit denials; Senate outreach on prior authorization legislation; Urge support for legislation/administrative action to extend the deadline to use PRF money; Urged HRSA to ensure that the drug companies that denied 340B Statute appropriate discounts make the impacted hospitals whole for the benefit of the vulnerable communities they serve; Support S. 2304 Drug-Price Transparency for Competition Act of 2021 (DTC Act of 2021), a bill to amend title XI of the Social Security Act to require that direct-to-consumer advertisements for prescription drugs and biological products include an appropriate disclosure of pricing information; Support S.246/H.R.851 Future Advancement of Academic Nursing Act or the FAAN Act, a bill to amend the Public Health Service Act to authorize grants to support schools of nursing in program enhancement and infrastructure modernization, increasing the number of nursing faculty and students, and for other purposes; Support S. 1568/HR 4407Technical Reset to Advance the Instruction of Nurses Act or the TRAIN Act, a bill to amend title XVIII of the Social Security Act to provide a waiver of the cap on annual payments for nursing and allied health education payments; Comment letter to the Occupational Safety and Health Administration (OSHA) recommending the withdrawal of the COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Meeting with Department of Labor staff to discuss our concerns about the OSHA COVID-19 Emergency Temporary Standard for occupational exposure to COVID-19; Discussion with ASPR staff overseeing the Strategic National Stockpile about their intent to procure supplies of surgical masks; Call with Senator Cassidys staff to discuss concerns about impact of FEMA COVID-19 funding of traveling nurse agencies on hospital nursing shortages; Oppose S 2428, False Claims Amendments Act of 2021A bill to amend title 31, United States Code, to modify False Claims Act procedures, and for other purposes; Discussions about Provider Relief Fund - reporting on past disbursements and urging HHS to disburse remaining PRF money; Discussions about the challenges that teaching hospitals have with training the physician workforce, residency caps that limit funding for training programs, a shortage of residents pursuing primary care specialties, a growing patient pool due to the newly insured and aging of the population; Discussions about the hospital and health system priorities for infrastructure and reconciliation bills; Letter urging Congress to maintain the current legal and regulatory framework for evaluating mergers and acquisitions; Hill outreach to discuss the benefits of health care integration; Hill outreach about the negative impact of potentially anticompetitive conduct by nurse-staffing agencies; Support HR 5035/ S 2982 Child Suicide Prevention and Lethal Means Safety Act, a bill to authorize the Secretary of Health and Human Services to award grants to establish or expand programs to implement evidence-aligned practices in health care settings for the purpose of reducing the suicide rates of covered individuals, and for other purposes; Support H.R.5376 Build Back Better Act, this bill provides funding, establishes programs, and otherwise modifies provisions relating to a broad array of areas, including education, labor, child care, health care, taxes, immigration, and the environment; Discussions with members of congress about the implementation of Rural Emergency Hospital payment designation; Discussions on the No Surprises Act Implementation (surprise billing) and urging federal regulators to restore the independence of the independent dispute resolution process in the No Surprises Act Part 2 regulations; Support HR 5699 Student Assisted Vaccination Effort (SAVE) Act, a bill to expand the definition of qualified persons for purposes of the Public Readiness and Emergency Preparedness Act to include health professional students; Support S 2873 Preventing and Addressing Trauma with Health Services Act (PATHS Act), a bill to require the Secretary of Health and Human Services to award grants to establish or expand programs and activities to increase access to high-quality culturally competent trauma support and mental health care; Letter urging HRSA to delay proposals to withdraw certain HPSAs; Support S 3497 and HR 6397, Medical Student Education Authorization Act of 2022, a bill to amend the Public Health Service Act to establish a grant program to award grants to public institutions of higher education located in a covered State; Support HR 6279 and S 3629, Opioid Treatment Access Act of 2022, a bill to authorize a study