Expanded Telehealth Access Act

S 1315/HR 3630 - The Lymphedema Treatment At: Support passage. HR 5536 - Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act: Advocated for passage of SMART Act and related S5 (To amend title XVIII of the Social Security Act to ensure appropriate supervision requirements for outpatient physical therapy and outpatient occupational therapy), which contained provision of SMART Act that revised supervision rules for Occupational Therapy Assistants. HR 2168/S3193 - Expanded Telehealth Access Act: Advocated for passage. S. 368/HR 1332 - Telehealth Modernization Act: Advocated for passage. HR 1990/S 2556 - Medicare Orthotics and Prosthetics Patient-Centered Care Act: Lobbied for changes to the bills to ensure the legislation does not disrupt the ability of occupational therapy practitioners to provide and bill for orthotics and prosthetics and related services under Medicare. S.4712-OT Mental Health Parity Act: Support Passage of bill to direct CMS to put forward guidance clarifying that occupational therapy services can be provided to a person with a mental or behavioral health diagnosis under Medicare and Medicaid. HR3173/S3018-Improving Seniors' Timely Access to Care Act: Support passage. HR 6202 - Telehealth Extension Act: Endorsed S.3593 - Telehealth Extension & Evaluation Act: Endorsed HR 6770-PACE Plus Act and S 3626 PACE Expanded Act: Support passage HR 8800 - Supporting Medicare Providers Act of 2022: Advocate for passage HR 4040, Advancing Telehealth Beond COVID-19 Act of 2021 - Support Senate adoption to extend telehealth waivers through the end of 2024. Provision adopted as part of the year-end Omnibus. H.R. 2617 - Consolidated Appropriations Act of 2023: Support inclusion of all above provisions in end of year Omnibus bill. No bill: Supported efforts to include occupational therapy in new school-based Medicaid guidelines, where appropriate. No bill number: Support for passage of legislative provisions to clarify providers who are exempt from competitive bidding when providing orthotics and prosthetics, and reducing fraud in the provision of orthotics and prosthetics.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1587/S. 1731, the Medicare Audiologist Access and Services Act of 2021 H.R. 2168/S. 3193, the Expanded Telehealth Access Act H.R. 4040, the Advancing Telehealth Beyond COVID-19 Act of 2021 H.R. 4311, the Medicare Dental, Vision, and Hearing Benefit Act H.R. 6202, the Telehealth Extension Act H.R. 6020/S. 3314, the Supporting Medicare Providers Act of 2021 H.R. 7876, the Connecting Rural Telehealth to the Future Act H.R. 2471, the Consolidated Appropriations Act, 2022 (Public Law 117-103) Implementation of S. 610, the Protecting Medicare and American Farmers from Sequester Cuts Act Implementation of H.R. 1319, American Rescue Plan Act of 2021 (Public Law 117-2) Issues related to enhanced Federal Medical Assistance Percentage in Medicaid Various issues related to CMS Actions surrounding: Medicare supervision requirements audits of medical records and claims for Part A and B services code development and reimbursement of personal protective equipment Quality reporting under MIPS Implementation of the IMPACT Act Medicare physician fee schedule Prospective payments systems Demonstration projects/episodic payment models Accountable Care Organizations Federally-facilitated marketplace Medicare Advantage Reimbursement of telehealth services COVID-19 emergency telepractice coverage of Medicare, Medicare Advantage and Medicaid Medicare telehealth coverage under Part A and B Essential and Non-essential personnel designation Implementation of CARES Act (P.L. 116-136) Provision and payment for Part A therapy Various issues related to implementation of ACA Various issues related to Medicaid in schools Advocated for Medicaid Federal Medical Assistance Percentage (FMAP) Sequestration H.R. 3173/S. 3018, the Improving Seniors Timely Access to Care Act Issues related to extension of COVID-19 public health emergency H.R. 8800, the Supporting Medicare Providers Act of 2022 Issues related to coverage of augmentative and alternative communication devices and systems and their role in integration of individuals with disabilities in work and community settings Issues related to Medicare beneficiaries accessing services provided by audiologists without a physician order H.R.6833 - Continuing Appropriations and Ukraine Supplemental Appropriations Act, 2023 H.R. 2617, Consolidated Appropriations Act, 2023

Client expense: $270,000 · Firm income: Not reported

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

1. The Prevent Interruptions in Physical Therapy Act (H.R.1611/S.2612)to allow ALL private practice physical therapists-regardless of where their clinic is located-to use a locum tenens to provide their Medicare patients continued care when they need to be out of the clinic. 2. The Expanded Telehealth Access Act (H.R.2168/S.3193) to permanently add physical therapists, physical therapist assistants, and other rehabilitation therapists to the list of providers that Medicare pays for telehealth. 3. The Medicare Patient Empowerment Act (S.826/H.R.3322)to allow a Medicare beneficiary to enter into a direct contract with an eligible professional (regardless of whether that person was a participating or non-participating physician or practitioner) for any item or service covered by Medicare. 4. The SMART Act (H.R.5536) to delay implementation of the PTA/OTA differential by one year, exempt therapy assistants in rural and medically underserved areas from the differential, and to change the supervision requirement for PTAs in private practice settings to that which state law requires. 5. S.5, a bill to change the supervision requirement for PTAs in private practice settings to that which state law requires. 6. The Improving Seniors Timely Access to Care Act (H.R.3173/S.3108) to reduce administrative burden by requiring a streamed and standardized way Medicare Advantage (MA) plans use prior authorization as well as increasing oversight and transparency around prior authorization.

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

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

1. The Prevent Interruptions in Physical Therapy Act (H.R.1611/S.2612)to allow ALL private practice physical therapists-regardless of where their clinic is located-to use a locum tenens to provide their Medicare patients continued care when they need to be out of the clinic. 2. The Expanded Telehealth Access Act (H.R.2168/S.3193) to permanently add physical therapists, physical therapist assistants, and other rehabilitation therapists to the list of providers that Medicare pays for telehealth. 3. The Medicare Patient Empowerment Act (S.826/H.R.3322)to allow a Medicare beneficiary to enter into a direct contract with an eligible professional (regardless of whether that person was a participating or non-participating physician or practitioner) for any item or service covered by Medicare. 4. The SMART Act (H.R.5536) to delay implementation of the PTA/OTA differential by one year, exempt therapy assistants in rural and medically underserved areas from the differential, and to change the supervision requirement for PTAs in private practice settings to that which state law requires. 5. S.5, a bill to change the supervision requirement for PTAs in private practice settings to that which state law requires. 6. The Improving Seniors Timely Access to Care Act (H.R.3173/S.3108) to reduce administrative burden by requiring a streamed and standardized way Medicare Advantage (MA) plans use prior authorization as well as increasing oversight and transparency around prior authorization.

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

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

DMEPOS payment and coverage Extension of telehealth flexibilities S. 3193/H.R.2168 - Expanded Telehealth Access Act S. 2556/H.R.1990 - Medicare Orthotics and Prosthetics Patient-Centered Care Act Issues surrounding local coverage determinations, local coverage articles, and carrier advisory committees Issues surrounding Medicare reimbursement H.R. 4040 - Advancing Telehealth Beyond COVID-19 Act HR 8800 - Supporting Medicare Providers Act of 2022

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 1315/HR 3630 - The Lymphedema Treatment At: Support passage. HR 5536 - Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act: Advocated for passage and support introduction of similar legislation in the Senate. HR 2168/S3193 - Expanded Telehealth Access Act: Advocated for passage. S. 368/HR 1332 - Telehealth Modernization Act: Advocated for passage. HR 1990/S 2556 - Medicare Orthotics and Prosthetics Patient-Centered Care Act: Lobbied for changes to the bills to ensure the legislation does not disrupt the ability of occupational therapy practitioners to provide and bill for orthotics and prosthetics and related services under Medicare. S.4712-OT Mental Health Parity Act: Support Passage of bill to direct CMS to put forward guidance clarifying that occupational therapy services can be provided to a person with a mental or behavioral health diagnosis under Medicare and Medicaid. HR3173/S3018-Improving Seniors' Timely Access to Care Act: Support passage. HR 6202 - Telehealth Extension Act: Endorsed S.3593 - Telehealth Extension & Evaluation Act: Endorsed HR 6770-PACE Plus Act and S 3626 PACE Expanded Act: Support passage HR 8201: Promoting Health Care Quality Act of 2002 - support passage. No bill: Supported efforts to include occupational therapy in new school-based Medicaid guidelines, where appropriate. HR 8800 - Supporting Medicare Providers Act of 2022: Advocate for passage

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 8344: Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act of 2022 Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid H.R. 2168/S. 3193 Expanded Telehealth Access Act APTA PT Outcomes Registry/Qualified Clinical Data Registries Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Orthotics and Prosthetics H.R. 1990/S. 2556: Medicare Orthotics and Prosthetics Patient-Centered Care Act Medicare Private Contracting H.R. 3322/S. 826 Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule H.R. 5536 Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding H.R. 3630/S. 1315 Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act H.R. 3173/S. 3018 Improving Seniors Timely Access to Care Act H.R. 3650/S. 2048 Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule HR 6020 - Support Medicare Providers Act S. 3799 PREVENT Pandemics Act H.R. 5365 Primary Health Services Enhancement Act H.R. 8181 Optimizing Postpartum Outcomes Act H.R 8800 Supporting Medicare Providers Act of 2022