on certain exemptions for treatment of opioid use disorder through opioid treatment programs during the COVID-19 public health emergency; Support HR 5703 and S 3677, Post-Disaster Mental Health Response Act, a bill to amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to authorize the President to provide professional counseling services to victims of emergencies declared under such Act; Submitted a statement on the hearing for Pandemic Profiteers: Legislation to Stop Corporate Price Gouging regarding concerns about anticompetitive conduct on the part of health care staffing agencies, some of which have been exploiting the severe shortage of health care providers during the COVID-19 pandemic; Submitted a statement on the hearing for Americas Mental Health Crisis and supports additional approaches to help ensure improved access to needed comprehensive, affordable and quality behavioral health services; Provide comments to the Affordability Subcommittee of the Healthy Future Task Force expressing our shared focus with Congress on providing relief from the pandemic, ensuring a smooth recovery and rebuilding a better health care system for the future, all while continuing to support efforts to promote greater affordability and value to patients and the health care system; Submitted statement on the hearing for Recruiting, Revitalizing & Diversifying: Examining the Health Care Workforce Shortage about the challenges ahead and the need to examine Americas health care workforce shortage. We must work together to solve these issues so that our nations hospitals and health systems can continue to care for the patients and communities they serve; Submitted statement on the hearing for Protecting Youth Mental Health: Part II - Identifying and Addressing Barriers to Care examines ways to protect the mental health of our nations youth; Submitted statement on the hearing for Exploring Pathways to Affordable, Universal Health Coverage Care expressing the need to build upon and improve our existing system to increase access to coverage of comprehensive health benefits; Submitted a letter to provide information regarding the challenges facing Americas health care workforce as the country enters the third year of the COVID-19 pandemic; Provided comments to the Modernization Subcommittee of the Healthy Future Task Force urging Congress to consider how to ensure the telehealth flexibilities could remain in place for patients and health care providers beyond the PHE; Support HR 7053 and S 3792, Hospital Inpatient Services Modernization Act, a bill to amend title XVIII of the Social Security Act to extend acute hospital care at home waiver flexibilities; Support resolution, 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; Letter urges Congress to provide immediate additional support for hospitals and health systems serving their communities during this unprecedented public health crisis. While the support Congress has provided during the last two years of the COVID-19 pandemic has helped hospitals care for their patients and communities, there is still a significant need for financial support and relief as COVID-19 challenges persist; Support S 3904, Healthcare Cybersecurity Act of 2022, a bill to enhance the cybersecurity of the Healthcare and Public Health Sector; Letter urging OSHA to extend the comment deadline for the rule making on the occupational exposure to COVID-19 in healthcare settings by at least an additional 30 days, through May 23; Meeting with the Office of the Assistant Secretary of Health (OASH) at HHS to discuss the widespread blood shortages in the U.S. and next steps; Stakeholder calls with HHS ASPR regarding the distribution/administration of COVID-19 therapeutics; Discussions on S 571, Public Health Funding Prevents Pandemics Act, a bill to fully fund the Prevention and Public Health Fund and reaffirm the importance of prevention in the United States healthcare system; Regular calls with ASPR and other stakeholders participating in the Health Care and Public Health (HPH) Sector Joint Supply Chain Resilience Working Group (Joint SCRWG), a formal Working Group under the authority of the Critical Infrastructure Partnership Advisory Council (CIPAC) to support the Presidents vision for a resilient public health supply chain; Monthly calls with ASPRs Hospital Preparedness Program (HPP) to discuss updates on the hospital association COVID-19 funding program; Call with ASPR Healthcare and Public Health Government Coordinating Council leadership and other hospital associations to provide feedback on the COVID-19 hospital data guidance update.

Issue: Educate Congress and the administration on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. Draft Graduate Medical Education Reform Act Issue: Support increased funding for the National Health Service Corps, Teaching Health Center GME, and National Disaster Medical Service (NDMS) demonstration pilot. Support increased Medicare support for Graduate Medical Education/physician training. Issues: Educate Congress and the administration about academic medicines response to the opioid epidemic. Support funding for training on substance use disorders, pain management, and safe prescribing practices. Support suspension of DATA waivers and new guidelines to expand access to buprenorphine. Support continuation of telehealth flexibilities allowing authorized practitioners to prescribe buprenorphine. Issue: Educate Congress on the role of academic medicine in the provision of mental and behavioral health care. Support measures to expand access to mental health care, including enhanced enforcement of mental health parity laws, expanded funding for integrated behavioral health models, and the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). H.R. 1384/ S.445 Mainstreaming Addiction Treatment (MAT) Act of 2021 Issue: Support suspension of waiver requirement for certain providers to prescribe buprenorphine. P.L. 116-22, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 Issues: Support the Hospital Preparedness Program and the reauthorization of the Pandemic and All-Hazards Preparedness Act. Support increased funding authorization levels. Issue: Support high-quality affordable health insurance. Support programs and funds for safety-net providers. Issue: Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, including not providing 340B discounts on covered drugs purchased at community pharmacies. H.R. 3203/S. 773 Issue: Support policy to allow 340B DSH hospitals to remain eligible to participate in the program throughout the current public health emergency even if their DSH adjustment falls below the current threshold due to changes in payor mix as a result of the COVID-19 pandemic. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Support increased interoperability and exchange of electronic health information and delayed enforcement of information blocking rule until comprehensive guidance is issued. Issue: Support the ongoing refinement of the two new mandatory alternative payment models, the Radiation Oncology Model and End-stage Renal Disease Treatment Choices Model, to better incentivize high-quality care for all patients. H.R. 4128/ S. 2209 Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021 Issue: Educate Congress on development of Laboratory Developed Tests and impact of burdensome regulation on patients access to care at academic medical centers. Issue: Development of Enhanced Primary Care Pilot Act proposal Draft Health Equity and Accountability Act Issue: Support programs to improve health equity and address social determinants of health. Issue: Support initiatives of hospitals to promote affordable housing in local communities and eliminate other social determinants of health to improve health equity. H.R. 2503 Social Determinants Accelerator Act of 2021 Issue: Support grants to address social determinants of health Issue: Support congressional investment in the Centers for Medicare and Medicaid Innovation (CMMI) models to reduce maternal mortality and improve maternal health. Issue: Support maternal health initiatives to expand coverage for postpartum women and expand demonstration project grants. H.R. 959 Black Maternal Health Momnibus Act of 2021 S. 1695 / H.R. 4387 Maternal Health Quality Improvement Act S. 1491/ H.R. 769 Rural MOMs Act H.R. 4387 Maternal Health Quality Improvement Act of 2021 H.R. 5376, Build Back Better Act H.R. 925 / S. 347 Data to Save Moms Act Issue: Support legislative efforts to improve maternal health and reduce rates of maternal mortality, including the Momnibus. Support legislative initiatives to improve data collection to improve maternal health equity. Issue: Support policies to promote firearm safety, universal background checks, violence prevention programs, extreme risk protection orders, child access safety laws, and reinstating assault weapons ban. Issue: Support funding for Community Violence Interventions/ Hospital Based Violence Intervention Programs P.L. 117-105, Dr. Lorna Breen Health Care Provider Protection Act Issue: Support grants directed at improving clinician burnout and well-being. Issue: Provide feedback on implementation of the Provider Relief Fund. Support extension for use of PRF funds. Issue: Support improvements to the Medicare Accelerated and Advance Payment Programs, including delaying recoupment of MAAP loans. Issue: Support extension of public health emergency declaration. Issue: Provide feedback on COVID-19 and pandemic response. S. 3799, PREVENT Pandemics Act Issue: Provide feedback on pandemic preparedness legislation, urge inclusion of provisions to support academic medical centers preparedness activities. Issue: Support establishment of regional pandemic response centers, stronger linkages between public health and academic medicine, and the role of medical students and academic medical centers in administering COVID vaccines. Issue: Urge establishment and implementation of robust national COVID-19 testing strategy; functional, redundant, and transparent supply chain; improved federal coordination; investments in public health and health care human and other resources; data modernization initiatives; and other actions to improve current and future pandemic response. H.R. 708, S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act Issue: Support for a temporary uniform licensing standard for all practitioners in all states throughout the COVID-19 public health emergency S. 674 Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Support ensuring patients are put first, that conscience protections align with medical professionalism standards, and oppose interference in the patient-physician relationship. Issue: Support increased interoperability and exchange of electronic health information. Support delay of enforcement beyond April 2021. Issue: Support robust research agenda for the Patient-Centered Outcomes Research Institute. Issue: Support promotion of data sharing and clinical trials results reporting. H.R. 6000, Cures 2.0 Act Issue: Provide feedback on provisions related to public health, patients and caregivers, FDA, CMS, and research, and ARPA-H. Issue: Promote strategies to strengthen the health, public health, and research workforces. H.R. 3671, Doctors of Community Act Issue: Discuss authorization of the Teaching Health Center Graduate Medical Education program. Issue: Provide guidance on the implementation of the No Surprises Act. Issue: Provide feedback on proposed modifications to the HIPAA privacy rule. H.R. 5035, S. 2982 Child Suicide Prevention and Lethal Means Safety Act Issue: Support legislation to provide grants to improve suicide prevention and lethal means safety. Issue: Inform about medical education on caring for older adults, nutrition, climate change, and opportunities to accelerate training. H.R. 7152/ S.3534, The Tracking Pathogens Act Issue: Support expansion of CDC activities related to genomic sequencing of pathogens. Issue: Support reignition of Cancer Moonshot. HR 5035, The Child Suicide Prevention and Lethal Means Safety Act Issue: Support expansion of training for health professionals to prevent self-harm or suicide