Client expense: $194,970 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 1587/S. 1731, the Medicare Audiologist Access and Services Act of 2021 H.R. 2168/S. 3193, the Expanded Telehealth Access Act H.R. 4040, the Advancing Telehealth Beyond COVID-19 Act of 2021 H.R. 4311, the Medicare Dental, Vision, and Hearing Benefit Act H.R. 6202, the Telehealth Extension Act H.R. 6020/S. 3314, the Supporting Medicare Providers Act of 2021 H.R. 7876, the Connecting Rural Telehealth to the Future Act H.R. 2471, the Consolidated Appropriations Act, 2022 (Public Law 117-103) Implementation of S. 610, the Protecting Medicare and American Farmers from Sequester Cuts Act Implementation of H.R. 1319, American Rescue Plan Act of 2021 (Public Law 117-2) Issues related to enhanced Federal Medical Assistance Percentage in Medicaid Various issues related to CMS Actions surrounding: Medicare supervision requirements audits of medical records and claims for Part A and B services code development and reimbursement of personal protective equipment Quality reporting under MIPS Implementation of the IMPACT Act Medicare physician fee schedule Prospective payments systems Demonstration projects/episodic payment models Accountable Care Organizations Federally-facilitated marketplace Medicare Advantage Reimbursement of telehealth services COVID-19 emergency telepractice coverage of Medicare, Medicare Advantage and Medicaid Medicare telehealth coverage under Part A and B Essential and Non-essential personnel designation Implementation of CARES Act (P.L. 116-136) Provision and payment for Part A therapy Various issues related to implementation of ACA Various issues related to Medicaid in schools Advocated for Medicaid Federal Medical Assistance Percentage (FMAP) Sequestration H.R. 3173/S. 3018, the Improving Seniors Timely Access to Care Act Issues related to extension of COVID-19 public health emergency H.R. 8800, the Supporting Medicare Providers Act of 2022 Issues related to coverage of augmentative and alternative communication devices and systems and their role in integration of individuals with disabilities in work and community settings Issues related to Medicare beneficiaries accessing services provided by audiologists without a physician order

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

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

Public Health Emergency, Telehealth, and Physician Virtual Supervision issues. H.R.2168/S.3193 - Expanded Telehealth Access Act, H.R.2903/S.1512- CONNECT for Health Act, H.R. 6202 - Telehealth Expansion Act, H.R.1332/S.368 - Telehealth Modernization Act, H.R.7573/S.3593 - Telehealth Extension and Evaluation Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. The Prevent Interruptions in Physical Therapy Act (H.R.1611/S.2612)and potential Senate companion bill, to allow ALL private practice physical therapists-regardless of where their clinic is located-to use a locum tenens to provide their Medicare patients continued care when they need to be out of the clinic. 2. The Expanded Telehealth Access Act (H.R.2168/S.3193) and potential Senate companion bill, to permanently add physical therapists, physical therapist assistants, and other rehabilitation therapists to the list of providers that Medicare pays for telehealth. 3. The Medicare Patient Empowerment Act (S.826/H.R.3322)to allow a Medicare beneficiary to enter into a direct contract with an eligible professional (regardless of whether that person was a participating or non-participating physician or practitioner) for any item or service covered by Medicare. 4. The SMART Act (H.R.5536) to delay implementation of the PTA/OTA differential by one year, exempt therapy assistants in rural and medically underserved areas from the differential, and to change the supervision requirement for PTAs in private practice settings to that which state law requires. 5. The Improving Seniors Timely Access to Care Act (H.R.3173/S.3108) to reduce administrative burden by requiring a streamed and standardized way Medicare Advantage (MA) plans use prior authorization as well as increasing oversight and transparency around prior authorization. 6. The bipartisan Primary Health Services Enhancement Act (H.R.5365) would allow CHCs to offer physical therapy services which will be provided by a physical therapist.

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

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

1. The Prevent Interruptions in Physical Therapy Act (H.R.1611/S.2612)and potential Senate companion bill, to allow ALL private practice physical therapists-regardless of where their clinic is located-to use a locum tenens to provide their Medicare patients continued care when they need to be out of the clinic. 2. The Expanded Telehealth Access Act (H.R.2168/S.3193) and potential Senate companion bill, to permanently add physical therapists, physical therapist assistants, and other rehabilitation therapists to the list of providers that Medicare pays for telehealth. 3. The Medicare Patient Empowerment Act (S.826/H.R.3322)to allow a Medicare beneficiary to enter into a direct contract with an eligible professional (regardless of whether that person was a participating or non-participating physician or practitioner) for any item or service covered by Medicare. 4. The SMART Act (H.R.5536) to delay implementation of the PTA/OTA differential by one year, exempt therapy assistants in rural and medically underserved areas from the differential, and to change the supervision requirement for PTAs in private practice settings to that which state law requires. 5. The Improving Seniors Timely Access to Care Act (H.R.3173/S.3108) to reduce administrative burden by requiring a streamed and standardized way Medicare Advantage (MA) plans use prior authorization as well as increasing oversight and transparency around prior authorization.

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

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

HR 1868 - A bill to prevent across-the-board direct spending cuts and for other purposes: Support for delaying Medicare Sequester and passage of bill. S 1315/HR 3630 - The Lymphedema Treatment At: Support passage. HR 5536 - Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act: Advocated for passage HR 2168/S3193 - Expanded Telehealth Access Act: Advocated for passage. S. 368/HR 1332 - Telehealth Modernization Act: Advocated for passage. HR 1990/S 2556 - Medicare Orthotics and Prosthetics Patient-Centered Care Act: Lobbied for changes to the bills to ensure the legislation does not disrupt the ability of occupational therapy practitioners to provide and bill for orthotics and prosthetics and related services under Medicare. No bill number: advocated for inclusion of language in Senate mental health legislation, directing CMS to put forward guidance clarifying that occupational therapy services can be provided to a person with a mental or behavioral health diagnosis under Medicare and Medicaid. No bill number: advocated for inclusion of language in Senate mental health legislation requiring an occupational therapy evaluation for anyone with dementia who lives in a skilled nursing or long-term care facility, or who is newly diagnosed with schizophrenia. HR3173/S3018-Improving Seniors' Timely Access to Care Act: Support passage. HR 6202 - Telehealth Extension Act: Endorsed S.3593 - Telehealth Extension & Evaluation Act: Endorsed HR 6770-PACE Plus Act and S 3626 PACE Expanded Act: Support passage S 2938 - Bipartisan Safer Communities Act: Support passage. No bill: Advocated for occupational therapy's role in long COVID treatment and recovery.

Client expense: $150,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Health Emergency, Telehealth, and Physician Virtual Supervision issues. H.R.2168/S.3193 - Expanded Telehealth Access Act, H.R.2903/S.1512- CONNECT for Health Act, H.R. 6202 - Telehealth Expansion Act, H.R.1332/S.368 - Telehealth Modernization Act, H.R.7573/S.3593 - Telehealth Extension and Evaluation Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Health Emergency, Telehealth, and Physician Virtual Supervision issues. H.R.2168/S.3193 - Expanded Telehealth Access Act, H.R.2903/S.1512- CONNECT for Health Act, H.R. 6202 - Telehealth Expansion Act, H.R.1332/S.368 - Telehealth Modernization Act, H.R.7573/S.3593 - Telehealth Extension and Evaluation Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Payment of EMG services under Medicare Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid H.R. 2168/S. 3193 Expanded Telehealth Access Act APTA PT Outcomes Registry/Qualified Clinical Data Registries Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Orthotics and Prosthetics Medicare Private Contracting H.R. 3322/S. 826 Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule H.R. 5536 Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Pelvic Health/Pelvic Health Awareness Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding H.R. 3630/S. 1315 Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act H.R. 3173/S. 3018 Improving Seniors Timely Access to Care Act H.R. 3650/S. 2048 Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule HR 6020 - Support Medicare Providers Act S. 3799 PREVENT Pandemics Act H.R. 5365 Primary Health Services Enhancement Act H.R. 8181 Optimizing Postpartum Outcomes Act

Client expense: $195,457 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

DMEPOS payment and coverage Extension of telehealth flexibilities S. 3193/H.R.2168 - Expanded Telehealth Access Act S. 2556/H.R.1990 - Medicare Orthotics and Prosthetics Patient-Centered Care Act Issues surrounding local coverage determinations, local coverage articles, and carrier advisory committees

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

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

H.R. 1587/S. 1731, the Medicare Audiologist Access and Services Act of 2021 H.R. 2168/S. 3193, the Expanded Telehealth Access Act H.R. 4311, the Medicare Dental, Vision, and Hearing Benefit Act H.R. 6202, the Telehealth Extension Act H.R. 6020/S. 3314, the Supporting Medicare Providers Act of 2021 H.R. 7876, the Connecting Rural Telehealth to the Future Act H.R. 2471, the Consolidated Appropriations Act, 2022 (Public Law 117-103) Implementation of S. 610, the Protecting Medicare and American Farmers from Sequester Cuts Act Implementation of H.R. 1319, American Rescue Plan Act of 2021 (Public Law 117-2) Issues related to enhanced Federal Medical Assistance Percentage in Medicaid Various issues related to CMS Actions surrounding: Medicare supervision requirements audits of medical records and claims for Part A and B services code development and reimbursement of personal protective equipment quality reporting under MIPS Implementation of the IMPACT Act Medicare physician fee schedule Prospective payments systems Demonstration projects/episodic payment models Accountable Care Organizations Federally-facilitated marketplace Medicare Advantage Reimbursement of telehealth services COVID-19 emergency telepractice coverage of Medicare, Medicare Advantage and Medicaid Medicare telehealth coverage under Part A and B Essential and Non-essential personnel designation Implementation of CARES Act (P.L. 116-136) Provision and payment for Part A therapy Various issues related to implementation of ACA Various issues related to Medicaid in schools Advocated for Medicaid Federal Medical Assistance Percentage (FMAP) Sequestration H.R. 3173/S. 3018, the Improving Seniors Timely Access to Care Act Issues related to extension of COVID-19 public health emergency

Client expense: $280,000 · Firm income: Not reported

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

United Spinal Association supports HR 2168 / S 3193 Expanded Telehealth Access Act. United Spinal Association supports HR 3932 / S 2076 The Pioneering Antimicrobial Subscriptions to End Up surging Resistance (PASTEUR) Act. United Spinal Association/VetsFirst supports The Advanced Safe Testing at Residence Telehealth (A-START) Act of 2021. Increase Funding for Spinal Cord Injury Model Systems - House/Senate. Discussed the need for SCIMS increased funding and next steps with Director Anjali Forber-Pratt, Dir., NIDILRR. United Spinal Association raised concerns: regarding accessibility of COVID-19 tests; MA and Part D programs, notice of benefit and payment parameters; support CMS access to dental surgical services, support the DMEPOS Relief Act (H.R. 6641); share concerns re the CMS ACA Exchange Rule; support the Health Data Use and Privacy Commission Act (S. 3620); shared concerns with CMS regarding access to DME in times of public health emergency. United Spinal advocacy and policy staff participated in a meeting with representatives from the CDC, CMS, and ACL urging the CDC to issue guidance on census reduction of nursing homes and other institutional settings as an infection control measure. United Spinal supported comments as part of the Disability and Rehabilitation Research Coalition on the draft Strategic Plan for the NIH Chief Officer for Scientific Workforce Diversity (COSWD). Support significant investment into home and community-based services and supports. Met with House and Senate in support of improvements in health equity (Ways and Means Committee Subcommittee on Health United States House of Representatives; testimony); SUPPORT EQUITABLE REFORMS TO THE MEDICARE PHYSICIAN FEE SCHEDULE; SUPPORT H.R. 944 TO ADDRESS SPECIALTY MEDICINE PHYSICIAN SHORTAGES IN RURAL AREAS; SUPPORT H.R. 2256/S. 834 TO INCREASE THE NUMBER OF GME RESIDENCY SLOTS; SUPPORT H.R. 2903/S. 1512; SUPPORT H.R. 5030/S.2706 TO IMPROVE DIVERSITY IN CLINICAL TRIALS TO PERMANENTLY EXPAND TELEHEALTH SERVICES

Client expense: Not reported · Firm income: $75,000

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

Public Health Emergency, Telehealth and Physician Virtual Supervision issues. H.R. 2168/S. 3193- Expanded Telehealth Access Act, H.R. 2903/S. 1512 - CONNECT for Health Act, HR 6202- Telehealth Expansion Act,HR 1332/S. 368- Telehealth Modernization Act, H.R 7573/S. 3593 - Telehealth Extension and Evaluation Act, S.368 - Telehealth Modernization AcT

Client expense: Not reported · Firm income: Not reported

S. 2210/HR 4131 - Better Care Better Jobs Act: Support inclusion of improved Medicaid Home and Community Based Services (HCBS) in any infrastructure package, including increased coverage for occupational therapy services under Home and Community Based Services and protection of the habilitation benefit. HR 1868 - A bill to prevent across-the-board direct spending cuts and for other purposes: Support for delaying Medicare Sequester and passage of bill. S 1315/HR 3630 - The Lymphedema Treatment At: Support passage. HR 5536 - Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act: Advocated for passage HR 2168/S3193 - Expanded Telehealth Access Act: Advocated for passage. S. 368/HR 1332 - Telehealth Modernization Act: Advocated for passage. HR 1990/S 2556 - Medicare Orthotics and Prosthetics Patient-Centered Care Act: Lobbied for changes to the bills to ensure the legislation does not disrupt the ability of occupational therapy practitioners to provide and bill for orthotics and prosthetics and related services under Medicare. No bill number: advocated for inclusion of language in Senate mental health legislation, directing CMS to put forward guidance clarifying that occupational therapy services can be provided to a person with a mental or behavioral health diagnosis under Medicare and Medicaid. No bill number: advocated for inclusion of language in Senate mental health legislation requiring an occupational therapy evaluation for anyone with dementia who lives in a skilled nursing or long-term care facility, or who is newly diagnosed with schizophrenia. HR3173/S3018-Improving Seniors' Timely Access to Care Act: Support passage. HR 6202 - Telehealth Extension Act: Endorsed S.3593 - Telehealth Extension & Evaluation Act: Endorsed

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Area Wage Index - New Brunswick-Lakewood CBSA; Radiation Oncology Model; Surprise Billing - Qualified Payment Amount; Site-neutral payment/BBA 2015 Sec. 603; Build Back Better Act (H.R. 5376); Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); Protecting the American Taxpayer and Medicare Act (S. 3344); Supporting Health Care Providers During the COVID-19 Pandemic Act (H.R. 6143); Supporting Medicare Providers Act of 2021 (S. 3314); Infrastructure Investment and Jobs Act (H.R. 3684); Resident Physician Shortage Reduction Act of 2021 (S.834); Accelerating Access to Critical Therapies for ALS Act (H.R. 3537/S. 1813); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Expanding Medical Education Act (H.R. 801/S. 3422); Opioid Treatment Access Act of 2022 (H.R. 6279); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Capping Prescription Costs Act of 2021 (H.R. 6228/S. 3339); No COVID-19 Vaccination Mandate Act of 2021 (H.R. 6170); Cures 2.0 Act (H.R. 6000); Respecting Our Frontline Workers Act (S. 3225); Provider Relief Fund Improvement Act (H.R. 5963); Inpatient Opioid Safety Act of 2021 (H.R. 5932); LOCAL HEALTH Act (H.R. 5898); Keeping Our COVID-19 Heroes Employed Act (H.R. 5860); Expanded Telehealth Access Act (H.R. 2168/S. 3193); Healthy Competition for Better Care Act (S. 3139); Hospital Revitalization Act of 2021 (S. 3105); Choose Home Care Act of 2021 (H.R. 5514/S. 2562); Good Samaritan Health Professionals Act of 2021 (H.R. 5239/S. 2941); 340B Accountability Act of 2021 (S. 2837).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Area Wage Index - New Brunswick-Lakewood CBSA; Radiation Oncology Model; Surprise Billing - Qualified Payment Amount; Site-neutral payment/BBA 2015 Sec. 603; Build Back Better Act (H.R. 5376); Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); Protecting the American Taxpayer and Medicare Act (S. 3344); Supporting Health Care Providers During the COVID-19 Pandemic Act (H.R. 6143); Supporting Medicare Providers Act of 2021 (S. 3314); Infrastructure Investment and Jobs Act (H.R. 3684); Resident Physician Shortage Reduction Act of 2021 (S.834); Accelerating Access to Critical Therapies for ALS Act (H.R. 3537/S. 1813); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Expanding Medical Education Act (H.R. 801/S. 3422); Opioid Treatment Access Act of 2022 (H.R. 6279); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Capping Prescription Costs Act of 2021 (H.R. 6228/S. 3339); No COVID-19 Vaccination Mandate Act of 2021 (H.R. 6170); Cures 2.0 Act (H.R. 6000); Respecting Our Frontline Workers Act (S. 3225); Provider Relief Fund Improvement Act (H.R. 5963); Inpatient Opioid Safety Act of 2021 (H.R. 5932); LOCAL HEALTH Act (H.R. 5898); Keeping Our COVID-19 Heroes Employed Act (H.R. 5860); Expanded Telehealth Access Act (H.R. 2168/S. 3193); Healthy Competition for Better Care Act (S. 3139); Hospital Revitalization Act of 2021 (S. 3105); Choose Home Care Act of 2021 (H.R. 5514/S. 2562); Good Samaritan Health Professionals Act of 2021 (H.R. 5239/S. 2941); 340B Accountability Act of 2021 (S. 2837).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Area Wage Index - New Brunswick-Lakewood CBSA; Radiation Oncology Model; Surprise Billing - Qualified Payment Amount; Site-neutral payment/BBA 2015 Sec. 603; Build Back Better Act (H.R. 5376); Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); Protecting the American Taxpayer and Medicare Act (S. 3344); Supporting Health Care Providers During the COVID-19 Pandemic Act (H.R. 6143); Supporting Medicare Providers Act of 2021 (S. 3314); Infrastructure Investment and Jobs Act (H.R. 3684); Resident Physician Shortage Reduction Act of 2021 (S.834); Accelerating Access to Critical Therapies for ALS Act (H.R. 3537/S. 1813); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Expanding Medical Education Act (H.R. 801/S. 3422); Opioid Treatment Access Act of 2022 (H.R. 6279); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Capping Prescription Costs Act of 2021 (H.R. 6228/S. 3339); No COVID-19 Vaccination Mandate Act of 2021 (H.R. 6170); Cures 2.0 Act (H.R. 6000); Respecting Our Frontline Workers Act (S. 3225); Provider Relief Fund Improvement Act (H.R. 5963); Inpatient Opioid Safety Act of 2021 (H.R. 5932); LOCAL HEALTH Act (H.R. 5898); Keeping Our COVID-19 Heroes Employed Act (H.R. 5860); Expanded Telehealth Access Act (H.R. 2168/S. 3193); Healthy Competition for Better Care Act (S. 3139); Hospital Revitalization Act of 2021 (S. 3105); Choose Home Care Act of 2021 (H.R. 5514/S. 2562); Good Samaritan Health Professionals Act of 2021 (H.R. 5239/S. 2941); 340B Accountability Act of 2021 (S. 2837).