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. 5376 - Build Back Better 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

Client expense: $110,000 · Firm income: Not reported

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

Issues relating to the intersection of suicide and firearms; H.R. 2749 / S. 1277 Lethal Means Safety Training Act; H.R. 5035 / S. 2982 the Child Suicide Prevention and Lethal Means Safety Act; Representative Brownley's Gun Suicide Prevention Act; issues relating to community violence; H.R. 4118 Break the Cycle of Violence Act.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to universal background checks; H.R. 8 Bipartisan Background Checks Act of 2021; S. 529 Background Check Expansion Act; H.R. 1446 Enhanced Background Checks Act of 2021; S. 591 Background Check Completion Act; issues relating to the intersection of health and firearms; H.R. 2749 / S. 1277 Lethal Means Safety Training Act; H.R. 5035 / S. 2982 the Child Suicide Prevention and Lethal Means Safety Act; Representative Brownley's Gun Suicide Prevention Act; H.R. 4118 Break the Cycle of Violence Act; H.R. 2377 / S. 1819 ERPO Act; issues relating to the intersection of policing and gun violence; H.R. 1280 George Floyd Justice in Policing Act of 2021; H.R. 1808 / S. 736 Assault Weapons Ban. H.R. 2377 / S. 1819 ERPO Act

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issue: Educate Congress and the administration on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. Draft Graduate Medical Education Reform Act Issue: Support increased funding for the National Health Service Corps, Teaching Health Center GME, and National Disaster Medical Service (NDMS) demonstration pilot. Support increased Medicare support for Graduate Medical Education/physician training. Issues: Educate Congress and the administration about academic medicines response to the opioid epidemic. Support funding for training on substance use disorders, pain management, and safe prescribing practices. Support suspension of DATA waivers and new guidelines to expand access to buprenorphine. Support continuation of telehealth flexibilities allowing authorized practitioners to prescribe buprenorphine. H.R. 1384/ S.445 Mainstreaming Addiction Treatment (MAT) Act of 2021 Issue: Support suspension of waiver requirement for certain providers to prescribe buprenorphine. P.L. 116-22, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 Issues: Support the Hospital Preparedness Program and the reauthorization of the Pandemic and All-Hazards Preparedness Act. Support increased funding authorization levels. Issue: Support high-quality affordable health insurance. Support programs and funds for safety-net providers. Issue: Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, including not providing 340B discounts on covered drugs purchased at community pharmacies. H.R. 3203/S. 773 Issue: Support policy to allow 340B DSH hospitals to remain eligible to participate in the program throughout the current public health emergency even if their DSH adjustment falls below the current threshold due to changes in payor mix as a result of the COVID-19 pandemic. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Oppose efforts to direct HHS to update the Medicare.gov Care Compare website. Issue: Support increased interoperability and exchange of electronic health information and delayed enforcement of information blocking rule until comprehensive guidance is issued. Issue: Support the ongoing refinement of the two new mandatory alternative payment models, the Radiation Oncology Model and End-stage Renal Disease Treatment Choices Model, to better incentivize high-quality care for all patients. H.R. 4128/ S. 2209 Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021 Issue: Educate Congress on development of Laboratory Developed Tests and impact of burdensome regulation on patients access to care at academic medical centers. Issue: Development of Enhanced Primary Care Pilot Act proposal Draft Health Equity and Accountability Act Issue: Support programs to improve health equity and address social determinants of health. Issue: Support initiatives of hospitals to promote affordable housing in local communities and eliminate other social determinants of health to improve health equity. H.R. 2503 Social Determinants Accelerator Act of 2021 Issue: Support grants to address social determinants of health Issue: Support congressional investment in the Centers for Medicare and Medicaid Innovation (CMMI) models to reduce maternal mortality and improve maternal health. Issue: Support maternal health initiatives to expand coverage for postpartum women and expand demonstration project grants. H.R. 959 Black Maternal Health Momnibus Act of 2021 S. 1695 / H.R. 4387 Maternal Health Quality Improvement Act S. 1491/ H.R. 769 Rural MOMs Act H.R. 4387 Maternal Health Quality Improvement Act of 2021 H.R. 5376, Build Back Better Act Issue: Support legislative efforts to improve maternal health and reduce rates of maternal mortality, including the Momnibus. Issue: Support policies to promote firearm safety, universal background checks, violence prevention programs, extreme risks protection orders, child access safety laws, and reinstating assault weapons ban. Issue: Support funding for Community Violence Interventions/ Hospital Based Violence Intervention Programs S. 610/H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act Issue: Support grants directed at improving clinician burnout and well-being. Issue: Provide feedback on implementation of the Provider Relief Fund. Support extension for use of PRF funds. Issue: Support improvements to the Medicare Accelerated and Advance Payment Programs, including delaying recoupment of MAAP loans. Issue: Support extension of public health emergency declaration. Issue: Provide feedback on COVID-19 and pandemic response centers of excellence legislation. Issue: Provide information on COVID-19 long haulers clinical care. Issue: Provide feedback on draft pandemic preparedness legislation Issue: Support establishment of regional pandemic response centers, stronger linkages between public health and academic medicine, and the role of medical students and academic medical centers in administering COVID vaccines. Issue: Urge establishment and implementation of robust national COVID-19 testing strategy and functional and transparent supply chain. Issue: Support mask requirements on public transportation. Issue: Provide input on COVID-19 vaccination requirements for health care workers. H.R. 708, S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act Issue: Support for a temporary uniform licensing standard for all practitioners in all states throughout the COVID-19 public health emergency S. 674 Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Support ensuring patients are put first and that conscience protections align with medical professionalism standards. Issue: Support increased interoperability and exchange of electronic health information. Support delay of enforcement beyond April 2021. Issue: Support robust research agenda for the Patient-Centered Outcomes Research Institute. Issue: Support promotion of data sharing and clinical trials results reporting. H.R. 6000 Cures 2.0 Act Issue: Provide feedback on provisions related to public health, patients and caregivers, FDA, CMS, and research, and ARPA-H. Issue: Promote strategies to strengthen the health, public health, and research workforces. H.R. 3671 - Doctors of Community Act Issue: Discuss authorization of the Teaching Health Center Graduate Medical Education program. Issue: Provide guidance on the implementation of the No Surprises Act. Issue: Provide feedback on proposed modifications to the HIPAA privacy rule. H.R. 5035, S. 2982 Child Suicide Prevention and Lethal Means Safety Act Issue: Support legislation to provide grants to improve suicide prevention and lethal means safety. Issue: Encourage actions to improve COVID-19 response and future pandemic preparedness including improved federal coordination, greater supply chain redundancy, and investments in public health and health care human resources. Issue: Inform about academic medicines efforts in UME, GME, and CME on caring for older adults. P.L. 117-81, National Defense Authorization Act for Fiscal Year 2022 Issue: Support maintaining current military medical billet levels.

Mental health, as related to firearms; United States Crime Victims Fund; Intimate partner violence and violence against women, as related to firearms; Firearm suicide; Public health emergencies; Community violence intervention programs, including hospital-based intervention programs; S. 281 Gun Violence Prevention Research Act of 2021; H.R. 825 Gun Violence Prevention Research Act of 2021; H.R. 1494 Zero Tolerance for Domestic Abusers Act; S. 527 Protecting Domestic Violence and Stalking Victims; H.R. 1620 Violence Against Women Reauthorization Act of 2021; S. 763 Lori Jackson Domestic Violence Survivor Protection Act; H.R. 3480 Extreme Risk Protection Order Act; S. 1819 Extreme Risk Protection Order Act; S. 2169 Lori Jackson - Nicolette Elias Domestic Violence Survivor Protection Act; H.R. 2377 Federal Extreme Risk Protection Act; H.R. 2749 Lethal Means Safety Training Act; S. 1277 Lethal Means Safety Training Act; S. 1825 Safe Gun Storage Act; H.R. 4118 Break the Cycle of Violence Act; S. 2275 Break the Cycle of Violence Act; S. 2086 Resilience Investment, Support, and Expansion (RISE) from Trauma Act; H.R. 4502 Labor, Health and Human Services, Education, Agriculture, Rural Development, Energy and Water Development, Financial Services and General Government, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2022; H.R. 4505 Commerce, Justice, Science, and Related Agencies Appropriations Act, 2022; H.R. 5035 Child Suicide Prevention and Lethal Means Safety Act; H.R. 5080 Secure Background Checks Act of 2021; H.R. 4380 To designate the El Paso Community Healing Garden National Memorial, and for other purposes; S. 2873 Preventing and Addressing Trauma with Health Services (PATHS) Act; H.R. 5376 Build Back Better Act; H.R. 748 Ethans Law; S. 190 Ethans Law; S. 3062 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2022: S. 3042 the Commerce, Justice, Science, and Related Agencies Appropriations Act of 2022; H.R. 5428 School Shooting Safety and Preparedness Act; S. 2982 Child Suicide Prevention and Lethal Means Safety Act.