Client expense: Not reported · Firm income: $100,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Area Wage Index - New Brunswick-Lakewood CBSA; Radiation Oncology Model; Surprise Billing - Qualified Payment Amount; Site-neutral payment/BBA 2015 Sec. 603; Build Back Better Act (H.R. 5376); Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); Protecting the American Taxpayer and Medicare Act (S. 3344); Supporting Health Care Providers During the COVID-19 Pandemic Act (H.R. 6143); Supporting Medicare Providers Act of 2021 (S. 3314); Infrastructure Investment and Jobs Act (H.R. 3684); Resident Physician Shortage Reduction Act of 2021 (S.834); Accelerating Access to Critical Therapies for ALS Act (H.R. 3537/S. 1813); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Expanding Medical Education Act (H.R. 801/S. 3422); Opioid Treatment Access Act of 2022 (H.R. 6279); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Capping Prescription Costs Act of 2021 (H.R. 6228/S. 3339); No COVID-19 Vaccination Mandate Act of 2021 (H.R. 6170); Cures 2.0 Act (H.R. 6000); Respecting Our Frontline Workers Act (S. 3225); Provider Relief Fund Improvement Act (H.R. 5963); Inpatient Opioid Safety Act of 2021 (H.R. 5932); LOCAL HEALTH Act (H.R. 5898); Keeping Our COVID-19 Heroes Employed Act (H.R. 5860); Expanded Telehealth Access Act (H.R. 2168/S. 3193); Healthy Competition for Better Care Act (S. 3139); Hospital Revitalization Act of 2021 (S. 3105); Choose Home Care Act of 2021 (H.R. 5514/S. 2562); Good Samaritan Health Professionals Act of 2021 (H.R. 5239/S. 2941); 340B Accountability Act of 2021 (S. 2837).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Area Wage Index - New Brunswick-Lakewood CBSA; Radiation Oncology Model; Surprise Billing - Qualified Payment Amount; Site-neutral payment/BBA 2015 Sec. 603; Build Back Better Act (H.R. 5376); Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); Protecting the American Taxpayer and Medicare Act (S. 3344); Supporting Health Care Providers During the COVID-19 Pandemic Act (H.R. 6143); Supporting Medicare Providers Act of 2021 (S. 3314); Infrastructure Investment and Jobs Act (H.R. 3684); Resident Physician Shortage Reduction Act of 2021 (S.834); Accelerating Access to Critical Therapies for ALS Act (H.R. 3537/S. 1813); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Expanding Medical Education Act (H.R. 801/S. 3422); Opioid Treatment Access Act of 2022 (H.R. 6279); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Capping Prescription Costs Act of 2021 (H.R. 6228/S. 3339); No COVID-19 Vaccination Mandate Act of 2021 (H.R. 6170); Cures 2.0 Act (H.R. 6000); Respecting Our Frontline Workers Act (S. 3225); Provider Relief Fund Improvement Act (H.R. 5963); Inpatient Opioid Safety Act of 2021 (H.R. 5932); LOCAL HEALTH Act (H.R. 5898); Keeping Our COVID-19 Heroes Employed Act (H.R. 5860); Expanded Telehealth Access Act (H.R. 2168/S. 3193); Healthy Competition for Better Care Act (S. 3139); Hospital Revitalization Act of 2021 (S. 3105); Choose Home Care Act of 2021 (H.R. 5514/S. 2562); Good Samaritan Health Professionals Act of 2021 (H.R. 5239/S. 2941); 340B Accountability Act of 2021 (S. 2837).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Area Wage Index - New Brunswick-Lakewood CBSA; Radiation Oncology Model; Surprise Billing - Qualified Payment Amount; Site-neutral payment/BBA 2015 Sec. 603; Build Back Better Act (H.R. 5376); Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); Protecting the American Taxpayer and Medicare Act (S. 3344); Supporting Health Care Providers During the COVID-19 Pandemic Act (H.R. 6143); Supporting Medicare Providers Act of 2021 (S. 3314); Infrastructure Investment and Jobs Act (H.R. 3684); Resident Physician Shortage Reduction Act of 2021 (S.834); Accelerating Access to Critical Therapies for ALS Act (H.R. 3537/S. 1813); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Expanding Medical Education Act (H.R. 801/S. 3422); Opioid Treatment Access Act of 2022 (H.R. 6279); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Capping Prescription Costs Act of 2021 (H.R. 6228/S. 3339); No COVID-19 Vaccination Mandate Act of 2021 (H.R. 6170); Cures 2.0 Act (H.R. 6000); Respecting Our Frontline Workers Act (S. 3225); Provider Relief Fund Improvement Act (H.R. 5963); Inpatient Opioid Safety Act of 2021 (H.R. 5932); LOCAL HEALTH Act (H.R. 5898); Keeping Our COVID-19 Heroes Employed Act (H.R. 5860); Expanded Telehealth Access Act (H.R. 2168/S. 3193); Healthy Competition for Better Care Act (S. 3139); Hospital Revitalization Act of 2021 (S. 3105); Choose Home Care Act of 2021 (H.R. 5514/S. 2562); Good Samaritan Health Professionals Act of 2021 (H.R. 5239/S. 2941); 340B Accountability Act of 2021 (S. 2837).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Area Wage Index - New Brunswick-Lakewood CBSA; Radiation Oncology Model; Surprise Billing - Qualified Payment Amount; Site-neutral payment/BBA 2015 Sec. 603; Build Back Better Act (H.R. 5376); Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); Protecting the American Taxpayer and Medicare Act (S. 3344); Supporting Health Care Providers During the COVID-19 Pandemic Act (H.R. 6143); Supporting Medicare Providers Act of 2021 (S. 3314); Infrastructure Investment and Jobs Act (H.R. 3684); Resident Physician Shortage Reduction Act of 2021 (S.834); Accelerating Access to Critical Therapies for ALS Act (H.R. 3537/S. 1813); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Expanding Medical Education Act (H.R. 801/S. 3422); Opioid Treatment Access Act of 2022 (H.R. 6279); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Capping Prescription Costs Act of 2021 (H.R. 6228/S. 3339); No COVID-19 Vaccination Mandate Act of 2021 (H.R. 6170); Cures 2.0 Act (H.R. 6000); Respecting Our Frontline Workers Act (S. 3225); Provider Relief Fund Improvement Act (H.R. 5963); Inpatient Opioid Safety Act of 2021 (H.R. 5932); LOCAL HEALTH Act (H.R. 5898); Keeping Our COVID-19 Heroes Employed Act (H.R. 5860); Expanded Telehealth Access Act (H.R. 2168/S. 3193); Healthy Competition for Better Care Act (S. 3139); Hospital Revitalization Act of 2021 (S. 3105); Choose Home Care Act of 2021 (H.R. 5514/S. 2562); Good Samaritan Health Professionals Act of 2021 (H.R. 5239/S. 2941); 340B Accountability Act of 2021 (S. 2837).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Payment of EMG services under Medicare Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid H.R. 2168/S. 3193 Expanded Telehealth Access Act APTA PT Outcomes Registry/Qualified Clinical Data Registries Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Orthotics and Prosthetics Medicare Private Contracting H.R. 3322/S. 826 Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule H.R. 5536 Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding H.R. 3630/S. 1315 Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act H.R. 3173/S. 3018 Improving Seniors Timely Access to Care Act H.R. 3650/S. 2048 Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule HR 6020 - Support Medicare Providers Act S. 3799 PREVENT Pandemics Act H.R. 5365 Primary Health Services Enhancement Act

Client expense: $236,616 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Veterans Affairs, Dept of (VA), White House Office

H.R. 1587/S. 1731, the Medicare Audiologist Access and Services Act of 2021 H.R. 5376, the Build Back Better Act H.R. 2168/S. 3193, the Expanded Telehealth Access Act H.R. 4311, the Medicare Dental, Vision, and Hearing Benefit Act H.R. 6202, the Telehealth Extension Act H.R. 6020/S. 3314, the Supporting Medicare Providers Act of 2021 H.R. 2471, the Consolidated Appropriations Act, 2022 (Public Law 117-103) Implementation of S. 610, the Protecting Medicare and American Farmers from Sequester Cuts Act Implementation of H.R. 1319, American Rescue Plan Act of 2021 (Public Law 117-2) Issues related to enhanced Federal Medical Assistance Percentage in Medicaid Various issues related to CMS Actions surrounding: Medicare supervision requirements audits of medical records and claims for Part A and B services code development and reimbursement of personal protective equipment Quality reporting under MIPS Implementation of the IMPACT Act Medicare physician fee schedule Prospective payments systems Demonstration projects/episodic payment models Accountable Care Organizations Federally-facilitated marketplace Medicare Advantage Reimbursement of telehealth services COVID-19 emergency telepractice coverage of Medicare, Medicare Advantage and Medicaid Medicare telehealth coverage under Part A and B Essential and Non-essential personnel designation Implementation of CARES Act (P.L. 116-136) Provision and payment for Part A therapy Various issues related to implementation of ACA Various issues related to Medicaid in schools Advocated for Medicaid Federal Medical Assistance Percentage (FMAP) Sequestration

Client expense: $280,000 · Firm income: Not reported

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

DMEPOS payment and coverage Extension of telehealth flexibilities S. 3193/H.R.2168 - Expanded Telehealth Access Act S. 2556/H.R.1990 - Medicare Orthotics and Prosthetics Patient-Centered Care Act Issues surrounding local coverage determinations, local coverage articles, and carrier advisory committees

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

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

1. The Prevent Interruptions in Physical Therapy Act (H.R.1611/S.2612)and potential Senate companion bill, to allow ALL private practice physical therapists-regardless of where their clinic is located-to use a locum tenens to provide their Medicare patients continued care when they need to be out of the clinic. 2. The Expanded Telehealth Access Act (H.R.2168/S.3193) and potential Senate companion bill, to permanently add physical therapists, physical therapist assistants, and other rehabilitation therapists to the list of providers that Medicare pays for telehealth. 3. The Medicare Patient Empowerment Act (S.826/H.R.3322)to allow a Medicare beneficiary to enter into a direct contract with an eligible professional (regardless of whether that person was a participating or non-participating physician or practitioner) for any item or service covered by Medicare. 4. The SMART Act (H.R.5536) to delay implementation of the PTA/OTA differential by one year, exempt therapy assistants in rural and medically underserved areas from the differential, and to change the supervision requirement for PTAs in private practice settings to that which state law requires. 5. Gain supporters for extending the 3.75% Medicare payment adjustment for another year, including gaining cosigners for Bera-Bucshon letter requesting that action before end of 2021. 6. The bipartisan Eliminating Provider Relief Fund Tax Penalties Act (H.R.2079) is seeking to override the 2020 IRS guidance which stated provider relief fund grants are to be treated as gross income and therefore taxable. 7. The Improving Seniors Timely Access to Care Act (H.R.3173/S.3108) to reduce administrative burden by requiring a streamed and standardized way Medicare Advantage (MA) plans use prior authorization as well as increasing oversight and transparency around prior authorization.