Background checks; Improving the National Instant Criminal Background Check System; Intimate partner violence and violence against women, as related to firearms; Trafficking of firearms; National Firearms Act; Presidential Cabinet appointments; Judicial appointments; Interstate transport of firearms; Semiautomatic firearms; Firearm tracing; Firearm permitting; Lost and stolen firearms; Violence Against Women Act; Gun dealer regulation; Essential operations of firearms dealers and manufacturers; An interagency task force on gun violence prevention; Guns in the hands of law enforcement; Recordkeeping; Data sharing; Point of contact states; Office of Victims of Crime; Policing; Bump stocks; Firearms export licenses; H.R. 1280 George Floyd Justice in Policing Act of 2021; H.R. 8 Bipartisan Background Checks Act of 2021; S. 529 Background Check Expansion Act of 2021; S. 591 A bill to prohibit firearms dealers from selling a firearm prior to the completion of a background check; S. 736 Assault Weapons Ban; H.R. 1808 Assault Weapons Ban; H.R. 1494 Zero Tolerance for Domestic Abusers Act; S. 527 Protecting Domestic Violence and Stalking Victims; H.R. 647 Closing the Loophole on Interstate Firearm Sales Act; H.R. 880 Firearm Safety Act of 2021; H.R. 881 To require the Surgeon General of the Public Health Service to submit to Congress an annual report on the effects of gun violence on public health; H.R. 882 Keeping Guns from High-Risk Individuals Act; S. 281 Gun Violence Prevention Research Act of 2021; H.R. 825 Gun Violence Prevention Research Act of 2021; H.R. 1004 Firearm Risk Protection Act of 2021; H.R. 1006 Gun Show Loophole Closing Act of 2021; H.R. 1007 Hadiya Pendleton and Nyasia Pryear-Yard Gun Trafficking and Crime Prevention Act of 2021; H.R. 1477 To modernize the Undetectable Firearms Act of 1988; H.R. 1560 To establish a Federal Advisory Council to Support Victims of Gun Violence; H.R. 1576 To provide for a coordinated national research program to examine the nature, causes, consequences, and prevention of violence and unintended injury and death relating to gun ownership, use, and trafficking, and for other purposes; S. 556 A bill to establish a Federal Advisory Council to Support Victims of Gun Violence; H.R. 1769 NICS Denial Notification Act of 2021; S. 675 NICS Denial Notification Act of 2020; H.R. 1620 Violence Against Women Reauthorization Act of 2021; S. 763 Lori Jackson Domestic Violence Survivor Protection Act; S. 974 Tiahrt Restrictions Repeal Act; H.R. 2280 Prevent Gun Trafficking Act; S. 770 Handgun Purchaser Licensing Act; H.R. 1782 Empowering Law Enforcement for Safer Firearm Transfers Act; H.R. 3015 Raise the Age Act; H.R. 3480 Extreme Risk Protection Order Act; S. 1819 Extreme Risk Protection Order Act; S. 2169 Lori Jackson - Nicolette Elias Domestic Violence Survivor Protection Act; H.R. 3299 Protecting our Communities Act; H.R. 3096 Federal Law Enforcement Officer Service Weapon Purchase Act; H.R. 2466 Law Enforcement Protection Act; H.R. 3740 Handgun Licensing and Registration Act; H.R. 2971 Foreign National Firearms Background Check Enhancement Act; H.R. 3159 Safer Neighborhoods Gun Buyback; H.R. 2377 Federal Extreme Risk Protection Act; H.R. 2715 Jaimes Law; S. 1237 Jaimes Law; S. 878 Stop Illegal Trafficking in Firearms Act; S. 2275 Break the Cycle of Violence Act; H.R. 4118 Break the Cycle of Violence Act H.R. 2749 Lethal Means Safety Training Act; S. 1277 Lethal Means Safety Training Act; H.R. 3929 Disarm Hate Act; S. 2090 Disarm Hate Act; H.R. 3088 Untraceable Firearms Act; S. 1558 Untraceable Firearms Act; S. 1825 Safe Gun Storage Act; H.R. 2814 Equal Access to Justice for Victims of Gun Violence Act; S. 1338 Equal Access to Justice for Victims of Gun Violence Act; H.R. 2510 Keep America Safe Act; S. 1108 Keep America Safe Act; S. 1155 Virginia Plan to Reduce Gun Violence Act of 2021; S. 2250 Protect Our Prosecutors and Judges Act; H.R. 130 Kimberly Vaughan Firearm Safe Storage Act; H.R. 2707 Handgun Purchaser Licensing Act; H.R. 2427 NFA Modernization Act of 2021; H.R. 2426 State Access to Firearms Evading Revocation Act; H.R. 5427 Closing The Bump Stock Loophole Act; H.R. 5245 Gun Trafficker Detection Act; H.R. 4502 Labor, Health and Human Services, Education, Agriculture, Rural Development, Energy and Water Development, Financial Services and General Government, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2022; H.R. 4505 Commerce, Justice, Science, and Related Agencies Appropriations Act, 2022; H.R. 4350 National Defense Authorization Act of Fiscal Year 2022; S. 2169 Lori Jackson - Nicolette Elias Domestic Violence Survivor Protection Act; H.R. 4888 Local Public Health And Safety Protection Act; H.R. 4423 Gun Theft Prevention Act; H.R. 5465 To amend title 18, United States Code, to require federally licensed firearms importers, manufacturers, and dealers to meet certain requirements with respect to securing their firearms inventory, business records, and business premises; S. 2908 A bill to amend title 18, United States Code, to require federally licensed firearms importers, manufacturers, and dealers to meet certain requirements with respect to securing their firearms inventory, business records, and business premises; H.R. 1752 COOL OFF Act; S. 2725 Accountability for Online Firearms Marketplaces Act of 2021; H.R. 4836 Firearm Owners Responsibility and Safety Act; H.R. 4139 Lori Jackson-Nicolette Elias Domestic Violence Survivor Protection Act; S. 2169 Lori Jackson-Nicolette Elias Domestic Violence Survivor Protection Act; H.R. 6225 Federal Firearm Licensee Act; H.R. 748 Ethans Law; S. 190 Ethans Law; S. 3042 the Commerce, Justice, Science, and Related Agencies Appropriations Act of 2022; S. 3062 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2022; H.R. 5428 School Shooting Safety and Preparedness Act; H.R.5768 VICTIM Act of 2021; H.R. 3096 Federal Law Enforcement Officer Service Weapon Purchase Act; H.R. 1752 COOL Off Act; H.R. 4565 SECURE Firearm Storage Act; H.R. 5273 Gun Safety Board and Research Act; H.R. 5878 End Gun Violence Act of 2021; S. 2982 Child Suicide Prevention and Lethal Means Safety Act; H.R 5764 Gun Violence Prevention Through Financial Intelligence Act; H.R. 6213 Fire Sale Loophole Closing Act; S. 2792 National Defense Authorization Act for Fiscal Year 2022; H.R. 1518 21st Century NICS Act; H.R. 5678 Firearms Retailer Code of Conduct Act of 2021.

Background checks; Improving the National Instant Criminal Background Check System; Intimate partner violence and violence against women, as related to firearms; Mental health, as related to firearms; Trafficking of firearms; National Firearms Act; Presidential Cabinet appointments; Interstate transport of firearms; Federal firearm licensee break-ins; Semiautomatic firearms; Firearm accessories; Gun permitting; Firearm tracing; 3D printing of firearms; Lost and stolen firearms; Violence Against Women Act; Consumer product safety; Gun dealer regulation; Fugitives from justice; Federal Judicial Nominations; ATF leadership; Guns in the hands of law enforcement; Recordkeeping; Data sharing; Point of contact states; Community violence intervention; Bump stock regulation; Firearms exports licenses; H.R. 1280 George Floyd Justice in Policing Act of 2021; H.R. 8 Bipartisan Background Checks Act of 2021; S. 529 Background Check Expansion Act of 2021; S. 591 A bill to prohibit firearms dealers from selling a firearm prior to the completion of a background check; S. 736 Assault Weapons Ban; H.R. 1808 Assault Weapons Ban; H.R. 1494 Zero Tolerance for Domestic Abusers Act; S. 527 Protecting Domestic Violence and Stalking Victims; H.R. 647 Closing the Loophole on Interstate Firearm Sales Act; H.R. 880 Firearm Safety Act of 2021; H.R. 881 To require the Surgeon General of the Public Health Service to submit to Congress an annual report on the effects of gun violence on public health; H.R. 882 Keeping Guns from High-Risk Individuals Act; S. 281 Gun Violence Prevention Research Act of 2021; H.R. 825 Gun Violence Prevention Research Act of 2021; H.R. 1004 Firearm Risk Protection Act of 2021; H.R. 1006 Gun Show Loophole Closing Act of 2021; H.R. 1007 Hadiya Pendleton and Nyasia Pryear-Yard Gun Trafficking and Crime Prevention Act of 2021; H.R. 1477 To modernize the Undetectable Firearms Act of 1988; H.R. 1470 To amend the Revised Statutes to remove the defense of qualified immunity in the case of any action under section 1979, and for other purposes; H.R. 1560 To establish a Federal Advisory Council to Support Victims of Gun Violence; H.R. 1576 To provide for a coordinated national research program to examine the nature, causes, consequences, and prevention of violence and unintended injury and death relating to gun ownership, use, and trafficking, and for other purposes; S. 556 A bill to establish a Federal Advisory Council to Support Victims of Gun Violence; H.R. 1769 NICS Denial Notification Act of 2021; S. 675 NICS Denial Notification Act of 2020; H.R. 1620 Violence Against Women Reauthorization Act of 2021; S. 763 Lori Jackson Domestic Violence Survivor Protection Act; S. 974 Tiahrt Restrictions Repeal Act; H.R. 2280 Prevent Gun Trafficking Act; S. 770 Handgun Purchaser Licensing Act; H.R. 1782 Empowering Law Enforcement for Safer Firearm Transfers Act; H.R. 4194 The Peoples Response Act; H.R. 4118 Break the Cycle of Violence Act; S. 2275 Break the Cycle of Violence Act; S. 2169 Lori Jackson - Nicolette Elias Domestic Violence Survivor Protection Act; H.R. 1454 Ghost Guns Are Guns Act; H.R. 3299 Protecting our Communities Act; H.R. 3096 Federal Law Enforcement Officer Service Weapon Purchase Act; H.R. 2466 Law Enforcement Protection Act; H.R. 2971 Foreign National Firearms Background Check Enhancement Act; H.R. 3159 Safer Neighborhoods Gun Buyback; H.R. 2715 Jaimes Law; S. 1237 Jaimes Law; S. 878 Stop Illegal Trafficking in Firearms Act; S. 2275 Break the Cycle of Violence Act; H.R. 4118 Break the Cycle of Violence Act; H.R. 3929 Disarm Hate Act; S. 2090 Disarm Hate Act; H.R. 4246 Background Check Point of Contact Act of 2021; H.R. 3088 Untraceable Firearms Act; S. 1558 Untraceable Firearms Act; H.R. 2814 Equal Access to Justice for Victims of Gun Violence Act; S. 1338 Equal Access to Justice for Victims of Gun Violence Act; H.R. 2707 Handgun Purchaser Licensing Act; H.R. 5428 School Shooting Safety and Preparedness Act; H.R. 5427 Closing The Bump Stock Loophole Act; H.R. 5245 Gun Trafficker Detection Act; H.R. 4502, Labor, Health and Human Services, Education, Agriculture, Rural Development, Energy and Water Development, Financial Services and General Government, Interior, Environment, Military Construction, Veterans Affairs, Transportation, and Housing and Urban Development Appropriations Act, 2022; H.R. 4505 Commerce, Justice, Science, and Related Agencies Appropriations Act, 2022; H.R. 4350 National Defense Authorization Act of Fiscal Year 2022; S. 2169 Lori Jackson - Nicolette Elias Domestic Violence Survivor Protection Act; H.R. 4194 The Peoples Response Act; H.R. 4888 Local Public Health And Safety Protection Act; H.R. 4423 Gun Theft Prevention Act; H.R. 5465 To amend title 18, United States Code, to require federally licensed firearms importers, manufacturers, and dealers to meet certain requirements with respect to securing their firearms inventory, business records, and business premises; S. 2908 A bill to amend title 18, United States Code, to require federally licensed firearms importers, manufacturers, and dealers to meet certain requirements with respect to securing their firearms inventory, business records, and business premises; H.R. 5080 Secure Background Checks Act of 2021; H.R. 1752 COOL OFF Act; S. 2725 Accountability for Online Firearms Marketplaces Act of 2021; H.R. 6225 Federal Firearm Licensee Act; H.R. 748 Ethans Law; S. 190 Ethans Law; S. 3042 the Commerce, Justice, Science, and Related Agencies Appropriations Act of 2022; S. 3062 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2022; H.R. 5428 School Shooting Safety and Preparedness Act; H.R. 5768 VICTIM Act of 2021; H.R. 3096 Federal Law Enforcement Officer Service Weapon Purchase Act; H.R. 1752 COOL Off Act; H.R. 4565 SECURE Firearm Storage Act; H.R. 5273 Gun Safety Board and Research Act; H.R. 5878 End Gun Violence Act of 2021; S. 2982 Child Suicide Prevention and Lethal Means Safety Act; H.R. 5764 Gun Violence Prevention Through Financial Intelligence Act; S. 2792 National Defense Authorization Act for Fiscal Year 2022; H.R. 1518 21st Century NICS Act; H.R. 5678 Firearms Retailer Code of Conduct Act of 2021.