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

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

H.R. 19 - Lower Costs, More Cures Act of 2021 - Rep. McMorris Rodgers, Cathy [R-WA-5] - Medicare and Medicaid reforms H.R. 56 - Patient Access to Medical Foods Act - Rep. Biggs, Andy [R-AZ-5] - coverage of medical foods H.R. 66 - CARING for Kids Act - Rep. Buchanan, Vern [R-FL-16] - CHIP extension H.R. 315 - Medicare Sequester COVID Moratorium Act - Rep. Schneider, Bradley Scott [D-IL-10] - Medicare Sequester H.R. 340 - Incentivizing Medicaid Expansion Act of 2021 - Rep. Veasey, Marc A. [D-TX-33] - Medicaid expansion H.R. 502 - Medicare Dental Benefit Act of 2021 - Rep. Barragan, Nanette Diaz [D-CA-44] - Medicare dental coverage H.R. 525 - COVID HCBS Relief Act of 2021 - Rep. Dingell, Debbie [D-MI-12] - HCBS H.R. 599 - Protecting Medicare Beneficiaries with Pre-Existing Conditions Act - Rep. Schneider, Bradley Scott [D-IL-10] - pre-existing conditions H.R. 722 - Ensuring Vaccination and Treatment Affordability Act - Rep. Pappas, Chris [D-NH-1] - cost-sharing for COVID-19 vaccines H.R. 918 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Rep. Cardenas, Tony [D-CA-29] - Medicaid & COVID-19 H.R. 955 - Medicaid Reentry Act of 2021 - Rep. Tonko, Paul [D-NY-20] - Medicaid coverage H.R. 975 - Ensuring Seniors Access to COVID Treatments Act - Rep. Casten, Sean [D-IL-6] - coverage of COVID-19 drugs H.R. 1227 - Medicare-X Choice Act of 2021 - Rep. Delgado, Antonio [D-NY-19] - Medicare-X H.R. 1495 - Jim Ramstad Legacy of Recovery Act - Rep. Emmer, Tom [R-MN-6] - Medicaid coverage for SUD H.R. 1717 - Protecting Married Seniors from Impoverishment Act of 2021 - Rep. Upton, Fred [R-MI-6] - HCBS and spousal impoverishment H.R. 1722 - Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2021 - Rep. Velazquez, Nydia M. [D-NY-7] - Medicaid for territories H.R. 1791 - CHIPP Act - Rep. Barragan, Nanette Diaz [D-CA-44] - CHIP extension H.R. 1795 - Expanded Coverage for Former Foster Youth Act - Rep. Bass, Karen [D-CA-37] - coverage for foster youth H.R. 1880 - To amend the Deficit Reduction Act of 2005 to make permanent the Money Follows the Person Rebalancing Demonstration - Rep. Dingell, Debbie [D-MI-12] - Money Follows the Person extension H.R. 1969 - Medicare Advantage Integrity Act - Resident Commissioner Gonzalez-Colon, Jenniffer [R-PR-At Large] - Medicare Advantage benchmark rates H.R. 1976 - Medicare for All Act of 2021 - Rep. Jayapal, Pramila [D-WA-7] - Medicare for All H.R. 1978 - Protecting Seniors Through Immunization Act of 2021 - Rep. Kuster, Ann M. [D-NH-2] - cost sharing for vaccines under Medicare part D H.R. 1999 - Protect Seniors and Cut Waste Act - Rep. Smith, Jason [R-MO-8] - sequester for Pay-As-You-Go H.R. 2166 - Ensuring Parity in MA and PACE for Audio-Only Telehealth Act of 2021 - Rep. Sewell, Terri A. [D-AL-7] - Medicare coverage of telehealth H.R. 2217 - Territory Federal Matching Requirement Equity Act of 2021 - Resident Commissioner Gonzalez-Colon, Jenniffer [R-PR-At Large] - FMAP for territories H.R. 2297 - MIND Act - Rep. Boyle, Brendan F. [D-PA-2] - Medicaid payment for services provided in institutions for mental diseases H.R. 2464 - More Help for Seniors Act of 2021 - Rep. Craig, Angie [D-MN-2] - Medicare prescription drug benefit H.R. 2881 - Medicare Buy-In and Health Care Stabilization Act of 2021 - Rep. Higgins, Brian [D-NY-26] - Medicare public insurance H.R. 3108 - Medical Nutrition Therapy Act of 2021 - Rep. Kelly, Robin L. [D-IL-2] - coverage of medical foods H.R. 3173 - Improving Seniors Timely Access to Care Act of 2021 - Rep. DelBene, Suzan K. [D-WA-1] - prior authorization H.R. 3447 - Permanency for Audio-Only Telehealth Act - Rep. Smith, Jason [R-MO-8] - Medicare telehealth coverage H.R. 3450 - Medicaid Bump Act - Rep. Tonko, Paul [D-NY-20] - Medicaid funding and behavioral health H.R. 3894 - CARING for Social Determinants Act of 2021- Rep. Blunt Rochester, Lisa [D-DE-At Large] - Medicaid and SDOH H.R. 3961 - COVER Now Act - Rep. Doggett, Lloyd [D-TX-35] - Medicaid expansion H.R. 4040 Advancing Telehealth Beyond COVID-19 Act of 2021- Rep. Cheney, Liz [R-WY-At Large] - Medicare telehealth coverage H.R. 4043 - Ensuring Patient Access to Critical Breakthrough Products Act of 2021 - Rep. DelBene, Suzan K. [D-WA-1] - Medicare coverage of breakthrough devices H.R. 4074 - Addressing Social Determinants in Medicare Advantage Act of 2021 - Rep. Bilirakis, Gus M. [R-FL-12] - Medicare Advantage supplemental benefits H.R. 4158 - Insulin Access for All Act of 2021 - Rep. Rush, Bobby L. [D-IL-1] - cost sharing for insulin H.R. 4187 - Medicare Vision Act of 2021 - Rep. Schrier, Kim [D-WA - Medicare vision coverage H.R. 4263 - Patient Parity Protection Act of 2021 - Rep. Gottheimer, Josh [D-NJ-5] - out-of-network services H.R. 4311 - Medicare Dental, Vision, and Hearing Benefit Act of 2021 - Rep. Doggett, Lloyd [D-TX-35] - Medicare dental, vision, and hearing benefits H.R. 4406 - Supporting Medicaid in the U.S. Territories Act of 2021 - Rep. Soto, Darren [D-FL-9] - Medicaid support in U.S. territories H.R. 4439 - Medicaid Dental Benefit Act - Rep. Barragan, Nanette Diaz [D-CA-44] - Medicaid dental benefit H.R. 4640 - Close the Medigap Act of 2021 - Rep. Doggett, Lloyd [D-TX-35] - Medicare supplemental health insurance policies H.R. 4650 - Medicare Dental Coverage Act of 2021 - Rep. Kelly, Robin L. [D-IL-2] - Medicare dental benefit H.R. 4941 - PACE Part D Choice Act of 2021 - Rep. Blumenauer, Earl [D-OR-3] - prescription drug plans in the Medicare-only PACE program H.R. 4942 - BETTER Kidney Care Act - Rep. Blumenauer, Earl [D-OR-3] - demonstration program for Medicare enrollees with ESRD H.R. 4974 - State Public Option Act - Rep. Schrier, Kim [D-WA-8] - Medicaid public option H.R. 5099 - Lowering Medicare Premiums and Prescription Drug Costs Act - Rep. Schneider, Bradley Scott [D-IL-10] - Medicare cost-sharing benefits H.R. 5110 - Medicare Medically Necessary Dental Care Act of 2021 - Rep. Cohen, Steve [D-TN-9] - Medicare dental benefits H.R. 5165 - Improving Medicare Coverage Act - Rep. Jayapal, Pramila [D-WA-7] - Medicare eligibility age H.R. 5414 - Ensuring Medicaid Continuity for Children in Foster Care Act of 2021 - Rep. Bilirakis, Gus M. [R-FL-12] - Medicaid coverage for children in foster care H.R. 5425 - Protecting Rural Telehealth Access Act - Rep. O'Halleran, Tom [D-AZ-1] - Medicare telehealth services H.R. 5576 - Fair Drug Prices for Kids Act - Rep. Wild, Susan [D-PA-7] - Medicaid Drug Rebate Program under CHIP H.R. 5632 - Long-Term Care Pharmacy Definition Act of 2021 - Rep. Schrader, Kurt [D-OR-5] - Medicare long term care pharmacy H.R. 5674 - Medicare Mental Health Inpatient Equity Act of 2021 - Rep. Tonko, Paul [D-NY-20] - inpatient psychiatric hospital services under Medicare H.R. 6101 - Drug Price Transparency in Medicaid Act of 2021 - Rep. Carter, Earl L. "Buddy" [R-GA-1] - drug pricing in Medicaid S. 97 - Medicare Dental Benefit Act of 2021 - Sen. Cardin, Benjamin L. [D-MD] - Medicare dental coverage S. 150 - Ensuring Parity in MA for Audio-Only Telehealth Act of 2021 - Sen. Cortez Masto, Catherine [D-NV] - Medicaid telehealth coverage S. 151 - COVID HCBS Relief Act of 2021 - Sen. Casey, Robert P., Jr. [D-PA] - HCBS S. 274 - Stronger Medicaid Response to the COVID-19 Pandemic Act - Sen. Bennet, Michael F. [D-CO] - Medicaid & COVID-19 S. 340 - TREATS Act - Sen. Portman, Rob [R-OH] - telehealth - Medicare telehealth coverage S. 386 - Medicare-X Choice Act of 2021 - Sen. Bennet, Michael F. [D-CO] - Medicare-X S. 448 - Ensuring Kids Have Access to Medically Necessary Dental Care Act - Sen. Cardin, Benjamin L. [D-MD] - CHIP S. 653 - COMP Act - Sen. Portman, Rob [R-OH] - Medicare secondary payer rules S. 748 - Medicare Sequester Relief Act - Sen. Shaheen, Jeanne [D-NH] - Medicare sequestration S. 1180 - Choose Medicare Act - Sen. Merkley, Jeff [D-OR] - Medicare public insurance S. 1536 - Medical Nutrition Therapy Act of 2021 - Sen. Collins, Susan M. [R-ME] - coverage of medical foods S. 1727 - Medicaid Bump Act - Sen. Smith, Tina [D-MN] - Medicaid funding and behavioral health S. 1844 - Lowering Medicare Premiums and Prescription Drug Costs Act - Sen. Casey, Robert P., Jr. [D-PA] - Medicare premiums and drug costs S. 2111 - Audio-Only Telehealth for Emergencies Act - Sen. Kennedy, John [R-LA] - Medicare coverage of telehealth S. 2112 - EASE Behavioral Health Services Act - Sen. Kennedy, John [R-LA] - telehealth S. 2164 - Lower Costs, More Cures Act of 2021 - Sen. Crapo, Mike [R-ID] - Medicare and Medicaid reforms S. 2197 - Rural and Frontier Telehealth Expansion Act - Sen. Rosen, Jacky [D-NV] - FMAP & telehealth S. 2210 - Better Care Better Jobs Act - Sen. Casey, Robert P., Jr. [D-PA] - HCBS S. 2236 - Expanding Health Care Options for Early Retirees Act - Sen. Brown, Sherrod [D-OH] - Medicare buy-in S. 2315 - Medicaid Saves Lives Act - Sen. Warnock, Raphael [D-GA] - Medicaid expansion S. 2618 - Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2021 - Sen. Casey, Bob [D-PA] - Medicaid dental, vision, and hearing benefits S. 2639 - State Public Option Act - Sen. Schatz, Brian [D-HI] - Medicaid public option S. 2689 - Ensuring Medicaid Continuity for Children in Foster Care Act of 2021 - Sen. Burr, Richard [R-NC] - Medicaid-eligibility for children in foster care S. 3018 - Improving Seniors Timely Access to Care Act of 2021 - Sen. Marshall, Roger [R-KS] - prior authorization under MA S. 3061 - Medicare Mental Health Inpatient Equity Act of 2021 - Sen. Collins, Susan M. [R-ME] - inpatient psychiatric hospital services under Medicare S. 3193 - Expanded Telehealth Access Act - Sen. Daines, Steve [R-MT] - Medicare telehealth service providers S. 3332 - Let States Innovate Under Medicaid Act - Sen. Braun, Mike [R-IN] - Medicaid program promotion Regulatory Issues: Ongoing implementation issues for the Medicare Advantage (MA) and Medicare Part D prescription drug programs, including risk adjustment methodology, network adequacy and provider directories, encounter data and other data-related issues, and risk adjustment data validation (RADV) audit issues including proposed RADV regulation for MA; bidding and payment issues (including MA rate assumptions, MA coding intensity, MA Secondary Payer issues, Part D reinsurance, Part D low income subsidies, Part D direct and indirect remuneration (DIR), and audits); calendar year 2022 policy and technical regulation for MA and Part D; Part D reform, out of pocket limits; issues related to Medicare for All, Medicare buy-in, reduced Medicare eligibility age, and public option; issues relating to 2022 Rate Notice; issues related to coverage in non-Medicaid Expansion States (e.g., Gap Population); issues related to expanded Medicare fee for service benefits (dental, hearing and vision); issues related to Medicaid coverage gap; potential Medicare NCD relating to monoclonal antibodies for treatment of Alzheimers disease; Executive Orders relating to international pricing, Part D rebates, insulin costs, and importation; issues related to MLTSS; issues related to removal of safe harbor protection for rebates; issues relating to COVID-19, including testing and vaccines; issues related to health equity; issues related to vaccination; issues related to audio-only telehealth; issues related to addressing the social determinants of health, including housing, transportation, nutrition, educational opportunities, and MA supplemental benefits; issues related to Medicaid presumptive eligibility and continuous eligibility; issues relating to Medicaid best price; in-home health risk assessments; Medicare Medical Loss Ratio issues; issues related to changes to prior authorization regulations, electronic documentation, and related issues; issues relating to sequestration under the Medicare Advantage and Part D programs; implications of physician fee schedule on MA; application process, audits to evaluate compliance with MA and Part D program rules, benefit design rules, enrollment rules, requirements for notice and denial forms, marketing materials review and approval, marketing activities, including conduct and compensation of brokers and agents and plan sponsor marketing staff; measurement and oversight of plan performance including Special Needs Plans (SNPs); quality measures, grievance and appeals processes, fraud and abuse compliance including training; contracting issues for Dual Eligible SNPs; Federal preemption of State authority under MA and Part D programs, Part D prescription drug event data reporting, Part D formulary rules, Part D pharmacy access standards, Part D coverage gap discount program, including employer group waiver plan (EGWP) issues, and other operational issues; issues raised by Part D coverage of new specialty drugs, the Part D non-interference policy and related issues (e.g., preferred pharmacy and any willing pharmacy requirements, standards for network pharmacy reimbursement, and policies regarding sponsor negotiation of pharmacy price concessions); issues related to the international price index; issues related to child and maternal health; issues related to Medicaid supplemental and disproportionate share hospital (DSH) funding; issues related to Medicaid funding for territories; issues related to medical management; issues relating to MA supplemental benefits; Medication Therapy Management Program requirements and the Center for Medicare and Medicaid Innovation (CMMI) Demonstration; MA EGWP issues; CMMI's value based payment models; Part D requirements for offering basic and enhanced alternative plans; MA and Part D systems issues affecting enrollment and disenrollment processing and payment and other operational issues; issues relating to MA and Part D Star Rating system including measures, the methodology for calculating ratings, and the role of the ratings for payment purposes; functionality of the Medicare Personal Plan Finder and Drug Plan Finder; National Medicare Education Program; Medicare demonstration program on performance-based payments for physician groups; physician quality reporting initiative; issues relating to Medicare coverage policy and national coverage decisions; issues relating to MACRA, including implications for MA and Part D plans; Medicare/Medicaid integration for dual eligibles, including implementation of the Capitated Financial Alignment Demonstration and related issues (e.g., quality ratings); Medicaid managed care regulations and policies, including CMS's substantial revisions to the managed care regulations, mental health parity rules, the Medicaid managed care actuarial soundness standard, quality oversight, Medicaid and CHIP Payment and Access Commission (MACPAC), grievance and appeals processes, fraud and abuse compliance, beneficiary information requirements, treatment of Medicaid health plan member hospital days in the upper payment limit calculation; policies affecting State Medicaid funding, including block grants, the calculation of the federal medical assistance (federal matching) percentage (FMAP), and intergovernmental transfers (IGTs); coordination of benefits with state Medicaid programs; Medicaid prescription drug cost issues affecting Medicaid health plans including issues raised by Medicaid coverage of new specialty drugs; health plan-related Childrens Health Insurance Program (CHIP) issues, including eligibility and outreach issues and CHIP reauthorization; implementation of Medicaid changes made in Deficit Reduction Act of 2005, including Medicaid managed care organization provider tax issues; standards for electronic prescribing; implementation of Medicaid changes of interest to Medicaid health plans made in the Affordable Care Act (ACA) including Medicaid expansion, the managed care organization (MCO) prescription drug rebate provisions, minimum payments to primary care providers (PCPs), interactions between the Medicaid program and health insurance exchanges, and Medicaid and CHIP maintenance of effort (MOE) requirements; implications of the health insurer fee for Medicaid health plans; issues related to Medicaid Managed long-term care including home and community-based waiver services (HCBS); expanding the availability of Medicare Advantage and Medicaid health plan telemedicine programs; implications of the new non-discrimination rules for health plans participating in public programs; issues related to Medigap coverage; issues related to business continuity in relation to pandemics or natural events (e.g., hurricane, tornado, etc.); cybersecurity; provider directories; value-based insurance design models; Part D prescriber enrollment requirements; Part D recovery audit contractor programs; issues relating to enrollment of beneficiaries with ESRD into MA plans; issues related to health homes for children with medically complex conditions; socioeconomic status impacts on star ratings related to MA and Part D programs; and other issues relating to health care reform implementation.

Client expense: $2,630,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE, Treasury, Dept of, White House Office

S. 2210/HR 4131 - Better Care Better Jobs Act: Support inclusion of improved Medicaid Home and Community Based Services (HCBS) in any infrastructure package, including increased coverage for occupational therapy services under Home and Community Based Services and protection of the habilitation benefit. HR 1868 - A bill to prevent across-the-board direct spending cuts and for other purposes: Support for delaying Medicare Sequester and passage of bill. S 1315/HR 3630 - The Lymphedema Treatment At: Support passage. HR 5536 - Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act: Advocated for passage HR 2168/S3193 - Expanded Telehealth Access Act: Advocated for passage. S. 368/HR 1332 - Telehealth Modernization Act: Advocated for passage. S. 610-Protecting Medicare and American Farmers from Sequester Cuts Act and H.R. 6413-Supporting Health Care Providers During the COVID-19 Pandemic Act: Advocated for policies to prevent cuts to the Medicare Physician Fee Schedule (MPFS), scheduled to take effect on January 1, 2022, including reform of the MPFS. HR 1990/S 2556 - Medicare Orthotics and Prosthetics Patient-Centered Care Act: Lobbied for changes to the bills to ensure the legislation does not disrupt the ability of occupational therapy practitioners to provide and bill for orthotics and prosthetics and related services under Medicare. No bill number: advocated for inclusion of language in Senate mental health legislation, directing CMS to put forward guidance clarifying that occupational therapy services can be provided to a person with a mental or behavioral health diagnosis under Medicare and Medicaid. No bill number: advocated for inclusion of language in Senate mental health legislation requiring an occupational therapy evaluation for anyone with dementia who lives in a skilled nursing or long-term care facility, or who is newly diagnosed with schizophrenia.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Area Wage Index - New Brunswick-Lakewood CBSA; Radiation Oncology Model; Surprise Billing - Qualified Payment Amount; Site-neutral payment/BBA 2015 Sec. 603; Build Back Better Act (H.R. 5376); Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); Protecting the American Taxpayer and Medicare Act (S. 3344); Supporting Health Care Providers During the COVID-19 Pandemic Act (H.R. 6143); Supporting Medicare Providers Act of 2021 (S. 3314); Infrastructure Investment and Jobs Act (H.R. 3684); Resident Physician Shortage Reduction Act of 2021 (S.834); Accelerating Access to Critical Therapies for ALS Act (H.R. 3537/S. 1813); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Expanding Medical Education Act (H.R. 801/S. 3422); Opioid Treatment Access Act of 2022 (H.R. 6279); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Capping Prescription Costs Act of 2021 (H.R. 6228/S. 3339); No COVID-19 Vaccination Mandate Act of 2021 (H.R. 6170); Cures 2.0 Act (H.R. 6000); Respecting Our Frontline Workers Act (S. 3225); Provider Relief Fund Improvement Act (H.R. 5963); Inpatient Opioid Safety Act of 2021 (H.R. 5932); LOCAL HEALTH Act (H.R. 5898); Keeping Our COVID-19 Heroes Employed Act (H.R. 5860); Expanded Telehealth Access Act (H.R. 2168/S. 3193); Healthy Competition for Better Care Act (S. 3139); Hospital Revitalization Act of 2021 (S. 3105); Choose Home Care Act of 2021 (H.R. 5514/S. 2562); Good Samaritan Health Professionals Act of 2021 (H.R. 5239/S. 2941); 340B Accountability Act of 2021 (S. 2837).

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

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

Payment of EMG services under Medicare Medicare sequestration moratorium Medicaid coverage and reimbursement Medicare wound care coverage National Correct Coding Initiative Edits Protection of programs related to physical therapy in deficit reduction Medicare Advantage Essential Health Benefits Medicare improvement standards Inclusion of physical therapists in quality programs Medicare Self-referral Coverage of telehealth under Medicare, Medicare Advantage, and Medicaid H.R. 2168/S. 3193 Expanded Telehealth Access Act APTA PT Outcomes Registry/Qualified Clinical Data Registries Medicare Quality Programs Accelerating Innovation in Medicine Act Improving Medicare Post-Acute Care Transformation Act Chronic Care Management Orthotics and Prosthetics Medicare Private Contracting H.R. 3322/S. 826 Medicare Patient Empowerment Act Skilled Nursing Facility 3-Day rule H.R. 5536 Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act PTA Differential in Medicare Prior Authorization in Medicare Advantage Plans Alternative payment models Health information technology: Electronic health records, health IT incentives for physical therapists, certification of EHRs interoperability, and information blocking durable medical equipment prosthetics orthotics and supplies competitive bidding H.R. 3630/S. 1315 Lymphedema Treatment Act Medicare enrollment Skilled Nursing Facility payment Home Health payment Medical review (Medicare) Reducing Health Care costs REAADI & DRMA Acts Home Health Payment Innovation Act H.R. 3173/S. 3018 Improving Seniors Timely Access to Care Act H.R. 3650/S. 2048 Improving Access to Medicare Coverage Act Critical Access Hospital Relief Act Medicare Fee Schedule Unified post-acute care prospective payment system Inpatient rehabilitation facilities / long term care hospital payment HIPAA proposed rule HR 6020 - Support Medicare Providers Act

Client expense: $182,825 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Small Business Administration (SBA), Social Security Administration (SSA), Veterans Affairs, Dept of (VA), White House Office

DMEPOS payment and coverage Medicare Part B reimbursement Extension of telehealth flexibilities S. 3193/H.R.2168 - Expanded Telehealth Access Act S. 2556/H.R.1990 - Medicare Orthotics and Prosthetics Patient-Centered Care Act H.R. 5536 - Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act S. 610 - the Protecting Medicare & American Farmers from Sequester Cuts Act

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1587/S. 1731, the Medicare Audiologist Access and Services Act of 2021 H.R. 5376, the Build Back Better Act H.R. 2168/S. 3193, the Expanded Telehealth Access Act H.R. 4311, the Medicare Dental, Vision, and Hearing Benefit Act H.R. 6202, the Telehealth Extension Act H.R. 6020/S. 3314, the Supporting Medicare Providers Act of 2021 S. 610, the Protecting Medicare and American Farmers from Sequester Cuts Act H.R. 1319, American Rescue Plan Act of 2021 (Public Law 117-2) Issues related to enhanced Federal Medical Assistance Percentage in Medicaid Various issues related to CMS Actions surrounding: Medicare supervision requirements audits of medical records and claims for Part A and B services code development and reimbursement of personal protective equipment Quality reporting under MIPS Implementation of the IMPACT Act Medicare physician fee schedule Prospective payments systems Demonstration projects/episodic payment models Accountable Care Organizations Federally-facilitated marketplace Medicare Advantage Reimbursement of telehealth services COVID-19 emergency telepractice coverage of Medicare, Medicare Advantage and Medicaid Medicare telehealth coverage under Part A and B Essential and Non-essential personnel designation Implementation of CARES Act (P.L. 116-136) Provision and payment for Part A therapy Various issues related to implementation of ACA Various issues related to Medicaid in schools Advocated for Medicaid Federal Medical Assistance Percentage (FMAP) Sequestration

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

H.R. 2168/S. 3193, the Expanded Telehealth Access Act H.R. 1332/S. 368, the Telehealth Modernization Act H.R. 366, the Protecting Access to Post-COVID-19 Telehealth Act of 2021 H.R. 5376, the Build Back Better Act H.R. 5561, the Early Hearing Detection and Intervention Act Issues related to funding for the Early Hearing Detection and Intervention Act Issues related to funding for the National Institute on Deafness and Other Communication Disorders Issues related to funding for the National Institute on Disability, Independent Living, and Rehabilitative Research Various issues related to Block Grants, Essential Health Benefits, and STLD coverage Various issues related to non-discrimination legislation and regulation Various issues related to DOL and HHS actions surrounding the Summary of Benefits and Coverage H.R. 3320/S. 1679, the Allied Health Workforce Diversity Act FDA regulation of over-the-counter hearing aids H.R. 2903/S. 1512 - CONNECT for Health Act of 2021 Issues related to implementation of surprise billing regulations Issues related to development of a public health insurance option Access to adequate personal protective equipment and policy changes to enhance safety during the COVID-19 pandemic, which also includes clear masks for people with hearing loss and other communication disorders Issues regarding hazard pay for frontline healthcare workers H.R. 1319, American Rescue Plan Act of 2021 (Public Law 117-2)