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 S. 987 - Comprehensive Addiction and Recovery Act (CARA) 3.0 PA student involvement in vaccination efforts H.R. 3890 - Physician Assistant Education Public Health Initiatives Act H.R. 5376 - Build Back Better 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

Client expense: $110,000 · Firm income: Not reported

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

Issues relating to universal background checks; H.R. 8 Bipartisan Background Checks Act of 2021; S. 529 Background Check Expansion Act; H.R. 1446 Enhanced Background Checks Act of 2021; S. 591 Background Check Completion Act; issues relating to the intersection of suicide and firearms; H.R. 2749 / S. 1277 Lethal Means Safety Training Act; H.R. 5035 / S. 2982 the Child Suicide Prevention and Lethal Means Safety Act; Representative Brownley's Gun Suicide Prevention Act; H.R. 1280 George Floyd Justice in Policing Act of 2021; H.R. 1808 / S. 736 Assault Weapons Ban.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues relating to the intersection of suicide and firearms; H.R. 2749 / S. 1277 Lethal Means Safety Training Act; H.R. 5035 / S. 2982 the Child Suicide Prevention and Lethal Means Safety Act; Representative Brownley's Gun Suicide Prevention Act.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issue: Educate Congress and the administration on academic medicines missions, including education, research, patient care, GME, workforce, and physician shortages in rural and urban communities. Draft Graduate Medical Education Reform Act Issue: Support increased funding for the National Health Service Corps, Teaching Health Center GME, and National Disaster Medical Service (NDMS) demonstration pilot. Support increased Medicare support for Graduate Medical Education/physician training. Issues: Educate Congress and the administration about academic medicines response to the opioid epidemic. Support funding for training on substance use disorders, pain management, and safe prescribing practices. Support suspension of DATA waivers and new guidelines to expand access to buprenorphine. Support continuation of telehealth flexibilities allowing authorized practitioners to prescribe buprenorphine. H.R. 1384/ S.445 Mainstreaming Addiction Treatment (MAT) Act of 2021 Issue: Support suspension of waiver requirement for certain providers to prescribe buprenorphine. P.L. 116-22, Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 Issues: Support the Hospital Preparedness Program and the reauthorization of the Pandemic and All-Hazards Preparedness Act. Support increased funding authorization levels. Issue: Support high-quality affordable health insurance. Support programs and funds for safety-net providers. Issue: Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, including not providing 340B discounts on covered drugs purchased at community pharmacies. H.R. 3203/S. 773 Issue: Support policy to allow 340B DSH hospitals to remain eligible to participate in the program throughout the current public health emergency even if their DSH adjustment falls below the current threshold due to changes in payor mix as a result of the COVID-19 pandemic. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Oppose efforts to direct HHS to update the Medicare.gov Care Compare website. Issue: Support increased interoperability and exchange of electronic health information and delayed enforcement of information blocking rule until comprehensive guidance is issued. Issue: Support the ongoing refinement of the two new mandatory alternative payment models, the Radiation Oncology Model and End-stage Renal Disease Treatment Choices Model, to better incentivize high-quality care for all patients. H.R. 4128/ S. 2209 Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2021 Issue: Educate Congress on development of Laboratory Developed Tests and impact of burdensome regulation on patients access to care at academic medical centers. Issue: Development of Enhanced Primary Care Pilot Act proposal Draft Health Equity and Accountability Act Issue: Support programs to improve health equity and address social determinants of health. Issue: Support initiatives of hospitals to promote affordable housing in local communities and eliminate other social determinants of health to improve health equity. H.R. 2503 Social Determinants Accelerator Act of 2021 Issue: Support grants to address social determinants of health Issue: Support congressional investment in the Centers for Medicare and Medicaid Innovation (CMMI) models to reduce maternal mortality and improve maternal health. Issue: Support maternal health initiatives to expand coverage for postpartum women and expand demonstration project grants. H.R. 959 Black Maternal Health Momnibus Act of 2021 S. 1695 / H.R. 4387 Maternal Health Quality Improvement Act S. 1491/ H.R. 769 Rural MOMs Act H.R. 4387 Maternal Health Quality Improvement Act of 2021 H.R. 5376, Build Back Better Act Issue: Support legislative efforts to improve maternal health and reduce rates of maternal mortality, including the Momnibus. Issue: Support policies to promote firearm safety, universal background checks, violence prevention programs, extreme risks protection orders, child access safety laws, and reinstating assault weapons ban. Issue: Support funding for Community Violence Interventions/ Hospital Based Violence Intervention Programs S. 610/H.R. 1667, Dr. Lorna Breen Health Care Provider Protection Act Issue: Support grants directed at improving clinician burnout and well-being. Issue: Provide feedback on implementation of the Provider Relief Fund. Support extension for use of PRF funds. Issue: Support improvements to the Medicare Accelerated and Advance Payment Programs, including delaying recoupment of MAAP loans. Issue: Support extension of public health emergency declaration. Issue: Provide feedback on COVID-19 and pandemic response centers of excellence legislation. Issue: Provide information on COVID-19 long haulers clinical care. Issue: Provide feedback on draft pandemic preparedness legislation Issue: Support establishment of regional pandemic response centers, stronger linkages between public health and academic medicine, and the role of medical students and academic medical centers in administering COVID vaccines. Issue: Urge establishment and implementation of robust national COVID-19 testing strategy and functional and transparent supply chain. Issue: Support mask requirements on public transportation. Issue: Provide input on COVID-19 vaccination requirements for health care workers. H.R. 708, S. 168, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act Issue: Support for a temporary uniform licensing standard for all practitioners in all states throughout the COVID-19 public health emergency S. 674 Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Support ensuring patients are put first and that conscience protections align with medical professionalism standards. Issue: Support increased interoperability and exchange of electronic health information. Support delay of enforcement beyond April 2021. Issue: Support promotion of data sharing and clinical trials results reporting. H.R. 791/ S. 236 - Tracking COVID-19 Variants Act Issue: Support expansion of CDC-supported genomic sequencing, including at academic medical centers. Issue: Provide feedback on draft Cures 2.0 legislation, including on Public health, patients and caregivers, FDA, CMS, and research, and respond to request for information on ARPA-H. Issue: Promote strategies to strengthen the health, public health, and research workforces. H.R. 3671 - Doctors of Community Act Issue: Discuss authorization of the Teaching Health Center Graduate Medical Education program. Issue: Provide guidance on the implementation of the No Surprises Act. Issue: Provide feedback on proposed modifications to the HIPAA privacy rule. H.R. 5035, S. 2982 Child Suicide Prevention and Lethal Means Safety Act Issue: Support legislation to provide grants to improve suicide prevention and lethal means safety. Issue: Encourage actions to improve COVID-19 response and future pandemic preparedness including improved federal coordination, greater supply chain redundancy, and investments in public health and health care human resources. Issue: Inform about academic medicines efforts in UME, GME, and CME on caring for older adults.

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 H.R. 5376 - Build Back Better Act S. 2114 - Student Assisted Vaccination Effort Act H.R. 5035/S. 2982 - Child Suicide Prevention and Lethal Means Safety Act

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

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