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), SENATE

Medicare Area Wage Index - New Brunswick-Lakewood CBSA; Radiation Oncology Model; Surprise Billing - Qualified Payment Amount; Site-neutral payment/BBA 2015 Sec. 603; Build Back Better Act (H.R. 5376); Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); Protecting the American Taxpayer and Medicare Act (S. 3344); Supporting Health Care Providers During the COVID-19 Pandemic Act (H.R. 6143); Supporting Medicare Providers Act of 2021 (S. 3314); Infrastructure Investment and Jobs Act (H.R. 3684); Resident Physician Shortage Reduction Act of 2021 (S.834); Accelerating Access to Critical Therapies for ALS Act (H.R. 3537/S. 1813); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Expanding Medical Education Act (H.R. 801/S. 3422); Opioid Treatment Access Act of 2022 (H.R. 6279); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Capping Prescription Costs Act of 2021 (H.R. 6228/S. 3339); No COVID-19 Vaccination Mandate Act of 2021 (H.R. 6170); Cures 2.0 Act (H.R. 6000); Respecting Our Frontline Workers Act (S. 3225); Provider Relief Fund Improvement Act (H.R. 5963); Inpatient Opioid Safety Act of 2021 (H.R. 5932); LOCAL HEALTH Act (H.R. 5898); Keeping Our COVID-19 Heroes Employed Act (H.R. 5860); Expanded Telehealth Access Act (H.R. 2168/S. 3193); Healthy Competition for Better Care Act (S. 3139); Hospital Revitalization Act of 2021 (S. 3105); Choose Home Care Act of 2021 (H.R. 5514/S. 2562); Good Samaritan Health Professionals Act of 2021 (H.R. 5239/S. 2941); 340B Accountability Act of 2021 (S. 2837).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Area Wage Index - New Brunswick-Lakewood CBSA; Radiation Oncology Model; Surprise Billing - Qualified Payment Amount; Site-neutral payment/BBA 2015 Sec. 603; Build Back Better Act (H.R. 5376); Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); Protecting the American Taxpayer and Medicare Act (S. 3344); Supporting Health Care Providers During the COVID-19 Pandemic Act (H.R. 6143); Supporting Medicare Providers Act of 2021 (S. 3314); Infrastructure Investment and Jobs Act (H.R. 3684); Resident Physician Shortage Reduction Act of 2021 (S.834); Accelerating Access to Critical Therapies for ALS Act (H.R. 3537/S. 1813); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Expanding Medical Education Act (H.R. 801/S. 3422); Opioid Treatment Access Act of 2022 (H.R. 6279); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Capping Prescription Costs Act of 2021 (H.R. 6228/S. 3339); No COVID-19 Vaccination Mandate Act of 2021 (H.R. 6170); Cures 2.0 Act (H.R. 6000); Respecting Our Frontline Workers Act (S. 3225); Provider Relief Fund Improvement Act (H.R. 5963); Inpatient Opioid Safety Act of 2021 (H.R. 5932); LOCAL HEALTH Act (H.R. 5898); Keeping Our COVID-19 Heroes Employed Act (H.R. 5860); Expanded Telehealth Access Act (H.R. 2168/S. 3193); Healthy Competition for Better Care Act (S. 3139); Hospital Revitalization Act of 2021 (S. 3105); Choose Home Care Act of 2021 (H.R. 5514/S. 2562); Good Samaritan Health Professionals Act of 2021 (H.R. 5239/S. 2941); 340B Accountability Act of 2021 (S. 2837).

Client expense: Not reported · Firm income: $100,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Area Wage Index - New Brunswick-Lakewood CBSA; Radiation Oncology Model; Surprise Billing - Qualified Payment Amount; Site-neutral payment/BBA 2015 Sec. 603; Build Back Better Act (H.R. 5376); Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); Protecting the American Taxpayer and Medicare Act (S. 3344); Supporting Health Care Providers During the COVID-19 Pandemic Act (H.R. 6143); Supporting Medicare Providers Act of 2021 (S. 3314); Infrastructure Investment and Jobs Act (H.R. 3684); Resident Physician Shortage Reduction Act of 2021 (S.834); Accelerating Access to Critical Therapies for ALS Act (H.R. 3537/S. 1813); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Expanding Medical Education Act (H.R. 801/S. 3422); Opioid Treatment Access Act of 2022 (H.R. 6279); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Capping Prescription Costs Act of 2021 (H.R. 6228/S. 3339); No COVID-19 Vaccination Mandate Act of 2021 (H.R. 6170); Cures 2.0 Act (H.R. 6000); Respecting Our Frontline Workers Act (S. 3225); Provider Relief Fund Improvement Act (H.R. 5963); Inpatient Opioid Safety Act of 2021 (H.R. 5932); LOCAL HEALTH Act (H.R. 5898); Keeping Our COVID-19 Heroes Employed Act (H.R. 5860); Expanded Telehealth Access Act (H.R. 2168/S. 3193); Healthy Competition for Better Care Act (S. 3139); Hospital Revitalization Act of 2021 (S. 3105); Choose Home Care Act of 2021 (H.R. 5514/S. 2562); Good Samaritan Health Professionals Act of 2021 (H.R. 5239/S. 2941); 340B Accountability Act of 2021 (S. 2837).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Area Wage Index - New Brunswick-Lakewood CBSA; Radiation Oncology Model; Surprise Billing - Qualified Payment Amount; Site-neutral payment/BBA 2015 Sec. 603; Build Back Better Act (H.R. 5376); Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); Protecting the American Taxpayer and Medicare Act (S. 3344); Supporting Health Care Providers During the COVID-19 Pandemic Act (H.R. 6143); Supporting Medicare Providers Act of 2021 (S. 3314); Infrastructure Investment and Jobs Act (H.R. 3684); Resident Physician Shortage Reduction Act of 2021 (S.834); Accelerating Access to Critical Therapies for ALS Act (H.R. 3537/S. 1813); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Expanding Medical Education Act (H.R. 801/S. 3422); Opioid Treatment Access Act of 2022 (H.R. 6279); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Capping Prescription Costs Act of 2021 (H.R. 6228/S. 3339); No COVID-19 Vaccination Mandate Act of 2021 (H.R. 6170); Cures 2.0 Act (H.R. 6000); Respecting Our Frontline Workers Act (S. 3225); Provider Relief Fund Improvement Act (H.R. 5963); Inpatient Opioid Safety Act of 2021 (H.R. 5932); LOCAL HEALTH Act (H.R. 5898); Keeping Our COVID-19 Heroes Employed Act (H.R. 5860); Expanded Telehealth Access Act (H.R. 2168/S. 3193); Healthy Competition for Better Care Act (S. 3139); Hospital Revitalization Act of 2021 (S. 3105); Choose Home Care Act of 2021 (H.R. 5514/S. 2562); Good Samaritan Health Professionals Act of 2021 (H.R. 5239/S. 2941); 340B Accountability Act of 2021 (S. 2837).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Medicare Area Wage Index - New Brunswick-Lakewood CBSA; Radiation Oncology Model; Surprise Billing - Qualified Payment Amount; Site-neutral payment/BBA 2015 Sec. 603; Build Back Better Act (H.R. 5376); Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610); Protecting the American Taxpayer and Medicare Act (S. 3344); Supporting Health Care Providers During the COVID-19 Pandemic Act (H.R. 6143); Supporting Medicare Providers Act of 2021 (S. 3314); Infrastructure Investment and Jobs Act (H.R. 3684); Resident Physician Shortage Reduction Act of 2021 (S.834); Accelerating Access to Critical Therapies for ALS Act (H.R. 3537/S. 1813); Comprehensive Addiction Resources Emergency Act of 2021 (H.R. 6311/S. 3418); Expanding Medical Education Act (H.R. 801/S. 3422); Opioid Treatment Access Act of 2022 (H.R. 6279); Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667); Capping Prescription Costs Act of 2021 (H.R. 6228/S. 3339); No COVID-19 Vaccination Mandate Act of 2021 (H.R. 6170); Cures 2.0 Act (H.R. 6000); Respecting Our Frontline Workers Act (S. 3225); Provider Relief Fund Improvement Act (H.R. 5963); Inpatient Opioid Safety Act of 2021 (H.R. 5932); LOCAL HEALTH Act (H.R. 5898); Keeping Our COVID-19 Heroes Employed Act (H.R. 5860); Expanded Telehealth Access Act (H.R. 2168/S. 3193); Healthy Competition for Better Care Act (S. 3139); Hospital Revitalization Act of 2021 (S. 3105); Choose Home Care Act of 2021 (H.R. 5514/S. 2562); Good Samaritan Health Professionals Act of 2021 (H.R. 5239/S. 2941); 340B Accountability Act of 2021 (S. 2837).

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. The Prevent Interruptions in Physical Therapy Act (H.R.1611/S.2612)and potential Senate companion bill, to allow ALL private practice physical therapists-regardless of where their clinic is located-to use a locum tenens to provide their Medicare patients continued care when they need to be out of the clinic. 2. The Expanded Telehealth Access Act (H.R.2168/S.3193) and potential Senate companion bill, to permanently add physical therapists, physical therapist assistants, and other rehabilitation therapists to the list of providers that Medicare pays for telehealth. 3. The Medicare Patient Empowerment Act (S.826/H.R.3322)to allow a Medicare beneficiary to enter into a direct contract with an eligible professional (regardless of whether that person was a participating or non-participating physician or practitioner) for any item or service covered by Medicare. 4. The SMART Act (H.R.5536) to delay implementation of the PTA/OTA differential by one year, exempt therapy assistants in rural and medically underserved areas from the differential, and to change the supervision requirement for PTAs in private practice settings to that which state law requires. 5. Gain supporters for extending the 3.75% Medicare payment adjustment for another year, including gaining cosigners for Bera-Bucshon letter requesting that action before end of 2021. 6. The bipartisan Eliminating Provider Relief Fund Tax Penalties Act (H.R.2079) is seeking to override the 2020 IRS guidance which stated provider relief fund grants are to be treated as gross income and therefore taxable. 7. The Improving Seniors Timely Access to Care Act (H.R.3173/S.3108) to reduce administrative burden by requiring a streamed and standardized way Medicare Advantage (MA) plans use prior authorization as well as increasing oversight and transparency around prior authorization.

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

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